Our patient, a 30-year-old female patient, applied to us with left kidney pain and when we performed urinalysis, urine culture and kidney tomography in the stone protocol, it was seen that she had two stones in the left kidney and at the same time she had urinary infection because we know that stones increase the tendency to urinary tract infections over time and increase the possibility of occurrence. Therefore, when we consider the location of the stone causing recurrent urinary tract infections, causing pain and the size of the stone, the treatment planned for the patient is endoscopic laser stone treatment, which we call endoscopic laser stone treatment, which is the process of going up to the kidney with a flexible ureterorenoscope and breaking the stone in the kidney with holmium laser.
We have planned this for this patient today and we are doing it under general anesthesia for the moment. Our procedure will take an average of 45 minutes, the patient is hospitalized overnight after the procedure, and we place a stent that we call Double J stent in the patient during the operation, which we will keep inside for a week to 10 days right behind the procedure. The procedure we will apply to our patient is limited to this.
Today, we are performing endoscopic laser stone treatment for left kidney stones. When we look at kidney stones, they generally present to the hospital with severe pain, bleeding in the urine, recurrent urinary tract infections, and occasionally with renal dysfunction.
In general, we accept stones over 5 mm in the patient group that need to be treated, especially with some kind of surgical treatment. For stones below 5 mm, we can postpone the interventions considering the possibility of stones falling. In this group of patients, if there is a change in the kidney, an intervention is also considered for stones below 5 mm.
Although it varies according to the size of the kidney stones, when we look at the treatment methods, the ESVL technique, which we call stone crushing, comes first. These are often defined as the technique of breaking kidney stones with an external sound wave, but today their success is extremely limited and we apply them more often, especially for stones under 1 centimeter.
If the stone load of the kidney stone is above what we normally expect, especially for stones above 1.5-2 cm, we apply the technique called Percutaneous Nephrolithotripsy, which is the technique of breaking and removing the kidney stones by entering through a 1 cm hole in the lumbar region.
In addition to these, if there are ureteral stones or stones as large as 1 cm in the pelvis, we enter with the urethra wing, which we call endoscopic laser stone treatment, from the urethra to the ureter and from the ureter to the kidney and break the stones with the holmium laser technique we call laser.
Although our stone crushing process varies according to the size of the stone, it takes about an hour on average, and at the end of the operation, we put a Double J stent in the patient. The Double J stent stays in the patient for an average of one week to 10 days and then we remove them under sedation.
Therefore, today, endoscopic laser stone treatment is a highly successful technique in kidney stones, ureteral stones and bladder stones and is seen as a surgical technique in which the patient is healed and applied considering a very fast recovery process without any complications.
Generally, these patients stay in the hospital for one night after the operation and the Double J stent is removed after one week. In endoscopic laser stone treatments, we do not just break the stones, we take them out with special baskets while breaking the stones, and these stones are also sent for analysis at the same time.
Again, in patients with recurrent kidney stones, it is extremely important to investigate the causes of the stone, which we call etiologic factors, in patients with a history of multiple similar stones.
#endoscopiclasertreatment #kidneystones #lithotripsy #minimallyinvasive #urology #healthcare
19 фев 2023
