A kidney stone is a solid crystalline mass that develops in the kidneys. It is sometimes referred to as a renal calculus or nephrolithiasis. It is made up of many elements like calcium, oxalate, uric acid, cystine, and struvite. The size of kidney stones can vary, from tiny particles that pass through the urinary canal undetected to bigger stones that can be quite painful and uncomfortable.
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A tiny tube called a ureteroscope is placed into the urethra and bladder during a minimally invasive procedure called a ureteroscopy to access the kidney or ureteral stone. The stone is subsequently cut into bits with the aid of mechanical, ultrasonic, or laser tools, and the smaller fragments are either removed or allowed to pass naturally.
The procedure of ureteroscopy surgery involves the following steps:
Preparation: In order to assess your urinary tract and choose the most effective surgical strategy, you may need to perform a number of tests prior to the procedure, such as imaging scans, blood tests, or urine tests.
Both general anaesthesia, which renders you unconscious, and local anaesthesia with sedation, which keeps you awake but relaxed and pain-free, are options for ureteroscopy anaesthesia.
The ureteroscope is inserted into your urethra, the orifice through which urine exits the body, after you've been given anaesthesia by a surgeon or urologist.
Treatment and visualisation: The surgeon can view the urinary tract on a monitor attached to the camera as it is directed into the ureter and kidney. This gives the surgeon a thorough look of the structures, enabling him or her to spot any anomalies or stones.
Placement of a stent (if necessary): To facilitate urine flow and prevent obstruction while the ureter heals, a stent, which is a tiny tube, may occasionally be inserted. If there is a chance of edoema or obstruction following the procedure, this is usually done.
After the required procedures are finished, the ureteroscope is taken out, and you are then transferred to a recovery area for observation.
Large kidney stones or complex kidney stones that cannot be adequately treated with non-invasive techniques like medicine or shock wave lithotripsy are removed by a surgical procedure called percutaneous nephrolithotripsy (PCNL). Through a small incision in the back, the kidney is accessed during this minimally invasive treatment.
Once the stones have been discovered, several methods can be employed to fragment them. This can entail shattering the stones with pneumatic or ultrasonic energy. Additionally, the surgeon may employ laser radiation to fragment the stones before removing them whole with specialised tools.
Usually, a medical history, physical examination, and diagnostic testing are used to diagnose kidney stones. Here is a summary of the kidney stone diagnostic process:
Medical History: The doctor will inquire about your symptoms, such as the kind and location of discomfort, any prior kidney stone experiences, and any risk factors you may have, such as dietary habits, medical diseases with which you may be living, or your family history.
Physical Exam: The doctor might do a physical exam to evaluate your general health and search for indications of kidney stone-related issues, such as fever, soreness over the kidneys, or unusual urine colour.
Imaging examinations: A variety of imaging methods are used to identify the existence, size, and location of kidney stones. These tests consist of:
X-rays: The majority of kidney stones, especially those that contain calcium, can be identified with the aid of X-ray pictures. However, some kinds of stones, including those made of uric acid, could not be noticeable on standard X-rays.
Ultrasound: The urinary tract and kidneys can be visualised using sound waves in ultrasound imaging. It is helpful for assessing problems or obstructions brought on by stones and can detect larger stones.
Computed Tomography (CT) Scan: CT scans give precise pictures of the kidneys and urinary system, making it possible to identify and diagnose kidney stones with accuracy. When determining the size of the obstruction and finding tiny stones, CT scans are especially useful.
Urine testing: Analysing a urine sample can reveal important details about the composition of kidney stones and assist in locating any underlying disorders that might be responsible for stone production. A urinalysis, which analyses the physical and chemical characteristics of the urine, and/or a urine culture, which screens for any infection, may be required for this.
For the treatment of kidney stones, there are non-surgical options. Smaller stones that are most likely to pass naturally or with the aid of medical intervention are often treated using these treatments. Here are a few typical non-surgical methods:
Observation and Fluids: In certain circumstances, tiny kidney stones can be removed from the urinary tract by increasing fluid intake and managing pain. To encourage urine flow and aid in the passage of stones, the patient may be recommended to drink plenty of water. During the procedure, painkillers may be provided to treat any discomfort. The progress of the stone may be monitored often using imaging techniques.
Medication: Medication can be used to dissolve some types of stones or to help kidney stones pass more easily. Tamsulosin is an example of an alpha-blocker that can ease ureteric muscle tension, facilitating the passage of stones. It may be necessary to take additional drugs, like potassium citrate, to assist prevent the development of specific kinds of kidney stones.
Ureteral Stent Insertion: To temporarily relieve an obstruction brought on by a kidney stone, a thin, flexible tube known as a ureteral stent may be put into the urethra, bladder, and ureter. The stent aids in preserving urine flow and permits passage of the stone or later treatment with alternative methods.
