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Ureteroscopy Tips

Best Ways To Treat Kidney Stones!

Dr. D.K. Agarwal 92% (206 ratings)
MBBS, MD - General Medicine, DM - Nephrology, DNB (Nephrology)
Nephrologist, Faridabad
Best Ways To Treat Kidney Stones!

Kidney stones are often small enough and pass through urine without much bother. Most kidney stones are smaller than 4 mm in diameter. Having said this, even the smallest of kidney stones can be really painful until they pass through urine (learn more what Urine Says about Your Health). It typically takes a couple of days for the body to get rid of it. While medication and self-care are the foremost options, there are a range of other options as well available for treating kidney stones.

Admission to a Hospital

You must get admitted to a hospital if the stone moves to the ureter, thereby resulting in severe pain. Typically kidney stones which are more than 6 mms in diameter need to be surgically removed through procedures such as ureteroscopy, percutaneous nephrolithotomy (PCNL), open surgery and extracorporeal shock wave lithotripsy (ESWL). A doctor takes a call on any of the above procedure if:

1. The patient is inching towards a kidney failure.

2. The pain doesn’t go away even after taking pain killers.

3. If the patient is pregnant (learn more about for healthy pregnancy)

4. If the patient is more than 60 years.

Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL is one of the simple and most preferred stone removing procedures. It involves the usage of ultrasound shock waves to break the bigger stones into smaller ones. The latter is then passed through urine. A patient is given a few painkillers since this mode of treatment could be a little uncomfortable. A patient might need multiple ESWLs to successfully get rid of all the stones.

Ureteroscopy

If a stone gets stuck in the ureter, a medical procedure known as the ureteroscopy is performed. In this procedure, a thin telescope is passed through the urethra and bladder to the ureter. Either a second instrument is used or the telescope itself has laser energy to break the bigger stone into smaller ones.

Percutaneous Nephrolithotomy (PCNL)

PCNL is an alternative to ESWL for removing big stones. This procedure involves the usage of nephroscope that is routed into the kidney through a small incision made behind the back of the patient. This procedure requires general anesthesia and is effective for breaking stones that have a diameter of 20 mm or more. It has a success rate of 86%.

Open Surgery

This is one of the older methods to eradicate kidney stones. Unless the stone size is abnormally large and other procedures cannot be performed, open surgery is generally avoided. An open surgery involves making an incision and getting access to the ureter and the kidney. The surgeon then removes the stone from the kidney. This procedure requires general anesthesia. If you wish to discuss about any specific problem, you can consult a nephrologist.

1833 people found this helpful

Kidney Stones: Best Way To Treat It

Dr. Gireesh Reddy 89% (60 ratings)
Interventional Nephrology, DM - Nephrology, MD - General Medicine, MBBS
Nephrologist, Bangalore
Kidney Stones: Best Way To Treat It

Kidney stones are often small enough and pass through urine without much bother. Most kidney stones are smaller than 4 mm in diameter. Having said this, even the smallest of kidney stones can be really painful until they pass through urine (learn more what Urine Says About Your Health). It typically takes a couple of days for the body to get rid of it. While medication and self-care are the foremost options, there are a range of other options as well available for treating kidney stones.

Admission to a Hospital-

You must get admitted to a hospital if the stone moves to the ureter, thereby resulting in severe pain. Typically kidney stones which are more than 6 mms in diameter need to be surgically removed through procedures such as ureteroscopy, percutaneous nephrolithotomy (PCNL), open surgery and extracorporeal shock wave lithotripsy (ESWL). A doctor takes a call on any of the above procedure if:

  1. The patient is inching towards a kidney failure.

  2. The pain doesn’t go away even after taking pain killers.

  3. If the patient is pregnant (learn more about for healthy pregnancy)

  4. If the patient is more than 60 years.

Extracorporeal Shock Wave Lithotripsy (ESWL)-

ESWL is one of the simple and most preferred stone removing procedures. It involves the usage of ultrasound shock waves to break the bigger stones into smaller ones. The latter is then passed through urine. A patient is given a few painkillers since this mode of treatment could be a little uncomfortable. A patient might need multiple ESWLs to successfully get rid of all the stones.

Ureteroscopy:

If a stone gets stuck in the ureter, a medical procedure known as the ureteroscopy is performed. In this procedure, a thin telescope is passed through the urethra and bladder to the ureter. Either a second instrument is used or the telescope itself has laser energy to break the bigger stone into smaller ones. This procedure is ideal for stones that have a diameter more than 15 mm.

Percutaneous Nephrolithotomy (PCNL)

PCNL is an alternative to ESWL for removing big stones. This procedure involves the usage of nephroscope that is routed into the kidney through a small incision made behind the back of the patient. This procedure requires general anesthesia and is effective for breaking stones that have a diameter of 20 mm or more. It has a success rate of 86%.

Open Surgery:

This is one of the older methods to eradicate kidney stones. Unless the stone size is abnormally large and other procedures cannot be performed, open surgery is generally avoided. An open surgery involves making an incision and getting access to the ureter and the kidney. The surgeon then removes the stone from the kidney. This procedure requires general anesthesia and the patient needs to be under observation for at least 24 hours, post surgery.

3165 people found this helpful

Kidney Stones - 5 Ways To Treat It!

Dr. Ashok Sarin 90% (42 ratings)
MD, MBBS, FRCP - Nephrology
Nephrologist, Delhi
Kidney Stones - 5 Ways To Treat It!

Kidney stones are also known as renal calculi and can be found not only in the kidneys but anywhere in the urinary tract such as the ureters, urinary bladder and the urethra. Kidney stones are solid masses of crystals or minerals and salts. These crystals can vary according to size and even shape. The stones are formed when the waste salts and minerals in the urine accumulate and form a solid mass. They get stuck in the urinary tract and result in a very painful condition. Kidney stones normally do not create too much problem unless they get blocked in the passage of urine. Treatment options depend upon the size of the stone. Small calculi pass easily through urine by consuming plenty of water. Larger stones require treatment; whether it is only medication or surgery depends on the severity of the condition.

Following are 5 ways to treat kidney stones:

  1. Medication: Medication is used to relieve pain and also help in easy passage of the stones. Medication using alpha adrenergic blockers and calcium channel blockers are normally prescribed as they provide faster clearance rates for the stones. But medication is effective only for stones that have diameters ranging from 4mm to 10mm. Medication using anti-emetic drugs is useful against nausea caused due to kidney stones.
  2. Open surgery: Kidney stone removal by open surgery is not very common and is recommended only when the stone is very large or there is any abnormality in anatomy. By open surgery the stone is removed from the ureter or the kidney, wherever it gets stuck.
  3. Ureteroscopy: Ureteroscopy is done to remove stones stuck in the ureter. In this procedure, a thin tube is passed from the urethra into the urinary bladder and then into the ureter near the stone which is stuck. The stone is removed either using a laser energy or by another instrument. The procedure is done while the patient is under general anaesthesia. Sometimes a temporary plastic tube may be inserted into the ureter to drain out the stone fragments (as done by laser energy) into the bladder.
  4. Percutaneous nephrolithotomy (PCNL): PCNL is a procedure wherein larger stones are plucked out from anywhere in the kidney where they are stuck with the help of an instrument called nephroscope. The larger sized stones are first broken down using pneumatic or laser energy and then pulled out using the telescopic instrument.
  5. Home remedies: The first step towards naturally flushing out small stones from the kidneys is drinking plenty of water. At least 10-12 glasses of water must be consumed every day to flush out the stones. Other natural remedies for flushing stones out of the system are lemon juice squeezed in water, basil juice mixed in tea, apple cider vinegar stirred in water, pomegranate juice, kidney bean broth etc.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2637 people found this helpful

Surgical Management of Kidney Stones

Dr. Anil Agarwal 90% (159 ratings)
MBBS, MS - Urology, DNB
Urologist, Guwahati
Surgical Management of Kidney Stones

Kidney stones are not exactly stones, but hard deposits that are composed of minerals such as calcium or uric acid. These deposits start accumulating and over time enlarge to form obstructions within the urinary tract. Most kidney stones pass out on their own with little or no medication required, but in some cases, they have to be taken out through surgery. Let us now look at the surgery options available for the removal of kidney stones and why they are needed.

Need for surgery:
You might have to opt for a surgical procedure if you are in a lot of pain and if the stone is very large and cannot pass out on its own. Surgery will also be advised if the stone blocks the urinary tract hampering the free flow of urine. There are four types of surgical procedures that can be done for kidney stones.

  1. Shockwave lithotripsy
  2. Ureteroscopy
  3. Percutaneous nephrolithotomy
  4. Open surgery

Shock Wave Lithotripsy
This is the most common procedure that is performed for the removal of a kidney stone. It works best for small or medium stones. It is noninvasive - there are no cuts or scars made in your skin. In this procedure, the doctor after identifying the exact location of the stone sends out shock waves aimed at your kidneys. This dislodges the stone and breaks it into small pieces. This is a painless procedure, and no hospitalization is needed. You might have blood in the urine for a few days after the procedure, but it is considered normal and heals on its own. Check with your doctor in case you experience any complications

Ureteroscopy
This procedure is recommended to treat stones in the kidneys and ureters. A thin, flexible scope is used to find and remove the stones. There are no cuts made, and you will be under anesthesia throughout the procedure. A thin scope is passed through your bladder and ureter to reach the kidney. Once the exact location of the stone is reached, the doctor uses a small basket to scoop out the stone. In case the stone is big, a laser is used to break the stones. This is procedure too does not require a hospital stay. Recovery time is short and you can get back to normal activities soon.


Percutaneous Nephrolithotomy or Percutaneous Nephrolithotripsy
This procedure is done when you have a large size stone and the other methods do not work. In this procedure, a small cut is made in the back, and a thin tube is inserted to reach the stone. Once it reaches the stone, high-frequency sound waves are used to break the stone. You will be under anesthesia throughout the procedure. This can be considered as the most successful types of procedure and is routinely used to remove large stones. Recovery time is short but a short stay in hospital of about a day will be required.

Open surgery
This procedure is rarely done nowadays as it involves the traditional method of surgery. However in some rare cases, when your stone is very large, and the other methods are not an option this approach is used. Hospitalization is required for this procedure and the recovery period usually takes between 4 to 6 weeks. In case you have a concern or query you can always consult an expert & get answers to your questions!

2773 people found this helpful

Urinary Stone Disease - How Treatment Vary According to Symptoms?

Dr. Mandeep Phukan 90% (56 ratings)
M.Ch - Urology/Genito-Urinary Surgery
Urologist, Guwahati
Urinary Stone Disease - How Treatment Vary According to Symptoms?

The kidneys are the main excretory organs of the body and are responsible for removing all mineral wastes from the body. This high concentration of minerals predisposes them to form stones- which are small crystals of various minerals they are exposed to. The entire urinary tract starting from the kidneys, the ureters, and the bladder are at risk of developing stones. The risk is higher in people who do not drink enough water, as the minerals are not able to be cleared out.
 

Depending on the location, stones are named

  1. Renal: These are formed in the body of the kidneys.
  2. Ureteric: The urine passes from the kidney to the ureter through the ureters and can form stones, leading to blockage also
  3. Bladder: When the urine is stored in the bladder for a while, the chances of forming stones are quite high.

Symptoms

  • Pain that is sharp, shooting pain on either side of the spine.
  • There could be fever, vomiting, etc., but the pain is very indicative.

Management

  • Stones less than 4 mm usually pass on their own
  • Larger ones may require shock waves from an external source which breaks it into smaller ones, which are then eliminated.

Immediate treatment

  • Intravenous injections of pain relievers; repeat if required.
  • Antiemetics to control nausea and vomiting
  • Watch for an hour for improved symptoms
  • Send the patient home with these prescriptions for continued use
  • Increased amount of water consumption (up to 3 liters per day), until the urine is almost colorless
  • Strain the urine to check if the stone is passed, this is done.

If the patient presents with the following symptoms, immediate admission may be required:

  • Persisting symptoms after an hour of treatment
  • Pregnancy
  • Persistently high fever (about 104) with severe shakes and/or chills
  • People on dialysis and/or renal failure
  • Elderly (greater than 60 year olds)
  • Severe dehydration and/or vomiting

Larger kidney stones (>4 mm) are managed as below.

  • Extracorporeal shock wave lithotripsy (ESWL): This common treatment uses shock waves from an external source which breaks down the stones. The smaller ones easily pass through the urine.
  • Ureteroscopy: In ureteroscopy, a endoscope is passed through urethra to the ureters.
  • Open surgery: If the above measures are not feasible, open surgery may be the last option. This is very rarely used though.

Prevention of kidney stones

  • Drink adequate amounts of water, at least 2 liters per day
  • Cut down oxalate rich foods like beet, nuts, okra, spinach, etc.
  • Reduce sodium and animal protein
  • Continue calcium as always. If you wish to discuss about any specific problem, you can consult a Urologist.
2050 people found this helpful

4 Procedures To Treat Large Kidney Stones

Dr. Sarwar Eqbal 87% (15 ratings)
MBBS, MS - General Surgery, DNB - Urology
Urologist, Delhi
4 Procedures To Treat Large Kidney Stones

A kidney stone may not be as big as the stones in your garden but can be quite a pain. Kidney stones are actually mineral crystals formed that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
Not all kidney stones need to be treated with surgery. Of the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 
 Larger kidney stones may need you to be hospitalized for treatment. These are:

- Extracorporeal Shock Wave Lithotripsy (ESWL)

To begin this form of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed though the kidney stone to break it into smaller pieces. These can then be passed out of the body through urine.

- Ureteroscopy
This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 

- Percutaneous Nephrolithotomy (PCNL)
This surgery is performed under general anesthesia.  It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 

- Open Surgery
Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone. If you wish to discuss about any specific problem, you can consult a Urologist.

1753 people found this helpful

Large Kidney Stones - 5 Treatment Methods

Dr. Udai Singh 92% (492 ratings)
MBBS, MS - General Surgery, MCh - Urology
Urologist, Jaipur
Large Kidney Stones - 5 Treatment Methods

A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:

  • Extracorporeal shock wave lithotripsy (ESWL): To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
  • Ureteroscopy: This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
  • Percutaneous nephrolithotomy (PCNL): This surgery is performed under general anesthesia.  It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 
  • Open surgery: Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone.
  • Retrograde intrarenal surgery: In RIRS, the scope is placed through the urethra (the urinary opening) into the bladder and then through the ureter into the urine-collecting part of the kidney. The scope thus is moved retrograde (up the urinary tract system) to within the kidney (intrarenal). RIRS may be done to remove a stone. Consult an expert & get answers to your questions!
2017 people found this helpful

Suffering From Kidney Stones - Things You Can Do!

Dr. Saurabh 86% (10 ratings)
MCH-Urology
Urologist, Delhi
Suffering From Kidney Stones - Things You Can Do!

There is a rich concentration of minerals in the kidneys, and when there is no sufficient medium to clear it out, these can form small crystals within the urinary tract and can settle anywhere along the urinary tract. Stones can, therefore, be found in any part of the kidney and the ureters, which connect the kidney to the bladder.

The pain that is associated with kidney stones is very diagnostic. It includes a sharp shooting pain in the back of the abdomen, on either side of the spine. Kidney stones tend to be recurrent, and so patients who have had an episode would be able to tell when they have kidney stone pain.

When the size of the stone is less than 4 mm, it is usually passed through urine and eliminated from the system. However, if it is more than that, shock waves are used from an external source to break the bigger stones into smaller ones, which then get eliminated from the body through the kidneys on their own.

Ways to manage kidney stones
Immediate relief measures would include intravenous injections of pain relievers, which will help in getting rid of the pain. An additional shot may be required after a while for people suffering from severe pain. Also most people present with severe nausea and vomiting may require anti-emetics for the same. When being sent home, they may be given these medications to be continued at home.

Once you are home, the doctor may ask you to drink lots of water (up to 3 liters of water) and strain the urine to collect the stone as it is passed. The urine turning colourless is an indication that the water intake is adequate. If there is any colour in the urine, water intake should be increased.

Immediate admission to the hospital may be required in the following conditions:

  1. In people with one kidney where the stone has already come down to the ureter
  2. Pregnancy
  3. Persistently high fever of up to 104 with shaking and chills
  4. Elderly people, greater than 60 years of age
  5. Severe dehydration and vomiting
  6. No improvement of symptoms after an hour of treatment

Larger kidney stones would be removed by one of the following methods:

  1. Extracorporeal shock wave lithotripsy (ESWL): This is the most common mode of treatment, where shock waves are used to break down the stones into smaller segments, which are then passed out through the urine.
  2. Ureteroscopy: This involves passing a tube from the urethra all the way up to the bladder to retrieve the stone.

Open surgery in people where the above measures are not feasible. If you wish to discuss about any specific problem, you can ask a free question.

2848 people found this helpful

11 Most Common Types of Endoscopy!

Dr. Raj Vigna Venugopal 88% (14 ratings)
MBBS, MD - Internal Medicine , DM - Gastroenterology
Gastroenterologist, Bangalore
11 Most Common Types of Endoscopy!

A cut on your skin can be seen by the naked eye, but injuries and infections to internal organs are not so easily visible to the eye. The procedure to view and operate on the body’s internal organs is known as an endoscopy. An endoscopy is performed using a flexible tube with a camera attached at one end known as an endoscope. This is inserted into the body though a natural opening in the body such as the mouth or through a small incision on the body.

While the camera gives the doctor a view of the internal organs, forceps or a pair of scissors can be used to operate or remove tissue that needs to be biopsied. Since an endoscopy is performed without making large incisions, it negates the development of scarring.

Types of Endoscopies

Endoscopies can be used for both diagnostic and therapeutic purposes. It is also one of the means for early detection of cancer. There are 11 main types of endoscopies which include:

  1. Arthroscopy: This is used to get a closer look at joints. In such cases, the endoscope is inserted into a small incision near the joint being examined.
  2. Upper gastrointestinal endoscopy: Examining the esophagus and upper intestinal tract by inserting a scope through the mouth is known as an upper gastrointestinal endoscopy.
  3. Colonoscopy: In this procedure, a scope is inserted through the anus to get a view of the colon.
  4. Bronchoscopy: This procedure is used to examine a patient’s lungs. It involves the insertion of a scope into the nose or mouth to give a view of the lungs.
  5. Cystoscopy: When the bladder needs to be examined closely, an endoscope is inserted through the urethra. This is known as a cystoscopy.
  6. Enteroscopy: This is a procedure where the scope is inserted through the mouth or anus to get a look at the small intestines.
  7. Hysteroscopy: Here a scope is inserted through the vagina to get a look at the inside of the uterus.
  8. Laparoscopy: It is an endoscopy to examine the abdominal area is known as a laparoscopy. This scope is inserted through an incision in the abdomen.
  9. Laryngoscopy: This type of endoscopy involves inserting a scope through the mouth or nose to examine the voice box.
  10. Mediastinoscopy: By inserting a scope into an incision above the breastbone, doctors can get a look at the area between the lungs. This is known as a mediastinoscopy.
  11. Ureteroscopy: This procedure is used to examine the patient’s ureter by inserting a scope through the urethra.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3810 people found this helpful

How To Get Rid Of Kidney Stones?

Dr. Abhinav Agarwal 87% (56 ratings)
MBBS, M.S. (General Surgery), MBA (Healthcare), M.Ch - Urology/Genito-Urinary Surgery
Urologist, Gurgaon
How To Get Rid Of Kidney Stones?

A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the ureter and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:

  • Extracorporeal shock wave lithotripsy (ESWL): To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
  • Ureteroscopy: This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
  • Percutaneous nephrolithotomy (PCNL): This surgery is performed under general anesthesia.  It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 
  • Open surgery: Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone. In case you have a concern or query you can always consult an expert & get answers to your questions!
2039 people found this helpful
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