What is Urinary Stone Disease (Urolithiasis)?
In our country, urinary tract stone disease (urolithiasis) is seen frequently due to geographical, genetic and nutritional habits of our society. Approximately every ten people in one period of his life stone occurs. Men form stones 3 times more often than women. This difference is now decreasing due to changes in lifestyle and diet. Stone disease is frequently seen between 30 and 50 years of age, and it is seen even in newborn babies or 80s.
How is the stone formed?
As a result of the imbalance in the excretion and retention of electrolytes in urine, stone crystals are formed first. There may be an underlying genetic disease, metabolic or hormonal disorder, urinary tract drainage or congenital abnormality in some stone types. The stones that develop in the kidneys can stay there or move to the urethra (ureter).
What are symptoms of urolithiasis cause ?
The patient can feel the severe pain known as renal colic due to blockage of the urinary tract. This is a sharp pain that feels in your area, the waist and the flank (both sides of the body, from the lower part of the ribs to the hips). If the stone is not in the kidney, but in ureter, pain is felt in the groin and thigh region. Renal colitis can be accompanied by nausea, vomiting, bloody urine, painful urine, and fever.
How to Diagnose?
In patients presenting with renal colic, ultrasound, x-ray or tomography, presence of stones, obstruction, and degree and level of obstruction are investigated.
How are Emergency Situations Treated?
Many patients presenting with renal colic to the emergency department receive pain relief treatment. In patients with small size ureter or kidney stones with imaging methods, urinary tract obstruction is expected to decrease spontaneously if there is no obstruction. During this time, your doctor will give you some advice to make you easy to remove the stone. For this purpose, a stent can be inserted into your urethra or directly into your kidney. In most cases, congestion may be accompanied by infection.
How do you move your stone out of your body?
In the treatment of stones that lead to the symptoms, three methods are generally preferred:
Shock waves stone break (ESWL), Ureteroscopy (URS), Percutaneous nephrolithotomy (PNL).
Stone breakage with shock waves (ESWL): • SWL is made with a machine that breaks stones from outside the body • Focused shock waves (high-energy high-energy sound waves with short signals) are transferred from the skin to the stone to break the stone • The stone absorbs the energy of the shock waves and thus separates it into small pieces • The stone particles are then removed in the urine in the following days or weeks.
Ureteroscopic Lithotripsy (URS)
Under anesthesia is done without making any incision in the body with the help of a small diameter endoscope. With this endoscope, the urinary tract to the bladder (urinary bladder) from there to the urinary canal (ureter) and kidney until the stone breaks out. In the kidney and upper ureteral stones, the stones are powdered using laser, especially flexible URS.
Percutaneous Nephrolithotomy (PNL)
The removal of kidney stones through a tube placed from the back to the kidney under anesthesia is taken out. It is especially preferred for larger stones. Nowadays, the risks of percutaneous nephrolithotomy are minimized by using smaller diameter instruments. Less damage to kidney tissue has been shown by using mini or ultraminium PNL. All these techniques are applied successfully in our hospital.
This method, which has been popular in recent years, involves the same procedures as the standard PNL, but allows for the study of a miniature nephroscope and more miniature instruments. It has been reported that it has almost the same success rates in renal stones as 1-2.5 cm. However, it is not preferred because it increases the rate of complications as it prolongs the duration of the procedure in larger stones. Because of the shorter recovery time compared to standard PNL, it is considered to be a more preferred method of kidney stone treatment.