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 crush the stone in the affected kidney and remove it from the body naturally. During the operation, the doctor uses a special device called a lithotripter. The impact on the body is made by means of short pulses that the device emits. Due to this, the stone decreases in size and leaves the body.
Views
There are 4 types of contact lithotripsy.
- Mechanical. The crushing of the stone is carried out directly atimpact of the tool on the calculus.
- Pneumatic. The crushing process is carried out using a shock wave that is directed directly at the stone.
- Ultrasonic. This type of therapy is used to destroy small stones with low density.
- Laser. With the help of laser contact lithotripsy, any stone can be crushed, regardless of its density and size. The effectiveness of the procedure also lies in the fact that after it even the smallest particles do not remain from the stone, which can subsequently turn into stone again. And due to the fact that the laser penetrates to a very shallow depth, the surrounding tissues are not damaged.
Benefits
Contact lithotripsy of kidney stones has a number of advantages over other methods of treating this pathology:
- The patient stays in the hospital for no more than three days after the operation.
- 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 quite low.
- The recovery period is much shorter than after other types of surgery.
- Tissues and organs are not damaged during the operation.
- Unlike other therapies, it is virtually painless.
It is worth noting the fact that today it is contact lithotripsy of the kidneys that is the mostpopular with doctors and patients alike.
Indications
The presence of stones in the genitourinary system and kidneys in itself 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 for contact lithotripsy include:
- Malignant and benign tumors, tuberculosis affecting the genitourinary system, coronary heart disease, aortic aneurysm, poor blood clotting.
- Pregnancy, critical days.
- Complications after the previous lithotripsy or its ineffectiveness.
- 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, influenza, 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 necessary examinations and tests. The following tests are usually prescribed:
- general analysisblood and urine;
- feces on worm eggs;
- testing for syphilis, hepatitis B and C forms.
Evacuation of the bowel on the day of the operation is mandatory. If the patient cannot empty himself due to constipation, then he is prescribed a laxative or an enema. With bloating and gas formation, the doctor prescribes drugs that alleviate unpleasant symptoms. If the blood pressure exceeds the permissible limits, then the patient is prescribed drugs that reduce it. Taking 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 an operation is to be performed 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 have a mandatory consultation with a cardiologist.
How the procedure works
Surgical intervention to crush stones using lithotripsy is performed using local anesthesia. During the procedure, the patient may experience some discomfort as the contact lithotripsy machine supplies compressed air (3500 to 6500 kPa). In view ofDue to the fact that this method of intervention implies a mechanical effect on the body, during the operation, in addition to anesthesia, painkillers are also injected, as a result of which the patient does not experience any pain.
The doctor uses an ultrasound machine to determine the exact location of the stones. Then he directs the ureterorenoscope, which consists of forceps and a small basket, directly to this place, due to which the stones are crushed into small pieces. Then the doctor inserts an endoscope and a pin into the bladder through the urethra, with the help of which large pieces of the 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 rehabilitation period, every 3-4 days it is necessary to visit the attending physician 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 that are temporary:
- Painful sensations that are associated with the discharge 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 Papaverine.
- Blood aturination is a consequence of an injury received during surgery or during the passage of stones. This phenomenon is quite normal if it does not last more than three days. If blood in the urine appears after that, then you should consult a doctor.
- Frequent urination throughout the day is quite normal for such an operation, which eventually normalizes. However, an alarming symptom may be the lack of urination for a day after the operation, in this case, you should immediately consult a doctor.
- Increased body temperature is also quite normal after lithotripsy, it is only important to ensure that the indicators do not exceed 38 ° C. If such a temperature does not decrease for more than three days, then this is a serious reason to see a doctor.
The patient may be prescribed a course of antibiotic therapy to avoid possible consequences. In addition, in the first month after the operation, some precautions should be taken, namely: do not lift more than three kilograms, do not run, you can only walk for 35-45 minutes a day at a slow, measured pace.
If the condition is normal, then a month after the operation, you can start doing exercises, but you must remember that within 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 forcrushing and removing stones.
After contact lithotripsy of ureteral 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 stones from the kidneys, but does not completely relieve him of urolithiasis. Therefore, in order to avoid postoperative complications and the recurrence of stones, one should lead a physically active lifestyle, if it is not possible to engage in specialized places, then it is necessary to at least do morning exercises, visit the pool, take walks in the fresh air as often as possible, in general, lead a he althy Lifestyle. The quality of water and food also plays a big role in the formation of stones, in this regard, you need to drink only purified water and purchase quality food.
