Cause: Disease of organs adjacent to the urinary tract urinary system systemic disease Infectious diseases blood disease Immunity, autoimmune diseases Cardiovascular diseases

Initial hematuria, terminal hematuria, complete hematuria

General character check

chemical examination

microscopy

Activity-related pain and hematuria Identify the location of pain onset and where it radiates Past medical or family history Rule out other conditions that can cause abdominal pain

Blood analysis – reflects kidney function Urinalysis – determines the nature of stones Stone composition analysis

Ultrasound examination: first choice, suitable for everyone. Features: 1. Mass or spot-like strong echo in the ureter, accompanied by sound shadow behind; 2. Dilatation of the ureters and kidneys above the stone site; 3. When there is complete obstruction, there is no urine spraying at the opening of the ipsilateral ureter; 4. Color Doppler blood flow imaging shows that colorful mosaic Doppler flash artifacts can be seen around or behind some stones;

Urinary tract plain film More than 90% of X-ray positive stones can be found. Anteroposterior and lateral radiographs can exclude other calcification shadows in the outer abdomen such as gallbladder stones, mesenteric lymph node calcification, phleboliths, etc. The lateral radiograph showed that the upper urinary tract stones were located behind the front edge of the vertebral body, and the intra-abdominal calcification shadow was located in front of the vertebral body. If the stone is too small or the degree of calcification is not high, pure uric acid stones and cystine stones will not be displayed.

Intravenous urography (IVP) evaluates changes in renal structure and function caused by stones, and whether there are urinary tract abnormalities such as congenital malformations that cause stones. If there is a filling defect, it indicates the possibility of X-ray negative stones or polyps, renal cancer, etc.

Retrograde or percutaneous nephrography It is an invasive examination and is used when differential diagnosis is needed in other locations where stones cannot be determined or when the condition of the urinary system below the stones is unknown.

Unenhanced CT It can detect stones in the middle and lower segments of the ureter that cannot be shown by the above examinations or are smaller. It is helpful to identify opaque stones, tumors, blood clots, etc., and to understand whether there are renal malformations.

Magnetic resonance imaging (MRU) to understand hydronephrosis and is suitable for people allergic to contrast media

radionuclide nephrography Determine lateral renal function

Paishi Granules: Main functions Clear away heat and diuresis, relieve phlegm and eliminate stones. Functional indications Diseases such as kidney stones, ureteral stones, and bladder stones are caused by damp heat in the lower part of the body:. Applicable diseases Used for treating kidney stones, ureteral stones, bladder stones and other diseases caused by damp heat in the lower part of the body

Extracorporeal shock wave lithotripsy (ESWL)

Ureteroscopic lithotripsy

Squamous cell carcinoma of the renal pelvis is more likely to occur in middle-aged and elderly people aged 50 to 70 years, with slightly more women than men.

CT MRI Pyelogram: no visualization of the renal calyces, evidence of tumor infiltration B-ultrasound: space-occupying hypoechoic area

1. Direct observation of tumors 2. Sampling for biological examination 3. Observe hematuria. 4. Assess the extent of the disease 5. Check the bladder wall 6. Light guide analysis

Gold standard - observing pathological structures

Renal cell carcinoma: The boundaries of the involved renal parenchyma are often clear, with “fast in and fast out” type of enhancement Renal pelvis cancer: The boundary of the involved renal parenchyma is not clear, and the involved renal parenchyma shows continuous reduction in enhancement. The two are obviously different. Typical rich blood supply renal cancer and renal pelvis cancer are often easy to distinguish through the difference in enhancement methods. Lymph node metastasis is common in renal pelvis cancer. Direct invasion, hematogenous metastasis and lymph node metastasis are common in renal cancer

Urine exfoliated cell test Find as many tumor cells as possible FISH test Detection of molecular markers Nuclear matrix protein NMP 22, cytokeratin fragments CYFRA 21-1 and TPS, cell membrane glycoprotein CA 19-9

Hemi-urectomy - cuff resection of the affected kidney, ureter and bladder

Renal pelvis squamous cell carcinoma is not highly sensitive to radiotherapy and chemotherapy Instillation therapy (chemotherapy) Chemotherapy drugs are injected into the bladder through the catheter, and the toxic effects of the drugs themselves are used to destroy remaining tumor cells and reduce tumor recurrence. intravesical immunotherapy Inducing local immune response in the body through intravesical instillation of immune preparations (BCG vaccine is preferred)