A patient with a 6 mm obstructing ureteric stone has fever, rigors and rising inflammatory markers. What is the most important step?
Answer and explanation
Correct answer: B. Urgent decompression by nephrostomy or ureteric stent
- Step 1: Infection behind an obstruction is a urological emergency, risking sepsis and loss of the kidney. Step 2. Antibiotics alone cannot clear pus behind a blockage, so the system must be drained first, and the stone is treated later. Answer: Urgent decompression by nephrostomy or ureteric stent. Why not the others: Waiting risks septic shock. Lithotripsy in the presence of infected obstruction can cause bacteraemia. Medical expulsive therapy is not suitable in sepsis and discharge is unsafe.
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