The most painless and effective kidney stone treatment is the latest and most popular procedure called Ureteroscopic Holmium Laser Lithotripsy. A small telescope and Holmium Laser are used in this procedure by the urologist doctor to break and crumble the stones stuck in the urinary tract in to tiny fragments that can easily be removed or passed through urine. This procedure is used to treat stones from ureter, bladder, kidney and the urethra as well. Now, with this minimally invasive procedure, kidney stone treatment no longer involves surgery with actual incisions. Except for rare cases, kidney stones are managed most commonly through Laser surgery.
Methods of Lithotripsy
Lithotripsy has made the treatment of kidney stones less invasive, painless and effective. Lithotripsy is basically a technique used for treating stones in the kidney and ureter that does not require surgery. There are two different approaches to lithotripsy. Both the methods are effective and can relieve the pain immediately. They have also shown high success rates in complete treatment of kidney stones.
Shock Waves – The most common method of lithotripsy for kidney stone treatment is Extracorporeal Shock Wave Lithotripsy (ESWL). The procedure is simple where Ultrasound shock waves are focused from outside the body to target and bombard the kidney stones. The shattered pieces of stone can be passed out through urine. There is no need for anaesthesia as this procedure is not painful, but can be used for little comfort. ESWL method of Lithotripsy can remove all stones in the upper ureter and kidney but unfortunately, not all types of kidney stones can be treated this way. More so, there is a possibility to develop Steinstrasse, which is a complication that causes the ureter to be blocked by collection of stone fragments after the procedure. As a result, stone fragments are occasionally left in the body, requiring additional treatments. Hence, depending on the severity of the condition, patients may require more than one session of lithotripsy to remove the stones.
Ureteroscopy – A more recent method of Lithotripsy Laser surgery otherwise known as Ureteroscopic Holmium Laser. It is a minimally invasive procedure that has made it very popular and is available with urologist doctor for treatment of kidney stones. Ureteroscopy is a safe procedure, usually performed in an outpatient surgical centre setting. There is no incision needed in this procedure and is absolutely painless. This procedure is usually used to remove large stones from 4 mm up to 20mm in diameter, located in the ureter, bladder, kidney as well as the urethra. However, the procedure involves insertion of a scope, and this requires spinal anaesthesia to be administered.
An ureteroscope is a very narrow scope that can be either rigid or flexible and allows the Urologist to move the scope up the ureter till the stone and see it on a video monitor via fibreoptics. Once the stones are located, instead of using sound waves as the energy source as in ESWL, ureteroscopy uses the energy pulse of a laser beam that are targeted and applied directly to the stone, to chip it away and break into tiny particles. The procedure derives its name from the application that involves breaking of kidney stones into fragments with the help of a holmium laser. A holmium laser of 100 Watts power is used to reduce the stones to dust that allows the particles to be flushed out easily while urinating or can be extracted by the urologist. A stent may be fixed to keep the ureter wide and open to facilitate urination. This prevents any chances of Steinstrasse condition.
Temporary plastic tubes that may be inserted into the ureter from the bladder to the kidney are called stents. The purpose of fixing a stent is to keep the ureter open after surgery of a stone so that urine may flow freely, carrying all the fragments and sands of stone. This enables the oedema and inflammation that resulted from the presence of the stone and also the effects of stone treatment to resolve. The stent is placed after the procedure is finished while the patient is still under anaesthesia. The stent is located entirely inside the system and cannot be seen. Very mild bladder irritation, mild flank pain while urinating and little blood in urine as normal signs can be expected with the stent after the procedure. It will be removed later, usually the following week in an instant follow up procedure.
Laser Lithotripsy over ESWL
ESWL is often a preferred choice as it is less invasive with typically no scopes that are inserted into the urinary system and no stent is placed. But, Ureteroscopy being a more direct approach, and therefore more effective than ESWL offers the relief of only few stone fragments to be eliminated after the procedure. Both the advantages of stone free rates and the finesse that the procedure often provides, ureteroscopy is the chosen method when the option is offered. Certain stones may sometimes require more than one session of a procedure, or a combination of procedures for complete removal of kidney stones.
Advantages of Ureteroscopic Lithotripsy with Holmium Laser:
- It is the most effective, safe and least invasive procedure for kidney, bladder and ureteral stones.
- Offers high success rate irrespective of stone size and location.
- The procedure being done under anaesthesia is totally painless and discomfort free.
- Holmium Laser has the ability to break down even the hardest stones into sand-like fragments.
- Larger, multiple stones can be removed with ease.
- Discharge on the same day and back to work within two days.
- No risk of Steinstrasse.
Even though the best of painless and effective kidney stone treatment are available, it is necessary to talk to the urologist doctor about the benefits and risks of the surgery before choosing any treatment option. It is absolutely essential to know about the surgery’s long term effects, success rate, hospital stay, etc., in making an informed decision.