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Lithotripsy
Lithotripsy is a non-invasive procedure involving the physical destruction of hardened masses like kidney stones, bezoars or gallstones. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" ( litho- + τρίψω ripso. Uses Lithotripsy is a non-invasive procedure used to break up hardened masses like kidney stones, bezoars or gallstones. Contraindications "Commonly cited absolute contraindications to SWL include pregnancy, coagulopathy or use of platelet aggregation inhibitors, aortic aneurysms, severe untreated hypertension, and untreated urinary tract infections Techniques * Extracorporeal shock wave therapy * Intracorporeal (endoscopic lithotripsy): ** Laser lithotripsy : effective for larger stones (> 2 cm) with good stone-free and complication rates. ** Electrohydraulic lithotripsy ** Mechanical lithotripsy ** Ultrasonic lithotripsy : safer for small stones (<10 mm)


History

Surgery was the only metho ...
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Laser Lithotripsy
Laser lithotripsy is a surgical procedure to remove stones from urinary tract, i.e., kidney, ureter, bladder, or urethra. History Laser lithotripsy was invented at the Wellman Center for Photo medicine at Massachusetts General Hospital in the 1980s to remove impacted urinary stones. Optical fibers carry light pulses that pulverize the stone. Candela licensed the technology and released the first commercial laser lithotripsy system. Initially 504 nm dye lasers were used, then holmium lasers were studied in the 1990s. Procedure A urologist inserts a scope into the urinary tract to locate the stone. The scope may be a cystoscope, ureteroscope, renoscope or nephroscope. An optical fiber is inserted through the working channel of the scope, and laser light is directly emitted to the stone. The stone is fragmented and the remaining pieces are collected in a "basket" and/or washed out of the urinary tract, along with the finer particulate "dust." The procedure is done under either ...
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Kidney Stone
Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine stream. A small stone may pass without causing symptoms. If a stone grows to more than , it can cause blockage of the ureter, resulting in sharp and severe pain in the lower back or abdomen. A stone may also result in blood in the urine, vomiting, or painful urination. About half of people who have had a kidney stone will have another within ten years. Most stones form by a combination of genetics and environmental factors. Risk factors include high urine calcium levels, obesity, certain foods, some medications, calcium supplements, hyperparathyroidism, gout and not drinking enough fluids. Stones form in the kidney when minerals in urine are at high concentration. The diagnosis is usually based on symptoms, urine testing, and medical i ...
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Electrohydraulic Lithotripsy
Electrohydraulic Lithotripsy (EHL) is a medical procedure which uses targeted shockwaves to break up kidney stones and gallstones. 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. The procedure is non-invasive and has a 90% success rate, which makes it a first-line treatment for smaller kidney stones. EHL was the first modern extracorporeal lithotripter invented in 1954 by an engineer from Kyiv, but because he was out of favor with the Stalinist government, he was banished and the use of his invention was delayed for around 10 years. This procedure is also used to treat gallstones in the bile or pancreatic ducts that are difficult to remove with other methods of lithotripsy. While being less expensive than laser lithotripsy Laser lithotripsy is a surgical procedure to remove stones from urinary tract, i.e., kidney, ureter, bladder, or urethra. History L ...
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Extracorporeal Shock Wave Lithotripsy
Extracorporeal shockwave therapy (ESWT) is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders. ESWT sends acoustic shock waves into bone or soft tissue, in effect reinjuring the area on a cellular level and breaking up the scarring that has penetrated tendons and ligaments. The controlled reinjuring of tissue allows the body to regenerate blood vessels and bone cells. The resulting revascularization leads to faster healing and often a return to pre-injury activity levels. It is a treatment using powerful acoustic pulses which is mostly used to treat kidney stones and in physical therapy and orthopedics. Medical uses The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. It is also reported to be used for salivary stones and pancreatic stones. In the UK, the National Inst ...
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Extracorporeal Shock Wave Therapy
Extracorporeal shockwave therapy (ESWT) is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders. ESWT sends acoustic shock waves into bone or soft tissue, in effect reinjuring the area on a cellular level and breaking up the scarring that has penetrated tendons and ligaments. The controlled reinjuring of tissue allows the body to regenerate blood vessels and bone cells. The resulting revascularization leads to faster healing and often a return to pre-injury activity levels. It is a treatment using powerful acoustic pulses which is mostly used to treat kidney stones and in physical therapy and orthopedics. Medical uses The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. It is also reported to be used for salivary stones and pancreatic stones. In the UK, the National Inst ...
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Gallstone
A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of migrated gallstones within bile ducts. Most people with gallstones (about 80%) are asymptomatic. However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack"). This happens in 1–4% of those with gallstones each year. Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), obstructive jaundice, and infection in bile ducts ( cholangitis). Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, dar ...
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Jean Civiale
Jean Civiale (1792–1867) was a French surgery, surgeon and urologist, who, in 1823,Jean Civiale
Didusch Center for Urologic History invented a surgical instrument (the lithotrite) and performed transurethral lithotripsy, the first known minimally invasive surgery, to crush Kidney stone disease, stones inside the Urinary bladder, bladder without having to open the abdomen (lithotomy). To remove a calculus, Civiale inserted his instrument through the urethra and bored holes in the stone. Afterwards, he crushed it with the same instrument and aspired the resulting fragments or let them flow normally with urine. Civiale founded the first urology service in the world, at the Necker Hospital in Paris. Civiale has been also recently recognized as a pioneer of evidence-based medicine. In 1835, the Académie des Sciences in ...
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Non-invasive Procedure
A medical procedure is defined as ''non-invasive'' when no break in the skin is created and there is no contact with the mucosa, or skin break, or internal body cavity beyond a natural or artificial body orifice. For example, deep palpation and percussion are non-invasive but a rectal examination is invasive. Likewise, examination of the ear-drum or inside the nose or a wound dressing change all fall outside the definition of ''non-invasive procedure''. There are many non-invasive procedures, ranging from simple observation, to specialised forms of surgery, such as radiosurgery. Extracorporeal shock wave lithotripsy is a non-invasive treatment of stones in the kidney, gallbladder or liver, using an acoustic pulse. For centuries, physicians have employed many simple non-invasive methods based on physical parameters in order to assess body function in health and disease (physical examination and inspection), such as pulse-taking, the auscultation of heart sounds and lung sounds (u ...
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Lithotrite
The lithotrite was an early medical device, invented by Al-Zahrawi, an early form of which he called "Michaab". He was able to crush the stone inside the bladder without the need for a surgical incision. It was later modified by Jean Civiale, and was used to perform transurethral lithotripsy, the first known minimally invasive surgery, to crush stones inside the bladder without having to open the abdomen (lithotomy). To remove a calculus the instrument was inserted through the urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra ... and holes bored in the stone. Afterwards, it was crushed with the same instrument and resulting fragments aspirated or allowed to flow normally with urine. References Medical equipment Urologic procedures {{surgery-stub ...
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Medline Plus
MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish with select content in additional languages. The site brings together information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), other U.S. government agencies, and health-related organizations. There is also a site optimized for display on mobile devices, in both English and Spanish. In 2015, about 400 million people from around the world used MedlinePlus. The service is funded by the NLM and is free to users. MedlinePlus provides encyclopedic information on health and drug issues, and provides a directory of medical services. MedlinePlus Connect links patients or providers in electronic health record (EHR) systems to related MedlinePlus information on conditions or medications. PubMed Health was another NLM site that offered consumer health information, in ...
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Urine
Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular metabolism generates many by-products that are rich in nitrogen and must be cleared from the bloodstream, such as urea, uric acid, and creatinine. These by-products are expelled from the body during urination, which is the primary method for excreting water-soluble chemicals from the body. A urinalysis can detect nitrogenous wastes of the mammalian body. Urine plays an important role in the earth's nitrogen cycle. In balanced ecosystems, urine fertilizes the soil and thus helps plants to grow. Therefore, urine can be used as a fertilizer. Some animals use it to mark their territories. Historically, aged or fermented urine (known as lant) was also used for gunpowder production, household cleaning, tanning of leather and dyeing of t ...
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Cyan
Cyan () is the color between green and blue on the visible spectrum of light. It is evoked by light with a predominant wavelength between 490 and 520 nm, between the wavelengths of green and blue. In the subtractive color system, or CMYK color model, which can be overlaid to produce all colors in paint and color printing, cyan is one of the primary colors, along with magenta and yellow. In the additive color system, or RGB color model, used to create all the colors on a computer or television display, cyan is made by mixing equal amounts of green and blue light. Cyan is the complement of red; it can be made by the removal of red from white. Mixing red light and cyan light at the right intensity will make white light. Colors in the cyan color range are teal, turquoise, electric blue, aquamarine, and others described as blue-green. Etymology and terminology Its name is derived from the Ancient Greek word ''kyanos'' (κύανος), meaning "dark blue enamel, Lapis la ...
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