| Discussion in 'All Categories' started by David Uniformo - Dec 12th, 2012 11:33 am. | |
David Uniformo
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Dear Doctor I am suffering from kidney stone. Please let me know what are the different treatment options available at your hospital. Thanks Uniformo |
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re: I am suffering from Kidney stone
by Dr J S Chowhan -
Dec 12th, 2012
11:44 am
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Dr J S Chowhan
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Dear Uniformo Thanks for asking a good question about Kidney stone. Stones are formed from minerals excreted within the urine as well as the greater the concentration of the minerals the much more likely they're to precipitate and form stones. Additionally, there are many natural stone inhibitors from the urine and low levels of the can result in a greater likelihood of stone formation. Stones can be connected with urinary infections , congenital kidney abnormalities as well as other health conditions. There are numerous types of stones that will form. The most common ones are calcium and oxalate based. The stone formed is dependent upon biochemical analysis of the stone. Many different treatments are around for stone disease. The correct therapy is determined by stone and patient factors. Many ureteric stones will pass spontaneously depending on the stone size , location and shape. Most stones that can pass accomplish that within About 6 weeks after symptoms have started. Ureteric stones 4-5mm in size use a 50% probability of spontaneous passage. You may well be given a drugs called Flomaxtra or Minipress to aid the passage of your stone. FIbreoptic pyeloscopy is inidicated for the removal of kidney and ureteric stones. It demands the passage of your narrow telescope the ureter to the stone and fragmenting the stone while using the holmium laser. The bigger stone fragments are then extracted by using a basket device. The lesser fragments will pass spontaneously. Ordinarily a stent is put temporarily as soon as the operation. This is removed within a separate procedure 2-4 weeks later. Holmium laser fragmentation of ureteric stone You will end up admitted to hospital usually about the morning of ones treatment and remain in hospital being a day patient or overnight stay according to factors like distance from your home including country and interstate patients, ancillary procedures and degree of post treatment discomfort. The operations is completed within general anaesthetic administered by a specialist. The ureteroscopy surgery originate from 30 to Sixty minutes, depending on the size and position with the stone. There'll be some discomfort with urinating there is going to be some blood within the urine stay following your treatment. Generally in most people, the passage in the remaining stone particles is totally painless. Extracorporeal Shock Wave lithotripsy The current management of kidney stones employs at World Laparoscopy Hospital for small stone is the use of a minimal invasive technology called ESWL. ESWL leads to the disintegration of kidney stones into small, sand-like particles, which can be spontaneously discharged in urine. The treatment is carried out utilizing a machine called the Kidney Lithotripter. A lot more than 1,000,000 patients have already been treated world-wide, and its particular safety and effectiveness in eliminating kidney stones is well established. ESWL for kidney stones, represents a huge benefit to you, the person, as opposed to conventional medical procedures. ESWL can do fragmenting 90% of all renal stones, 10% of renal stones are far too hard for perhaps the Lithotripter to fragment. You may be admitted to World Laparoscopy Hospital usually about the morning of one's treatment and remain in hospital as being a day patient or overnight stay depending on factors like distance out of your home including country and interstate patients, ancillary procedures and degree of post treatment discomfort. You will have to come with an anaesthetic for the ESWL, which can be often a general anaesthetic administered by way of a specialist. The ESWL treatment at World Laparoscopy Hospital will take from 30 to One hour, with respect to the height and width of the stone. ESWL does cause minor bruising to the kidney and as a result blood will be seen in the urine for several days as soon as the treatment. In most people, the passage with the stone particles is entirely painless. About 25-50% will experience some pain passing the stone particles and definately will need a tablet or injection to ease the discomfort. Inside 10%, the particles could potentially cause a short lived blockage as they change from the kidney and travel along the ureter towards the bladder. In this situation, a nephrostomy tube should be inserted in to the kidney to temporarily drain the urine, as the particles pass through the device. Hardly ever a haemorrhage can happen round the treated kidney, however, normally, this is self limiting and infrequently requires surgical procedures. You will need to cease taking Aspirin, Warfarin or any anticoagulant tablets, or signify in case you have a known bleeding tendency. There's some evidence that ESWL may elevate blood pressure levels ultimately, however, this remains scientifically unproven. Sometimes (about 30%) an additional procedure could possibly be necessary just before your ESWL treatment. This may involve inserting a Ureteric Catheter or Stent, which reaches in the bladder for the kidney, or performing a Percutaneous Ultrasonic Lithotripsy (PUL). A ureteric catheter is mostly employed for stones lodged inside the ureter. PUL is conducted just before ESWL for huge kidney stones, also referred to as staghorn stones. Let me notify you if either of such additional procedures is important. The complete effectiveness for ESWL treatment when it comes to complete stone clearance is 75-80%. Any residual stone fragments are generally small , not harmful. Larger stones 10-15mm diameter, or multiple stones may need a repeat ESWL treatment. Following a return home you ought to follow the following advice, 1.Resume normal activities whenever you feel able. 2.Carry on and drink 2.5-3.0 litres of clear fluid daily. 3.Undertake daily exercise to inspire spontaneous stone elimination. 4.Lie on your own stomach at the very least initially, every night when retiring to sleep. You should immediately inform if: a. Fever above 38.5 deg.C or b. Unremitting pain, not controlled by pain relieving tablets eg. Panadeine. Check you have an appointment to get a follow-up X-Ray 2-3 weeks after your ESWL treatment, before review within rooms. Also ensure you take your X-Rays home from hospital. Percutaneous Nephrolithotomy (PCNL) PCNL can be used primarily for giant stones in the kidney or upper ureter or being a salvage means of failed ESWL procedures or in situations where it not safe to proceed with ESWL. This operation is carried out under general anaesthesia and in most cases involves a healthcare facility admission of 2-4 days. . This procedure is split into 2 parts; accessibility to the kidney and stone removal. This involves the roll-out of a passage through the skin for the interior of your kidney. Through mtss is a hollow sheath is placed. This allows then this passage of an telescope in the within the kidney to visialised the stone. Over the telescope the stone is fragmented into small pieces that are then removed. Following stone removal a hollow drainage tube is positioned to ensure adequate drainage in the kidney. This really is removed over the following 24-48 hours. Open or Laparoscopic stone removal at World Laparoscopy Hospital These are uncommon operations to take out stones as a result of ease and success from the less invasive stone treatments. Stone prevention Having experienced first hand this and disability of your kidney stone, you may undoubtedly want to stop the formation of further stones. Stones recur in 50% of patients within maybe five or ten years, along with the source of kidney stones is often multifactorial and is different from one patient to a different. Kidney stones form in the event the urine becomes super-saturated with crystals of calcium, oxalate, phosphate and urate. This happens when there is increased creation of these crystals in the urine, usually in conjunction with a low urinary volume, which results in an elevated probability of kidney stone formation. There's also inhibitors of crystal formation that happen to be naturally created by one's body, and may be deficient in a few people, and in turn this may lead to stone formation. There is often a genealogy and family history of kidney stones, and patients coming from a Mediterranean family background can also be predisposed to an increased likelihood of kidney stone formation. This means that an innate tendency to stone formation, that there Kidney stones commonly form during hot weather, suggesting that dehydration is really a major factor, and in reality it's been well shown that increasing the urinary output from 800 to at least one,200 ml. each day will reduce the stone formation by 86%. Other risks for stone formation include obesity along with the use of a higher animal protein diet. There are numerous specific health conditions for example renal tubular acidosis, hyperparathyroidism, gout, sarcoidosis, and medullary sponge kidney, that happen to be directly related towards the formation of kidney stones, as well as for which specific treatment could possibly be indicated. Over these patients treatment might include the prescription of allopurinol or thiazide diuretic tablets. Treatment with potassium or sodium citrate is shown to substantially slow up the recurrence of kidney stones in patients with 'abnormal' amounts of citrate within the urine. Patients with renal tubular acidosis, chronic diarrhoeal states, and patients on thiazide diuretic therapy are common susceptible to hypocitraturia. A tiny but specific crowd who form urate stones will benefit from alkalinisation from the urine with sodium bicarbonate, along with allopurinol along with a high fluid intake. For many patients, however, a certain reason behind stone formation are not found despite metabolic investigations. In this case, you should consume 2-3 litres of fluid per day, particularly through the warm weather, so as to keep the urine dilute preventing crystallisation. The lake in Melbourne is just not regarded as loaded with mineral content and there is no must drink sterilized water in order to filter your mineral water. Standard water should be avoided, as it carries a high mineral/calcium content. You need to avoid the excessive consumption of dairy food fot it necessary for whole wheat toast, tea/coffee only. Alcohol also is likely to dehydrate our bodies and you will drink one glass water per vino or two or beer consumed, in order to replace the fluid lost. Soda pops (except Coco-Cola), veggie juice, soda water, and tap water are the most useful forms of fluid replacement. Cooking salt is recognized to improve the urinary output of calcium, and salt should therefore not added to the food, either during cooking or at mealtimes. Finally, if you find a structural abnormality to the drainage of your kidney, then corrective surgery may be needed to allow for the urine to drain freely in the kidney which will help prevent stone formation. With regards J S Chowhan |
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