Urolithiasis affects about 45% of patients registered with a urologist. The usual surgery to remove kidney stones is quite painful and traumatic. Therefore, such operations were replaced by an innovative method - contact lithotripsy. This article discusses the advantages of this method over conventional surgery.
What is lithotripsy?
Lithotripsy is a technique that allows you to grind a stone in an affected kidney and remove it from the body in a natural way. During the operation, the doctor uses a special device called a lithotripter. The impact on the body is produced through short pulses that the device emits. Due to this, the stone decreases in size and leaves the body.
Kinds
There are 4 types of contact lithotripsy.
- Mechanical Stone crushing is carried out directly when the tool acts on the calculus.
- Pneumatic The process of crushing is carried out using a shock wave, which is sent directly to the stone.
- Ultrasonic This type of therapy is used to destroy small stones with low density.
- Laser Using laser contact lithotripsy, any stone can be crushed, no matter what density and size it has. The effectiveness of the procedure lies in the fact that after it, even the smallest particles that can later turn back to stone do not remain from the stone. And due to the fact that the laser penetrates to a very shallow depth, the surrounding tissue is not damaged.
Benefits
Contact lithotripsy of kidney stones has a number of advantages over other methods of treatment of this pathology:
- The patient after surgery is in the hospital for no more than three days.
- After contact lithotripsy of the kidneys, there is no need to use any other means or medications in order for the calculi to leave the body.
- The risk of complications is rather small.
- The rehabilitation period lasts much less than after other types of surgical intervention.
- Tissues and organs are not damaged during surgery.
- Unlike other methods of therapy, everything happens virtually painlessly.
It is worth noting the fact that today it is contact lithotripsy of the kidneys that is most popular among both doctors and patients.
Indications
In itself, the presence of calculi in the genitourinary system and kidneys is a direct indication for contact lithotripsy. However, during the examination, it is necessary to clarify the density and structure of the stone in order to know for sure that such an operation is generally advisable and will help to crush the stone.
Contraindications
Contraindications to contact lithotripsy include:
- Malignant and benign tumors, tuberculosis affecting the genitourinary system, coronary heart disease, aortic aneurysm, poor blood coagulation.
- Pregnancy, critical days.
- Complications after the previous lithotripsy or the inefficiency of its implementation.
- Exacerbation of chronic or acute forms of the disease, regardless of whether these pathologies are associated with the genitourinary system or not.
- Problems with the spine, in particular, severe forms of its deformation.
- ARI, flu, tonsillitis and other colds.
- Violation of the gastrointestinal tract.
- Obesity.
- Diseases of bones and joints.
Preparation for the procedure
Preparation for contact lithotripsy includes all the necessary examinations and tests. The following tests are usually prescribed:
- general analysis of blood and urine;
- feces on worm eggs;
- check for syphilis, hepatitis B and C forms.
Bowel movement immediately on the day of surgery is required. If the patient cannot empty himself on account of constipation, then a laxative or enema is prescribed. With bloating and gas formation, the doctor prescribes drugs that relieve unpleasant symptoms. If the blood pressure exceeds the permissible norms, then the patient is prescribed drugs that reduce it. The use of any sedatives is prohibited before and after the operation, as this can provoke an allergic reaction and cause anaphylactic shock.
On the day of surgery, the patient must have breakfast. During breakfast, you can not eat any fatty and junk food. The best option would be oatmeal or a sandwich and weak green tea. A few days before the operation and within 2-3 months after it, the patient is contraindicated in taking any alcoholic beverages. If there is an operation on the lower part of the ureter, then the patient must drink a liter of water before the operation. Before hospitalization, the patient is recommended to consult a cardiologist.
How is the procedure
Surgery to crush stones using lithotripsy is performed using local anesthesia. During the procedure, the patient may experience slight discomfort, as the apparatus for contact lithotripsy supplies compressed air (from 3500 to 6500 kPa). Due to the fact that this method of intervention involves a mechanical effect on the body, during the operation, in addition to anesthesia, painkillers are injected, as a result of which the patient does not experience any pain.
The doctor through the apparatus for ultrasound determines the exact location of the stones. After that, the ureterorenoscope, which consists of forceps and a small basket, directs directly to this place, so that the stones are crushed into small pieces. Then the doctor through the urethra introduces an endoscope and a pin into the bladder, with the help of which large pieces of stone are removed, and small ones are excreted from the body naturally during urination.
Rehabilitation period
Recovery of the body after contact lithotripsy of stones lasts an average of two to four weeks. Throughout the entire rehabilitation period, it is necessary to visit the attending physician every 3-4 days so that he can notice and eliminate all possible negative consequences of the operation in a timely manner.
During rehabilitation, the patient may experience the following unpleasant symptoms, which are temporary in nature:
- Painful sensations associated with the passage of cameos from the kidneys. In order to reduce such unpleasant symptoms, the doctor usually prescribes analgesic antispasmodic drugs, the most effective of which in this case are No-shpa and Papaverin.
- Blood during urination is the result of an injury received during surgery or when stones are moving away. This phenomenon is quite normal if it does not last more than three days. If blood in the urine appears even after, then you should consult a doctor.
- Frequent urination throughout the day is a normal phenomenon for such an operation, which normalizes over time. However, an alarming symptom may be the absence of urination during the day after surgery, in this case, you should immediately consult a doctor.
- Elevated body temperature is also quite normal after lithotripsy, it is only important to ensure that the indicators do not exceed 38 ° C. If this temperature does not drop for more than three days, then this is a serious reason to see a doctor.
In order to avoid possible consequences, a patient may be prescribed a course of antibiotic therapy. In addition, in the first month after the operation, some precautions should be maintained, namely: do not lift more than three kilograms, do not run, you can walk only 35-45 minutes a day in slow, measured steps.
If the condition is normal, then a month after the operation, you can start to exercise, but you must remember that for six months you should avoid exercises in which you need to raise your hands up. Gradually, you can increase the duration of walks.
Possible complications
Complications after contact lithotripsy of the ureter are possible. Their number is insignificant in comparison with what consequences arise after a conventional operation to crush and remove stones.
After contact lithotripsy of ureter stones, complications such as exacerbation of acute pyelonephritis, renal colic, flatulence, nausea with vomiting, constipation, a sharp increase or decrease in blood pressure are possible.
Lithotripsy helps the patient to remove kidney stones, but does not completely relieve urolithiasis. Therefore, in order to avoid postoperative complications and the reappearance of stones, a physically active lifestyle should be maintained, if it is not possible to engage in specialized places, you should at least do morning exercises, visit the pool, and make outdoor walks as often as possible, in general, maintain a healthy Lifestyle. The quality of water and nutrition also plays a large role in the formation of calculi; in this regard, you need to drink only purified water and acquire quality food.