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Urinary Stone Disease - Urolithiasis

Written and reviewed by
M.Ch - Urology/Genito-Urinary Surgery, MS - General Surgery, MBBS
Urologist, Mumbai  •  42 years experience
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I am Dr. Shrikant M Badwe. I am a urologist. I have my own setup for urinary disease in Mumbai. I am also attached to various major hospitals, Mumbai. Now let's talk about what are the newest advances in treatment of urinary stone disease i.e. urolithiasis. One must remember there are a lot of advancements happening in every field. Now the stones can be formed anywhere in the kidney. This disease was treated totally in a different way in the past and now we have latest technologies. Previously we used to make a big cut in the body to remove the stones. Nowadays we enter the kidney through a pinhole. Small incision is made through which a wire can be passed. We remove the stone completely. This is known as PCNL. Now it also has changed a lot. Initially, the size of the hole was not that small but now it is becoming smaller and smaller.

A new technique with which we can make a very small hole or incision to fragment the stone and remove it. There are stones which carry urine from the kidney to the bladder which is known as ureter, those can be treated by special instruments. Previously, we used to go with large telescope inside the kidney and its size was 14 mm and now we are using the instrument of 4 mm. With such an instrument it is not that easy to burst the stone. So, we require laser for fragmentation. And we remove the stones with small incisions only. If the stones are right higher up from the kidney, sometimes these instruments cannot go to that level and sometimes these stones can move into the kidney. For this, we have flexible scope. It can enter right inside the kidney. It can reach anywhere in the kidney. With this we also have to pass a fiber which is a laser fiber. There are lots of advantages and disadvantages of laser. It is extremely fast. It never causes any damage to the surrounding delicate structure. Any hardest stone can also be fragmented with that.

Mechanical blasting of the stone causes lots of injuries. All these can be prevented if we use holmium laser. The procedure can be done very fast and patient can also be discharged from 48-72 hours. Stones in the bladder are easy to treat. We go inside through urinary passage inside the bladder and fragment the stone. Small stones can be passed out of the system. Now, these stones also require some interventions. Like patient is getting continues pain and it is disturbing his day to day life than one goes in and treat it. Second thing, if patient is getting fever then it means that patient's kidney is getting infected. So, we have to treat it early. And if both the kidney starts getting damaged, then one kidney needs to be treated early to treat the stone. So, patient who requires treatment early are pilots, air-hostess, sailor or somebody is having exams, marriage in near future because they cannot take the leaves for long. Treatment of stones in the urinary system should be done with lot of thoughtfulness and holistic thinking of the patient's stone or the type of stones. It should be offered with honesty and with ethical approach. So, if you want to have treatment of this kind of stones, you can contact me through

Thank You.

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