Dhukkubbii Dhagaa Tiruu Cimaa vs. Tiruu Dhukkubaan Gufate (Urosepsis) .¶

An uncomplicated kidney stone attack (acute renal colic) is famous for causing some of the most intense, agonizing pain a human can experience, yet an uncomplicated stone under 5 millimeters (0.2 inches) will eventually pass on its own in 80 to 90 percent of cases. However, the exact moment a kidney stone traps infected urine behind it inside the renal pelvis (obstructive pyelonephritis / pyonephrosis), the clinical situation changes from a painful outpatient stone into a life-threatening urological surgical emergency. Because the obstructed kidney continues filtering blood at high pressure, bacteria and endotoxins trapped above the stone are forced directly across the renal papillae into the renal veins (pyelovenous backflow), triggering fulminant urosepsis, shookii seeptikii (septic shock) jedhamuun beekama, and death within 6 to 24 hours unless emergency surgical drainage (a ureteral JJ stent or percutaneous nephrostomy tube) is performed immediately.

Your immediate responsibilities when severe flank, back, or groin pain strikes are to screen instantly for the "Infected Stone" emergency (any renal colic accompanied by a fever above 38.0 degrees Celsius / 100.4 degrees Fahrenheit, shaking chills/rigors, foul-smelling cloudy pus-filled urine, or confusion), screen for complete urinary shutoff (anuria or having only one functioning kidney), verify in any patient over age 50 to 60 that the sudden flank pain is not a rupturing abdominal aortic aneurysm (AAA), avoid force-chugging gallons of water during an active pain spasm (which balloons the blocked kidney capsule and worsens pain and vomiting), and call emergency medical services immediately if any red flags are present.

Amma kana godhi¶

1. Call emergency medical services immediately if a kidney stone is accompanied by FEVER, CHILLS, or SHOCK ("An Infected Blocked Kidney"): Call your local emergency number (911 in the United States and Canada, 112 across the European Union, 999 in the United Kingdom, 000 in Australia) or check our directory of lakkoofsa balaa tasaa if someone with severe flank, back, or groin pain develops a fever (38.0 degrees Celsius / 100.4 degrees Fahrenheit or higher) or abnormally low body temperature (<36.0 C / 96.8 F), uncontrollable shaking chills (rigors), dizziness or fainting when standing, new confusion or lethargy, or complete inability to pass urine. Oral antibiotics alone cannot cure pus trapped behind a stone; the kidney must be surgically drained in the hospital within hours.
2. Go to an emergency department immediately if the person has only ONE functioning kidney (or a kidney transplant) or is pregnant: If a stone blocks the ureter of a solitary kidney or a transplanted kidney, the person has zero backup kidney and immediately enters anuric miidhaan tiruu cimaa and life-threatening hyperkalemia.
3. Rule out a rupturing Abdominal Aortic Aneurysm (AAA) in anyone over age 50: In adults over 50 (especially men, smokers, or people with high blood pressure) who have never had a kidney stone before, a tearing or leaking abdominal aortic aneurysm retroperitoneal bleed presses on the exact same nerves as a left or right kidney stone, causing identical sudden flank-to-groin pain and even microscopic blood in the urine. Always treat a "first-time kidney stone over age 50" as a potential aortic emergency requiring an immediate emergency department CT scan or ultrasound.
4. Do NOT force-chug massive amounts of water during an acute renal colic spasm: A widespread myth tells people to chug liters of water during an acute kidney stone attack to "flush the stone out." During an active ureteral obstruction, drinking large volumes of water increases urine production above the jammed stone, inflating the renal capsule like a tight balloon (hydronephrosis), spiking renal pelvic pressure, triggering severe vomiting, and risking rupture of the renal calyx (forniceal rupture). Sip small amounts of water only if thirsty and not nauseated.
5. Apply comforting local warmth (a warm bath, shower, or heating pad) to the flank if NO fever is present: Unlike appendicitis (where heat is forbidden), randomized clinical trials show that placing a warm heating pad or warm blanket (40 to 42 degrees Celsius / 104 to 107.6 degrees Fahrenheit) directly over the lower back/flank relaxes ureteral smooth muscle spasm and significantly reduces acute renal colic pain and nausea during transport.
6. Strain all urine through a fine mesh strainer, coffee filter, or gauze if managing a confirmed uncomplicated stone: Catching the passed stone (which may look like a tiny 2 to 5 millimeter jagged brown, yellow, or tan grain of sand or gravel) allows urologists to analyze its exact chemical composition (calcium oxalate, uric acid, struvite, or cystine) and prevent future stones.

flowchart TD
    Start["Sudden, Agonizing Flank / Costovertebral Angle Back Pain Radiating Around Side to Groin, Testicle, or Labia"] --> CheckSepsis{"1. Check Obstructed Infected Kidney (Urosepsis) Red Flags: Fever (>=38.0 C), Chills/Rigors, Cloudy Foul Urine, Confusion, or Shock?"}
    CheckSepsis -->|Yes| CallEMS["Call Emergency Services (911 / 112 / 999) Immediately: Time-Critical Urological Decompression Required"]
    CheckSepsis -->|No Fever/Chills| CheckAAA{"2. Is Patient Over Age 50 With a 'First-Time Stone', Known Aortic Aneurysm, Dizziness, or Syncope?"}
    CheckAAA -->|Yes| CallEMS_AAA["Call Emergency Services Immediately: Rule Out Ruptured Abdominal Aortic Aneurysm (AAA)"]
    CheckAAA -->|No| CheckRenal{"3. Check Kidney & Vomiting Red Flags: Solitary/Transplant Kidney, Pregnancy, Zero Urine Output, or Intractable Vomiting?"}
    CheckRenal -->|Yes| UrgentED["Transport Immediately to a Hospital Emergency Department for IV Analgesia, Antiemetics, and Imaging"]
    CheckRenal -->|No Red Flags| EvalED["Arrange Prompt Medical Evaluation (Non-Contrast CT / Ultrasound) and Urine Straining"]
    CallEMS --> FirstAid["4. Apply Warm Pack to Flank (If No Fever), Do NOT Force-Chug Water During Acute Spasm, Position Comfortably"]
    UrgentED --> FirstAid

Tiruu Tiruu Walxaxaa Hin Taane fi Tiruu Dhukkuba Qabe Cufame (Pyonephrosis fi Urosepsis) .¶

Dhagaan tiruu infekshinii hin qabne maaliif dhukkubbii to’achuu fi ilaaluun nagaadhaan kan to’atamu yoo ta’u, dhagaan tiruu infekshinii ujummoo fincaanii qabu qoricha hospitaalaa keessatti balaawwan hatattamaa lubbuu namaa galaafatan keessaa isa tokko?

dhagaa tiruu walxaxaa hin taane (renal colic) keessatti fincaan sterile dhagaa ureter fi renal pelvis keessa jiru duuba duubatti deebi'a (hydronephrosis). Diriirsuun kaapsulaa kalee fibrous fi spasm ujummoo fincaanii dhukkubbii hamaa 10/10 kan fidu yoo ta’u, fincaan mataan isaa sterile dha.

Tiruu dhukkuba kanaan qabame cufame (obstructive pyelonephritis ykn pyonephrosis) keessatti baakteeriyaan (kan akka Escherichia coli, Proteus mirabilis, Klebsiella, Pseudomonas, ykn Enterococcus) sirna walitti qabuu cufame, dhiibbaa qabu dhagaa sanaa olitti qabamu. Tiruun cufame bu'uuraan **dhiibbaa calaqqisiisa arteriin ol'aanaa jalatti cufa cufame ta'a:

1. Maaliif antibaayootikii qofti tiruu dhukkuba kanaan qabame cufame bira gahuu ykn fayyisuu HIN DANDA'U: Tokkoffaa, tiruu guutummaatti cufame keessatti glomerular filtration waan dhaabbatuuf, antibaayootikoonni hidda dhiigaa keessaa ykn afaaniin fudhataman fincaan dhagaa olitti dhaabbate keessa calaluu hin danda'an. Lammaffaa, dhiibbaan intrapelvic ol’aanaan (30 hanga 40 mmHg ol) imimmaan maaykirooskoopii fiixee kaalisii kalee irratti bana (pyelovenous and pyelolymphatic backflow), baakteeriyaa lubbuu qabuu fi endotoxin baakteeriyaa kallattiin gara dhiiga sirnaatti dha’annaa onnee hunda keessatti lilmoodhaan naqa.
2. Uurosepsis osoo bishaan hin ba’iin saffisaan hangam akka ajjeesu: Utuu hatattamaa makaanikaal decompression tiruu (retrograde ureteral stenting kutaa baqaqsanii hodhuu keessatti ykn percutaneous nephrostomy tube karaa dugdaatti kaa’uu interventional radiology), du’a obstructive urosepsis dhibbeentaa 20 hanga 40 caala, fi delaying decompression sa’aatii 12 hanga 24 ol balaa septic shock fi du’a dachaa sadii ta’a.

Anatomy of a kidney stone attack: How pain location tracks the stone's journey down the ureter¶

A kidney stone does not hurt while sitting quietly inside the wide renal calyx of the kidney (unless it is a massive staghorn infection stone). Pain explodes the moment the stone drops into the narrow, muscular ureter (which is only 2 to 4 millimeters wide) and becomes wedged at one of the three anatomical choke points (narrowings) of the urinary tract. As the stone moves downward toward the bladder, the location of the pain shifts predictably along the ilioinguinal and genitofemoral nerves (T11 to L2):

Choke Point 1: The Ureteropelvic Junction (UPJ, where the kidney funnel meets the top of the ureter)¶

• Where you feel it: Sudden, deep, knife-like pain high in the costovertebral angle (CVA), the V-shaped corner on your back where the bottom 12^th rib meets the spine.
• Mallattoolee kanaan walqabatan: Kaapsulaan tiruu fibers narvii autonomic celiac ganglion garaacha waliin waan qoodduuf, danqaan UPJ ol'aanaa garaa kaasaa battalaa, cimaa fi irra deddeebiin garaa kaasaa kan yeroo baayyee a weerara ujummoo fincaanii, dhukkuba xannacha sombaa, ykn dhukkuba garaachaa.

Qabxii Choke 2: Ujummoo Dhiigaa Iliac qaxxaamuruu (Mid-ureter at the pelvic brim) .¶

• Bakka sitti dhaga'amutti: Dhukkubbiin kun gara fuulduraa fi gaditti cinaacha naannoo cinaacha mudhii irraa gara kudhaama garaa gadii mirgaa ykn bitaa fi gadi gara groin creasetti balaqqeessa.
• Kiyyoo adda baasuu: Dhagaan tokko maashaa psoas irratti mid-ureter mirgaa irratti yeroo dhaabbatu, itti dhiyeenyaan fakkeessa dhukkuba apendiksii cimaa (gara mirgaatiin) ykn acute diverticulitis (gama bitaa). Haa taʼu malee, dhukkubsataan sun akkamitti akka amala qabu hubadhu:
• Dhukkubsataan peritonitis from appendicitis qabu sochiin hundi peritoneum waan miidhuuf qorroo fi sochii malee siree irra ciisa.
• Dhukkubsataan renal colic qabu ni ni rifata, daandii irra deema, lafa irratti qaxxaamuree, yeroo hunda bakka jijjiirra kofa dhiita'uu ujummoo fincaanii keessaa ("mallattoo sochii qaamaa") fayyisu argachuuf akkasumaan yaala.

Qabxii Choke 3: Ureterovesical Junction (UVJ, bakka jala ujummoo fincaanii dallaa ujummoo fincaanii seenu) .¶

• Balballi dhiphoo ujummoo fincaanii keessatti argamu (bal’inni isaa miliimeetira 1 hanga 2 qofa): Dhagaa** CT scan kutaa balaa tasaa irratti argamu keessaa **dhibbeentaa 60 hanga 70 ol kan ta’u asitti UVJ irratti kan maxxane yoo ta’u, ujummoo fincaanii keessa osoo hin kufin miliimeetira muraasa dura.
• Bakka sitti dhaga'amutti: Jalqaba ujummoo fincaanii narvii genitofemoral fi pudendal (L1, L2, S2-S4) qaama saalaa alaa fi bu'uura ujummoo fincaanii (trigone) waliin waan qooddatuuf, dhagaan UVJ irratti wedged ta'e akka:
• Dhukkubbiin qaraa dhiirota irratti kallattiin gara ipsilateral testicle fi scrotum, ykn dubartoota irratti gara labia majora fi vulva tti balaqqeessa'u (torshinii testicular ykn torsion ovarian; dhagaa tiruu keessatti, qaamni saalaa mataan isaa yeroo suuta tuqamu akka idilee fi kan hin dhiita’amne kan itti dhaga’amu yoo ta’u, torsion tiruu keessatti ammoo qaamni saalaa ol ka’ee, dhiita’ee fi haala bareedaa ta’een taa’a).
• Mallattoolee ujummoo fincaanii aarsuu cimaa: Daqiiqaa 3 keessatti fincaan baasuu akka qabdu tasa sitti dhagahamu (arriifannaa fi irra deddeebiin fincaan), dhukkubbiin fiixee ujummoo fincaanii irratti gubuu (dysuria), fi fincaan dhiigaa pink, red, ykn shaayii halluu qabu (gross hematuria) muraasa darbuu, yeroo infekshiniin hin jirrettillee.
• Yeroo boqonnaa: Dhagaan sun dhumarratti karaa UVJ gara ujummoo fincaanii bal'aa ta'etti erga ba'ee booda, dhukkubbiin cinaacha fi jilba 10/10 nama dhiphisu battalumatti jechuun ni danda'ama ni bada**. Dhagaa sana booda ujummoo fincaanii irraa karaa ujummoo fincaanii bal’aa ta’een (kan bal’inni isaa miliimeetira 6 hanga 8 ta’e) dabarsuun yeroo baay’ee yeroo gabaabaaf sekondii 2 keessatti ciccituu ykn kilink dhokataa ta’e qofa saanii mana fincaanii keessatti fida.

Guddina dhagaa fi carraa darbuu uumamaa: Dhagaawwan kamtu darbuu fi kamtu qabama?¶

Ogeeyyiin fayyaa hatattamaa Doosiin xiqqaan CT scan garaa fi qaama saalaa (CT KUB) ykn altiraasaawundii kalee yeroo raawwatan, safartuun tokkichi barbaachisaan (infekshiniin ykn tiruu kophaa ta’e hin jiru jennee yoo fudhanne) daayameetira qaxxaamuraa dhagaa miliimeetiraan dha:

Dhukkubbii dhagaa tiruu sterile ta’eef NSAIDn maaliif opioids rukuta (fi yeroo NSAIDn cimsee dhorkame) .¶

Yoo kutaa balaa tasaa keessa jirta ta’e ykn duraan ogeessa fayyaa dhagaa tiruu walxaxaa hin taane, sterile kan hojii tiruu idilee qabu (normal serum creatinine) mirkaneesseen madaalamtee jirta ta’e, akkaataa qorichi dhukkubbii hir’isu ujummoo fincaanii irratti akka hojjetu hubachuun gargaarsa ajaa’ibaa qaba:

1. Qorichootni Farra Inflammatory Nonsteroidal (NSAIDs) hundee dhukkuba garaachaa kalee irratti maaliif akka xiyyeeffatan¶

Dhagaan tokko ujummoo fincaanii yeroo cufu dhiibbaan tiruu keessaa ol ka'uun walnyaatinsa naannoo Prostaglandin E2 (PGE2) fi prostacyclin kakaasa. Prostaglandin E2 wantoota lama kan renal colic agonising taasisan hojjeta:

1. Arterioles afferent kan gara glomeruli tiruu seenan bal'isa, dhiibbaa fincaan calaluu ​​kallattiin gara tiruu duraan cufamee fi dhiita'etti dabala.
2. Innis jeequmsa, dhukkubbii maashaan lallaafaa dallaa ujummoo fincaanii naannoo dhagaa sanaatti kan kakaasu yoo ta’u, dhiita’uu dallaa ujummoo fincaanii naannoo (edema) ni dabala.

NSAIDs (kan akka hospitaala hidda dhiigaa keessaa ketorolac [Toradol] ykn qaama saalaa/afaan diclofenac, ibuprofen, ykn naproxen) kallattiin walnyaatinsa piroostaagilaandiin (cyclooxygenase inhibition) dhorku. Prostaglandin E2 cufuudhaan, NSAIDs yeroo walfakkaatutti dhiibbaa kaapsulaa tiruu dhiita’e keessa jiru gadi buusu, dhiita’uu maashaa ujummoo fincaanii laaffisu, dhiita’uu naannoo dhagaa xiqqeessa, akkasumas morfiin hidda dhiigaa keessaa kennamu wajjin wal bira qabamee yoo ilaalamu dhukkubbii olaanaa ykn walqixa ta’e kennuudhaan osoo garaa kaasaa ykn hirriba opioid-induced hin fidin.

2. Yeroo dhukkubsataa dhagaa tiruu qabu irratti qorichi NSAID CIMSAA DHORKAA ta'e¶

NSAIDn dhangala'aa dhiigaa gara filtara tiruu cufameetti waan hir'isuuf, haalota armaan gadii keessaa tokko yoo ta'e ibuprofen, naproxen, ketorolac, ykn diclofenac gonkumaa hin fudhatinaa:

• Hanga ammaatti qorannoo dhiiga hospitaalaa ykn seenaa hojii tiruu idilee mirkaneessu HIN qabdu, ykn miidhaa tiruu cimaa (creatinine olka’e) ykn dhukkuba tiruu yeroo dheeraa (CKD Sadarkaa 3, 4, ykn 5) qabda.
• Tiruu TOKKO qofa hojjetu (tiruu kophaa) ykn tiruu jijjiirrachuu qabda: Yeroo tiruu kee tokkichi dhagaadhaan cufame NSAID fudhachuun dhiyeessii dhiiga arteriolar afferent isaa hafe cufee battalumatti acute renal failure ariifachiisa.
• Ulfa jirta (NSAIDn guddina tiruu daa'imaa miidhuu fi daaktus arteriosus daa'imaa yeroo malee cufuu danda'a).
• Dhukkuba madaa garaachaa sochiirra jiru qabda, . dhiiguu garaachaa, or severe dehydration/urosepsis.
• In all of those cases, hospital physicians use intravenous acetaminophen (paracetamol) and titrated intravenous opioids (or ultrasound-guided erector spinae nerve blocks / intravenous lidocaine protocols) instead of NSAIDs.

Step-by-step prehospital care and long-term stone prevention¶

Tarkaanfii 1: Bulchiinsa manaa fi geejjibaa nageenya qabu yeroo acute episode¶

1. Check temperature with a thermometer immediately: Before treating any suspected kidney stone at home, measure body temperature. If temperature is 38.0 degrees Celsius (100.4 degrees Fahrenheit) or higher (or below 36.0 C / 96.8 F), or if the person has shaking chills, stop all home care and go straight to the emergency department or call 911 / 112 / 999.
2. Apply active external heat to the flank and lower back: Place a warm heating pad, warm water bottle wrapped in a towel, or warm chemical heat pack at 40 to 42 degrees Celsius (104 to 107.6 degrees Fahrenheit) over the painful flank and lower back during transport.
3. Avoid forced hydration during the acute pain peak: While waiting for the pain wave to subside or traveling to the emergency room, do not chug glasses of water. Once the acute colic spasm has been controlled and nausea has resolved, resume normal, steady fluid intake (2.0 to 2.5 liters per day) to help carry the stone downward.
4. Collect and strain every drop of urine: Urinate into a clean plastic urinal, cup, or hat and pour it through a medical stone strainer or white paper coffee filter. Once a hard stone crystal is caught, let it air-dry in a clean pill bottle (never wrap it in wet toilet paper, which dissolves or sticks to the crystal) and bring it to your physician for Fourier-transform infrared spectroscopy (FTIR) or X-ray diffraction stone analysis.

Step 2: Evidence-based dietary steps to prevent a second kidney stone¶

Without preventive changes, 50 percent of first-time kidney stone formers will suffer another stone within 5 to 10 years:

• Drink enough water to produce at least 2.5 liters (85 fluid ounces) of pale yellow urine every 24 hours: This single habit cuts stone recurrence in half across all stone types.
• Add natural citrate (real lemon or lime juice) to your daily water: Citrate in the urine binds to urinary calcium and naturally blocks calcium oxalate and calcium phosphate crystals from sticking together.
• Do NOT restrict dietary calcium (eat normal dairy/calcium WITH meals), but DO cut down on high sodium (salt): Paradoxically, a low-calcium diet increases calcium oxalate kidney stones because dietary calcium in your gut binds to oxalate from food (spinach, rhubarb, almonds, beets, chocolate, tea) so it leaves in your stool rather than absorbing into your urine. High dietary sodium (salt) forces the kidneys to dump excess calcium into the urine (hypercalciuria).

Understanding the 4 chemical types of kidney stones and special emergencies¶

When a kidney stone is caught in a strainer or removed during ureteroscopy, laboratory analysis identifies which of the four major mineral families caused the stone, each carrying distinct emergency considerations:

Dhagaa tiruu yeroo ulfaa fi dhukkubsattoota Indwelling Ureteral Stent qaban irratti¶

1. Yeroo ulfaa 'Renal colic' (Haadha fi daa'ima gadameessa keessa jiru lamaanuu eeguu) .¶

Tilmaamaan Dhukkubsattoota ulfaa 200 hanga 1,500 keessaa 1 dhagaa tiruu cimaa kan qabaatu yoo ta'u, baay'inaan yeroo ji'a sadii lammaffaa fi sadaffaa (yeroo piroojeestirooniin maashaa lallaafaa ujummoo fincaanii laaffisu fi gadameessi guddachaa jiru ujummoo fincaanii dhiibu, keessumaa gama mirgaa).

• Dhukkubsattoonni ulfaa dhukkuba kalee qaban maaliif madaallii hospitaala hatattamaa barbaachisa:
• Dhukkubbiin cimaan garaachaa kalee fi dhukkubni paayiloonefraayitis danqaa yeroo ulfaa hin yaalamne da’umsa yeroo malee fi da’umsa yeroo malee, urosepsis haadha, fi dhiibbaa dhiigaa preeclampsia fakkaatu kakaasuu danda’a.
• Suuraa adda baasuu raadiyaashiniin malee: Kutaaleen balaa tasaa yeroo ulfaa qorannoo jalqabaa ta’ee gonkumaa CT scan sadarkaa isaa eeggate hin fayyadaman; kanaa mannaa Renal and Pelvic Ultrasound (jeetiiwwan ujummoo fincaanii safaruu fi physiological hydronephrosis ulfaa dhagaa irraa adda baasuu) yoo barbaachise non-contrast Magnetic Resonance Urography (MRU) ykn pirootokoolii ultra-low-dose fayyadamu.
• Nageenya qoricha: NSAIDs (ibuprofen, ketorolac, naproxen) ulfa keessatti cimsee kan hin dhorkamnedha. Dhukkubbiin hidda dhiigaa keessaa acetaminophen fi titrated opioids fayyadamuun nagaadhaan kan to'atamu yoo ta'u, ho'i qaamaa, urosepsis, ykn dhukkubbiin refractory yoo uumame ogeeyyiin urologist yeroof internal ureteral JJ stent kaa'u. (ulfi kaalsiyeemii stent irratti akka saffisiisu torban 4 hanga 6tti jijjiirama) hanga da’umsa boodaatti.

2. Kunuunsa hatattamaa dhukkubsattoota duraan Indwelling Ureteral Stent ("JJ Stent") qabaniif .¶

Dhukkubsataan tokko dhiheenya kana double-J (JJ) ureteral stent ogeessa ujummoo fincaaniitiin ujummoo fincaanii isaanii keessa kan kaa’ame yoo ta’e (dhagaa bira darbuuf ykn laser lithotripsy booda fayyuuf), maaltu akka idilee fi balaa tasaa qulqulleessi:

• Mallattoolee isteentii idilee eegamu: Erga deemnee booda fincaan salphaan bifa pilaastikii ykn diimaa ta’e, addatti yeroo fincaan cinaacha irratti dhukkubsachuu (dhiibbaan ujummoo fincaanii tuubii isteentii qaawwa qabutti ol deebi’uu irraa kan ka’e), fi ariifannaa/frequency ujummoo fincaanii salphaa kooyilii jalaa isteentii irratti (tamsulosin fi oxybutynin/solifenacin ajajameen yaalame).
• Haala hatattamaa isteentii alaabaa diimaa qabu kan kutaa balaa tasaa hatattamaan daawwachuu barbaadu:
• Ho'a qaamaa haaraa (>=38.0 C / 100.4 F) ykn qorra (mallattoo isteentiin baayoofiilmii fi dhangala'aan akka marfame ykn cufame agarsiisa).
• Dhukkubbiin cinaacha 10/10 dhaabbataa, cimaan kan fincaan booda hin dhaabbanne deebi’uu (mallattoo isteentiin bakka isaatii bahee ykn dhiiga dhangala’een ykn ciccitaa dhagaatiin cufame agarsiisa).
• Fincaan furdaa, diimaa dukkanaa'aa dhiiga gurguddaa of keessaa qabu ykn fincaan baasuu dadhabuu (fincaan qabachuu cimaa (acute urinary retention).).
• Hidhaa stent dangling socho'a ykn harkifama: Isteentiin yeroo tokko tokko funyoo naayiloonii haphii tether kan ujummoo fincaanii keessaa ba'u kan qabu yoo ta'u, salphaatti waajjira irraa akka baafamuuf; ofii keetii funyoo stent gonkumaa hin harkisin yoo ogeessi urologist keetiin yeroo beellamame sanatti akka baastu ifatti qajeelfama yoo kenname malee.

Gaaffiiwwan yeroo baay’ee gaafataman¶

Maddoonni sakatta'aniiru¶

• Waldaa Urology Awurooppaa (EAU): Qajeelfama EAU Urolithiasis (2024 Update): Bulchiinsa Acute Renal Colic, Medical Expulsive Therapy, fi Tiruu Dhukkubaan Dhukkubame Yeroo Hatattamaa Decompression.
• Waldaa Uroloojii Ameerikaa (AUA) fi Waldaa Endourological (Ameerikaa): Hoggansa Yaalaa Dhagaa Tiruu fi Bulchiinsa Baqaqsanii Hodhuu Dhagaa: Qajeelfama Waldaa AUA/Endourological.
• Inistiitiyuutii Biyyoolessaa Fayyaa fi Kunuunsa Gahumsa (NICE, United Kingdom): Dhagaa Kalee fi Ureeterii: Madaallii fi Bulchiinsa (NG118).
• Duula Seepsiisii ​​lubbuun hafuu (SSC) fi Waldaa Dhukkuboota Daddarboo Ameerikaa (IDSA): Qajeelfama Idil-addunyaa Bulchiinsa Uurooseepsiisii ​​fi To’annoo Madda Hatattamaa Dhukkuba Paayiloonefraayitii Danqaan.
• Paataan S. A., Mitra B, Istiraanii L. D., fi kkf. (The Lancet): Kutaa yaalaa hatattamaa keessatti bulchiinsa dhukkubbii garaachaa kalee tiif qoricha dhukkubbii namatti fidu nageenya qabuu fi bu’a qabeessa ta’e kennuu: yaaliin to’annoo tasaa dachaa jaamaa, garee hedduu, tasaa (NSAIDn morfiinii caalaa dhukkubbii tiruu cimaa agarsiisu).

Qajeelfamoota walqabatan¶

• Sepsis fi septic shock adda baasuu fi gargaarsa jalqabaa hatattamaa
• Aortic dissection fi ruptured abdominal aortic aneurysm
• Fincaan qabachuu cimaa fi kunuunsa hatattamaa kateetira keessa jiraatu cufame
• Torsion testicular, torsion ovarian, fi dhukkubbii qaama saalaa cimaa
• Raabdomyolysis dadhabbii, miidhaan tiruu cimaa, fi fincaan dukkanaa’aa
• Lakkoofsa yeroo muddamaa biyyaan