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Kidney stones are primarily composed of calcium salts, with the most common being calcium oxalate (70-80%), followed by calcium phosphate and uric acid. When urine contains high concentrations of these ions, they can form crystals and eventually stones. [41] The formation of kidney stones occurs in three main phases: [41]
Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, [1] bezoars [2] or gallstones, which may be done non-invasively. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( litho- + τρίψω [tripso]).
Laser lithotripsy (LL) has been evaluated against Extracorporeal Shock Wave lithotripsy (ESWL), finding both to be safe and effective. [3] [4] ESWL may be safer for small stones (<10 mm), but less effective for 10–20 mm stones. [3] A 2013 meta-analysis found LL can treat larger stones (> 2 cm) with good stone-free and complication rates. [5]
Electrohydraulic Lithotripsy (EHL) is a medical procedure which uses targeted shockwaves to break up kidney stones and gallstones. [1] This form of extracorporeal lithotripsy is unique in that the shockwaves are produced by a vaporization bubble expanding and collapsing repeatedly, creating a pressure wave. [ 1 ]
A number of important medical conditions are caused by stones: [citation needed] Nephrolithiasis (kidney stones) Can cause hydronephrosis (swollen kidneys) and kidney failure; Can predispose to pyelonephritis (kidney infections) Can progress to urolithiasis; Urolithiasis (urinary bladder stones) Can progress to bladder outlet obstruction
Lithotomy differs from lithotripsy, where the stones are crushed either by a minimally invasive probe inserted through the exit canal, or by an acoustic pulse (extracorporeal shock wave lithotripsy), which is a non-invasive procedure. Because of these less invasive procedures, the use of lithotomy has decreased significantly in the modern era.
Percutaneous nephrolithotomy (PCNL) is a minimally-invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region. It is usually done under general anesthesia or spinal anesthesia.
Some of the passed fragments of a 1-cm calcium oxalate stone that was smashed using lithotripsy. The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones [3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse.
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