Kidney and Ureteral Stones
More than five percent of Americans will be affected by urinary stones at some point in their life. Stone disease is among the most painful and prevalent of urologic disorders, affecting more than 1.1 million Americans annually, primarily between the ages of 40 and 70. Kidney stones are formed out of crystals that grow in the urine, which is produced by the kidneys. In most cases, the crystals are too tiny to be noticed, and pass harmlessly out of the body. In others, they build up inside the kidney and coalesce into large particles, which are called stones. Risk factors for stone disease include dehydration, a high salt diet, a family history of stones, and certain foods, including leafy green vegetables, chocolate, coffee, tea, and nuts. Once a person develops a stone, others are likely to develop in the future.
If a stone becomes large enough, it can block or otherwise create pressure, pain and infection in the kidney or ureter, the tube that carries urine from the kidneys to the bladder. Pain or aching in the back on one or both sides is usually the first sign of a urinary stone. The pain can increase to alarming levels, which may trigger a trip to the emergency room. The symptoms can also include nausea and vomiting, frequent urge to urinate, a burning sensation during urination, bloody, cloudy or smelly urine, spasms of intense pain, and/or fever and chills. Anyone who has one or more of these symptoms should seek medical attention.
Often patients with urinary stones are managed with medications and large amounts of fluids. In those patients with larger stones or stones that are caught within the kidney or ureter, surgical intervention may be required. There are several treatment options, most of which do not require major surgery.Shockwave Lithotripsy (SWL) – In SWL, shock waves created outside the body travel through the skin and body tissues until they hit the denser stones, causing the stones to break down into sand-like particles, which are then easily passed through the urinary tract into the bladder. Occasionally, repeat SWL procedures are needed if the stone is not completely fragmented in one treatment. SWL is not ideal for very large stones, soft stones, or stones located in the ureter.
Percutaneous Nephrolithotomy – This procedure is an option if the stone is quite large or in a location that does not allow effective use of SWL. In this case, the surgeon makes a tiny incision in the patient’s back and creates a tunnel directly into the kidney. Using a nephroscope, the surgeon locates and removes the stone. For large stones, an energy probe may be needed to break the stone into small pieces.
Endoscopic Lithotripsy (also known as ureteroscopy) – If kidney stones are lodged in the ureter, they may require treatment with endoscopic lithotripsy. In this procedure, the surgeon passes a small fiberoptic or digital instrument called an ureteroscope through the urethra and bladder into the ureter. After looking through the ureteroscope to locate the stone, the surgeon removes it with a basket-like device. Some stones may need the use of a laser or other energy probe to break them into smaller pieces before removal. The location, size, and composition of the stone determine how it can best be treated.
The PercSys Accordion® Stone Management Device and the 10mm Accordion CoAx® Stone Control Device are designed to simplify and shorten endoscopic lithotripsy procedures. These Accordion devices facilitate the entrapment and removal of stones and stone fragments from the ureter. (Click for more information on the PercSys Accordion Stone Management Device and the 10mm Accordion CoAx Stone Control Device)
The 15mm Accordion CoAx® Stone Control Device provides physicians a means to prevent antegrade stone fragment migration during percutaneous nephrolithotomy (PCNL).(Click for more information on the 15mm Accordion CoAx Stone Control Device)