What Is It ?
There are one or more stones in your kidney. Stones cause pain, infection or bleeding, and can damage the kidney. The stone(s) need to be taken out. This operation is called a nephrolithotomy. You have two kidneys. They lie deep in your back on either side of your spine, in front of the lowest rib on each side. The kidneys make urine which passes down a tube (ureter) on each side to the bladder just below your tummy button. The stones usually lie where the ureter joins the kidney and can be taken out through an opening in the top of the ureter. Sometimes the kidney is so badly damaged by the stone(s) that it needs to be taken out as well. Sometimes just part of the kidney is taken out with the stone(s) to help the urine drain out of the kidney better. You will have enough kidney tissue after the operation to make urine properly .
The urogram and the CT scan are the preferred ways at We Care India partner hospital to diagnose kidney stones. Ultrasound is an option but may not detect small stones.
Intravenous Pyelography (Excretory Urogram)
A contrast dye is injected into the patient's vein, and a series of X-rays is taken as the dye moves from the bloodstream into the kidneys, ureters and bladder. If abnormalities are seen, the doctor may follow up with a CT scan - a series of thin X-ray beams that produce two-dimensional images of the organs.
Spiral CT Scan
This high-speed imaging test is used for patients who cannot tolerate contrast dye. A CT scan checks the abdomen in three minutes, and can reveal the presence of very small kidney stones that do not appear on conventional X-rays.
These high-frequency radio waves allow physicians to look at a patient's internal organs. This test is painless and noninvasive, but it may not detect small stones, especially those outside the kidneys.
Based on the type of stone and the cause, We Care India partner hospital Clinic physicians will recommend an appropriate treatment and prevention plan tailored to each patient.
Waiting And Watching
In about 85 percent of cases, kidney stones are small enough to pass during urination, usually within 72 hours of symptom onset. The best treatment for these stones is to drink plenty of water (as much as 2 to 3 quarts per day), stay physically active and wait. Painkillers may be prescribed to help alleviate the discomfort associated with passing a stone.
For patients who can pass a stone without medical intervention, urinating through a strainer may be recommended so that the stone can be recovered and analyzed. The mineral composition of the kidney stone will dictate appropriate treatment and future preventive measures.
Stones that are too large to pass on their own or that may cause bleeding, kidney damage or ongoing urinary tract infection may need surgical treatment.
Minimally Invasive Treatments
Extracorporeal Shock Wave Lithotripsy (ESWL)
This procedure is the usual treatment to remove stones about 1 centimeter or smaller. We Care India partner hospital Clinic was among the first medical centers in the India to use shock waves for treatment of kidney stones.
Patients lie on a cushion during the procedure. In many cases the stone will begin to crumble after 200 to 400 shock waves. The sandlike particles that remain after treatment are easily passed in the urine.
The shock waves are painful, so the procedure is performed with sedatives, local anesthesia or general anesthesia.
Some side effects of extracorporeal shock wave lithotripsy include blood in the urine for a short time after the procedure and minor bruising on the back or abdomen. Some patients may also experience discomfort as the stone fragments pass through the urinary tract. Others may need another treatment if the stone doesn't shatter completely. Most patients resume normal activity in a few days, but it may take months for all stone fragments to pass.
We Care India partner hospital surgeon removes large stones with a nephroscope.
When lithotripsy isn't effective, or the kidney stone is very large, a surgeon may remove it through a small incision in the back, using a nephroscope. The procedure, percutaneous nephrolithotomy, is performed using general anesthesia. Patients usually stay in the hospital for one to two days, with additional recovery time of one to two weeks.
After the nephroscope is inserted into the kidney, the urologist threads an ultrasonic probe or laser through the nephroscope to break up the stones and extract them. All stones and fragments are removed through the nephroscope during the procedure; none are left to pass through the urinary tract.
We Care India partner hospital doctors performed the first percutaneous ultrasonic stone removal in the India in 1985, and have treated thousands of patients since then. Experienced We Care India partner hospital Clinic urologists have a 95 percent success rate in clearing all stones with percutaneous nephrolithotomy. We Care India partner hospital physicians recommend this procedure for people whose stones are too large for other procedures and who are amenable to this procedure, or for those who need to be stone-free either for health reasons or because of their jobs, such as a heavy-equipment operator or airline pilot. In these professions, sudden pain due to passing stone fragments would endanger the person and others, so removal of all stone pieces is essential.
Ureteroscopic Stone Removal
This procedure is used to remove stones that are lodged in a ureter, and is usually performed on an outpatient basis while the patient is sedated with general or local anesthesia. The surgeon passes a small ureteroscope through the bladder into the ureter to snare the stone. In some cases, the surgeon will shatter the stone using a laser or a technique called electrohydraulic lithotripsy. To relieve swelling and help with healing, the surgeon may then place a small tube (stent) in the ureter for two to three days.
We Care India partner hospital Clinic physicians were among the first in the world to perform ureteroscopic stone removal, and were also instrumental in refining and improving the procedure. Today, We Care India partner hospital physicians who specialize in stone removal perform many ureteroscopic stone removals every year.
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