Patient reviews of laser stone removal are generally favorable. The advantages include painlessness, atraumaticity, and absence of complications. The contact laser method is a good opportunity to solve the problem in one session. The downside is that the procedure is not cheap. Laser contact lithotripsy is done if the remote method does not help, the patient has large stones with a high density or an abnormal structure of the skeletal system that makes it difficult to direct ultrasonic waves.
Contact method
The method is carried out using atraumatic endoscopic intervention. It is divided into three types:
- Ultrasonic. In this case, the stone is divided into fragments 1 mm in size, and then they are removed using an aspirator. Used mainly for loose formations.
- Pneumatic. Using a shock wave, deposits are split and removed with loops and forceps. In this way, the ureter is cleared of “stone paths” and other urinary tracts except the kidney.
- Laser. It is performed under the constant visual supervision of a physician. Most preferred method.
Contact retrograde lithotripsy is not recommended for persons with stenosis of the upper ureter, urethral strictures and pathological structure of the urinary system. In addition, after undergoing plastic surgery on the urinary canal, it is difficult to perform manipulations. During purulent-septic and acute inflammatory diseases of the genitourinary area, you should also not resort to this non-invasive intervention.
Remote ultrasonic crushing
The essence of the method of extracorporeal remote shock wave lithotripsy is the breakdown of deposits by a short pulse shock wave, which is formed using a special device - a lithotripter. The patient is placed on the table, the area around the kidney is lubricated with a special gel, and then a water cushion is applied. The waves are focused on the object and begin to influence. No anesthesia is required, but local anesthesia can be given at the patient's request. Stones fall apart under the destructive influence of impulses. All manipulations are carried out under ultrasound control. Having achieved crushing of deposits into small particles (less than 5 mm), the procedure is completed. It lasts about an hour. After which the patient can independently leave the hospital and be observed on an outpatient basis.
After the manipulations, you may experience dull pain in the lumbar region. Over time, their intensity decreases. Small parts of the stones formed after crushing are passed along with urine within several weeks. During this period, hematuria (the presence of blood in the urine) and colicky pain accompanying the passage of stones may be observed. Although extracorporeal lithotripsy is considered a low-traumatic method, damage cannot be completely excluded. Waves have a destructive effect not only on stones, but also on organ tissue. The resulting injury corresponds to a kidney bruise, after which it takes 5–7 days to recover. Of the complications that arise after surgery, the most unpleasant is the so-called stone path, which is formed from fragments of stones. Therefore, to prevent stone retention in the ureter, an endobiliary stent is placed - a special plastic tube. In addition, often the procedure does not help the first time. Some patients require repeat surgery. This is a significant disadvantage of this treatment option, since its cost is about 50 thousand rubles. Not everyone can afford a repeat course. However, in some clinics it is carried out under the compulsory medical insurance policy. The non-contact crushing method is preferred if the stones are loose and fragile. For dense salt formations, other treatment options are used.
Percutaneous stone removal
If the stones are coral-shaped or especially large and dense, the remote method is used in combination with the percutaneous one. During non-contact crushing, they are destroyed, and then the residual stones are removed using laparoscopic surgery. The percutaneous method involves penetration to the kidney using special surgical equipment. Percutaneous lithotripsy is performed in a hospital under general anesthesia.
The technique consists of passing a nephroscope to the kidney through a 2-3 centimeter incision in the lower back. It has a camera with which the doctor sees all the conglomerates. Then a sensor is advanced close to them along the nephroscopic channel and stones are crushed with a laser. Large fragments are removed with a lithoextractor, and small particles are removed on their own within a few days. The patient is discharged for 3–4 days. Preference is given to percutaneous lithotripsy due to the low risk of complications, good tolerability, and high efficiency. This operation can be performed on adults and children. One disadvantage of the percutaneous method is the use of general anesthesia. After lithotripsy, complications sometimes occur in the form of:
- pain,
- renal colic,
- tachycardia,
- increase or decrease in blood pressure,
- pyelonephritis,
- kidney hematomas,
- anuria (lack of urine during the day),
- "stone path".
If any of the listed conditions appear during the postoperative period, you should inform your doctor. He will prescribe appropriate treatment.
Education mechanism
Stone formation in the prostate is a dense structure of organic and inorganic origin. Calcifications are located in the ducts and lobules (acini) of the gland, complicating the movement of fluids in the organ, which leads to constant pain.
It is important to know ! The pathology occurs in men over 50 years of age in 80% of cases.
The exact reasons for the appearance of stones have not been determined, but there are two main theories:
- Long-term stagnation of organ secretion, which carries some infection and clogs the ducts of the glands,
- Deposits are formed from components of urine that stagnates in the ducts.
In any case, the resulting solid compounds are localized in the acini and ducts, causing injury to surrounding tissues and disrupting the circulation of fluids.
All this leads to the emergence and maintenance of the inflammatory process, since due to blockage, harmful microorganisms accumulate in the gland.
Reviews
Most patients who have undergone laser lithotripsy note that the operation is painless and minimally invasive. In one session you can forget about the problems associated with kidney stones. But there is also a negative assessment of such treatment, which is associated with the high cost of the procedure.
Doctors clearly confirm the advantage of laser lithotripsy over traditional treatment methods. After all, this method of treating renal stone pathology is characterized by minimal trauma and postoperative consequences.
Source: gidmed.com
Cause of occurrence
Stagnation of secretions and problems with urination lead to the appearance of stones.
Stagnation also provokes chronic diseases, which include:
- inflammation (bacterial and non-bacterial),
- adenoma,
- benign hyperplasia,
- cancer.
In addition to chronic diseases, prostate stones can also cause certain situations that urologists call risk factors.
These include:
- stress and overwork on a regular basis,
- smoking and alcohol abuse,
- frequent hypothermia,
- passive lifestyle,
- lack of personal hygiene,
- injuries to the penis and testicles,
- infections,
- inflammation of the urinary system.
In addition, one of the most serious risk factors is irregular sex life. The accumulation of ejaculate can provoke stagnation of prostate secretion.
Remove or wait?
I have kidney stones. They say we need to get rid of them. But it doesn't bother me yet. So, maybe it’s not worth flogging the fever?
Vasily, Yoshkar-Ola
–?It all depends on the size of the stones and the changes they caused in the urinary tract. It is no secret that the presence of kidney stones. The bladder or ureter is a source of inflammation and can lead to chronic pyelonephritis, renal failure, even kidney death, which may subsequently require renal replacement therapy (hemodialysis) and a kidney transplant.
Risk factors for urolithiasis are:
>>?genetic predisposition;
>>?chronic diseases of the gastrointestinal tract and genitourinary system;
>>?drinking hard water with a high salt content.
Kinds
Concretions in the gland are divided into subtypes according to the mechanism of occurrence, chemical composition and location. According to the mechanism of appearance, there are endogenous and exogenous.
Endogenous ones are formed due to regular stagnant processes in the organ and are localized in any ducts and departments.
Due to prolonged stagnation of secretions, amyloids begin to form - protein substances on which phosphate and calcium salts fall.
They are about 2-2.5 mm in diameter, round and slightly elongated into an ellipse. Their photos can be found on the Internet.
Exogenous ones are formed as a result of a pathology in which urine enters the prostate ducts (reflux). They consist of uric and oxalic acid (oxalates), as well as urates, and are localized in the distal ducts. They are pointed in shape, up to 4 mm in diameter.
According to their chemical composition, pebbles are divided into:
- phosphate - phosphoric acids predominate in their composition,
- calcifications – consisting of calcium salts. This type is the most dangerous, the formations are very hard and are not destroyed as a result of drug therapy,
- oxalate - consist of oxalic acid,
- urate - their composition is dominated by uric acids and their salts.
According to their location, stones in the prostate are divided into:
- true - localized in the prostate gland and its ducts,
- false ones are concentrated in the bladder, kidneys and the mouth of the prostate duct.
The type, composition and location are determined by the urologist using modern diagnostic methods - ultrasound, CT or MRI. The data obtained allows you to prescribe the correct treatment complex.
6. Clinician, center on Stavropolskaya
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- MSCT of cardiac vessels
- MSCT of the kidneys
- MSCT of the pancreas
A complete list of costs and types of examination can be found by calling or visiting the hospital’s website.
Consequences
Prostate stones are a serious condition that cannot be ignored even if it does not cause significant discomfort.
Blockage of the ducts leads to the onset of an inflammatory process, which in turn can provoke:
- infections and infection of a partner - as a result of microtraumas, the organ becomes covered with bleeding wounds in which pathogenic microorganisms accumulate,
- urination disorder - due to constant pain, a man cannot go to the toilet normally, urine stagnation begins,
- weak erection
- constant inflammation and tissue injury,
- tissue necrosis,
- abscess - a cavity filled with pus appears in the gland,
- cyst – a cavity is formed in which fluid accumulates,
- thrombosis - arteries and veins begin to become clogged with blood clots, which leads to the onset of tissue necrosis and necrosis,
- infertility - stagnation of secretions provokes interruptions in the functioning of the seminal vesicles and the onset of pathogenic processes in them.
The appearance of stones should not be taken lightly - such formations, even in single quantities, can lead to serious injuries and disorders in the urinary and reproductive systems.
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“Very good doctor. At first I was afraid of his examination or bandaging, but now I go myself and understand that he will help. It is important to not only make it go away, but to find the cause of the pain and prevent further poor health of the bones, especially if you have osteomyelitis. Believe me. »
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Symptoms
Symptoms of the disease are varied and vary depending on the size, nature and location. In addition, symptoms also depend on the duration of the disease.
Common symptoms include:
- general weakness and disability,
- inability to concentrate, inattention,
- constant fatigue
- chronic temperature 37.5°C,
- migraine,
- nausea and lack of appetite.
If stone deposits began to form quite a long time ago and are fully formed, specific manifestations may begin:
- pain in the groin and perineum area,
- pain during defecation, erection, ejaculation and walking,
- tension in the lumbar and sacrum areas,
- problems with urination: pain, frequent urge, especially at night,
- blood in urine and semen,
- decreased libido,
- violation of potency,
- impotence.
At the beginning of the disease process, the patient may not pay attention to the signs of pathology, but sooner or later specific symptoms will begin that will force him to see a doctor. In some patients, specific symptoms appear earlier.
External shock wave lithotripsy: technologies of the future
- without surgical interventions,
- low-impact,
- in 85% of cases the patient can go home
immediately after the procedure! - short recovery period
- virtually no complications
- the procedure is performed under anesthesia (epidural anesthesia)
External lithotripsy scheme
How many procedures are required?
This question is quite difficult to answer. Everything is very individual and depends on the size
and
stone structures
. Sometimes one procedure is enough, and sometimes, if the stone is large and hard enough, several procedures may be required.
For more accurate information, you need to make an appointment with a specialist at the URO-PRO clinic.
for consultation and diagnosis. You may need to do a computed tomography and ultrasound, based on the examination, the doctor will determine the size, location and structure of the stone.
Based on these data, a further treatment plan will be determined.
What equipment is lithotripsy used at the URO-PRO clinic?
The URO-PRO clinic has installed a new generation multifunctional system for remote lithortipsy and endourology LITHOSKOP from Siemens. This is expert-class equipment that has no analogues.
“Pulso's new shock wave technology makes it possible to crush even stones in the urinary tract that would normally have to be removed through more complex invasive procedures due to their hardness, size or position.”
Prof.
Joachim Turoff Johannes Gutenberg University Clinic, Department of Urology, Mainz, Germany
Main advantages of the system:
- You are in a comfortable position
and you do not have to “adjust” to the device:
the adaptable shock wave head
for therapy in the “over-table” and “under-table” positions eliminates the need to change the patient’s position. - High efficiency Pulso™
- special technology minimizes
the need for repeated procedures
.
The technology used contributes to the maximum percentage of impact and destruction of stones. Thanks to modern Siemens technologies, side effects, complications and pain are significantly reduced
as energy density is reduced to a minimum. As a result, procedures can be performed without anesthesia; In most cases, the administration of painkillers is sufficient. - Superior X-ray and ultrasound image quality
facilitates effective patient care.
Diagnostics
After several symptoms arise, the man goes to see a urologist, where he is examined with various diagnostic methods.
After an external examination and clarification of symptoms, the urologist proceeds with a rectal examination and prescribes a collection of tests, which include:
- donation of urine - an increased number of leukocytes, erythrocytes and epithelial cells will be observed in the urine. But the main indicator is calcium and phosphorus salts in large quantities,
- general blood test - an increased number of leukocytes and a high erythrocyte sedimentation rate indicate an inflammatory process in the organ,
- collection of secretions - with stones, amyloid bodies and lecithin grains will be observed in it, as well as Böttcher crystals and Trussr-Lallement bodies, in addition to an increased number of erythrocytes and leukocytes, as well as epithelium,
- spermogram - it will contain an accumulation of blood clots, a low content of sperm, inactive and having irregular shapes.
After passing the tests, the patient is sent for diagnostics using modern technologies:
- Ultrasound - for visual examination of the organ and determining the location of the accumulation, which will help determine the nature of the formation,
- CT - the procedure allows you to determine with 100% accuracy the size of concretions and the mechanism of their formation,
- excretory urography - carried out by introducing contrast (iodine-containing drug) and x-ray irradiation into the body. The contrast passes throughout the urinary system and highlights stone formations, which become clearly visible in the images.
A complete diagnosis allows you to most accurately determine the nature of calcifications and the area of their localization. A specific study is prescribed to the patient depending on his condition and individual characteristics.
11.Krasnodar City Clinical Emergency Hospital
CONTACT INFORMATION Address: Krasnodar, 40 Let Pobedy, 14 Sign up for MSCT: Opening hours: Daily Website: www.bsmp-krd.ru Equipment: multispiral COST AND TYPES OF STUDY
- MSCT of the hip joint
- MSCT of the liver with contrast
- MSCT of teeth
A complete list of costs and types of examination can be found by calling or visiting the hospital’s website.
Treatment
How to get rid of pathology in the prostate gland. After accurately determining the nature of the stones and their location, the urologist chooses the most appropriate type of treatment.
It could be:
- drug therapy,
- surgical intervention,
- laser lithotripsy,
- ethnoscience.
It should be noted that some types of treatment are strictly prohibited, for example, massage, since massaging the organ can lead to serious injury. And if stones have formed in the prostate gland, treatment with folk remedies will be considered more as an additional, but not primary therapy.
Medication
Removing stone deposits involves the use of common therapy - medication, but it only helps if the formations are not of a calcium nature.
Otherwise, taking medications will not have the expected effect. Urologists prescribe various medications.
After a course of antibiotics, inflammation in the prostate gland decreases and the body effectively resists bacteria and their pathogenic effects.
Prescribe Augmentin 1000 mg up to 2 times a day, course 7-10 days, Ciprofloxacin 200 mg up to 2 times a day, course 5-10 days.
Anti-inflammatory drugs (non-steroidal) are prescribed to reduce pain: Diclofenac 100 mg (tablets) or 3 ml (ampoules) once a day, course of treatment – 5-10 days.
Antispasmodics stimulate the expansion of the ducts and improve the circulation of prostate secretions. Together with the secretion, the stones begin to move into the urethra and leave the body along with urine. No-shpa is prescribed up to 4 times a day for 12 days, Baralgin up to 3-4 times a day for 10-12 days.
Alpha blockers help relax the muscle tissue of the urethra and dilate the urethra. Thanks to these medications, urine and secretions are eliminated painlessly. Omnix is used - 0.4 mg once a day for 1-3 months.
Note! Taking medications without a doctor's prescription is strictly not recommended, as it can lead to deterioration of health and the development of negative processes.
Operation
Surgical intervention is carried out in two cases: if calcium deposits and drug therapy have not brought the desired effect within 1-2 months and the condition.
Surgery may also be prescribed if the patient has acute pain, and the indications and state of his health do not allow spending several months on medication treatment.
Such indications include:
- intense pain that does not go away even after taking painkillers,
- urinary retention for more than 12 hours (anuria),
- acute renal failure.
If such symptoms are present, the doctor prescribes immediate surgery and removal of stones from the prostate. There are two types of surgical treatment for this problem - prostatectomy and resection.
During prostatectomy, calcifications are completely removed from the prostate gland through an incision in the lower abdomen or between the anus and scrotum. Recently, laparoscopy has become popular, during which the organ is removed using an endoscope. During resection, a section of the prostate gland is cut out and thus the stones are removed from the prostate.
The operations are performed under general anesthesia by the surgeon, followed by rehabilitation therapy and a special regimen.
Traditional methods
If prostate stones are diagnosed, treatment with folk remedies is used along with medications.
How to remove stones from the prostate using traditional methods and is it possible to do this?
Traditional medicine methods can be used as additional therapy, but only with the permission of the attending physician.
It should be noted that calcium rock cannot be dissolved.
There are not many medicinal plants that can cope with such a problem, but decoctions and infusions from them are quite effective in dissolving formations.
If stones are in the prostate, treatment with folk remedies may not be effective enough.
It is important to know ! Traditional medicine recipes cannot quickly dissolve stones; such therapy takes 6 months or more.
Removing stones from the prostate can be done with the help of some decoctions of medicinal plants, but only if they have begun to form.
If there are stones in the prostate, treatment with folk remedies advises using medicinal herbs for stone deposits:
- Madder powder 1 tsp. for 1 tbsp. water for 2 months,
- Rosehip root decoction – 2-3 tbsp. lie crushed root, brew with 1 liter of boiling water and boil for 15 minutes, leave for 6 hours and drink ½ glass 3 times a day for 2-3 months,
- Chestnut shell decoction - pour 1 liter of boiling water over the crushed shell and cook for 30 minutes. Leave for 2 days and drink 1 tbsp. up to 5 times a day.
Traditional medicine methods are almost powerless against formations in the prostate gland if pathology has already been detected in the genitourinary system. Urologists allow the use of such prescriptions along with drug therapy, but categorically prohibit relying only on them - this can lead to serious complications.
Modern technologies
Modern medicine, along with drug and surgical therapy, also recommends some new technologies to remove stones in the genitourinary system. Since there is no intervention inside the body, this treatment is called non-invasive or extracorporeal lithotripsy of the prostate.
Prostate lithotripsy is performed using low-frequency radiation that is irradiated into the lower abdomen or perineum.
The stones in the prostate are crushed, the formations disintegrate into their components, and the sand in the urine comes out in the usual way.
The treatment takes place over 10 sessions, during which all formations are removed from the prostate with a laser. Laser treatment is one of the most effective today.
Magnetic therapy involves exposure to a constant magnetic field, after which the sand in the ducts combines with urine and comes out. Magnetic waves have a stimulating and vasodilating effect on blood vessels.
Treatment of urate formations in the body occurs with the help of neurostimulation of the action of pulsed currents on the nerve endings of the organ to stimulate vasodilation and restore the functions of the organ. It prevents thrombosis.
Phonophoresis is the crushing of stones in the prostate, which occurs due to the impact of low-intensity ultrasound on them. This makes it possible to increase the sensitivity of tissues to drug therapy.
Therapy is prescribed based on the patient’s individual characteristics, taking into account his state of health and the stage of calculosis.
Chop or delete?
I suffer from urolithiasis. And I am faced with a choice: should I crush my stones or remove them? Which is better to choose?
Olga, Nizhny Novgorod
In the first case, crushing of a stone (usually medium in size - from 1 to 1.5 cm) is carried out using a special remote lithotripsy apparatus, which, by creating a special field, fragments kidney stones without internal intervention in the human body.
The other two methods involve tissue penetration and are more often used for larger and more multiple stones. The essence of these methods is as follows: under conduction or general anesthesia, the patient is punctured in the skin above the kidney and, under ultrasound and X-ray control, an optical system is inserted through a special tube or an instrument is brought into the stone through the urethra along the ureter.
Then, using special devices (ultrasonic, laser, pneumatic, electric pulse), the stone is crushed. Thanks to these techniques, you can immediately destroy all the stones and remove their fragments. In this case, the patient returns to active life much faster than if traditional open surgery was used.
However, the choice of stone removal method is a matter for the doctor.
Urolithiasis can be recognized by the following signs:
>>?pain and feeling of heaviness in the lower back, just above and to the side of the sacrum;
>>?pain in the lower abdomen, as well as in the groin, in the genital area;
>>?pain when urinating, frequent urination, cloudy urine;
Recovery process
The duration and nature of the recovery period depends on the course of treatment. If drug therapy requires only some changes in diet, then recovery after surgery is difficult and requires significant changes in lifestyle.
When removal of stones from the prostate gland is completed, the patient:
- observed in hospital for 3-4 days,
- may see blood in the urine,
- takes painkillers,
- cannot lift more than 2-3 kg,
- Must abstain from sexual activity for 2 weeks.
If part or all of an organ has been removed, the rehabilitation period after surgery lasts about 2 weeks, after which the patient can be considered completely healthy and return to their normal lifestyle.
To prevent recurrence of calculosis, you should adhere to proper nutrition:
- Avoid excessively fatty and smoked foods, alcohol, and carbonated drinks.
- try to eat protein and vitamin-rich foods,
- to live an active lifestyle,
- exercise regularly,
- have a regular sex life,
- rest in a timely manner,
- See a urologist regularly.
These recommendations should also be followed after drug and non-invasive therapy. Prostate stones can be treated with folk remedies and a healthy lifestyle.
Preparing for surgery
Due to the possible development of bleeding, at least seven days before surgery it is necessary to stop taking the following medications: aspirin and all drugs containing acetylsalicylic acid (cardiomagnyl, aspirin-cardio and others), Plavix, warfarin, phenylin, ibuprofen, diclofenac, Celebrex, indomethacin.
If urine culture shows the presence of infection, inform your doctor, and you will be prescribed antibacterial drugs in advance. In some cases, antibiotics may need to be taken two weeks before surgery even if the urine culture is negative.
