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.

Discharge block
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.

High ureteral
If there is a significant urinary retention, a spontaneous outlet can be excluded. Conveniently the ESWL or endoskopopische removal (mechanical removal).

Deeper ureteral
Up to a size of 5 mm, it can spontaneously disappear. With normal renal function can still be used on non-operative measures.

Bladder stone
the stone should be smashed and then sucked to the suction pump. Then should be addressed (eg, enlarged prostate), the primary disease.

Newswise — DETROIT – The risk of women developing kidney stones is rising, as is the number of cases being seen in U.S. emergency departments, while the rate of hospitalization for the disorder has remained stable.

Those are among the findings of a new study led by Henry Ford Hospital researchers that set out to look at trends in visits, hospitalization and charges during a four-year period for patients who went to U.S. hospital emergency departments for treatment of kidney stones.

“While the number of patients visiting the emergency department had increased over that time period, it was women who had the greatest increase in visits,” says Khurshid R. Ghani, M.D., of Henry Ford’s Vattikuti Urology Institute and lead author of the study.

The study is published online in the Journal of Urology.

Citing recent population-based studies that have shown an increase in kidney stones among women, Dr. Ghani says his team’s findings in the ER provide further evidence that the risk of stones in women appears to be increasing.

“Women are becoming more and more obese. Obesity is a major risk factor for developing a kidney stone. And one fascinating thing about women versus men is obese women are more likely to develop a stone than an obese man,” says Dr. Ghani.

Drawing raw data from the Nationwide Emergency Department Sample (NEDS), the research team looked for related emergency room visits from 2006 – 2009. They found a total of more than 3.6 million visits for upper urinary tract stones.

During the study period, the incidence of the disorder rose from 289 to 306 per 100,000 people. Among the study group, 12 percent were hospitalized as a result of their visits and rates remained stable during the study period.

“I think in the last 10 years, the way urologists manage kidney stone patients in the ER has changed dramatically,” says Dr. Ghani. “Today, the emergency room physician and urologist have access to better diagnostic tools that allow for a more precise diagnosis. We use a CT scan, which is a quick test that allows for an immediate diagnosis and is available in every emergency department.

“Better diagnosis may be contributing to our findings that patients are not being admitted to the hospital as frequently as they had in the past. Also, medication can help with the spontaneous passage of these stones. As a result, some of these patients may be safely managed through the outpatient system with follow-up visits.”

For those who do get admitted to the hospital, the study showed that the highest likelihood was related to sepsis, or blood infection, which can sometimes occur when the stone causes a blockage and urinary tract infection.

Most notably, the charges for emergency department visits rose to $5 billion in 2009 from $3.8 billion dollars in 2006.

“One of the possible reasons for the increase in charges is the use of a CT scan to diagnose a kidney stone,” Dr. Ghani says.

“Fifteen years ago, around 5-10 percent of patients visiting the emergency department for a kidney stone would get a CT scan. Today, 70 percent of patients who visit the emergency department get a scan. While they’re wonderful tools of technology that allow an accurate diagnosis, they are expensive,” says Dr. Ghani.
Funding source: Henry Ford Hospital

Comment/Share

Kidney stone has become a widespread urologic disorder these days. Tiny stones pass out through urine, but if stones are larger in size, they may even require surgery for removal. Human body consists of two bean shaped kidneys located below ribs, towards the back of the body, on either side of spine. Kidneys filter waste and surplus water from blood, and help in excreting it in the form of urine.

Kidneys help in maintaining a perfect balance of salts in blood. Urine passes from kidneys to ureters, two urine carrying ducts projecting from each kidney. Through ureters, urine reaches urinary bladder, a urine collecting sac in lower abdomen. The bladder walls expand to accommodate urine and contract when urine is expelled through the urethra, an opening at the lower end of the bladder. This article briefly describes the major causes, symptoms and herbal remedies for kidney stones.

Causes

1. Family history
2. Certain food items
3. Urinary tract infection
4. Blockage of urinary tract
5. Cystic kidney disease
6. Inherited disorder called hypercalciuria.
7. Uric acid metabolism disorder called hyperuricosuria.
8. Metabolic disorders like hyperparathyroidism, cystinuria, hyperoxaluria.
9. Excess intake of Vitamin D
10. Gout
11. Intake of water pills, calcium based antacids, medicines for HIV.
12. Chronic bowel inflammation
13. Intestinal bypass surgery.

Symptoms

1. Sharp pain in lower abdomen, back and around groins
2. Chills
3. Fever
4. Passage of blood in urine
5. Difficulty in passing urine
6. Frequent urination urgency
7. Nausea and vomiting
8. Burning sensation while urinating.

Herbal Remedies for Kidney Stone Removal

1. One may take a mixture made by boiling 25 gm asparagus root, fennel bulb, parsley root and celery in 600 ml water. This is a magical drink to prevent stone.

2. Cramp bark reduces urinary tract spasms and has diuretic properties. It helps in stone removal from kidney.

3. The herb horsetail removes kidney stones effectively. It is an effective herbal remedy for stone removal.

4. Saint John’s Wort is also quite beneficial in flushing out stones.

5. Stinging nettle checks bleeding during urination and removes stones from kidneys.

6. Yarrow and Shepherd’s purse help in dissolving stones.

7. Dandelion root tea is very useful. It dilates urethra and helps in easy expelling of kidney stones.

8. Red clover blossoms help in grinding stones.

9. Cranberries are effective in melting stones.

10. Rosemary is an efficient stone removing herb.

11. Bilberry also helps in eliminating stones from kidney.

12. Kid Clear capsule is an effective herbal supplement for dissolving kidney stones and gallbladder stones without causing any side effects.

Hope this article will help you in treating kidney stone problem naturally.

Unfortunately, “kidney stone” had a sequel for me, one even more terrifying, horrifying, and shocking.

Medical tests during the kidney-stone crisis explained some other symptoms that have been gradually worsening for me over the last several years. The diagnosis was aortic valve stenosis, a stiffening of the valve that feeds oxygenated blood to the rest of the body. This is primarily a birth defect associated with aortic valves that do not have the normal three leaves. This was causing not only breathlessness, but permanent heart damage, and led to something far worse than kidney stone removal: heart surgery.

Please learn from my following medical adventure, to avoid my suffering. (While primarily a birth defect, better diet and exercise programs the last thirty years might have delayed this agony.)

I suspect that most people, unless they know someone who has gone through heart surgery, underestimate how much pain, time, and cost it involves. Search for “double bypass surgery” news stories, and you might almost get the impression that it is not really all that bad — a very common procedure that is just a bit worse than a tonsillectomy. This may be one of the few cases where the news media fail to adequately convey the seriousness in pain, time, costs, and risks of what is a surprisingly common procedure (230,000 procedures a year in the U.S. costing about $144,000 each).

Let me start out by explaining that I was actually pretty lucky on this — I was able to have a “keyhole” aortic valve replacement instead of an open chest procedure.

What did they do to me?

1. Heart-lung machine at the right groin artery and vein. (You don’t think they are going to replace a valve while the heart is running, do you?)

2. Cut a keyhole through the muscles of the chest.

3. Spread a couple of ribs apart.

4. Cut open the aorta through the keyhole.

5. Remove the malfunctioning valve.

6. Sew in a new bioprosthetic valve made of Dacron and (in my case) a horse aortic valve. (Yes, I can now boast of at least being valved like a horse.)

7. Sew up the aorta and close up the keyhole between my ribs.

8. Leave two sharp plastic drainage tubes in the chest that you feel every time you cough, breathe, or move for the next few days. They come out two days post-op, and they hurt when they come out, but at least they stop intensely hurting then.

9. Leave two electrical leads in place for a couple of days in case the doctors decide that you need a pacemaker. To quote the nurse: “Most patients say that removing them feels ‘funny.’” No, there was nothing confusing or ambiguous when the nurses removed them two days post-op; they hurt enormously.

The surgery took five hours on a Friday. I have a few thankfully vague memories of the recovery room, of which the worst was that I still had a breathing tube down my throat and I was gagging. (Yes, my anesthesiologist warned me that this would likely happen.) I don’t remember if I was strapped down to prevent me from pulling it out, but I suspect so.

Saturday was one enormous fog of pain, confusion, and despair. I was aware of my surroundings, but the details made no sense to me. My family was with me for most of this time; the nursing staff at St. Alphonsus’ did a spectacular job of trying to alleviate my suffering, but there are holes in your chest, and every time you move, cough, or inhale, it stings incredibly. Even if you stop breathing it hurts, pain the narcotics only dull but do not eliminate. You are coughing up occasional globs of clotted blood, perhaps from being on oxygen, which dries out your airways. You can’t really sleep, except in a narcotic stupor.

Every couple hours around the clock someone comes by to poke the end of your finger for a blood sugar test. Why? I did not know this: major surgery causes your body to release a flood of sugar, even if you do not have diabetes. This requires IV drips and separate injections of two different kinds of insulin to try to balance it out, because all that blood sugar screws up healing of blood vessels.

Sunday was perhaps the worst day. I was coming out from under the anesthetic fog enough to fully appreciate my pain and helplessness. At the same time, the hurt of breathing, moving, and extreme constipation caused me to wonder if I might have been better off dying on the operating table.