Patient's question:
My father was recently diagnosed with kidney stones and has been experiencing frequent pain. He has tried traditional Chinese medicine, Western medicine, intravenous fluids, and pain injections, but the pain still occurs intermittently, and the effects are not significant. I would like to ask if laser treatment could be used to remove that "stone"?Doctor's answer:
Hello, the currently effective methods for treating urinary calculi are as follows:1. Non-surgical treatment: Suitable for patients with stones smaller than 1 cm, stones with a tendency to move downward, no significant impact on renal function, and no urinary tract infection.
Drink plenty of water, which not only increases urine volume to flush the urinary tract and promote the downward movement of stones but also dilutes urine to reduce crystal precipitation. Herbal medicine treatment; acupuncture methods, acupuncture or electroacupuncture at points such as Shen Shu, Bladder Shu, San Yin Jiao, Zusanli, Shuidao, and Tianhu can increase the peristalsis of the renal pelvis and ureter, facilitating the excretion of stones. Regularly perform jumping exercises or inverted positions and tapping activities, which are also beneficial for stone excretion. Other active treatments for primary diseases and regulation of urine pH, etc.
This method can only be applied to a small number of stone patients, and the success rate cannot be guaranteed to be 100%, so it is also necessary to be prepared to choose other methods.
2. Ureteral stone basketing: Using a stone basket under cystoscopy to remove the stone. Suitable for small, mobile mid-to-distal ureteral stones.
3. Extracorporeal shock wave lithotripsy: Mainly used for upper ureteral stones.
Since the first successful application of extracorporeal shock wave lithotripsy for kidney stones in 1980, this method has developed rapidly, and its therapeutic effect on upper urinary tract stones has been widely recognized. For the treatment of specific patients, appropriate lithotripsy parameters and auxiliary measures should be adopted based on the patient's age, stone size, location, etc., to achieve satisfactory results.
After lithotripsy, diuretic and stone expulsion treatment is still required, with close monitoring to prevent the formation of "stone street" phenomena, which can lead to obstruction.
4. Ureteroscopy stone removal or lithotripsy: After ureteral dilation, a ureteroscope is inserted. When the stone is seen, it is fragmented using liquid electric or ultrasonic lithotripsy devices. The stone can also be directly removed using stone retrieval forceps. The most representative and currently the most advanced is neodymium laser combined with ureteroscopy or nephroscopy for lithotripsy and stone removal. Its advantages are minimally invasive or non-invasive, causing almost no harm to the human body. It is suitable for stones of any size and location, including gallbladder stones, intrahepatic, etc., marking a new era in stone treatment.
5. Pneumatic lithotripsy: Pneumatic lithotripsy is a minimally invasive treatment technology that has revolutionized traditional stone treatment methods. Its principle is to use the energy generated by compressed gas to drive the bullet of the lithotripsy handle. The bullet impacts the stone in a pulsed manner, shattering it. The energy conversion does not involve electrical energy, produces very little heat energy, and the amplitude of vibration before and after impact does not exceed 2 mm. It only causes mild and transient damage to the mucosa, such as mild edema and bleeding, with no long-term effects. This treatment method is safe, efficient, simple, and has few complications, allowing more than 90% of stone patients to undergo treatment without surgery.
6. Surgical ureterolithotomy: Suitable for patients with stones larger than 1 cm, with rough surfaces that cannot be expelled naturally, or with ureteral stenosis and infection. When stones cause urinary flow obstruction, affecting renal function, or when non-surgical therapy is ineffective and extracorporeal shock wave lithotripsy is not available, surgical treatment should be considered. In principle, for bilateral renal stones, the simpler and safer side should be treated first; for a unilateral renal stone with a ureteral stone on the other side, the ureteral stone should be treated first; for bilateral ureteral stones, the side with more severe hydronephrosis should be treated first. For patients with severe obstruction and general weakness who are not suitable for more complex stone removal surgery, renal drainage can be performed first. Anti-inflammatory treatment must be used before and after surgery.
Stone removal by incision is associated with large wounds and significant bleeding, and is generally only used when necessary. Postoperative recovery is slow, and hospital stays are long.