Common urological operations: lithotripsy

The medical term "urological operations" is generalizing and is used to designate various surgical methods for treating the organs of the genitourinary system. These include:

• Kidney surgery (nephrectomy, pyelotomy, nephrotomy)
• Operations on the ureter
• Bladder surgery
• Urethral surgery
• Operations on the testicles and penis.

By the method of carrying out urological operations are divided into endoscopic (which are carried out through a small incision with an endoscope) and cavitary (open operations that are carried out through the incision of the abdominal cavity).

There are many diseases of the urogenital system, the treatment of which requires surgical intervention. Indications for urological operations include such diseases as infections and kidney and bladder stones, prostate enlargement, oncological diseases, cysts, cystitis. One of the most common diseases from this list is a kidney stone disease, or kidney stones . In this article, we will consider one of the most effective methods of treating kidney stones - lithotripsy.

Lithotripsy is a non-invasive urological operation on the kidneys, the essence of which is the destruction of stones by exposing them to a special instrument that emits shock impulses. The stones are crushed until they become so large that they can exit by themselves. To aim the pulses on the stones, ultrasound scanning or X-rays are used. This method is widely used in practice since the 80s.

Lithotripsy is carried out under local anesthesia and lasts about one hour. The frequency and intensity of the shock waves increase gradually, which allows the body to get used to the procedure. Some modern apparatuses allow the procedure to be carried out without anesthesia, however in such cases the patients still experience moderate pain. This is due to the passage of waves through the tissues and irritation of nerve endings.

Indications for lithotripsy

Lithotripsy is used to crush stones up to 2.5 cm in size. It should also be noted that this method of treatment is suitable for both adults and children.

Contraindications to the procedure include:

• Impossibility of aiming the shock wave on the stone (for example, due to obesity or deformation of the spine)
• Violation of blood clotting
• Reception of anticoagulants
• Menstruation
• Exacerbation of the pathology of the gastrointestinal tract
• Inflammatory processes in the body.

Types of lithotripsy

According to the type of shock waves, electromagnetic, piezoelectric and electro-hydraulic lithotripsy are isolated.

Depending on the method of action on the stones, remote and contact lithotripsy is isolated. With remote lithotripsy, shock waves are directed to the stone with a tool located outside. Contact lithotripsy involves the introduction of an instrument into the body. The tool is brought directly to the stone (hence the contact name) through the urethra, bladder and ureter. As a rule, contact lithotripsy is more effective than distance therapy. The decision to choose a particular method of lithotripsy is made by the attending physician depending on the characteristics of the disease and the condition of the patient.

The advantages of lithotripsy

The main advantage of lithotripsy is the absence of the need to make a cut on the skin. Accordingly, the procedure is less traumatic than invasive urological operations and entails a minimum number of complications. The recovery period after lithotripsy also takes much less time than rehabilitation after other stone removal procedures. In addition, lithotripsy requires less expenditure compared to other treatments.