Treatment procedures for urolithiasis
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Department of Urology, Municipal Hospital in Olsztyn, Poland
Submission date: 2010-05-31
Acceptance date: 2010-06-30
Online publication date: 2012-12-04
Publication date: 2023-03-13
Pol. Ann. Med. 2010;17(1):123-128
Introduction. Urolithiasis remains a great medical challenge. The last two decades of the 20th century witnessed a rapid development in minimally invasive surgery methods for urolithotomy. The beginning of the 21st century is marked with a further perfecting of these methods. Aim. The aim of this work was to present modern methods for evacuating uroliths from kidneys, ureters, bladder and urethra. The choice of the most adequate method is discussed, taking into account location and size of concrement and a patient’s condition. Discussion. Up till the 1980s, uroliths located in kidneys and ureters could have been removed only surgically. In some cases, concrements were extracted from the inferior ureter by the Zeiss-loop procedure or with a Dormia basket. At the beginning of the 1980s, three new minimally invasive surgery methods of lithotomy were introduced: extracorporeal shock wave lithotripsy, percutaneous nephrolithotripsy and ureteroscopic lithotripsy. Modern treatment of urolithiasis is based on the rational establishment of recommendations for one of these methods or their combination. A proper treatment of urolithiasis is ensured by performing it in a center equipped with adequate medical equipment and devices, and employing urologists with clinical experiences and technical skills. Despite technological advancement, surgical treatment is not complications free. The fewest complications definitely occur in evacuating smaller uroliths as well as in treating urolithiasis uncomplicated by infection and urine retention. Conclusions. Early diagnosis of urolithiasis and the application of minimally invasive surgery methods to remove concrements ensure retaining a proper kidney function.
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