In the treatment of borek stones, the dimensions of the stone, the number of the stones and the places where they settle are the most important factors. Kidney stones are mostly formed with a diameter of 2-4 mm, and these stones are usually large enough to pass through the urinary canals and can easily fall off by themselves. Treatment is generally not needed for stones of this size.
Drug treatment in kidney stones
Small kidney stones can cause severe pain when falling from the kidney and urinary tract. In this case, these stones can be dropped temporarily with painkillers and antispasmodic drugs and with plenty of fluid intake. In addition, nausea-vomiting may develop, and antiemetic (nausea) medications can be used for this. Recently, medicines called alpha-1 receptor blockers, which are mostly used in the symptomatic treatment of prostate enlargement, are used to reduce ureter stones.
Ureterorenoscopy
This procedure is a closed surgery method. General anesthesia is required during this procedure. A fiberoptic device called ureteroscopy is used. Ureteroscopy first reaches the bladder and then the ureter, reaching the stone area and seeing the stone. This treatment is applied to the stones in the ureter or kidney. When stone is seen by ureteroscopy, the stone is broken with stone breaking tools called pneumatic or holmium laser lithotriptors. After ureteroscopy, after the stone is completely cleaned, it is decided whether to place a D-J stent in the ureter by deciding on the degree of edema at the place where the stone resides. These stents prevent the urinary canal from clogging between the kidney and bladder. Even if the stones or edema channel is blocked, there is no obstruction thanks to the space inside the stend. In this way, the pain that may occur after the operation is prevented.
Percutaneous Nephrolithotomy (PCNL) Closed Kidney Stone Surgery
PCNL (closed kidney stone surgery) is the treatment option to be used if it is thought that ESWL or ureteroscopy cannot be applied in stones over 2 cm. General anesthesia is applied during PCNL. The biggest advantage of this method is that it has replaced open surgery. By reaching the kidney through a 1 cm incision, the stones in the kidney can be completely cleaned. During the procedure, the entry point to the kidney is first determined by a detailed radiological examination (especially tomography). After the patient is anesthetized with general anesthesia, a thin needle is first entered into the kidney. After reaching the desired area, a guide wire is passed through this needle. Optical instruments are transmitted to the kidney through this passage, which is created by placing thicker needles up to 1 cm and then instruments over the guide wire. Thanks to these optical instruments called nephroscope, the stone in the kidney is displayed very easily. Pneumatic or ultrasonic lithotriptors are generally used for stone breaking. After the stone is broken and broken, the stone holders and stones are taken out. All pieces of stone broken during the process must be cleaned. However, this may not always be possible. After cleaning the stones, a nephrostomy tube is inserted through the nephroscope, and PCNL surgery is ended. After 2 days, the kidney is checked and the tube is removed. After this procedure, the patient is discharged the next day.
Flexible ureteralrenoscope called flexible urethra, which are bending and bending, started to be used in the kidney, and the success of full cleaning of the stone has increased gradually.
Open Surgery
Open surgery option in kidney stones is almost completely abandoned. It is very rarely used in special cases.
Does Kidney Stone Repeat?
Patients should not forget that after stone treatment, there is a risk of stone formation again in approximately 30-40% of patients who form stone once. The type of stone should be determined by analyzing the pieces obtained from the stone after the procedure. According to the results of this analysis, additional treatments and recommendations can be made to the patient to prevent stone formation.
Kiss. Dr. Osman Nuri Akbulut
Department of Urology
Medilife Bağcılar Hospital
Drug treatment in kidney stones
Small kidney stones can cause severe pain when falling from the kidney and urinary tract. In this case, these stones can be dropped temporarily with painkillers and antispasmodic drugs and with plenty of fluid intake. In addition, nausea-vomiting may develop, and antiemetic (nausea) medications can be used for this. Recently, medicines called alpha-1 receptor blockers, which are mostly used in the symptomatic treatment of prostate enlargement, are used to reduce ureter stones.
Ureterorenoscopy
This procedure is a closed surgery method. General anesthesia is required during this procedure. A fiberoptic device called ureteroscopy is used. Ureteroscopy first reaches the bladder and then the ureter, reaching the stone area and seeing the stone. This treatment is applied to the stones in the ureter or kidney. When stone is seen by ureteroscopy, the stone is broken with stone breaking tools called pneumatic or holmium laser lithotriptors. After ureteroscopy, after the stone is completely cleaned, it is decided whether to place a D-J stent in the ureter by deciding on the degree of edema at the place where the stone resides. These stents prevent the urinary canal from clogging between the kidney and bladder. Even if the stones or edema channel is blocked, there is no obstruction thanks to the space inside the stend. In this way, the pain that may occur after the operation is prevented.
Percutaneous Nephrolithotomy (PCNL) Closed Kidney Stone Surgery
PCNL (closed kidney stone surgery) is the treatment option to be used if it is thought that ESWL or ureteroscopy cannot be applied in stones over 2 cm. General anesthesia is applied during PCNL. The biggest advantage of this method is that it has replaced open surgery. By reaching the kidney through a 1 cm incision, the stones in the kidney can be completely cleaned. During the procedure, the entry point to the kidney is first determined by a detailed radiological examination (especially tomography). After the patient is anesthetized with general anesthesia, a thin needle is first entered into the kidney. After reaching the desired area, a guide wire is passed through this needle. Optical instruments are transmitted to the kidney through this passage, which is created by placing thicker needles up to 1 cm and then instruments over the guide wire. Thanks to these optical instruments called nephroscope, the stone in the kidney is displayed very easily. Pneumatic or ultrasonic lithotriptors are generally used for stone breaking. After the stone is broken and broken, the stone holders and stones are taken out. All pieces of stone broken during the process must be cleaned. However, this may not always be possible. After cleaning the stones, a nephrostomy tube is inserted through the nephroscope, and PCNL surgery is ended. After 2 days, the kidney is checked and the tube is removed. After this procedure, the patient is discharged the next day.
Flexible ureteralrenoscope called flexible urethra, which are bending and bending, started to be used in the kidney, and the success of full cleaning of the stone has increased gradually.
Open Surgery
Open surgery option in kidney stones is almost completely abandoned. It is very rarely used in special cases.
Does Kidney Stone Repeat?
Patients should not forget that after stone treatment, there is a risk of stone formation again in approximately 30-40% of patients who form stone once. The type of stone should be determined by analyzing the pieces obtained from the stone after the procedure. According to the results of this analysis, additional treatments and recommendations can be made to the patient to prevent stone formation.
Kiss. Dr. Osman Nuri Akbulut
Department of Urology
Medilife Bağcılar Hospital