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LITOTRIPCIA |
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Lithotripsy
uses shock waves to pulverize urinary calculi (kidney stones)
non-invasively. In contrast, other methods of stone removal require
open surgery (surgical nephrotomy); extraction of the stone through a
puncture in the side of the patient (percutaneous extraction); or the
insertion of a ureteroscope via the urethra with subsequent stone
fragmentation and removal by mechanical means. All invasive procedures
carry higher a risk of infection complications than non-invasive
procedures such as lithotripsy |
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Occasionally,
if the stone blocks the flow of urine (an obstructive calculus) the
patient experiences severe pain (renal colic). This pain can be
controlled by introducing a stent into the ureter. The stent is
basically a tube which is place in the ureter and allows the urine to
drain past the obstruction. The stent may be left in after lithotripsy
in case of obstruction due to fragments becoming lodged in the ureter. |
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A shock
wave is characterized by a very rapid pressure increase, in the
transmission medium and is quite different from Ultrasound. The shock
waves is transmitted through he patient skin and passes harmlessly
through the patient's soft tissue. The shock wave passes through the
kidney and strikes the stone. At the stone boundary, energy is lost,
and this causes small cracks to form on the edge of the stone. The
same effect occurs when the shock wave exits the stone. With
successive shocks, the cracks open up, and in turn, smaller cracks
form within the large cracks. Eventually, the stone is reduced to
small particles, which are then flushed out of the kidneys or ureter
naturally during urination. |
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The process
generally takes about 1 hour during which up to 8,000 shocks are
administered. The patient will experience some discomfort during the
treatment depending on the patient's pain tolerance. Analgesics may be
administered to make the patient more comfortable. |
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© Endourological
Institute, Inc. 2002 |
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