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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (5): 939-942. doi: 10.19723/j.issn.1671-167X.2023.05.025

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Diagnosis and treatment of four cases of asymptomatic and non-hydrous ureteral calculi

Cai-peng QIN,Fei WANG,Yi-qing DU,Xiao-wei ZHANG,Qing LI,Shi-jun LIU,Tao XU*()   

  1. Department of Urology, Peking Univesity People's Hospital, Beijing 100044, China
  • Received:2023-03-20 Online:2023-10-18 Published:2023-10-09
  • Contact: Tao XU E-mail:xutao@pkuph.edu.cn

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Abstract:

This paper analyzed the clinical data, diagnosis and treatment of 4 asymptomatic patients with ureteral calculi without hydrops in our hospital from October 2018 to January 2019, and comprehensively discussed the previous literature. The 4 patients in this group had no obvious clinical symptoms, no positive stones were found in the B-ultrasound of the urinary system, and no hydroureter and hydroureter of the affected side was found. Urinary CT scan confirmed ureteral stones. They were all located in the lower ureter, and the stones obstructed the lumen. The stones were round and smooth, and there was no obvious hyperplasia and edema in the surrounding mucosa. The lithotripsy was completed in the first-stage operation, and the DJ catheter was left behind for one month after the operation. Based on the clinical diagnosis and treatment process of the 4 cases of asymptomatic calculi in this group and the analysis of previous studies, these patients were mostly detected by imaging examinations or other systematic imaging examinations during the regular review of urinary calculi. Ureteral stones with obstruction did not necessarily have stone-related symptoms. The onset of renal colic involved an increase in intraluminal pressure, related stimulation of nerve endings, smooth muscle spasms caused by stretching of the ureteral wall, and systemic changes in cytokines and related hormones. Cascade reactions, etc., were associated with the movement of stones down. Ureteral stones without hydrops were mostly located in the lower ureter, which had a certain buffering effect on obstructive pressure. Asymptomatic ureteral calculi could also induce irreversible damage to renal function, and the proportion of damage increased with the diameter of the stone. Patients with a history of urinary calculi, especially those with asymptomatic stones for the first time, should be paid attention to during clinical follow-up. At present, there are few research reports on asymptomatic and non-accumulating ureteral calculi. We analyze the clinical diagnosis and treatment process and characteristics of this group of patients combined with previous literature to provide a reference for the diagnosis and treatment of such patients.

Key words: Asymptom, Anhydronephrosis, Ureteral stones, Renal injury

CLC Number: 

  • R693.4

Figure 1

Image data of case 1 A, B-ultrasound of the urinary system in case 1 showed no expansion of the renal pelvis and calices; B, no strong echo of stones; C, CT of the urinary system showed that the stones located in the lower ureter, with a length of 1 cm (arrow show)."

Figure 2

Image data of case 2 A, B-ultrasound of the urinary system in case 2 showed no expansion of the renal pelvis and calices; B, no hyperechoic stones were detected; C, CT of the urinary system showed that the stones located in the lower ureter, with a long diameter of 0.9 cm (arrow show)."

Figure 3

Image data of case 3 A, B-ultrasound of the urinary system in case 3 showed no expansion of the renal pelvis and calices; B, no strong echo of stones; C, CT showed that the stones were located in the lower ureter, with a long diameter of 0.7 cm (arrow show)."

Figure 4

Image data of case 4 A, B-ultrasound of the urinary system in case 4 showed no expansion of the renal pelvis and calices; B, no strong echo of stones; C, CT of the urinary system showed that the stones were located in the lower ureter, with a length of 1.4 cm (arrow show)."

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