On December 17, football superstar Messi suddenly suffered from kidney colic and missed the semi-finals of the Club World Cup and China Evergrande (even though Messi and Neymar were absent, Barcelona still easily defeated Evergrande 3-0). This breaking news has attracted people's attention to renal colic and kidney stones.
Only 2 days later, on December 19, foreign media reported that Messi "had removed the stones with the help of a doctor" and was expected to be in the final of the Club World Cup. But so far, the media has not specified what kind of treatment he has received.
Here, I believe many people will ask:
Why did Messi get kidney stones?
How did he remove the stones?
For this reason, Xiaokang Meier interviewed Professor Chang Ligao, the discipline leader of Sichuan Stone Disease Hospital and an expert in urinary stones.
Professor Chang Ligao analyzed that the reason why Messi suffered from kidney stones is closely related to his athlete's identity. Several occupational characteristics of athletes are the main reasons for prone to urinary stones such as kidneys, ureters, and bladders.
Several factors can easily cause Messi to suffer from kidney stones
Professor Chang Ligao introduced:
First of all, athletes have a lot of exercise, which will inevitably cause a lot of sweat. Even if players usually drink a lot of water, they often cannot catch up with the sweat they shed, which will cause their urine to be overconcentrated and crystallized, and then urinary stones such as kidney stones appear;
Secondly, athletes consume a lot of energy, so they need to consume high-protein foods rich in energy, such as meat. You should know that a high-protein diet is one of the main causes of urinary stones.
The reason is that a high-protein diet can promote the excretion of calcium, uric acid and oxalic acid in the urine, reduce the excretion of citric acid in the urine, reduce the pH of the urine, and greatly increase the incidence of urinary stones. High-protein foods are also often rich in high cholesterol, such as eggs, seafood, animal offal, etc. A high cholesterol diet is also a high-risk factor for urinary stones.
Again, athletes also consume more salt. Salt can increase the excretion of calcium and cystine in the urine, reduce the excretion of citric acid in urine, and increase the pH of urine. It is one of the risk factors for the formation of urinary tract stones with calcium-containing content;
In addition, athletes will also often consume sugar, and the intake of refined sugar will also increase the excretion of calcium, oxalic acid, and uric acid in the urine, increasing the risk of urinary stone formation.
Therefore, it is no surprise that Messi suffered from kidney stones. In the football world, except for Messi, the football king Pele and Maradona are all patients with kidney stones, including "Cauliva" Villa, and even former Liverpool coach Benitez, who have been troubled by kidney stones. (In addition to football players, long-distance runners are also a severely affected area for kidney stones. Foreign studies have pointed out that only about 8% of marathon athletes do not have urinary stones.)
Messi's kidney stone treatment will not exceed the standard
"Messi is a superstar, he is not short of money, he must be treated with the most advanced technology in the world today!" I believe many people will think so.
"Messi has the conditions to find the best experts and use the best method to treat it. However, even so, he has to receive treatment in accordance with the international stone diagnosis and treatment standards." Professor Chang Ligao said: "As a football superstar, Messi needs to deal with kidney stones as soon as possible to put it into the next game. But why don't ordinary people want to use the method with the least damage and the fastest recovery for treatment?"
Therefore, in general, patients with kidney stones who have kidney colic such as Messi, the process of receiving treatment is as follows:
Step 1: Emergency analgesia
For patients with acute stone attacks, pain relief is usually the most urgent medical measure. Because of acute stone attacks, almost no one can bear it - it hurts more than a woman having a baby. (So, Messi can't stand it, so he can only miss the game.)
Professor Chang Ligao said that pain relief is generally done by medication, and the main pain relief drugs include: diclofenac sodium, anti-inflammatory pain, ibuprofen, hydromorphone hydrochloride + atropine sulfate, mesamotto, pentazocin, tramadol, etc.In contrast, the anesthetic analgesic diclofenac sodium has better effect and fewer side effects.
Step 2: Confirm the condition, preoperative evaluation
After emergency pain relief, you will undergo a comprehensive examination to confirm the location and size of the kidney stones, etc., to see if there is any urinary tract obstruction, whether there is hydronephrosis, and whether it has an impact on kidney function.
Currently, there are three ways to perform imaging examinations on urinary stones:
1. Generally, abdominal flat film (KUB) combined ultrasound examination (US). This method can diagnose most urinary stones.
2. Exhaustive urography (IVU) can be used.
3. Non-enhanced helical CT can also be used, which is fast and does not require contrast agent.
In addition to imaging examinations, relevant biochemical examinations are also required to confirm whether there is urinary tract infection, coagulation function abnormalities, etc., and conduct preoperative evaluation.
Step 3: Select the treatment plan
After confirming the location, size and other conditions of the Messi stone, you can choose the treatment plan based on this.
There are many treatment methods for kidney stones, including self-sorption, drug stone discharge, external shock wave (ESWL), ureteroscopic lithotripsy (fiber soft ureteroscopic lithotripsy), percutaneous kidney lithotripsy lithotripsy, open surgical lithotripsy, etc.
After inspection, if Messi's stone diameter is confirmed to be ≤4 mm, the chance of self-discharge can be as high as 80%; if ≥7 mm, the possibility of self-discharge will be quite low, and gravel or stone removal treatment is required.
so many treatment options? How should Messi choose?
"It depends on the characteristics of Messi's stones and the advantages and disadvantages of various treatment methods." Due to the lack of relevant information on Messi's kidney stones, Professor Chang Ligao compared the mainstream treatment methods currently underway in the world:
External shock wave lithotripsy (ESWL)
--This method is the first choice for kidney stones with a diameter of ≤20 mm or a surface area of ≤300 mm.
Advantages: ESWL has small trauma, few complications, no anesthesia required, etc.
Disadvantages: requires multiple treatments for relatively strong stones, prone to residual stone fragments, slow stone discharge time, and multiple implementations can damage kidney function. If multiple external lithotripsy failures are successful, other methods must be taken to retrieve the stone. Clinically, it is recommended that the number of gravels should not exceed 3 times.
Percutaneous nephroscopic lithography (PNL)
—commonly known as hole drilling and stone extraction.
Advantages: can quickly and effectively graft the stone, suitable for almost all urinary stones, including most ESWL and upper urinary tract stones that are difficult to deal with when ESWL is difficult to deal with when open surgery; high success rate and few complications;
Disadvantages: has a high risk of puncture and has high requirements for doctor experience and technology; although it is minimally invasive, wounds still need to be left on the surface of the human body.
ureteroscopy lithotripsy
—including ureteric hard lens and soft lens (fibrous soft ureteroscopy is better than). It can enter the gravel and collect stones through the natural cavity of the human body (urethra → bladder → ureter → kidney).
Advantages: fast and effective stone grafting; suitable for kidney stones less than 2CM, stones that cannot be treated with ESWL and difficult to puncture channel of PNL; no trauma on the body surface, less damage to the human body;
Disadvantages: is relatively rare compared to other methods.
Open surgery
——Opening the stomach and taking stones. With the increasing popularity of percutaneous nephroscopy and fibrous soft ureteroscopy lithotripsy, the use of open surgery is decreasing and is gradually becoming marginalized.
Advantages: has a wide range of adaptations, including stones that cannot undergo ESWL, PNL, and URS.
Disadvantages: has high risk, great pain, slow recovery, and has great damage to the human body.
lysate and litholysis treatment
- Dissolving stones through chemical methods, or drug-based methods to expand the ureter and diuretic effect, and expel stones or stone fragments from the body are effective auxiliary treatment methods. They are often used as auxiliary treatment for external shock wave lithotripsy, percutaneous nephroscopic lithotripsy, ureteroscopic lithotripsy and open surgery lithotripsy.
Experts inferred:
Messi must have received extracorporeal shock wave gravel
Professor Chang Ligao speculated that the media had never heard of Messi having kidney stones before, so he had renal colic this time, which should be the first time he was diagnosed, and the doctor should choose extracorporeal shock wave gravel for him.
PS: On December 19, news came from the media that doctors had removed the kidney stones from Messi's body. Media reports said that the Barcelona team doctor suggested that Messi wait for another 24 hours to observe his body's reaction. So far, all reports have not pointed out the treatment Messi has received.
Based on this, Professor Chang Ligao inferred that Messi should have taken the extracorporeal shock wave gravel this time.
However, Messi should not be happy too early!
"Messi was born in 1987 and is only 28 years old this year. According to the career of a football player, he will serve for many years, and the chance of recurrence of kidney stones will be very high." Professor Chang Ligao said that the recurrence rate of kidney stones itself is very high, and Messi's professional characteristics of working as a football player will not change, so his chance of recurrence of kidney stones will definitely be very high.
Since multiple use of external shock wave lithotripsy can affect kidney function, if Messi relapses in the future, he should adopt fibrous soft ureteroscopic lithotripsy for treatment.
After reading the popular science of Xiaokang Girl today, have you gained a deeper understanding of how to "gravel"?~
