ESWL: extracorporeal shock wave lithotripsy ( مطلوب الاسم )
It is a procedure to break up stones inside the urinary tract, bile ducts or pancreatic duct with a series of shock waves generated by a machine called a lithotripter. The shock waves enter the body and are targeted using an X-ray

Used for stones that are too large to pass on their own (larger than 5 millimeters in diameter — about the size of a pencil eraser)

🔍Another source -> ESWL used for stones that are less than 2cm

الفرق بين ESWL & laser lithotripsy

ESWL as an outpatient procedure does not require analgesia or anesthesia; it remains the first line therapy for proximal ureteral stones while ureteroscopic laser lithotripsy as a surgical procedure requires general anesthesia, hospitalization and much more costs
Eswl is used for stone less than 2 cm
analysis found Laser Lithotripsy can treat larger stones (> 2 cm) with good stone-free and complication rates

هاي مو كلها ذكرها الدكتور
يعني اكو معلومات اني هسة بحثت عنهن وضفتهن
بس الدكتور ذاكر هاي المواضيع يعني بشكل عابر

وطبعا المعلومات هواية فماتوقع اكدر اكملهن كلهن هسة
راح استمر لحد الي اكدر عليه وبعدها اكمل الباقي بغير وقت .. ان شاء الله ما أتأخر

We cant use urine sample to know if the stone is upper or lower
Unless we take smple from the kidney

Renal Colicky pain caused by stone is either due to obstruction by the stone or movment of the stone

Anatomical sites where stone can get lodged: The ureteropelvic junction (UPJ), the ureteral crossing of the iliac vessels, and the ureterovesical junction (UVJ

Vesical stone :
Primary :formed in the bladder
Scendory : the stone formed at another location and then get to bladder

Primary occurs in children
Scendory occurs in adult due to obstruction of urethra [ cause urine to accumlate in the bladder]

Or due to prostate enlargment which also interfere with urine outflow

Symptoms
intermittent urination
Loin pain
Pain during urination.
Testical pain
Nocturia & frequent urination
Blood in urine
Difficult urination or interrupted urination

Urine is acidic ( normal )
Urine ph =4.5 - 8.0
But some situation may increase the acidity ,for example:

*Uric acid
*UTI caused by E.COLI
*Tubular acid leak
*Ketosis caused by:
DM , starvation , fever

Alkaline urine caused by
*Infection caused by bacteria that split urea to ammonia ( klebsila ,
proteus , pseudomonus erogenosa)

*Drugs (potassium citrate, sodium citrate) لهذا لازم نسأل المريض ان كان
ياخذ دواء من ادوية التي تسبب alkaline urine

*Renal tubular acidosis ( because the kidney cant excrete acid into urine)
Renal tubular acidosis Type 1 : urine ph > 5.5
Type 2 : urine ph >7
Type 3: urine ph <5

اي مريض عنده hematuria يكون عنده albuminuria عالي كذلك

وهناك سبب اضافي هنا هو
False reaction if high amount of heamaturia

ذني الصور لكيتهن افضل من الكتابة
لان الدكتور مجرد ذكر كم سبب على السريع فأكو الي لحكت اكتبه واكو لا فيعني هاي الصور اشمل شوية

Glucose in urine :
* hyperglycemia >10mmol /l
In DM , acute pancreatitis

*renal glycosuria ( glucose is abnormaly excreted from the kidney)

*increased intestinal reabsorption