2.3 kidney stone removal by Ureterenoskopie
In this treatment of kidney stone / urinary, in the course of an endoscopic (camera tube) study with the same distance.
To this end, the patient is placed supine with legs (called lithotomy position). Then, the endoscope through the urethra into the bladder advanced. Now, the openings of the urethra to be identified and, if necessary, by means of an initially dilated Ureterenkatheters or guidewire. Next, the ureter now be searched according to the kidney stone. This is found, there are several possible approaches. So you can either zertümmern the stone using sound waves and then vacuum, or by shock waves break up (eg by laser) and then removed with a forceps. It is an alternative to ESWL, which offers the possibility, for example, existing dilate strictures of the urethra and thus the same off future sources of problems.
This method is recommended for kidney stones / bladder stones greater than 5 mm, violent, uncontrollable colic or kidney stones that do not come off despite conservative therapy. Moreover, it is applied with increasing urinary or existing urinary tract infection. Also deep and very stubborn urinary stones can be removed or pushed back into the renal pelvis in order to subsequently be removed by ESWL.
complications such as urinary tract infections, bleeding or perforation of the ureter are rare.
Kidney KelchsteinIst not usually require treatment if no symptoms, or urinary infection present.With blood in the urine and untreatable infections, and certain occupational groups (pilots, professional drivers) ESWL
Renal pelvis stone
for no longer spontaneously abgangsfähigem stone (> 5 mm) ESWL or PNL.
there are usually no symptoms, but can be a chronic kidney infection (pyelonephritis) with subsequent risk of kidney failure and death. Therefore, one should also operate: ESWL, PNL, or the combination of both. Then can be caused by a so-called outgoing debris stone road that needs to be surgically removed.
If there is a significant urinary retention, a spontaneous outlet can be excluded. Conveniently the ESWL or endoskopopische removal (mechanical removal).
Up to a size of 5 mm, it can spontaneously disappear. With normal renal function can still be used on non-operative measures.
the stone should be smashed and then sucked to the suction pump. Then should be addressed (eg, enlarged prostate), the primary disease.
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