Crushing stones in any part of the system responsible for removing urine from the body is a complex process that requires the use of modern technologies.
We are talking about minimally invasive methods of getting rid of stones. Such procedures are highly effective and have a minimum side effects, allow you to maintain your ability to work.
How does the process of crushing stones work and what does modern medicine offer patients?
General information
A procedure that allows, using (various) influences, to transform into . As a result of the procedure, stone crushed to the state of sand is removed from the body. In this case:
It's simple: under the influence of a laser or ultrasound, the calculus is destroyed, its particles leave the body naturally(with urine), which avoids serious surgical interventions.
As a result of the procedure, the patient remains able to work and can return to professional activities within 1–2 days.
Some procedures (minimally invasive) are carried out under the SMS program (that is, free of charge). Others are considered paid because they require clinics to have appropriate equipment.
But crushing stones, carried out by any of the methods, is not considered a method of treatment. Since it does not allow you to completely get rid of the disease (ICD), restore and normalize metabolic processes.
It only removes stones that disrupt the functioning of the kidneys and can negatively affect the process of urine discharge, which is fraught with certain consequences.
Types and classification
There are several types of lithotripsy. The method is selected individually, depending on the patient’s condition and indications for use. Does it.
Contact method
Does not imply a violation of the natural integrity of the skin. Thin-diameter tubes (hard metal or soft fibrous) are inserted into the human urethra. This method is only suitable for crushing stones in the ureter and bladder.
A laser beam or ultrasound passes through the tubes, under the influence of which the process of crushing stones occurs.
Remains (large shards) are removed using special loops that are specifically designed for this.
All this time the patient is under anesthesia, pain relief is used extensively.
Remote method
Involves influencing a stone using a device. No electrodes or tubes are inserted into the patient's body. The influence is carried out from the outside. 
What the device can be, the main classification:
- electromagnetic;
- piezoelectric;
- electrohydraulic.
Under the influence of waves, stones are destroyed, but the process requires careful control. It is carried out using ultrasound or x-ray.
Advantages of the method over surgery
The operation involves a long hospital stay for the patient. The recovery period and the likelihood of developing complications makes surgical method correction of ICD is quite unattractive for patients.
The same cannot be said about minimally invasive procedures, which are easily tolerated by patients and rarely lead to complications.
The main advantages of lithotripsy:
- has a short recovery period;
- well tolerated by patients of any age;
- does not involve extensive surgical procedures (incisions);
- passes with minimal losses blood.
The recovery period takes several days, during which time the person can remain under the supervision of a doctor (in a hospital), after a few days he is discharged, which makes it possible to return to work while maintaining full working capacity.
Postoperative period
It only takes a few days and goes away without complications (mostly). After the operation, the person is under the supervision of doctors for several days, then goes home. Doctors recommend following a drinking regimen, diet, and giving up bad habits.
For some time, the person is prescribed rest and limits it physical activity. Avoid lifting weights for 2-4 weeks.
Efficiency of the procedure
Efficacy depends on indications. If the size of the stones allows, their density is within acceptable limits, then the likelihood of complications is minimal. And the effectiveness of minimally invasive methods of influence is assessed as high.
Recovery forecasts
If after lithotripsy you do not follow simple recommendations doctor, then the likelihood of re-formation of stones is extremely high.
But if a person strictly follows the advice, follows a diet and drinking regime, then you can not encounter manifestations of ICD for a long period of time.
Lithotripsy is modern method stone crushing, which is used for various groups of patients. Progress makes it possible, with the help of modern technologies, to turn stones into sand without making a single cut on the surface of the body.
Such manipulations are considered minimally invasive, less traumatic and relatively safe. What allows a person to maintain his ability to work. And also avoid serious consequences associated with surgery.
There are several ways to treat – medication and surgery. An important direction in providing assistance is the destruction of emerging stones and the normalization of metabolic disorders. At the moment, contact (endoscopic) lithotripsy of kidney stones and remote lithotripsy are widely used.
All over the world, stone crushing technology has become quite popular. Thanks to it, 25% of patients got rid of the need for abdominal and endoscopic surgery to remove stones. And also the complications that may be associated with this.
What is lithotripsy?
Lithotripsy is a procedure for crushing stones without violating the integrity of the patient’s skin. This technique began to be used back in the 70s of the last century, and is still popular today, as it is low-traumatic and effective.
Lithotripsy is based on the use of waves that reach the stone and destroy it into the smallest possible formations or sand. After this, they can easily exit naturally through the urinary tract. This method does not require strip surgery, which is considered an invasive method, and is accompanied by a long recovery period. Lithotripsy can be contact (endoscopic) and remote.
Indications for such an operation are the size of stones of at least 0.5 cm, but not more than 2.5 cm. The effectiveness of the procedure largely depends on the qualitative composition of the formation, and slightly less on its volume. The procedure is successfully performed not only in adults, but even in small children.
A patient who has undergone lithotripsy can begin normal activities within a few days after treatment. Pain sensations during and after the procedure are reduced by approximately two times compared to other types of intervention.
Before performing lithotripsy, the doctor must explain to the patient all the advantages and possible complications of this treatment method, write a list of necessary studies and step-by-step preparation.
To undergo lithotripsy, the patient must pass all tests, undergo an x-ray, ultrasound, cardiogram, and check the blood coagulation system. Before the procedure, you should cleanse the intestines with an enema. If you are constantly taking blood thinners, the patient must notify the doctor in advance, then stop taking them two weeks before the stone grinding procedure, or temporarily switch to other types of medications.
What is included in the cost of the procedure?
The cost of treatment depends on the category of complexity of the operation (size of stones in the kidneys or urinary tract, location, their number, presence of concomitant diseases). Everything is determined by the doctor after collecting anamnesis and diagnostic results. The final cost of treating the disease includes lithotripsy, consultation with an anesthesiologist, anesthesia benefits (if there is anesthesia), hospital stay, treatment and food.
Contact lithotripsy price
Advantages of the method
Compared to extracorporeal lithotripsy and other methods of stone removal, the contact method has a number of advantages:
- minimal percentage of possible complications;
- very short rehabilitation period;
- no pain after the procedure;
- introduction of instruments through natural routes, which eliminates the need for incisions and complications associated with them;
- affordable price.
Treatment (crushing kidney stones)
Contact lithotripsy is performed under general anesthesia. Its type is selected by a specialist depending on the age and condition of the patient. It is possible to use endotracheal, intravenous and epidural anesthesia. To prevent infectious complications, parenteral administration of an antibiotic with a broad spectrum of action is possible.
A special thin endoscope is passed through the bladder and ureter into the renal pelvis. This allows you to keep the skin intact and remove all the stones in one procedure. Ultrasound or laser can be used to break up stones.
Using ultrasound, a small-density stone can be broken into small components, which are then removed by aspiration. But this method is not suitable for dense stones.
The laser can turn any stone into dust, which is why it is considered more convenient. The entire procedure is controlled, and a picture of the field is displayed on the screen.
Contact lithotripsy of a ureteral stone allows you to get rid of the stone in any part of it. At the same time, the remaining organs remain undamaged. This procedure is indicated for long stay calculus, or its dense standing in the lumen of the organ.
Contact stone lithotripsy bladder carried out according to the same scheme as in other structures of the urinary tract.
Indications for laser lithotripsy are:
- Contraindications to extracorporeal lithotripsy.
- Absence positive result from taking medications and the second session of remote stone destruction.
- The appearance of “paths” after the passage of a stone with a violation of the outflow of urine.
- The presence of multiple stones in the ureter and bladder.
Complications of lithotripsy
With modern equipment and highly qualified surgeons and staff, there are practically no complications when crushing stones with a laser, but in some cases the following is possible:
- endoscopic contact lithotripsy of stones in the ureter can lead to minor perforation with a fiber instrument;
- reflux-pyelonephritis;
- recurrence of renal colic;
- ureteral stricture.
Some phenomena may be observed after lithotripsy, but they resolve over time:
- blood in urine;
- abdominal pain, bloating, constipation;
- increased blood pressure;
- urinary retention;
- increase in temperature;
- nausea and vomiting.
Such symptoms also occur when kidney stones pass naturally. If after a month these signs persist, then there is a need to consult a doctor and conduct a full examination. It is possible that the specialist will schedule a repeat crushing session. For pain, you should take an antispasmodic or analgesic.
Two weeks after the procedure, the doctor recommends a follow-up examination using an x-ray or ultrasound.
But it is necessary to understand that even a successfully performed procedure cannot guarantee the formation of new stones, so you should follow a diet, drink plenty of fluids, and monitor the functioning of the endocrine organs. Only if you follow all the doctor’s recommendations can the fight against urolithiasis be successful.
When this occurs, not only the formation of stones of various sizes occurs, but also their movement along the urinary tract. If a stone is blocked in the kidneys or on any part of the ureter, the patient begins to experience severe pain - the outflow of urine is disrupted, which leads to irreversible changes in the kidneys.
Therefore, if a patient is diagnosed with a blockage of the ureter with stones, then he receives emergency treatment. medical care. In a hospital setting, crushing stones in the ureter can be done in several ways.
What stones undergo this procedure?
The main goal in the treatment of urolithiasis is the removal of stones and subsequent therapy to prevent the formation of new stones in the kidneys and ureter.
The choice of method depends on the size, shape and density of the stone. If the size does not exceed 5 mm, then the attending physician prescribes conservative therapy aimed at to remove stones naturally.
If there are stones with a diameter of 5-10 mm, the success of conservative therapy decreases several times, and the doctor may prescribe special treatment or crushing stones.
If the stones are larger than 10 mm, then crushing or surgical removal of stones patients are prescribed without fail.
Are there any contraindications?
Crushing stones in the ureter is not always possible. Regardless of the method of crushing stones in the ureter, there is a number of contraindications for this procedure:
- If the stones are coral-shaped;
- Pregnancy at any stage;
- Diseases associated with blood clotting disorders;
- The patient has a pacemaker;
- Abdominal aortic aneurysm;
- Education is great;
- Infectious diseases;
- Pathological changes in bone tissue;
- Any cancer.
Methods for crushing stones in the ureter
There are several methods for crushing stones in the ureter:
- Remote;
- Contact;
- Transdermal.
Remote
This method involves the impact of ultrasonic (US) waves on stones in the ureter through muscle tissue, or through small punctures in the skin. Crushing stones with ultrasound is a painful process and must be carried out under local or general anesthesia. The whole crushing process takes approximately one hour.
Using ultrasound or x-ray examination, doctors determine the location of stones in the ureter and, after which, a lithotripter(device for ultrasonic crushing of stones).
The device generates ultrasonic waves, gradually increasing their frequency and decreasing the time interval between waves. During one treatment session, approximately 2000 ultrasonic strikes are performed on the stone. It all depends on the size and density of the stone. After completion of the crushing procedure, the remaining stones leave the ureter naturally.
Contact
Laser crushing is the most modern treatment method today. It is highly effective and non-traumatic, after which there are no relapses or side effects. Laser transurethral crushing can cope with stones whose dimensions do not exceed 3 cm, in one treatment session.
(The picture is clickable, click to enlarge)
During the operation, an endoscope equipped with a camera, a laser device and a miniature lamp is inserted into the ureter. After the doctor visualizes the stone, several laser strikes are applied to it, which can destroy it into the smallest particles without injuring the healthy tissue of the ureter.
Due to the gentle effect of the procedure on the body, the patient can be discharged from the hospital on the second day after treatment.
Percutaneous
Doctors use this removal method in cases where the stones are located in the uppermost part of the ureter, dangerously close to the renal pelvis. Remote or laser crushing of stones in this case threatens kidney tissue damage.
Crushing is also used if the stones are coral-shaped.
The patient, under general anesthesia, is given a puncture or skin incision in the lumbar region, allowing access to the diseased kidney and upper ureter. With this method of crushing and removing stones, stones of any size and shape can be removed.
This method is the most traumatic, after which infectious complications are possible.
The patient remains incapacitated for a fairly long period of time and is forced undergo a long recovery course.
Preparation for the procedure
To achieve the greatest effect when crushing stones in the ureter, it is necessary to undergo diagnostics, possible contraindications during medical procedures. The patient needs:
- Make urine and blood tests to determine the presence of inflammatory processes in the body;
- Undergo a fluorographic examination, since any surgical interventions are contraindicated in active tuberculosis;
- Additionally, you need to do a blood clotting test;
- Pass, ureters and other organs located in the pelvis;
- Perform urography;
- Donate blood for HIV and syphilis;
- If you have diseases of the cardiovascular system, you need to consult a therapist and do an ECG.
The procedure for crushing stones is quite specific, and you need to prepare for it. A few days before surgery It is necessary to exclude from the diet foods that cause increased gas formation in the intestines. These include: apples, cabbage, legumes, black bread, fermented milk products, fatty foods, juices.
A few hours before the procedure, you need to do an enema to empty the intestines of feces.
Complications after surgery
Complications after the stone crushing procedure are quite possible, but they are minor:
- At first, after ultrasonic and laser crushing of stones, there may be blood in the urine;
- Flatulence;
- Stool disorders;
- Pain in the abdomen or kidney area;
- Sudden jumps in blood pressure;
- Slight increase in temperature;
- Nausea and vomiting;
- The occurrence of renal colic due to incomplete removal of remnants of stones from the ureter.
To achieve maximum effect, after the procedure for crushing stones in the ureter, the patient is prescribed diuretics and anti-inflammatory drugs to exclude the development of infection in the ureter.
How to crush stones using the contact method - watch the video:
