Kidney stone treatment with hi tech laser technology

• These days 99 % of kidney stones are treated without surgery.
• Advanced lasers are being used to convert hard stones into dust and remove them through natural passage.
• The procedure is done under mostly spinal anaesthesia which numbs the lower body and patient gets a painfree experience.
• Using high grade lasers these procedures are fast and recovery is within 2 days.
• The reduced stay in hospital also prevents hospital acquired infections.
• Kidney stones treatment and its cost has changed over past few years due to newer technologies.
• Most of these procedures are covered under insurance and provide a gentle approach to a once long painful condition.

Medicines can only expel small 4 to 5 mm stones possibly however larger stones need fragmentation and removal in a single step.

Diagnosis will be primarily done to establish the location and size of stone and hardness too needs to be established in certain cases of ESWL .After blood tests including kidney function and bleeding time, the procedure options will be discussed with patient and decided by the specialist doctors.

Laser stone removal and ESWL along with MiniPCNL procedures have been refined and are use in India.

Single and multiple stones of various chemical compositions, size and shapes can be treated using different technology.

Yes recurrent stones can be treated, however modalities might differ because of previous surgeries if any. This treatment plan is finalised during consultation.

Lasers are used as latest option worldwide due to its fragmenting property which is free of blood loss and with no down time .Types of laser differ in different stone removal techniques.

Scientific and non-invasive (no cut ) procedure to  remove Kidney, Ureteric and Bladder Stones without surgery using sound waves .

Flexible uretroscopy ,RIRS .cystoscopy PCNL MINIPCNL are all techniques where no cut is given.

No cutting, no damage to kidney or other vital organs, international popular procedure....

Most cases in Urolife are treated by ESWL and gives result of stone free status after one or two sessions which are confirmed by ultrasound.

• PCNL When the approach is made through skin over the kidney a rigid tube called a nephroscope is used and through it laser (holmium laser )is passed in direct contact to stone and fragments are taken out .The size is approximately 10 mm diameter and in most cases no stitch is needed.
• MINIPCNL or MPCNL is the same above technique using a miniaturized nephroscope and is much better in terms of safety .Sizes upto 25 mm stone can be taken out and requires a much narrow passage.

In plain terms uretroscopy is the procedure where a ureteroscope (instrument with a light source and laser ) is used and URS is the treatment using this to remove ureteric stones .Similarly RIRS (Retrograde intrarenal surgery )is a similar process wherein a flexible ureteroscope is used and this is especially done to fragment and remove renal stones.

• When stones are found in kidney or ureter the removal process can often involve minimal cutting or making a hole in abdominal area.
• Removing the stone by this approach leaves a puncture wound over the kidney area
• This was the only option in past few years though being a minimal invasive procedure it took about a week to recover.
• A tube called as a drain is also attached after stone removal at puncture site. This is then removed after 3 days and the wound is dressed.
• With the advent of newer technologies this procedure called as RIRS makes it possible to remove stones without any cut on the body.
• The stone is powdered into dust using high grade lasers called holmium and all contents are removed through the natural urinary passage.

Hence no rest is needed and patient can resume work within two days.

The treatment time for ESWL or lithotripsy is one hour per sitting after which the patient can resume normal activity ,the total number of sittings will be decided by doctor in consultation .URS ,RIRS take one hour duration in process and patient is admitted for one night , whereas PCNL and MiniPCNL takes 1 and half hour approximately .However these timings can vary in complex cases.

Patients are screened for kidney function and once that is normal along with anaesthetic clearance these procedures can be performed.

The stone is taken out using a vacuum there and then and few left over particles get drained out through normal urinary passage .J stent facilitates this process.

Urologists, imaging specialist along with nephrologists and anaesthetists work as team in each case. In complicated cases other specialists opinion is also sought.

No, because stones are converted to small 2 to 3 mm particles and they easily flow through normal passage whereas most of it is sucked out during the process.

Yes, the chances are strong as the process of stone formation in body is not addressed ,however in Urolife ,proper stone analysis will be followed by diet charting and medications to stop recurrences.

In Urolife the results after each techniques are confirmed by ultrasound and x rays ,in certain cases CT scans too are needed.

Different centres follow specific protocols depending on technology available in hand , and in Urolife ESWL and ureteroscopy are first line treatments as far as possible they are non surgical.

Cost of ESWL ranges depending on location and size from 15 thousand to 35 thousand excluding the stenting cost.

These stones obstruct the flow of urine and lead to stagnation causing infection in kidneys and tract and eventually loss of renal function which becomes serious.

Several food and water compounds do not get metabolised and precipitate as insoluble particles which gets build up in course of time leading to stones. Cetain metabolic disturbances in body too are responsible and all these are part of prevention protocol in Urolife centre.

• Modern medicine does not address this possibility, however there are newer medicines which prevents or causes expulsion of micro fragments from the body.
• Patients have different types of stones in composition; most common calcium oxalate and calcium phosphate (80%) do not get dissolved by any medication or with water.

Yes high oxalate and calcium rich foods are responsible for stone formation, whereas few synthetic compounds in preservatives too have a role.

• Fever above 102. Degrees Fahrenheit
• Burning in urination or blood in urine. cloudy urine, or bad smelling urine
• Persistent nausea and vomiting
• Intolerable pain
• Certain medical conditions can make passing a stone potentially more dangerous, including those with only one kidney, those with diabetes, or those with decreased kidney function.

It appears that stones can form in as short a period of time as three months or can take long depending on water intake and climatic factors and dietary habits.

Stones in kidney or ureter can pass out naturally by drinking lots of water however the size should not be more than 4 mm .Larger stones upto 6 mm too are known to pass out naturally but can cause lot of pain and bleeding or internal abrasion and trying this out is full of such risks.

It is a hollow light weight tube lesser than the diameter of ureter which is placed from kidney to urinary bladder to ensure proper passage of urine and particles.

It’s a simple procedure done in aseptic conditions where the tip of stent is held to be taken out the patient is able to walk away after passing urine once.

In safe hands this should not happen until a stone fragment is left which causes pain.

Overnight fasting and few blood tests is all that is needed and patient can resume food and water intake the same day.

• Most kidney or ureteric stones will be treated without any open surgery, the options can be from ESWL, URS or RIRS.
• Discuss with your urologist the latest procedures and the most suitable procedure.
• Your procedure will depend on your stone size, location and your general body condition.
• RIRS is a costly treatment and due the cost at times patients opt for PCNL which is a minimal invasive procedure.
• The results are almost the same except the recovery period is about a week in PCNL whereas in RIRS one can join routine in a day or two.
• X ray and IVP will ensure that the procedure chosen by your urologist will deliver the best results, and at time a CT scan might be needed.
• Do not assume that complete stone removal either by laser or by ESWL will prevent further stone formation.
• In fact being treated or diagnosed once with this condition makes you more prone to recurrences.
• Simple steps are available to keep away stone reformation and mantain good renal health.
• Read more about these steps at www.kidneystonetreatment.in

• There are few conditions or body functioning states which will increase your chances of stones reformation.
• Mainly related to food intake, digestive system, kidney disease or infection and metabolic disturbances tend to make you prone for stone formation.
• Here is a pointer to refer, that once a stone has been diagnosed and even treated, the body will restart the formation until steps are not taken to find the exact cause or more precisely the causative agent.
• Most kidney stone treatment hospitals do not empasize the importance to get the expelled or collected stone fragments to be tested so as to take precise steps for prevention.
• In such case its mandatory to get diet charting along with steps taken to diagnose a metabolic disorder and thereby reduce the chances of being a kidney stone patient again.

Few dont's

• Do not cut down on water intake as dehydration will increase the chances of stone formation.
• Plenty of water will keep urine flow proper and expel early sedimentations regularly.
• Recent studies have shown that increased calcium containing.
• food actually prevent stone formation, however calcium supplements increase the risk.

• You can check your risk by knowing the below
• Did you get diagnosed for kidney stones in the past?
• Do you have a family history of kidney stone?
• Are you constantly feeling dehydrated?
• Do you have a sedentary life style and take of fluids too?
• Do you take protien supplements especially for muscle building?
• Are you troubled by repeated urinary infections?
• Any history of gout, blood pressure treatment and overactive parathyroid glands?
• If you think you have answered any or more than one in affirmative, then you must keep a watch and work to avoid kidney stone by taking few steps.
• Get detailed guidance by visiting www.kidneystonetreatment.in

• Urolife Medical Centre works with the primary approach as non surgical in majority of cases (Non invasive) and or in cases of larger stones more than 25 mm or lower ureteric stones as minimal invasive approach to pain free stone removal.
• Prevention protocol is part of Urolife treatment which includes diet charting along with few medications to prevent reformation.
• The team hence includes nephrologist, urologist, imaging specialist, endocrinologist and dietician. Early detection for any stone is a priority and follow up scans and x rays are done regularly and patients are advised to follow up with the centre and stay connected in future for any advice.
• Patients are free to drop in any query and visit the centre even after treatment for periodic evaluation.

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