What is urolithiasis? Our urinary system is like a “sewer pipe” that includes the kidneys, ureters, bladder and urethra. Urolithiasis is a general term for stones in any part of this “sewer”. Why do people get urolithiasis? The causes of urolithiasis are complex and are often the result of a combination of factors such as the natural environment, diet, family history, and certain diseases of the urinary tract. The degree of damage caused by a stone depends on its size, location, and the condition of the urinary tract itself. A stone “lodged” in the ureter can cause obstruction of the “downstream”, so that the urine secreted by the kidneys cannot be excreted smoothly and collects locally, causing hydrostatic pressure to rise, resulting in dilatation of the kidneys and ureter, and eventually causing damage to kidney function. Once the bacteria enter the bloodstream, a systemic infection will be formed. Water accumulation and infection in the urinary tract proximal to the stone will often promote the formation of new stones, leading to a vicious cycle. Similarly, stones embedded in the urethra as well as bladder stones can cause hematuria, difficulty in urination and urinary tract infections. Bladder stones can also cause hematuria and infections. In addition, long-term frictional irritation between stones and local urinary tract mucosa may lead to uroepithelial carcinoma. Therefore, once stones are found, we should go to the hospital for active and regular treatment. What are the dangers of urinary stones to our body? What are the symptoms of urolithiasis? We live in an intricate world where there is no set pattern to follow for anything. Likewise, the clinical manifestations of urolithiasis are complex and varied. However, in most cases, urolithiasis is often manifested as pain in the lower back and lower abdomen, either as a paroxysmal sharp pain or as a persistent vague pain. The pain is often accompanied by nausea, vomiting and indigestion, and many people often mistake themselves for having gastroenteritis. In addition, it is accompanied by symptoms such as fever, chills, frequent urination, urgent urination, painful urination, hematuria and difficulty in urination. There are also some patients who usually do not feel any discomfort and are often discovered accidentally during a physical examination. What are the common tests used to diagnose urolithiasis? Common tests include urinary routine, urological ultrasound, abdominal plain film, intravenous pyelogram, and spiral CT. Urologists often perform the appropriate tests to complete the diagnosis of urolithiasis depending on the condition of each patient. How should I treat my urolithiasis? Many people think that surgery means to open up the abdomen, but it is not. Nowadays, we emphasize the concept of “patient-oriented”, which means that among many treatment options, we should try to adopt the method with less damage, faster recovery and better efficacy to relieve people’s pain according to the patient’s specific condition. 1.Conservative treatment: Generally speaking, stones with small size, smooth surface, no obstruction in the urinary tract below the stone, and short time in the local imbedding can often be removed by themselves. The main methods to promote stone removal include drinking more water, exercising more, taking drugs to promote stone removal, and acupuncture treatment. For stones of special composition, such as uric acid stones and cystine stones, which are acidic stones, lithotripsy can be achieved by taking drugs that alkalize the urine, such as potassium sodium citrate and sodium bicarbonate tablets. 2.Extracorporeal shock wave lithotripsy (EWSL): It is a technique of “beating the bull across the mountain”. The shock wave generated outside of the body is focused on the stones in the body and crushes them, while the damage to the normal tissues is very small. It is suitable for those stones that are relatively small in size but are not expected to pass on their own, and for those that have failed to pass through conservative treatment. 3. Percutaneous nephrolithotomy (PCNL): A skin puncture is performed to open a “tunnel” into the kidney, and with the help of a slender nephroscope or ureteroscope, the kidney and the ureteral stones above the third lumbar vertebra are “peered into” and crushed using pneumatic ballistics, holmium laser and other forces. The stones are crushed and removed with the help of a nephroscope or ureteroscope. 4.Ureteroscopic lithotripsy: Our urinary system is connected to the outside world through the urethral orifice, which is the basis and condition for the application of ureteroscopic techniques for lithotripsy. It is generally used for ureteral stones and bladder stones below the third lumbar plane that are not suitable for conservative treatment, difficult to treat by extracorporeal impact lithotripsy or ineffective in treatment. 5. Open surgery: It is rarely used nowadays, only in cases where none of the above methods can effectively treat the stones. How can we prevent urinary stones? For any disease, prevention before the disease is always better than treatment after the disease. Therefore, we should pay attention to the prevention of urinary stones in our daily life to prevent the disease before it happens, mainly including: 1. Drink more water: maintaining at least 2.5-3.0 liters of urine per day is beneficial to prevent stones of any component type. There are two issues that need to be clarified: First, what kind of water to drink? Drink more plain water, mineral water, rather than strong tea, coffee, cola and other drinks; second, when to drink water? Here we are talking about “evenly distributed throughout the day”, rather than the daytime “open drinking”, the night “dripping water”. 2, some people think that “since most stones contain calcium, so we should try not to intake calcium”, this is too late. Long-term calcium intake is not enough, may lead to osteoporosis. So what we advocate is that you should consume the daily physiological requirement of calcium and try to get calcium sources from dairy products, tofu and small fish. 3, balanced diet: in the diet should reduce the intake of animal protein, fat, sodium and salt, and increase the intake of fruits, vegetables, coarse grains and fiber. In addition, for people with high oxalic acid content in urine, they should eat less almonds, beets, celery and spinach; patients with high uric acid content in urine should reduce the intake of animal offal, poultry skin, herring, sardines and anchovies. 4, For patients with uric acid stones and cystine stones, you can take drugs that alkalize the urine. 5.Actively treat diseases such as urinary tract infection, urinary tract obstruction, and urinary tract foreign body.