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Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

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Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Intracorporeal lithotripsy.

Peter Alken1

  • 1Department of Urology, University Clinic Mannheim, Theodor Kutzer Ufer 1-3, 68167, Mannheim, Germany. peter.alken@medma.uni-heidelberg.de.

Urolithiasis
|December 6, 2017
PubMed
Summary
This summary is machine-generated.

The use of extracorporeal shock wave lithotripsy (ESWL) has decreased since the 1980s, while percutaneous nephrolitholapaxy (PNL) and ureteroscopy (URS) have risen due to advances in intracorporeal lithotripsy (IL) techniques.

Keywords:
Ballistic lithotripsyElectrohydraulic lithotripsyHolmium:YAG laserImpact lithotripsyIntracorporeal lithotripsyLaser lithotripsyUltrasound lithotripsy

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Extracorporeal shock wave lithotripsy (ESWL) adoption has declined since the 1980s.
  • Percutaneous nephrolitholapaxy (PNL) and ureteroscopy (URS) have seen increased application rates.
  • Technological advancements in instruments and techniques for intracorporeal lithotripsy (IL) are the primary drivers for this shift.

Purpose of the Study:

  • To review the current landscape of intracorporeal lithotripsy (IL) options.
  • To highlight the progress and availability of minimally invasive treatments for urinary tract stones.
  • To indicate future directions and improvements in IL.

Main Methods:

  • Literature review of extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolitholapaxy (PNL), and ureteroscopy (URS).
  • Analysis of trends in the application rates of different lithotripsy methods.
  • Evaluation of advancements in intracorporeal lithotripsy (IL) technology.

Main Results:

  • A significant decline in the application rate of ESWL.
  • A corresponding increase in the use of PNL and URS.
  • A wide array of effective intracorporeal lithotripsy (IL) options are now available for treating stones throughout the urinary tract.

Conclusions:

  • Intracorporeal lithotripsy (IL) has become a dominant approach for minimally invasive stone treatment.
  • Continuous progress in IL technology offers improved treatment options.
  • Future developments in IL are anticipated to further enhance stone management.