How to treat ureteral stones with hydronephrosis

If ureteral stones are accompanied by hydronephrosis, the treatment will be more difficult. Therefore, for patients, when facing this disease, they should discover it as early as possible and take treatment measures as early as possible. There are common surgical treatment methods, but post-operative care should also be taken seriously.

1. When obstruction has caused severe hydronephrosis in the kidney, fistula drainage should be performed first.

2. Local treatment: Lesions at the obstruction site can be resolved by local treatment, such as adhesion separation, fibrous band cutting, vascular displacement and anastomosis, and stone removal. When prolonged local compression has caused severe damage to the local development of the ureter, this section of the ureter should be removed and then anastomosed.

3. Plastic surgery must master the key points of plastic surgery to ensure that the ureteropelvic anastomosis is at the lowest point of the renal pelvis. The ureteropelvic anastomosis should form a funnel shape. During repair, the surrounding fibers, adhesions, and scar tissues should be removed without damaging the blood supply. Remove excess renal pelvic wall and maintain a certain renal pelvic tension. If the ureteral stone hydronephrosis is too large, the thinner renal cortex can be folded inward and fixed to reduce the renal volume.

4. To reduce urine leakage from the anastomosis, a double pigtail catheter can be placed. In order to avoid the formation of scar fibrosis around the anastomosis due to urinary incontinence and hemolysis, a negative pressure suction tube can be placed outside the anastomosis for adequate drainage. There are many types of plastic surgery, but from the perspective of etiology and pathology, it is currently believed that the best approach is to remove the diseased segment and then anastomose it.