The kidneys are connected to the bladder through pipes called the ureters. Each ureter is 25 cm long and its lumen is just enough for urine to pass through them. Stones often get stuck in the urine pipe and block passage of urine from the kidneys leading to symptoms. Lets learn more about ureter stones.
Ureteric Stone Symptoms
- Pain in the kidney or back region
- Nausea and Vomiting
- Pain in Urine
- Burning in Urine
- Blood in Urine
- Swelling in the Kidneys
How is a Ureter Stone detected ?
Stones stuck in the pipe are often detected on an Ultrasound of the KUB region. An ultrasound can detect a stone in more than 95% Cases. It can also inform about the size location and the degree of existing kidney damage. `
Sometimes when a ureteric stone is missed on the ultrasound due to obesity, excessive bowel gases or unusual location of the stone (Usually in the middle part of the ureter), an X ray of the abdomen or a plain CT scan of the abdomen and pelvis can help to detect the stone.
Treatment or ureter stone
Most stones of size 5 to 6 mm or less usually pass out on their own. This passage may be aided with the use of medicines such as alpha blockers. The use of medicines to flush out or pass the ureter stone is called Medical Expulsive Therapy.
Removal of Ureter Stone may be needed if:
- Stone is very large
- Stone is causing swelling of the Kidneys and renal damage
- Stone is causing a lot of pain and need for painkiller injections again and again
- Stone is causing infections and bleeding
- Stone is not coming out on its own with medicines despite waiting for reasonable period of time
How is removal of ureter stone done ?
Removal of the ureter stone is a simple and quick surgery. It is painless and scarless and no dissection or cut is needed. We go through the normal urine tubes with a very small endoscope and break the stone with laser and remove its pieces. This surgery is called uretero-renoscopy.
If the stone is in the upper part of the ureter, it can also be broken using sound waves, a process called lithotripsy or ESWL (Extra-corporeal shock wave lithotripsy).
A stone which is in the uppermost part of the ureter may sometimes migrate into the kidney during the surgery and in that case it may require procedures such as an RIRS (Retrograde Intra-renal Surgery) or PCNL (Percutaneous Nephro-lithotripsy)
In some cases a DJ stent is placed after removing the stones such as in cases with:
- Pus in the kidneys
- Excessive swelling in the kidneys
- Impacted stone or stone causing a lot of swelling at the place where it is stuck
- For drainage of very fine dust like pieces
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