Non Surgical Treatment for Urinary Stones at the World Class Hospital in India

Kidney stones are also known as calculi (plural), or calculus (singular). When it is in the kidney, it is a renal calculus. The tube draining the kidney to the bladder is the ureter, and a stone in the ureter is a ureteral calculus. It is estimated that 20% of us will have a kidney stone in our lifetime. Of those who get a stone, 50% will recur. Passing a stone is usually very painful. However, many patients can pass a stone with only a “muscle ache” sensation in the back, and they may not be aware the pain was from a stone until it “pops out.”

When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (tube that carries urine from the kidney to the bladder) and cause severe pain that starts from the low back and radiates to the side or groin.

A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm causing severe pain.

Non-Surgical Treatment for Urinary Stones in India

Percutaneous Nephrolithotomy (PCNL)

Percutaneous Nephrolithotomy (PCNL) is a procedure to remove medium-sized or large stones from the kidney by means of a nephroscope passed into the kidney through a small puncture created in the patient’s back. A nephroscope uses an ultrasonic or laser probe to break up large kidney stones and suction it out. This procedure is usually done under general anaesthesia or spinal anaesthesia.

Extracorporeal shock wave lithotripsy (ESWL)

Extracorporeal Shock wave lithotripsy uses shock waves to break stone smaller than 2 cm into small fragments that can more easily flushed out of the urinary tract and pass out from the body.

After identification of the position of the stone with X-ray or ultrasound, shockwaves are applied to fragment the stones. ESWL treatment can be used to treat urinary stones in the kidney and ureter (urine pipe that brings urine from kidney to bladder).

Ureteroscopy (URS)

Renal stones that do not respond to lithotripsy (ESWL), that are very hard or located in areas where ESWL does not work well can be treated by flexible ureteroscopy. Many men and women who have contraindication to ESWL or for whom ESWL is unlikely to work (such as morbid obesity) may do well with ureteroscopy. Ureteroscopy is also effective for larger stones. Ureteroscopy is a procedure typically performed under general or spinal anesthesia. An endoscope (small camera) is inserted through the urethra without making an incision. The stone is then located, broken to pieces with Holmium laser and fragments can be pulled out using a special “basket”. There are two types of ureteroscopes: flexible ureteroscope is used for kidney and upper ureteral stones. Semirigid ureteroscope is used for lower ureteral stones.

Holmium Laser:

During the procedure, holmium laser is used to break up the stones in the kidney, ureter or bladder through a small endoscopic camera. A small scope (ureteroscope) is passed through the urethra into the bladder, and from there up into the ureter to reach stones in the ureter and the kidneys. Once the stones are located, they are targeted with a laser that breaks the stone into smaller pieces, which are then extracted, or into tiny pieces of dust that wash out from the kidney with normal urine flow. Most commonly Holmium laser is used to break up kidney stones as well as ureteral stones. Bladder stones can also be broken with holmium laser.

Signs & Symptoms of Kidney Stones

  • Blood in the Urine.
  • Increased Frequency of Urination.
  • Nausea and Vomiting.
  • Pain and Burning during Urination.
  • Fever, Chills, Loss of Appetite.
  • Urinary Tract Infection.

How are kidney stones diagnosed?

Sometimes “silent” stones — those that do not cause symptoms — are found on x-rays taken during a general health exam. If the stones are small, they will often pass out of the body unnoticed. Often, kidney stones are found on an x-ray or ultrasound taken of someone who complains of blood in the urine or sudden pain. These diagnostic images give the doctor valuable information about the stone’s size and location. Blood and urine tests help detect any abnormal substance that might promote stone formation.

The doctor may decide to scan the urinary system using a special test called a computerized tomography (CT) scan or an intravenous pyelogram (IVP). The results of all these tests help determine the proper treatment.

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