In patients with nephrolithiasis, patients are often prescribed laser crushing of stones. What is this technique, specificity and effectiveness of the method.
Kidney stone fragmentation by laser
Lithotripsy - this is the name for the laser crushing of kidney stones. This technique combines endoscopy and laser therapy of kidney stones.
The procedure for laser crushing of kidney stones has many advantages:
- Does not need anesthesia;
- Practically painless;
- Minimal probability of recurrence or formation of a new stone in the kidney tissues;
- No scarring;
- Improvement of the urinary flow, relief of inflammation, elimination of pain syndrome;
- Ability to eliminate stones that have an ambiguous and complex origin;
- Achieving results in one procedure;
- Minimal probability of damage to neighboring structures and the formation of fragment fragments;
- Highest efficiency in comparison with other techniques;
- Ability to get rid of stones of any size: from negligible to large.
In this case, the instruments are brought to the concrement, through which the destructive effect is carried out.
Indications
Lithotripsy is performed if the patient has such indications:
- Unsupervised renal colic, often recurrent and not amenable to elimination, provided that the presence of the calcane is diagnosed;
- Concrements( up to 2 cm) of any variety located directly in the kidney, urinary bladder, ureter, which do not have the ability to exit by themselves due to their large size.
The video on the procedure for stone crushing with laser:
Preparation of
The laser removal procedure requires careful preparation, which includes the following diagnostic procedures:
- A laboratory blood glucose test;
- Fluorography;
- Excretory urography;
- CT;
- ECG;
- Blood test for syphilis( Wasserman reaction);
- General study of blood composition.
Preparing for surgery is critical, because the outcome of treatment depends on the patient's condition. If an infectious-inflammatory lesion is detected, the patient is prescribed appropriate therapy with anti-inflammatory and antibacterial drugs, only then can proceed with lithotripsy.
Procedure
The essence of laser removal of calculi from the kidneys is as follows:
- An endoscope is inserted through the urethra and ureter;
- When the device reaches the stone, turn on the laser;
- Then, under laser action, all the liquid is evaporated from the stone, which leads to its destruction;
- The calculus scattered on sand leaves the kidneys in a natural way.
Due to the point effect, evaporation occurs only within the stone, without affecting adjacent tissues. The depth of laser penetration is a maximum of half a centimeter.
The entire process takes 0.5-1 hour. The operation is performed under endoscopic control, which allows you to follow each stage of the process and excludes the impact on nearby tissues. To avoid complications, the patient is prescribed antibiotic therapy before the procedure.
In the first days after crushing, frequent urination may be disturbing, which is considered the norm. In urine there may be bloody patches arising from the natural release of residual elements of the stones. Approximately in 3 days similar symptomatology disappears without any treatment.
The video procedure for laser crushing of stones:
Contraindications
Laser lithotripsy has a number of contraindications:
- The presence of acute inflammation of the prostate;Purulent pyelonephritis / pionephrosis / renal carbuncle / acute abscess;
- Severe organo-general state of the patient;
- Acute forms of inflammatory pathologies in other organs;
- Pregnancy;
- Having a heart rate driver;
- Coral stones;
- Aortic aneurysm;
- Extensive renal cyst;
- Blood flow disorders;
- Bone Marrow Anomalies;
- of Oncology.
In addition to the obvious contraindications, it is impossible not to clarify the possible consequences of the operation. In the first day after the procedure, the patient can feel renal colic and anuria, hematuria and stone paths. Sometimes there are hematomas and inflammations in the kidney structures.
Reviews
Most patients who have undergone laser lithotripsy, note the painlessness and minimally invasive operation. In one session, you can forget about the problems associated with kidney stone disease. But there is also a negative evaluation of such treatment, which is associated with the high cost of the procedure.
Doctors unequivocally confirm the advantage of laser lithotripsy over traditional methods of treatment. After all, this method of treatment of renal stone pathology is characterized by minimal traumatic and postoperative consequences.