Crushing Kidney Stones - Is There A Safe Method?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Crushing kidney stones with ultrasound and laser

How are kidney stones crushed by ultrasound?

Indications for the use of the procedure are the presence of large formations. During crushing, high-intensity ultrasonic beams break the stone into small pieces. If these fragments get into the ureter, pelvis, renal calyx, an exacerbation of the inflammatory process in the kidneys is possible. If there is a history of inflammatory diseases of the urinary system, such as pyelonephritis, glomerulonephritis, the stone crushing procedure can exacerbate these pathologies.

The sequence of ultrasound lithotripsy:

• Clarification of the localization of the stone in the ureter or in the kidney using diagnostic equipment.
• Installation of an ultrasonic sensor in the projection of the stone localization.
• Exposure to calculus with high-intensity ultrasonic beams for 10-15 minutes.
• Removal of small fragments of calculus from the kidney using a nephroscope.

If intravenous urography reveals that renal excretion is normal and urine is circulating without blockage, the last step is skipped. The patient can be discharged from the hospital in 3-4 days.

Indications. In case of urolithiasis, ultrasound is used in the presence of stones up to 1-2 cm in size. The procedure for crushing stones with ultrasound should be carried out exclusively in stationary conditions to avoid the risk of complications. One of these complications is bleeding from the urinary tract. If you carry out crushing with ultrasound at home, as practiced by private clinics, there is a danger of death due to the lack of resuscitation equipment at the doctor.

Types of kidney stones crushing:

• Extracorporeal lithotripsy - stone removal lasts up to 40 minutes, during this procedure, a shock wave is directed to a specific point of the calculus, the size of which can reach 35 mm. When the maximum threshold of shock wave energy is formed, the stone breaks down into separate fragments. The force of application of shock waves depends on the size and structure of the formation. When extracorporeal lithotripsy is performed without complications, the patient is discharged the next day after the procedure. This type of lithotripsy is prescribed for cardiac pathologies, stones in the bladder and increased blood clotting.
• Remote lithotripsy - the removal of calculus occurs under the influence of an acoustic wave, which is focused at a certain point, while soft tissues are not damaged. The procedure is successful when the doctor accurately determines the location of the stone, and the distance to the source of the waves.
• Contact lithotripsy - with this method, ultrasound acts at the point of contact of the stone with the urinary tract. The resulting fragments are removed after lithotripsy using a urethroscope or nephroscope. It is possible to install a stent into the ureter, for removal of which the patient returns to the hospital a week after the procedure. This method is 80-100% effective, has a minimum of complications and the ability to remove several stones at the same time.

Preparing to crush stones with ultrasound, the patient takes blood and urine tests, and undergoes an examination of the kidneys and urinary tract using echoscopy.

Two weeks after lithotripsy, intravenous urography is performed - an X-ray with contrast injected into the radial vein. With this method of X-ray examination, the contrast fills the renal-pelvic system, helps to determine whether a stone remains in the kidney, the presence or absence of a blockade of urine flow.

Contraindications to the procedure are high or low height, weight over 130 kg. Statistics show that such patients have more complications than others.

Consequences of the procedure

During the day, patients are in the hospital undergoing rehabilitation treatment. Preparations:

• Antibacterial agents;
• Antispasmodics;
• ? -adrenergic blockers;
• Non-steroidal anti-inflammatory drugs;
• Diuretic teas.

Advice: for the quick and painless removal of stone fragments and the prevention of complications, the doctor's prescriptions, dosage and frequency of medication should be followed exactly.

Possible symptoms after lithotripsy:

• An admixture of blood in the urine;
• Renal colic;
• Pain when urinating;
• The appearance of small stones in the urine;
• Frequent urination
• Hyperthermia.

The advantages of ultrasound lithotripsy are stable positive results, a minimum of complications, and quick rehabilitation. However, stones larger than 2 cm cannot be destroyed in this way. With a high density of stones, several sessions are required, the removal of small sharp fragments can cause severe pain. The remaining fragments provoke the formation of new stones.

There is a risk of blockage of the urinary tract by large fragments. To remove them, it may be necessary to insert a special loop through the urethra.

Contraindications:

• Bone abnormalities;
• Pregnancy;
• Pathology of the cardiovascular system;
• Pregnancy;
• Oncological processes;
• Decreased blood platelet count;
• Aortic aneurysm;
• Infectious diseases;
• The kidney cyst is large.

Even such a modern method as lithotripsy does not guarantee the absence of complications. They are extremely rare, but patients should be aware of this possibility.

Complications:

• Development of pyelonephritis or complication of an existing disease;
• Formation of hematoma in the kidney;
• The formation of a residual stone path, provoking a recurrence of urolithiasis.

Content:

• How to remove stones from the kidneys with a laser?
• Preparing for the stone crushing procedure
• Conservative methods for removing kidney stones
• Is there a safe folk remedy?
• Preventive measures

How to remove stones from the kidneys with a laser?

This modern technique of exposure to a directed light beam on stones in the urinary system appeared quite recently. For the most part, it is used by private urology clinics or medical centers. The technique is not sufficiently developed and may have complications.

Procedure for the procedure:

• An endoscope is inserted through the urinary canal and ureter;
• After placing it near the stone, laser destruction begins;
• In 10-15 minutes moisture evaporates from the conglomerate.

Pros of laser crushing:

• There is no pain and bleeding;
• It is possible to remove stones of a complex composition even from the pelvic organs;
• It is enough to carry out one session of laser therapy;
• The minimum number of fragments is formed.

Lithotripsy using this technique is performed with a holmium laser, which evaporates water from the conglomerate with a concentrated light flux. The laser beam does not penetrate deeper than 5 mm deep into the tissues, does not damage them. The procedure is performed under the guidance of an endoscope to help monitor the accuracy of lithotripsy.

Preparation for laser destruction of stones consists in the prophylactic intake of antibiotics and the selection of anesthesia corresponding to the age and state of health of the patient.

Preparing for the stone crushing procedure

Before removing kidney stones, the patient undergoes examination using laboratory and instrumental methods:

• General blood analysis;
• Blood sugar test;
• Wasserman blood test;
• Fluorography;
• CT scan;
• Excretory urography;
• Electrocardiography.

So that gases and feces in the intestine do not interfere with the passage of ultrasound or laser waves, the gastrointestinal tract is cleaned with an enema or cleansing drugs (Espumisan, Fortrans). With a thorough examination and preparation, in 60% of patients, the procedure is successful the first time, in another 25%, conglomerates are removed after a second procedure. Stones up to 1 cm in diameter are removed successfully in 100% of cases.

Conservative methods for removing kidney stones

To prevent kidney stones from increasing in size, you need to drink at least one and a half liters of water or any other liquid per day. This tactic reduces the concentration of urine and reduces the nuclei of crystallization in it. Renal failure leads to an increase in the amount of toxins in the blood serum. Drinking plenty of fluids reduces the concentration of toxic substances.

Purified water, cranberry or lingonberry juice are suitable as drinks. Compote from dried fruits and apples is less effective.

Diet is of great importance:

• Whole grains to cleanse the intestines;
• Vegetables and fruits as a source of fluid and fiber;
• Oranges, grapefruits, tomatoes, as a source of vitamin C;
• Ascorbic acid for dissolving calcium stones.

For the accelerated elimination of urine from the bladder and kidneys, to reduce its concentration, you need to engage in physiotherapy exercises.

Is there a safe folk remedy?

Every morning, within 15 minutes after getting up, you need to drink honey water. Crystals of honey settle on kidney stones and gently dissolve them. You need to prepare water at the rate of 2 teaspoons of honey per glass of water.

This method is considered the safest in traditional medicine, since with such a dissolution the stones will not move, which cannot be said about diuretic herbs and other means. But you need to use hearth for 1-6 months, depending on the size of the stones.

Preventive measures

In order to prevent the formation of stones and sand in the kidneys, manifesting themselves as back pain and complicated by renal failure, preventive measures must be taken:

• Avoid a sedentary lifestyle;
• Walk for at least an hour in the fresh air, constantly increasing the distance and duration of walks;
• Measure the number of steps taken per day with a pedometer;
• Get rid of excess weight, bad habits.

When the duration of the walk reaches 1.5 hours a day, the first positive results will appear. To stimulate interest, you can create new routes for yourself, looking at natural objects. It is useful to do light jogging in sports equipment.

Positive results will be brought about by a positive attitude towards life. To consolidate a positive result, preventive measures must be applied for many years.

Author of the article: Lebedev Andrey Sergeevich | Urologist

Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.