SurgeNote

🪨 ESWL for small stones, PCNL for big bones Small stones ≤2 cm → ESWL Larger → PCNL.

🚶‍♂️ Ureteric colic → Up and down, can’t lie down!

💎 Cystine → Cry & Scream = worst ureteric pain

🩺 Both blocked = Both kidneys cry = CRF 💔🩸

Ureteric stone 🪨 climbs the nerve ladder 🪜 → hits Genitofemoral 🎯 → groin/scrotum pain 😣.

Ureteric colic pain is referred along this nerve because the ureter shares visceral afferent fibers with L1–L2 spinal segments. Hence, stone in the ureter causes loin-to-groin pain radiating along genitofemoral distribution.

Proteus 🦠 makes urine basic 💧🧂 → clouds ☁️ + pus 🩸 + struvite 🪨.

Proteus species are urease-producing bacteria. Urease splits urea → ammonia → raises urine pH → alkaline urine. Alkaline urine + cloudiness with pus cells indicates urinary tract infection with Proteus. This environment also favors struvite (triple phosphate) stone formation.

انا بعد يغلط في سؤال منبه عليه أكثر من مرة 😂😂😂

Ureter 💥 tries to squeeze 💪 the stone 🪨 out → pain ⚡!

Ureteric colic pain is sharp, intermittent, and radiates along the ureter.