Description

Kidney Stone Crushing

How to Treat Kidney Stones?

Most kidney stones tend to go away on their
own. Approximately 80 of all urinary tract stones fall off with
medication. The most important factor affecting the fall of the stone is
the size of the stone. While stones smaller than 4 mm are expected to
fall, intervention is required for stones larger than 6 mm. In addition,
the shape of the stones and their location in the urinary tract are important
factors affecting the fall.

Spontaneous or drug-induced stone removal

ESWL (breaking stones with shock wave)

Minimally invasive procedures (Percutaneous
Nephrolithotomy, Ureterolithotripsy)

Classical open surgery method

Which of these approaches will be applied depends on the
location of the stone, its size, the damage it causes or can give to the
urinary tract and the type of stone. Nowadays, as a result of the
development of minimally invasive techniques, classical open surgery remains
the least used and least preferred method.

ESWL (Breaking stones with shock waves outside the body)

Shock waves emanating from a focus are directed onto the
stone, breaking the stone. There are ESWL devices that focus with X-ray
and ultrasound. Broken stone fragments are excreted through
urine. ESWL cannot be successful in all stones. Success depends on
the type, hardness, size and location of the stone in the urinary
tract. There may be stones that can be broken in a single session or
repetitive sessions may be needed.

Discomfort and pain may be felt during the ESWL
session. For this reason, pain relievers are used before
treatment. Most of the time, there is no need to stay in the hospital
after the procedure.

Minimally invasive interventions: The purpose of these
procedures is to get rid of the stone that threatens the urinary system and to
return the patient to daily life as soon as possible. Percutaneous
nephrolithotomy and Ureterolithotripsy are interventions in this group.

If the stone does not fall despite the treatment applied,
if it is in a size that will not fall, if it forms a complete block to prevent
the flow of urine in the urinary tract, if it causes recurrent urinary tract
infection, if it has caused damage to the kidneys, intervention is required.

Previously, open surgery was performed for stone, but
nowadays there is a new approach called minimally invasive
interventions. The aim of these attempts is to eliminate the disease as
soon as possible and to return the patient to his daily life at the
earliest. In minimally invasive procedures, the patient returns to his
normal life in the early period.

Percutaneous nephrolithotomy (PCNL)

In endoscopic kidney stone surgery, a 0.5-1 cm incision
is made in the back area at the kidney level. A thin tube with both ends
is placed in the kidney under X-ray control. With the help of the optical
device placed through this tube, the stone is seen on the monitor with the
video system and is removed with the help of special tools. The most
important advantage of percutaneous surgery is to preserve the normal structure
of body tissues. As a result, the healing process is fast. Patients
spend the postoperative period much more comfortably than open
surgery. Our patients are usually discharged in 2-3 days and can quickly
regain their daily activities. This is a relatively short time compared to
open kidney stone surgery.

Especially in stones placed in the lower pockets of the
kidney and large stones, the success of ESWL decreases significantly. In
these cases, PCNL surgery is a highly successful minimally invasive
procedure. Pneumatic lithotripsy and laser lithotripsy are used to remove
the stone during the surgical procedure. With the help of these
technologies, even the hardest stones are easily broken. With this
technique, stones that cover the whole pastry and called coraliform stones can
also be intervened.