In cases when concrements (stones) are not excreted from urinary ducts either spontaneously or as a result of conservative therapy, surgical treatment of the urinary stone disease is required.
INDICATIONS FOR SURGICAL INTERVENTION
- concrement size of more than 8 mm;
- strongly pronounced pain syndrome;
- development of renal pelvis cup degeneration due to urine passage impairment;
- hematuria (occurrence of red blood cells in urine;
- development of pyelonephritis;
- cessation of normal urine efflux.
SURGICAL TREATMENT OF URINARY STONE DISEASE AT THE RCMC
Using highly advanced equipment, the Urologic Surgical Facility of SI “Republican Clinical Medical Center” performs surgery operations aimed at treatment of all types of urinary stone diseases. Depending on the particulars of the disease, endoscopic and laparoscopic techniques are employed, as well as shockwave lithotripsy:
Ureterorenoscopy (URS) accompanied by contact laser lithotripsy (CLL)
The endoscopic method of urinary stone disease treatment combines high effectiveness and low invasiveness. The technique essentially involves gaining direct access to the concrement with an optical instrument and its subsequent disintegration with a laser. Optimal indications for the procedure are stones located in any part of renal duct. The intervention is carried out under X-ray control, and involves installation of a temporary internal drainage device (ureteral stent) after the completion of the operation.
Retrograde intrarenal surgery (RIRS)
This is an endoscopic urinary stone disease treatment technique which involves laser-induced destruction of stones located within the calices-pelvis system of a kidney with the use of rigid or flexible ureterorenoscopy methods. The technique combines the advantages of URS with low invasiveness. The intervention is carried out under X-ray control, and involves installation of a temporary internal drainage device (ureteral stent) after the completion of the operation.
Percutaneous nephrostolithotomy
This is a minimally invasive urinary stone disease treatment technique where access to the kidney is gained through a puncture at the lumbar region. The technique is recommended for patients with large kidney concrements, and is an alternative to open surgical operations. The intervention is carried out under X-ray control, and involves installation of both temporary internal (ureteral stent) and external drainage devices (nephrostomy drainage tube) after the completion of the operation.
CONTRAINDICATIONS
- blood clotting abnormalities;
- chronic active urinary duct infection;
- cardiovascular and pulmonary insufficiency;
- weight of the patient in excess of 120 kg.
PREPARATION FOR SURGERY INTERVENTION
- Laboratory tests: complete and biochemical blood assay, general urine test, blood coagulation test.
- Radiological studies: X-ray fluorogrpaphy;
- ECG.
- The consulting physician may appoint additional examinations.
- Additional preparation of the patient is carried out at the inpatient facilities of the RCMC one day before the operation.
HOW TO GET SURGICAL TREATMENT OF URINARY STONE DISEASE AT THE RCMC
- Call the Contact Center to make an appointment for a consultation with the head of the urological department
- Come to the consultation on time.
- On the day of the procedure conclude a contract for the provision of paid services at the registry.
- Pay the invoice at the cash desk of the RCMC or via ЕРИП (SSIS: Single Settlement and Information Space)