Stone Procedures - Cystolithotripsy
Introduction
Stones or calculi are small deposits of crystal-forming substances that cannot filter out through the excretory system. They usually deposit in the kidneys, ureter, or bladder, causing renal problems if left untreated for long. The smaller stones can enter the ureter and finally the bladder before getting flushed out via urine. Ureters are the long, pipe-like structures that collect the urine and other wastes from the kidneys to the bladder. Doctors usually recommend drinking plenty of fluids, light exercise, and painkillers for stones to pass naturally. But what happens if the stone is large and does not budge?
Larger stones cause more severe pain in the renal pelvis and cannot move through the ureters. Urologists may recommend surgery for stone removal or crushing the stones into smaller pieces through sound waves. The crushing allows the smaller stone pieces to pass through the ureters, and finally, they pass through the urine out of the body. However, the suitability of medical treatment depends on the stone size, its position in the excretory system, and the type. Crystal deposits can be of calcium salts, uric acid, or other minerals.
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In recent years, many procedures are being used to treat kidney stones. Depending on the position of the stone deposits, whether they are in the kidneys, ureters, or bladder, the doctor finalizes a specific course of treatment. Cystolithotripsy is one such surgical procedure that aims to treat the stones present in the urinary bladder. Larger stones may require a surgical procedure other than cystolithotripsy. Cystolithotripsy is a non-invasive procedure with no drastic effect on the quality of life.
Urologists recommend the surgical procedure only if necessary based on the severity of your symptoms and the stone size. Various factors have to be considered before undergoing surgical treatment for calculi:
- Blood tests
- Cardiovascular reports (electrocardiogram, blood pressure, pulse rate)
- Medication history, especially if you take blood thinners or anticoagulants.
- Ultrasound of the abdomen region
- Kidney tests reports
- Patients must avoid smoking and alcohol consumption (if applicable) before surgery.
- The time taken for surgery is roughly around 45 to 60 minutes.
- The urologist performs the surgery under local or general anesthesia.
- The surgical area, i.e., your genitals and urethra, are cleansed with a sterile solution and lubricated.
- The lithotripter attached to a tiny camera is inserted through the urethral opening. The camera helps locate the stone/s position in the bladder.
- The lithotripter crushes the stone into tiny pieces, allowing them to pass through the urine.
- A catheter is placed at the end of the procedure to collect the urine after the surgery.
- The surgical area is continuously irrigated if bleeding starts during the procedure.
- The catheter is removed once the bleeding stops.
- Infection
- Abdominal pain
- Urinary infection
- Reaction to anesthesia
- Possible nerve or tissue injury
Most people are kept under observation for one or two days before being discharged. Patients may observe some of the following side effects:
- ● Urine in the blood
- ● Abdominal pain and discomfort
- ● Nausea
- ● Vomiting
- ● Tingling sensation or burning feeling in the urethra during urination
If any of the side effects mentioned above persist, seek immediate medical attention. Do not self-medicate at any cost.
Doctors recommend not to stress physically at least for two weeks while you heal.
- Rest as much as possible.
- The bleeding may continue while urinating but in trace amounts.
- Drink plenty of fluids to clear out any residues of calculi if present.
- Take antibiotics and painkillers on time as prescribed by the urologist.
- Maintain a healthy diet.
- Avoid alcohol consumption (if applicable) soon after the surgery to prevent complications.
- Prevent caffeine intake to avoid irritative symptoms.
Different types of Lithotripters are used for crushing the calculi into smaller pieces.
- Some Lithotripters have an action similar to a pneumatic hammer that crushes the stones. They are called ballistic Lithotripters.
- Recent advancements have led to the use of LASER Lithotripters. The laser light helps crush the medium-sized stone to pieces.
Studies suggest that bladder calculi form because of urinary obstruction for a long time. The enlargement of the prostate gland or the urethral wall can cause urine accumulation in the bladder. Cystolithotripsy can cure urine obstruction and remove bladder calculi together. The average success rate of Lithotripsy without serious side effects and complications is 95%. In India, the cost of the surgery is, on average, around Rs. 30000. It might go up to Rs. 50000 or above.
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FAQ's
The side effects last for the initial few days, around four to five days after surgery.
The chances of stones recurring soon after the surgery are nil. However, depending on your general health and diet, you must watch out for future calculi.
Cystolithotripsy surgery cures bladder stones. However, there are other procedures to treat kidney stones.
You may consult a urologist for any kidney, bladder, urination, or stone problems.
Yes, you can. However, a strict recommendation is that you consult your cardiologist about the medication, especially anticoagulants. If your cardiologist gives you the go-ahead, consult a urologist for stone removal.