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- $Unique_ID{BRK00069}
- $Pretitle{}
- $Title{Surgery for Kidney Stones}
- $Subject{stones kidney surgery Genitourinary System stone kidneys surgeries
- PNL percutaneous nephrolithotomy urinary tract urethroscopy urethroscope ESWL
- extracorporeal shock-wave lithotripsy operation operations special procedure
- procedures}
- $Volume{J-16,P-16}
- $Log{
- Anatomy of the Kidney*0004801.scf
- Small Kidney Stones*0004802.scf
- Stag-Horn Kidney Stones*0004803.scf
- Passage of a Kidney Stone*0004804.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- Surgery for Kidney Stones
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- QUESTION: Is it always necessary to be operated on for kidney stones?
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-
- ANSWER: Well, let me begin by telling you of my experience. Ralph had become
- a statistic, as well as my patient. He had become one out of each eight men
- in this country, who by the age of 70, will develop a kidney stone. He came
- to me in distress and pain. A while back, he would have had two choices;
- either he would have been able to pass the stone or invasive, open surgery
- would have been performed. Of course, surgery was and still is dictated by
- some hard and fast rules. The first is the size of the stone and its ability
- to be passed. Usually stones smaller than 4 mm have a 75% change of being
- passed. Other criteria are persistent pain or bleeding, partial obstruction,
- chronic infection, and stones increasing in size. Well, Ralph had all these
- symptoms, but as a doctor practicing medicine in 1988, I had at my disposal
- three noninvasive techniques for the elimination of kidney stones, which I
- explained to Ralph.
- The first technique is called PNL (percutaneous nephrolithotomy) and
- involves the use of a needle to gain access to the kidney. A contrasting dye
- is instilled into the urinary tract to gain knowledge of the location of
- stones, and then the tract is dilated and removal is accomplished through
- forceps. This procedure is not for patients with bleeding problems or those
- who have hypersensitivity to the contrast medium. A second procedure is
- called urethroscopy and involves the use of a urethroscope; this procedure is
- for stones located in the ureter. The most recent procedure is ESWL
- (extracorporeal shock-wave lithotripsy), a method first used in Germany in
- 1980 and approved by the FDA for use in this country in 1984. This method
- uses shock waves, which break the stone into small sand-like particles, which
- the patient will pass in the next two- to three-week period.
- So, though Ralph was a candidate for removal of his kidney stones, he did
- not need open surgery. We discussed the best method for him and he was spared
- the lengthy hospitalization, the increased risk, and the drain on his
- finances. What these three methods have in common are a good success rate,
- and the ability to make a patient as good as new in a short period of time.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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