RENAL CALCULI

Renal calculi (Kidney stone disease) commonly affect younger individuals in the 2nd to 4th decades of life: However children, females and older individuals are no exception.

Apart from genetic, congenital and inherited disorders like uric acid stone disease, cystinuria and renal tubular acidosis- chronic dehydration and dietary imbalances are the commonest causes for the stone formation in our population. Infections and obstruction in the urinary tract need to be checked and treated.

Majority of stone formers do suffer from recurrence unless adequate measures are strictly followed.
 
Advances in management of Renal Calculi

Laparoscopic 
Pyelolithotomy/ Ureterolithotomy, using the retroperitonoscopy, we are able to clear all large and impacted Renal / Ureteric Calculi

ESWL (lithotripsy) 

PCNL (key hole surgery for large /stag horn Calculi.

Ureteroscopy (for any type of ureteric stone) 

Avoid large opening of abdomen / less morbidity
Short duration of stay
Early return to work

Extremely useful in women and morbid obese patients and patients with medical problems.

Now -90% of stone disease is managed without formal open surgery: lasers, electro hydraulic and ultrasonic shockwaves and energy delivered through. Pneumatic compression devices (lithoclast) are various energy sources now available to break the stones.
 
Complications of sub optimally managed Renal Calculi

Inadequate stone clearance and residual fragments

Urinary tract infection / sepsis Progressive Renal failure

Chronic / distressing symptoms disability.
 
Prevention: DIET/FLUID advice

Treatment of causative factors and regular x-ray / checkups, metabolic workup in selected cases and appropriate measures.
Department of Urology@ Apollo Hospitals
 
Urology 
Dr.Rajagopal,Dr.Arun Shah,Dr.Sharma & Dr.Ramesh C Reddy
Nephrology
Dr.Somashekar,Dr.Krishnan,Dr.Sanjay Maitra
 
Send your query on Health and Wellness to touchinglives@apollohospitals.com 
In case you are visiting Apollo Hospitals, please inform touching lives by phone- 23548888 or e-mail touchinglives@apollohospitals.com. We will be there to receive you and take care of you 
 
 

Retroperitoneoscopy Laparoscopy:

 

ESWL:

 

PCNL

  
For kidney stones more than 2cms
Staghorn calculi
For failed lithotripsy 
One cm key hole on the back
Average stay in the hospital 4-5 days


Total stone clearance 90-92%
Minimal morbidity
Early return to work
Good patient acceptance 
Limitations - Patients with CVS,
 
Ureteroscopy
 
For stones in the ureter upto 2cms
Hospital stay 2-3- days
Stone clearance 90-95%
No morbidity 
Early return to work