Урология - Urolithiasis

Pneumoureteropyelography –

calculus of right ureter

Ultrasound

Ultrasound has the advantage of avoiding exposure to radiation or contrast and can detect most renal calcifications, but it is less sensitive in delineating stone size and number and cannotdetect most ureteral stones.

Ulatrasound – kidney stone

Treatment

Diet

Medicamentous therapy is oriented to activate urodynamics and stop renal colica.

Fluid intake

Health resort treatment

Treatment of renal colica

Hot-water bottle, hot bath

Spasmolytics and analgetics (Diclophenac, Baralgine, No-spa)

Catheherisation or steinting of kidney

Percutaneuos nephrostomy

Surgical treatment

The indications for surgical intervention for upper tract stones include recurrent pain, highgrade obstruction, associated infection, growth of stones despite medical therapy, and large size of stones.

Treatment options include shock wave lithotripsy (SWL), ureteroscopy, percutaneous nephrostolithotomy (PCNL), and open or laparoscopic stone removal.

ESWL

SWL is the most commonly employed treatment modality for renal and ureteral calculi and for stones associated with some anatomic abnormalities, specifically obstruction (e.g., ureteropelvic junction obstruction, ureteric stricture, etc.) and the only completely noninvasive treatment option.

Contra-indicated at exacerbation of inflammatory process, severely decreased kidney function, chronic renal failure, haematuria.

Ureteroscopy

Ureteroscopy is primarily used to treat ureteral stones but is increasingly being used to treat renal calculi for which SWL has failed or is ill-advised.

Percutaneuos nephrolithotomy

Percutaneous nephrostolithotomy is indicated for large-volume renal calculi and for stones associated with some anatomic abnormalities.

Percutaneous nephrolitoextraction