Dr. Instructor Member Kubilay Sabuncu provided information on stone diseases in the urinary system. Dr. Instructor Sabuncu member Sabuncu stated that stone disease is a multifactorial disease and cannot always be explained by a single reason: diseases can predispose to stone formation. If there is a history of kidney stones in the family, especially in the first-degree relatives, the chance of stone disease increases. Although there are many environmental factors, the most important one can be said to be the climate. Especially in warm and sunny climates, susceptibility to stone disease may increase due to increased fluid loss and changes in vitamin D metabolism. In general, the frequency of stone disease increases, especially between the ages of 40 and 60. Stone disease is known to be rare before the age of 20, and kidney stone disease in children is very rare.
“The size and placement of the stone determines the pain”
Noting that the symptoms of urinary stone disease spread over a wide range, Dr. Instructor Lid Sabuncu continued, “While some stone patients have no complaints, some patients may experience ‘pain they have never felt in their life’. This is related to the size and location of the patient’s stone. It develops as a result of the blockage caused by the stone. This pain, which is usually unilateral, starts suddenly. However, it may be accompanied by nausea, vomiting, a burning sensation during urination, a feeling that the urine does not stop, or seeing of blood in the urine. After a comprehensive physical examination and tests, first of all, the pain really comes from the kidney. Ultrasound can be performed to understand whether it is due to the origin of the stone. However, ultrasound can not always provide enough information about the stones.Especially if the procedure is planned, computed tomography is often performed to evaluate the exact location and size of the stone.Computed tomography is now the m est sensitive method in diagnosing kidney stones. It can be said that t. After obtaining enough information about the stone with computed tomography, very different treatments can be applied, depending on the stone and the characteristics of the patient. Some patients can get rid of their stones without even the need for drug treatment, and some patients require very serious surgical procedures.
“It is possible to get rid of the stone with 3 different surgical methods”
Dr. Instructor Professor Kubilay Sabuncu explained the surgical methods commonly used today in the treatment of stone disease as follows: “The method we call ESWL is the abbreviation of extracorporeal shock wave lithotripsy, and it is the breaking of stones with sound waves from the outside the body.In this method, the patient does not need to sleep and is in special rooms for 30 minutes to 1 hour.The patient’s stones are broken up by sound waves with sessions that can last up to hours.It is generally not a painful procedure and there may be pain after the broken stone pieces fall during the procedure.It is not a method that can be applied to every stone and its success rate is about 70 percent even under the most ideal conditions.With suitable stones,Using this method , the patient can remove the stone without surgery.
Endoscopic ureteric stone treatment, i.e. closed kidney stone surgery, is an operation where the patient is under deep anesthesia and moves backwards through the system through which urine flows, without disturbing the integrity of any tissue in the body. During this operation, laser energy is often used to break the stones. This method, which can be applied to most stones, is a very successful operation. It usually doesn’t require a long hospital stay, but there are technical difficulties in applying it to stones of any size. Although it is used in the treatment of small stones in the canal (ureter) that connects the kidney and urinary bladder, and in the treatment of stones in the kidney no larger than 2 cm, it can also be used successfully in larger and more complex stones today. Treatment of these types of stones may require more than one surgery session.
Percutaneous stone surgery is an operation performed by entering the kidney from outside the body. The advantage is that large stones can be removed in large pieces after they are broken, and the patient can become stone-free more quickly. It is a method mainly used for kidney stones larger than 2 cm or in cases where other methods are used and there is failure. The stones in the kidney are broken up and brought out through the canal that has developed between the skin and the kidney. The diameter of this created channel has also shrunk considerably with the current technology and the risks of the operation have been reduced in this way.
Aside from this, although very rare these days, some kidney stones may require laparoscopic or open surgery. These methods are mainly used in kidneys that do not have normal anatomy or in cases where stone clearance cannot be achieved by other methods due to stone load.