Urolithiasis

Also known as “Stone disease”. Up to 20% of the population will suffer from urolithiasis throughout their lives.

The most typical clinic presentation of the lithiasis disease is renal colic: Medical emergency characterized by a severe pain on the lumbar area usually with irradiation towards the pelvis and frequently accompanied by symptoms associated to the parasympathetic nervous system (nausea, vomiting, dizziness…). The cause is the severe urethral obstruction because of the lithiasis which prevents the drainage of urine towards the bladder.

EXAMINATION: The diagnosis tests mostly used are:

• Simple Rx of the abdomen.

• Urologic Ultrasounds.

• Abdomen-pelvic CT scan.

TREATMENT:

• MEDICAL:
      For treating the severe pain produced by the renal colic.

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    Expelling treatment: Drugs helping the spontaneous kidney stone removal.

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    Metabolic study: It searches to identify the causes on the origin of lithiasis (eating disorders, diverse diseases…) which must be corrected in order to prevent the creation of kidney stones, or at least, to reduce its frequency.

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• NON MEDICAL:

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    Extracorporeal shock wave lithotripsy: In some patients urolithiasis can be fragmented in order to favour the spontaneous expulsion or to facilitate a subsequent extractive surgery.

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    Lithiasis surgery:

• • • · Urinary unblocking: The severe obstruction as a result of the renal colic produces hydronephrosis or renal obstruction. It is frequently treated by placing an endoscopic drainage (double J catheter) or sometimes an external drainage (nephrostomy tube drainage).

• • • · Ureterorrenoscopy: Endoscopic surgical procedure for the treatment of lithiasis when it is in the ureter. We take advantage of the natural conduits of the body (urethra, bladder, ureter…) to introduce the device completely and extract the stone (if its size is small) or to fragment it with Holmium laser before its definitive extinction.

• • • · RIRS/ECIRS: Sometimes lithiasis is lodged inside the kidney. In this case, we use a FLEXIBLE uretero-renoscope that allows the exploration of all colics and Holmium laser fragmentation of stones prior to their extinction. This technique is known as RIRS (Retrograde Inter-Renal Surgery). Miniaturization, the development of different energies such as laser, the improvement in endoscopic vision have allowed an accelerated development of this technique and allows the treatment of complex lithiasis using natural approaches of the body, with low number of complications, high resolution and usually with 24 hours of hospitalization.

• • • · Percutaneous nephrolithotomy: Lumbar access surgical technique for large lithiasis It can be used in combination with endourological processes. The development of the techniques previously explained has greatly reduced their use.