Coral stones filling the right kidney

Ho Chi Minh City Mr. Thoa, 60 years old, fever, back pain, blood in urine, doctor discovered many coral stones, the largest about 3.5x2.5 cm, in the right renal pelvis.

Urine culture test of the patient at Tam Anh General Hospital Hanoi also recorded E.coli bacteria.

On November 27, Associate Professor, Doctor, Doctor, CKII Tran Van Hinh, Head of the Department of Urology - Andrology and Nephrology, said that the patient's coral stones had complications of urinary tract infections. About 50-70% of patients with kidney stones have this complication, mostly intestinal bacteria.

After treating the urinary infection with antibiotics, the doctor performed a small percutaneous nephrolithotomy. Associate Professor Hinh said that coral stones with multiple stones like Mr. Thoa's are complex stones. In addition to large stones, small stones are located in the renal calyces, so the time to find and crush the stones can be prolonged, leading to many complications such as bleeding, remaining stones... if the surgeon is not experienced.

Dr. Hinh and his team set up a tunnel from the skin in the lumbar region, inserted a needle under ultrasound guidance, and dilated a small tunnel with a circumference of 1.8 cm to insert the endoscope into the renal pelvis and each calyx of the right kidney. The stones were crushed with a high-power laser and then sucked out.

Associate Professor Hinh (middle) and surgeons perform lithotripsy for a patient. Photo: Tam Anh Hospital

The surgery ended after 45 minutes, the patient was placed with a kidney drain and JJ catheter. After 4 days, Mr. Thoa was discharged from the hospital, and returned for a check-up after a month to remove the catheter.

Associate Professor Hinh said that in the past, coral stones were often treated with open surgery, but this method prolonged the recovery time and easily damaged the kidneys and surrounding organs. If the stones recurred, subsequent open surgeries would be difficult, increasing the risk of bleeding and life-threatening complications. In the mid- and late 20th century, this type of stone was broken through the skin with a standard small tunnel. The entrance to the kidney using this method was very large (2.8 cm in circumference), causing damage to a lot of kidney tissue and easily causing complications.

There are currently many minimally invasive methods to treat kidney stones depending on the location, nature, and size of the stone; the patient's physical condition, and underlying disease. Preferred methods include percutaneous nephrolithotomy with small tunnels, retrograde ureteroscopy, and flexible tube nephrolithotomy.

According to Associate Professor Hinh, mini-tunnel lithotripsy is one of the modern techniques with many advantages such as small access to the kidney, so there is less risk of damage to the kidney parenchyma, minimizing the risk of complications, bleeding complications during and after surgery. The process of performing ultrasound-guided endoscopy helps doctors and patients not be affected by radiation from X-rays, easily check the position of the lithotripsy tool, kidney morphology and stone position, detect moving crushed stone fragments to limit remaining stones. Doctors can detect early and handle promptly if there are complications of perirenal fluid accumulation, abdominal effusion.

Stones are crushed and sucked out using a pressure pump under ultrasound guidance. Photo: Tam Anh Hospital

Vietnam is located in the world's gravel belt due to many risk factors. Endogenous risk factors such as patients with chronic gastrointestinal diseases, metabolic disorders such as hyperthyroidism, gout causing increased uric acid in the blood, persistent recurrent urinary tract infections... Exogenous risk factors such as tropical climate, not drinking enough water, working a lot under the sunlight...

Associate Professor Hinh recommends that everyone have regular health check-ups to detect diseases early and avoid complications. People with symptoms of back pain, blood in the urine, fever and chills, vomiting, burning sensation when urinating... should see a doctor soon.

Emerald

At 8:00 p.m. on November 28, the online consultation "Dissolving kidney stones" will be broadcast on the VnExpress fanpage. The program will have the participation of Associate Professor, Dr. Vu Le Chuyen, Director of the Center for Urology - Nephrology - Andrology, Tam Anh General Hospital, Ho Chi Minh City; Associate Professor, Dr. CKII Tran Van Hinh, Head of the Department of Urology - Andrology and Nephrology, Tam Anh General Hospital, Hanoi.
Readers send questions here for advice.

Source link: https://vnexpress.net/soi-san-ho-lap-day-than-phai-4681886.html