There are many cases of patients diagnosed with complications such as acute urinary retention and acute renal failure due to large stones present in both ureters. This condition is commonly referred to as urinary tract stones (urolithiasis). Urolithiasis is a disease where stones originate in the kidneys and migrate through the ureters, causing severe pain.
If the stone size is small, natural expulsion through urine is possible. However, if the stone is large, it can cause severe pain and obstruct the ureter, thereby impeding the flow of urine.
Particularly, patients experiencing urinary tract stones in an emergency situation often seek medical attention due to severe pain. If a patient visits the emergency room in the middle of the night with unbearable pain, immediate surgical intervention might be challenging. In such instances, medical professionals may implement temporary measures, such as percutaneous nephrostomy, to alleviate pain and stabilize the patient's condition temporarily. This procedure helps to temporarily improve the patient's state by restoring the flow of urine from the kidney to the bladder. However, these temporary interventions alone do not eliminate the underlying cause, which is the stone itself.
For urinary tract stones, it is particularly crucial to select the appropriate treatment method based on the stone's size and location. While most cases are initially treated with extracorporeal shock wave lithotripsy (ESWL), there can be stones that are not amenable to this approach. If stones are located in areas difficult to access with lithotripsy, or if they are excessively large, unusually small, or multiple stones are present, endoscopic surgery becomes the necessary course of treatment.
Rigid endoscopes are primarily utilized for the removal of stones situated in the lower ureter. Flexible endoscopes, on the other hand, prove useful for addressing stones located in the kidney and upper ureter. Endoscopic surgery demands a high level of precision and expertise, and can occasionally lead to complications such as ureteral perforation. Nevertheless, a urology department staffed with experienced medical professionals is capable of effectively managing and responding to such complications.
When selecting a urology department for the treatment of urinary tract stones, several criteria should be taken into consideration. Firstly, it is essential to ascertain whether the medical institution is equipped with modern equipment and advanced technology. Secondly, the presence of experienced medical staff is crucial, as skilled professionals possess the capability to safely manage complex and varied stone cases. Lastly, there should be a designated space for patients and their guardians to rest both before and after surgical procedures.
Director Ryu Je-man of Goldman Urology Clinic, Seoul Station Branch, emphasized, “Urinary tract stones are a condition where early diagnosis and appropriate treatment are critically important. Receiving timely and accurate treatment can prevent kidney damage and effectively manage pain.” He further advised, “Therefore, when urinary tract stones are suspected, it is imperative to immediately visit a specialized medical institution for a diagnosis and to select the most appropriate treatment method. There are often instances where large stones are incidentally discovered without causing pain, yet have already led to severe damage to kidney function. For this reason, we strongly recommend seeking appropriate treatment for urinary tract stones as quickly as possible.”