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How are kidney stones crushed by ultrasound?
Indications for the use of the procedure are the presence of large formations. During crushing, high-intensity ultrasonic beams break the stone into small pieces. If these fragments get into the ureter, pelvis, renal calyces, an aggravation of the inflammatory process in the kidneys is possible. If there is a history of inflammatory diseases of the urinary system such as pyelonephritis, glomerulonephritis, the procedure for crushing stones can exacerbate these pathologies.
The sequence of ultrasonic lithotripsy:
Clarification of the localization of the stone in the ureter or in the kidney using diagnostic equipment.
Installation of an ultrasonic sensor in the projection of the localization of the stone.
Impact of high-intensity ultrasonic beams on the calculus for 10-15 minutes.
Removal of small fragments of calculus from the kidney using a nephroscope.
If intravenous urography has found that renal excretion is normal and urine is circulating without blockage, the last step is not performed. The patient can be discharged from the hospital after 3-4 days.
Indications. In urolithiasis, ultrasound is used in the presence of stones up to 1-2 cm in size. The procedure for crushing stones with ultrasound should be carried out exclusively in stationary conditions in order to avoid the risk of complications. One such complication is bleeding from the urinary tract. If crushing by ultrasound is carried out at home, as private clinics practice, there is a risk of death due to the doctor’s lack of resuscitation equipment.
Types of crushing of kidney stones:
Extracorporeal lithotripsy – stone removal lasts up to 40 minutes, during this procedure, the shock wave is directed to a certain point of the calculus, the size of which can reach up to 35 mm. When the maximum threshold of shock wave energy is formed, the stone is destroyed into separate fragments. The force of application of shock waves depends on the size and structure of the formation. When performing extracorporeal lithotripsy without complications, the patient is discharged the next day after the procedure. Carrying out this type of lithotripsy is prescribed for pathologies of the heart, stones in the bladder and increased blood clotting.
Remote lithotripsy – removal of the calculus occurs under the influence of an acoustic wave, which is focused at a certain point, soft tissues are not damaged. The procedure is successful when the doctor accurately determines the location of the stone, and the distance to the source of the waves.
contact lithotripsy – with this method, ultrasound acts at the point of contact of the stone with the urinary tract. The resulting fragments are removed after lithotripsy using a ureteroscope or nephroscope. It is possible to install a stent in the ureter, for the removal of which the patient returns to the hospital a week after the procedure. This method is 80-100% effective, has a minimum of complications and the possibility of simultaneous removal of several stones.
In preparation for the crushing of stones by ultrasound, the patient takes blood and urine tests, undergoes an examination of the kidneys and urinary tract using echoscopy.
2 weeks after lithotripsy, intravenous urography is performed – an x-ray with contrast injected into the radial vein. With this method of X-ray examination, the contrast fills the renal-pelvic system, helps to determine whether the stone remains in the kidney, the presence or absence of blockade of urine output.
Contraindications to the procedure – high or short height, weight over 130 kg. Statistics show that these patients are more likely than others to have complications.
Consequences of the procedure
During the day, patients are in the hospital, undergoing rehabilitation treatment. Preparations:
Antibacterial agents;
Antispasmodics;
blockers;
Non-steroidal anti-inflammatory drugs;
Diuretic teas.
Possible symptoms after lithotripsy:
The admixture of blood in the urine;
Renal colic;
Pain when urinating;
The appearance of small stones in the urine;
Frequent urination
Hyperthermia.
The advantages of ultrasonic lithotripsy are stable positive results, minimum complications, fast rehabilitation. However, stones larger than 2 cm cannot be destroyed by this method. With a high density of stones, several sessions are required, the removal of small sharp fragments can cause severe pain. The remaining fragments provoke the formation of new stones.
There is a risk of blockage of the urinary tract by large fragments. To remove them, it may be necessary to insert a special loop through the urethra.
Contraindications:
Bone anomalies;
Pregnancy;
Pathologies of the cardiovascular system;
Pregnancy;
Oncological processes;
Decreased level of blood platelets;
aortic aneurysm;
Infectious diseases;
Large kidney cyst.
Even such a modern method as lithotripsy does not guarantee the absence of complications. They are extremely rare, but patients should be aware of this possibility.
Complications:
The development of pyelonephritis or a complication of an existing disease;
The formation of a hematoma in the kidney;
The formation of a residual stone path, provoking a recurrence of urolithiasis.
How to remove stones from the kidneys with a laser?
This modern method of exposure to stones in the urinary system with a directed light beam has appeared quite recently. For the most part, it is used by private urological clinics or medical centers. The technique is not well developed and may have complications.
Procedure for the procedure:
An endoscope is inserted through the urinary canal and ureter;
After its placement near the stone, laser destruction begins;
Moisture is evaporated from the conglomerate in 10-15 minutes.
Advantages of laser crushing:
There is no pain and bleeding;
It is possible to remove stones of complex composition even from the pelvic organs;
One session of laser therapy is enough;
The minimum number of fragments is formed.
Lithotripsy according to this technique is carried out with a holmium laser, which evaporates water from the conglomerate with a concentrated light flux. The laser beam does not penetrate deeper than 5 mm deep into tissues and does not damage them. The procedure is carried out under the control of an endoscope, which helps to monitor the accuracy of the lithotripsy.
Preparation for laser destruction of stones consists in the prophylactic administration of antibiotics and the selection of anesthesia appropriate to the age and health of the patient.
Preparing for the stone crushing procedure
Before removing stones from the kidneys, the patient undergoes an examination using laboratory and instrumental methods:
General blood analysis;
Blood sugar test;
Blood test for the Wasserman reaction;
fluorography;
CT scan;
excretory urography;
Electrocardiography.
So that gases and feces in the intestine do not interfere with the passage of ultrasound or a laser wave, the gastrointestinal tract is cleaned with an enema or cleansing preparations (Espumizan, Fortrans). With a carefully conducted examination and preparation, in 60% of patients the procedure is successful the first time, in another 25% the conglomerates are removed after a second procedure. Stones up to 1 cm in diameter are successfully removed in 100% of cases.
Conservative methods to remove kidney stones
To prevent kidney stones from growing in size, you need to drink at least one and a half liters of water or any other liquid per day. This tactic reduces the concentration of urine and reduces the nuclei of crystallization in it. Kidney failure leads to an increase in the volume of toxins in the blood serum. The use of a large amount of liquid reduces the concentration of toxic substances.
Purified water, cranberry or lingonberry juice are suitable as drinks. Compote from dried fruits and apples is less effective.
Diet is important:
Whole grain products for colon cleansing;
Vegetables and fruits as a source of fluid and fiber;
Oranges, grapefruits, tomatoes as a source of vitamin C;
Ascorbic acid to dissolve calcium stones.
To accelerate the excretion of urine from the bladder and kidneys, to reduce its concentration, you need to engage in physiotherapy exercises.
Is there a safe home remedy?
Every morning, within 15 minutes after getting up, you need to drink honey water. Honey crystals settle on kidney stones and gently dissolve them. You need to prepare water at the rate of 2 teaspoons of honey per glass of water.
This method is considered the safest, since with such a dissolution, the stones will not move, which cannot be said about diuretic herbs and other means. But you need to use the hearth for 1-6 months, depending on the size of the stones.
Preventive measures
In order to prevent the formation of stones and sand in the kidneys, which manifest themselves as back pain and are complicated by kidney failure, precautionary measures must be taken:
Avoid a sedentary lifestyle;
Walk in the fresh air for at least an hour, constantly increasing the distance and duration of walks;
Measure the number of steps taken per day with a pedometer;
Get rid of excess weight, bad habits.
When the duration of the walk reaches 1,5 hours a day, the first positive results will appear. To stimulate interest, you can lay new routes for yourself, considering natural objects. It is useful to make light runs in sports equipment.
Positive results will bring a positive attitude towards life. To consolidate a positive result, preventive measures must be applied for many years.