Remote lithotripsy refers to non-surgical methods of treatment of urolithiasis. This technique has become very popular due to its effectiveness. Let us consider this method of therapy in more detail, we shall distinguish its types.
Lithotripsy - what is it?
Referring to doctors for help, often patients do not know what is remote lithotripsy, imagining a terrible operation. This hardware method of treatment of urolithiasis helps to quickly eliminate the manifestations of the disease - concrements. In this case, they can be localized, both in the ureter, and in the bladder and even in the kidney. The essence of the technique is the remote destruction of stones. A special device generates a shock wave, which the doctor directs to the exact location of the calculi. As a result, their gradual grinding occurs.
Lithotripsy - indications
Remote shock wave lithotripsy requires preliminary careful examination and assessment of the patient's condition. Doctors accurately determine the location of the location of stones, establish their structural features, size, count the total number. Indications for such manipulation, as remote shockwave lithotripsy are:
- ureteral or kidney stones, in diameter less than 2.5 cm;
- an attack of renal colic ;
- prolonged and frequent inflammation of the urogenital tract;
- no positive effect of conservative therapy;
- presence of stones in the ureters and bladder simultaneously.
In addition to these indications, doctors also provide individual. So a stone in the ureter can trigger the development of an acute kidney block, with the formation of hydronephrosis. In the absence of such treatment, as remote lithotripsy, this condition can lead to the development of renal failure. This disease requires long-term therapy, constant observation of specialists.
Lithotripsy of kidney stones
Remote lithotripsy of kidney stones involves the crushing of concrements with the aid of a shock wave. In this case, the lumbar region is affected through the skin. Depending on what type of energy is used during the procedure, the following types of lithotriptors (apparatus for crushing) are distinguished:
- electro-hydraulic;
- piezoelectric;
- electromagnetic.
Control over the area of exposure, the concentration of the shock wave, when remote-wave lithotripsy is performed, is performed by ultrasound. This type of nonoperative intervention is performed under general anesthesia. This completely excludes soreness. This technique doctors use to crush small stones, in diameter no more than 2 cm. As a result of the procedure, small grains of sand remain in the kidneys, which freely leave with urine outward.
Lithotripsy of stones in the gallbladder
Lithotripsy of the gallbladder is similar to the procedure described above. The difference is that the effect is directed to the bile calculi. They have a slightly different structure, often smaller in size, but stronger than the kidneys. Given these features, doctors use other device settings during the procedure. This helps to achieve the desired effect.
The parabolic reflector fixes the shock wave on the concrement. As a result, at the focusing point, the energy reaches a maximum and the stone easily collapses. Waves quickly penetrate through soft tissues, practically without losing initial energy. For the procedure on the concrete can affect up to 3000 waves. Their number is determined according to the composition and strength of gallstones.
Lithotripsy of stones in the ureter
Remote lithotripsy of ureteral stones has some peculiarities. Because of the limited space, the narrow lumen of the urethra, the procedure requires accuracy. The doctor must determine the location and number of stones, so that before starting manipulation, set the type of lithotriptor used. Control of the procedure is carried out using the ultrasound machine.
After the stones reach a small size, remote lithotripsy is stopped (remote effective lithotripsy). To exclude the subsequent plugging of the ducts after manipulation, patients are prescribed diuretics. Simultaneously, anti-inflammatory therapy is also carried out, if necessary, antibacterial drugs are prescribed to exclude the infection.
Remote lithotripsy - contraindications
Like any medical procedure, remote lithotripsy of stones has its contraindications. Before going to her patient there is a long examination. Doctors will take the final decision after receiving the results. DLT, remote lithotripsy, is not possible with:
- acute inflammatory processes, infections (pyelonephritis, cystitis);
- current pregnancy;
- violation of the blood coagulation system;
- excess body weight (obesity of 3 and 4 degrees);
- diseases of the cardiovascular system;
- tumoral processes;
- taking medications that dilute blood (Warfarin, Aspirin);
- narrowing of the ureters below the level of localization of the calculus.
Preparing for remote lithotripsy
Remote ultrasonic lithotripsy involves a preparatory stage. Before the procedure, a thorough cleansing of the intestine is carried out. For 5 days begin to follow a diet. Exclude from the diet:
- black bread;
- dairy products;
- fatty meals;
- beans;
- juices;
- fresh vegetables and fruits.
An inseparable stage of preparation are laboratory studies. They help to determine the state of the body. Before electro-hydraulic lithotripsy is performed, it is necessary:
- biochemistry of blood;
- general urine analysis;
- blood coagulation tests;
- Ultrasound to determine the size, location of stones, their number.