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What Are The Treatment Options For Kidney Stones?
Copyright 1995 Health ResponseAbility Systems, Inc."Silent" stones (those that are not causing any problem for the patient) normally do not require treatment. Acute attacks, on the other hand, may require hospitalization, because the pain is so severe. In most cases, the stone is small and the individual needs only pain relief and instructions concerning recovery of the stone after it is passed.
About 90 percent of stones pass spontaneously through the urinary system. Sometimes the stone becomes stuck in the ureter or bladder. In this event, the physician may suggest that the best thing to do is just to wait and see if the stone will pass if it is given a little time.
In some cases, the doctor may recommend removal by passing a cystoscope (a hollow tubular instrument) up into the bladder, grasping and withdrawing the stone with a basket-like device. Sometimes stones that are stuck in the bladder can be crushed using a tiny instrument inserted with a catheter. Some stones (those composed of uric acid) may be dissolved by medical treatment. In other cases, surgery may be recommended to extract stones stuck in the urinary system.
In recent years, clinicians have developed still other means of extracting stones from the kidney and upper ureter. In some instances. a needle and probe can be inserted through the skin creating a channel straight to the area of the stone. Through this channel, the stone can be viewed using a fiberoptic nephroscope.
In some cases, the doctor can insert an ultrasonic probe through the channel, placing it against the stone and gradually disintegrating it. Then the stone fragments are removed using special forceps, loops or baskets that grasp and draw out the pieces.
Sometimes an alternative technique employing an electrohydraulic instrument is used to shatter the stone. As the stone breaks up, the area is continuously irrigated and the pieces of stone are sucked up by a vacuum apparatus.
Another procedure known as coagulum pyelolithotomy can sometimes offer a simple, rapid means of removal of multiple stones in the kidney. In this treatment, a liquid containing calcium chloride, cryoprecipitate, thrombin, and indigo carmine is injected into the kidney and allowed to form a jelly-like clot.
Within minutes the stones are trapped inside the clot, which the surgeon then extracts with forceps. He sutures the incision, and the individual is free of the painful stones.
What Is Shock Wave Therapy?
Researchers are hopeful that the need for surgery may be reduced by a new therapy that uses high energy shock waves to pulverize kidney stones.
Before treatment, the individual is anesthetized and positioned in a water bath so that the kidney stone is precisely localized and targeted to receive the highest energy of the shock wave. The blast, which does not harm any other area of the individual, penetrates the kidney stone and shatters it.
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