New Delhi: Kidney stones are very common in India, accounting for 12 per cent of the global cases of this complication. The northern part of India relatively reports a higher rate of kidney stone cases. Kidney stones also known as renal stones are solid deposits that form within the kidneys when minerals and salts in urine crystallise.
Dr Shreyas Nagaraj, Consultant-Urology, Fortis Hospital Cunningham Road told News9, “Urinary stones, also known as calculi, are hard deposits of minerals that form within the urinary tract. These stones can cause excruciating pain, blood in the urine, and difficulty urinating. Traditionally, their removal involved surgery. Thankfully, advancements in medical technology have introduced minimally invasive procedures like cystolithotripsy, offering a less disruptive treatment option.”
Understanding Cystolithotripsy
“Cystolithotripsy, literally meaning “bladder stone crushing,” is a procedure used to fragment urinary stones located in the bladder or, in some cases, the lower portion of the ureter (the tube carrying urine from the kidney to the bladder),” according to Dr Nagaraj.
There are two main types of cystolithotripsy:
• Shockwave lithotripsy (SWL): This non-invasive technique utilises shock waves generated by a machine called a lithotripter. The shock waves travel painlessly through the body, targeting and fragmenting the stone into smaller pieces that can then pass through the urine.
• Laser cystolithotripsy: This minimally invasive procedure involves inserting a cystoscope, a thin, illuminated tube, into the urethra and bladder. A laser fibre within the cystoscope emits laser energy that breaks down the stone. The fragmented particles are then either extracted through the cystoscope or passed naturally through urination.
Who is a Candidate for Cystolithotripsy?
The suitability of cystolithotripsy depends on several factors, including:
• Stone size and location: Generally, stones smaller than 2 cm in diameter are ideal candidates. SWL may not be effective for larger stones or those located in the upper ureter.
• Stone composition: Certain stone types respond better to specific cystolithotripsy methods. For instance, SWL might not be suitable for very hard stones.
• Overall health: Patients with uncontrolled bleeding disorders or urinary tract infections may not be good candidates.
The Cystolithotripsy Procedure
The specific steps involved in cystolithotripsy vary depending on the chosen method. Here’s a general overview:
• Pre-procedure consultation: Your doctor will discuss your medical history, perform a physical examination, and order imaging tests like X-rays or CT scans to locate and assess the stone.
• Shockwave lithotripsy (SWL): You’ll be positioned on a table, and an ultrasound device will pinpoint the stone’s location. The lithotripter then delivers focused shock waves to the stone over 30-60 minutes. You might experience mild discomfort during the procedure, but you’ll be under local anaesthesia or mild sedation for pain management.
• Laser cystolithotripsy: General or spinal anaesthesia is usually administered for this procedure. A cystoscope is inserted through the urethra and into the bladder. The laser fibre within the cystoscope targets the stone, breaking it into fragments. These fragments may be extracted with a basket instrument or passed naturally.
Recovery after Cystolithotripsy
Both SWL and laser cystolithotripsy are outpatient procedures, allowing you to return home on the same day. Recovery is typically swift, with most patients experiencing minimal discomfort. You might be prescribed pain medication and advised to drink plenty of fluids to help expel the stone fragments.
Potential Complications
As with any medical procedure, cystolithotripsy carries some potential risks, such as:
• Blood in the urine: This is a common side effect that usually resolves on its own within a few days.
• Urinary tract infection: There’s an increased risk of infection after the procedure, so your doctor may prescribe antibiotics.
• Ureteral injury: This is a rare complication that might require additional procedures.
• Stone fragments not passing: In some cases, the stone fragments might be too large to pass and require further intervention.
Advantages of Cystolithotripsy
Compared to traditional surgery, cystolithotripsy offers several advantages:
• Minimally invasive: The procedure avoids large incisions, minimising scarring and discomfort.
• Outpatient procedure: You don’t require hospitalization.
• Faster recovery: Recovery time is significantly shorter compared to open surgery.
• Reduced risk of complications: There’s a lower risk of bleeding and infection compared to traditional surgery.
Cystolithotripsy is a safe and effective minimally invasive procedure for treating urinary stones in the bladder and lower ureter. If you’re experiencing symptoms suggestive of urinary stones, consult your doctor to determine if cystolithotripsy is the right treatment option for you. Early diagnosis and intervention are crucial for managing stones and preventing complications.
According to expert, cystolithotripsy, literally meaning “bladder stone crushing,” is a procedure used to fragment urinary stones located in the bladder or, in some cases, the lower portion of the ureter (the tube carrying urine from the kidney to the bladder) Health Conditions Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
