With respect to Division of Stone Disease, we provide treatment for stones in the kidney, the urinary bladder and elsewhere in the urinary tract.
Urinary stones occur in all parts of the urinary system. 97% of all urinary stones are located in the kidney and the ureter. Only 3% are found in the bladder and the urethra.
The following points describe the characteristics of stones:
The common symptoms of urinary stone formation are:
Laboratory Tests :
Initial treatment will focus upon the relief of pain. After this, the next step will be to facilitate the passage of the stone or the removal of the stone itself.
80-90% of all stones smaller than 5 mm will pass out on their own. If the stone is smooth, even stones of 7-8 mm may pass out on their own.
Stones larger than this will invariably need to be removed by one of the many methods available. If there is an anatomical abnormality, the priority will be to correct that abnormality while removing the stone.
ESWL (Lithotripsy) :
1-2 cm solitary stones in the kidney can preferably be treated by ESWL. uses highly focused electro magnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone is reduced to sand-like particles that can pass in the urine. Large stones may require more than one sessions. It can be used for patients of all age groups and those who have heart and breathing problems.
Larger stones in the kidney are preferably removed by PCNL. In this method, the patient needs to be admitted to the hospital. A small puncture is made from the back directly into the kidney, the stone is identified, fragmented and completely removed. Stones lower down in the urinary tract may be treated either by ESWL or again, by endoscopic methods, viz URS. In this, the stone is visualised and fragmented by passing a small endoscope through the urinary opening.
Illustration Showing How PCNL is Performed
Generally, an incision, that is 1 cm or less than 1 cm, is made in the flank. A guide wire is passed through this incision into the kidney. This is performed under fluoroscopy or x-ray control.
A passage is then created around this guide wire by dilatation. Through this passage, a nephroscope is passed into the kidney to visualise the stone and remove it. Larger stones can be fragmented by different methods and removed. Stones are therefore cleared easily. Once the procedure is complete, a tube is left through this tract as drainage for one or two days.
The main advantage of this approach is that, unlike traditional open surgery, only a 1 cm incision is made in the flank. The stones can be visualised directly and removed. The stay in the hospital is only for 3-4 days.
Most patients with urinary stones need to make certain minimal changes in their diet that may help in the prevention of a recurrence. These include:
Separate and specific changes in the diet may be suggested in the case of other conditions associated with urinary stones.
Patients who are suspected to have other metabolic or endocrine problems will need to undergo detailed testing. These are generally reserved for those patients who have recurrent stone formation.
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