Kidney stones solution to the problem

Kidney stones can be defined as small stones that form inside the urinary tract urinary tract (kidneys and bladder).
They are made of crystals of salts and organic material, normally present in urine, which are joined together. The crystals are normally eliminated in the urine, but when it does not, gradually increase in volume.

The subject of kidney stones mainly affects middle-aged and male. There are also cases of in children.

The disease is highlighted by one or more episodes of renal colic, accompanied by nausea, vomiting, burning urination or the need for frequent urination, blockage of urine output, dark-colored urine.

The different chemical composition is an element of distinction for different types of calculation. They differ, so the radio-opaque stones with a majority composition of calcium and radio-transparent calculations made by uric acid or sodium.
The location, volume, shape and chemical composition of the calculation associated with the presence or absence of infection are necessary elements to consider for a proper evaluation of the clinical picture. The diagnosis relies on the urinary tract ultrasonography and radiography of the abdomen without contrast. The T.C. spiral and / or IVU is essential to the planning of complex therapies, while the ascending is used in selected cases.

For the treatment of kidney stones include the following possibilities:

- Spontaneous expulsion: In a kidney stone about 80% of computers located in the ureter are deported without any further action. This possibility, however, is open only to the calculations of smaller than 5 mm, asymptomatic, with no obstruction of the outflow of urine and without infection. Are needed, however, regular checks of up to expulsion took place, to avoid leaving an undiagnosed growth of kidney damage calculation or asymptomatic chronic urinary stasis.

Dissolution of the calculation, with drug therapy.
Drug therapy is feasible in the case of kidney stones composed of uric acid stones and bring them to a "dissolution" in 70% of cases, provided that the urine flow regularly around the calculation (in case of obstruction of the outflow must be secured by placing a small catheter through the ureter). For kidney stones (very rare) this therapy is only possible in limited cases.

- Extracorporeal shock wave lithotripsy, it means crushing the stone, is the first-line therapy in kidney stones. 90% of cases of stones treated with lithotripsy. This therapy has largely replaced surgery of calculi in the open. With the shock wave, in this case we speak of extracorporeal shock wave lithotripsy; the calculation is broken up to form fragments smaller than 2 mm. The resulting grit is normally eliminated through the urinary tract without problems. After 3 months of treatment by lithotripsy about 80% of patients are free from the calculations. The complications of this treatment are rare: blood urine, colic, renal hematoma and urinary tract obstruction. Provisions ancillary to lithotripsy, such as placement of catheters in the ureter or kidney, are needed in only 30% of cases. Serious complications are very rare. Lithotripsy is suitable for any location within the urinary tract and calculation is performed using powerful painkillers and sedatives or spinal anesthesia, depending on the type of calculation and the fragmentation of the machine and the pain threshold of each patient. Lithotripsy is contraindicated in the following cases: purulent kidney infection, coagulation disorders and pregnancy.

- The endoscopic lithotripsy is instead an endoscopic procedure that involves no incision, and which ensures a success by almost 100% in the treatment of ureteral stones. It 's the method of choice for all ureteral stones with a diameter greater than 1 cm and those smaller than if associated with urinary stasis, and the second choice for all cases in which previous treatment of d-wave lithotripsy extracorporeal' shock failed. Is introduced through the urethra with a probe endoscopic called, one reaches the ureteral outlet, which introduces a safety guide wire. It then goes along the ureter until it reaches the calculation. Then using the Holmium laser to shatter and the fragments obtained are extracted.
This surgery is performed under general anesthesia and requires a hospital stay, in uncomplicated cases, in the Day Hospital or at most one night. In about 70% of cases it is necessary to the placement of a ureteral stent to "double-J stent or, for about a week to allow the discharge of urine without the annoying occurrence of colic.
The complications resulting from endoscopic lithotripsy can occur in 5-10% of cases.

- In cases where the calculation has a size from 2 cm up, we resort to surgery: is a small hole in the lumbar region, through which you come up with an endoscope to the kidney and there with the calculation of the laser is broken and the fragments extracted by suction.