Writen by Konstantinos Efstathiou, Scientific Head of the Urology Department of ANASSA Clinic
The kidneys are responsible for removing toxic substances from the blood through the production of urine as well as a number of other important processes. Urine produced in the kidneys is carried through two thin tubes called ureters to the bladder.
Known since the time of Hippocrates, Lithiasis is characterized by the finding of stones inside the kidney, ureter or bladder. It is one of the most frequent reasons for which a patient seeks the help of a urologist since it occurs in about 10% of the general population but unfortunately has very high rates of recurrence.
In most cases, kidney stones do not cause symptoms. But when they move from the kidney to the ureter they cause an obstruction in the flow of urine, resulting in severe pain and spasm of the ureter. This pain is called renal colic and can be accompanied by the excretion of blood in the urine.
THERAPEUTIC OPTIONS
Extracorporeal Lithotripsy
This technique is mainly suitable for stones of the upper ureter or kidney, but up to a certain size.
Ureteroscopy
The operation is usually performed under general or epidural anesthesia.
A special ureteroscope is advanced through the urethra and bladder into the ureter to where the stone is.
The ureteroscope can be rigid or flexible.
A laser fiber is advanced through a hole and fragments or pulverizes the stone. This is a minimally invasive procedure, which takes advantage of the normal holes and passages of the human body. Cuts and scars on the skin are thus avoided.
The stone is usually directly visible through the endoscope, which allows tools to be advanced to immediately capture and remove it or to break it up using a special laser fiber.
The ureteroscope can be semi-rigid or flexible.
Semi-rigid ureteroscopy is performed with a straight endoscope, which “looks” in a straight axis. Flexible ureteroscopy is performed with a very thin and flexible instrument, which can be guided to ‘twist’ angles up to 270o< span style="font-weight: 400;">. This allows access to every part of the renal drainage system. Thus, flexible ureteroscopy is used for kidney stones, while semi-rigid ureteroscopy is used for ureteral stones. In general, the flexible ureteroscope is a less traumatic tool.
The flexible ureteroscope can reach all points within the kidney, allowing the removal or fragmentation of stones of any consistency or location, especially if their size does not exceed 2.5 cm.< /span>
PCNL Percutaneous Nephrolithotripsy
It is a good choice for large stones inside the kidney. It is performed under general anesthesia. A small incision is made in the skin and with the help of special minimally invasive tools a cannula is inserted that reaches the kidney. Through this guide, a special nephroscope with a very small diameter is now advanced that reaches the kidney stone. There a special LASER fiber is inserted which pulverizes the stone at the point.
In conclusion, urolithiasis is a common condition of the urinary system. The possibilities of today’s high-tech applications have given new dimensions to its treatment.