Researchers from America have come up with a new technology that enables ultrasound to break up kidney stones, with a relatively simple procedure in the clinic.
Conducted by Jonathan Harper of the University of Washington and colleagues, the new technique, ‘burst wave lithotripsy (BWL’), promises to reduce costs and the healthcare burden for treating kidney stones. The study was published in the Journal of Urology, and was reported by newsweek.
This technology may provide a non-surgical treatment option for this painful condition, according to the first human study on it.
“The new BWL blast wave lithotripsy (BWL) technology has successfully fragmented stones of a variety of sizes, locations and densities to less than 2 millimeters within 10 minutes with minimal tissue injury,” the study said.
Small stones can be broken up with the extracorporeal shock wave lithotripsy (ESWL) technique, which uses shock waves to break down the stone and facilitate its natural passage out of the body. Patients are usually under anesthesia during the procedure, which is usually performed in a hospital or clinic.
But larger kidney stones usually need to be broken down into smaller pieces so they can be passed normally.
Unlike extracorporeal shock wave lithotripsy (ESWL), blastwave lithotripsy (PWL) uses short, coordinated bursts of ultrasound energy to break up stones more quickly and without anaesthesia.
Preclinical studies (not in humans) showed that it fractured experimental stones of various sizes and compositions. According to Harper and colleagues, their findings “are a step toward in-clinic lithotripsy for awake patients.”
As for the new study in humans, it included 19 patients, who had 25 confirmed stones, who were undergoing a surgery called ureteroscopy, which is used to treat large stones. Instead, they were first treated with a short exposure to BWL lithotripsy for no more than 10 minutes.
The ureteroscopy procedure involves passing an endoscope through the urethra, bladder, and into the ureter to treat the stone.
This is usually done under general anesthesia and lasts 1 to 3 hours. Small stones can be removed completely from the ureter, while large stones are broken up, usually with a laser, and then these parts are removed.
An average of 90% of the stone size was completely dissolved during the short treatment period. 39% of the aggregates were completely fragmented, while 52% were partially fragmented. Most of the shrapnel was small enough to pass without severe pain. The study found that there was little or no tissue injury from the BWL blast wave lithotripsy procedure, with the exception of light bleeding.
An important development in the treatment of kidney stones
Researchers believe that the new procedure is an important development in the treatment of kidney stones. When patients go to emergency rooms, they are often given opioid pain relievers while waiting for treatment. Some require several treatments, even after lithotripsy with shock waves from outside the body, and surgery.
“The ability to non-surgically break stones and expel the fragments in patients awake at first presentation in the emergency department or clinic provides timely treatment resulting in reduced overall pain and cost,” the researchers wrote.
The team will conduct further studies to reach their goal of “a 30-minute non-invasive treatment in the clinic without anesthesia”.
The blast wave lithotripsy technology has been licensed for commercial development and is currently undergoing separate clinical trials.
What is the meaning of kidney stones?
Kidney stones are hard, pebble-like pieces that form in one or both of your kidneys when there are high levels of certain minerals in your urine. Kidney stones rarely cause permanent damage if treated by a healthcare professional, according to the National Institute of Diabetes and Digestive and Kidney Diseases in the United States.
Kidney stones vary in size and shape. It may be as small as a grain of sand or as large as a pea. Some kidney stones are rarely the size of golf balls. Kidney stones may be smooth or rough and are usually yellow or brown.
Small kidney stones may pass through the urinary tract on their own, causing little or no pain. Large kidney stones may get stuck along the way. Kidney stones that block the flow of urine can block, causing severe pain or bleeding.
Severe pain or bleeding requires immediate medical or emergency medical attention
If you have symptoms of a kidney stone, including severe pain or bleeding, seek care immediately. A doctor, such as a urologist, can treat any pain and prevent further problems, such as a “urinary tract infection” (UTI).
What causes kidney stones?
Kidney stones are caused by high levels of calcium, oxalate and phosphorus in the urine. These minerals are usually found in urine and do not cause problems at low levels.
Certain foods may increase the chances of developing kidney stones in people who are at high risk of developing them.
What are the symptoms of having kidney stones?
Symptoms of kidney stones include:
- Sharp pain in your back, side, lower abdomen or groin.
- Pink, red or brown blood in the urine, also called hematuria.
- Constant need to urinate.
- Pain during urination.
- Inability to urinate or only urinate a small amount.
- Cloudy or foul-smelling urine.
See a health care professional right away if you have any of these symptoms. These symptoms may mean you have a kidney stone or a more serious condition.
Your pain may last a short or long time, or it may come and go in waves. Along with the pain, you may have:
kidney stones in english
Kidney stones are called nephrolithiasis in English.
Do kidney stones have another name?
The scientific name for kidney stones is “renal calculus” or “nephrolith”. You may hear health care professionals call this condition “nephrolithiasis,” “urolithiasis,” or “urinary stones.”
Types of kidney stones
You will likely have one of the 4 main types of kidney stones. Treatment for kidney stones usually depends on their size, location, and components.
The following are the types of kidney stones:
Calcium stones, including calcium oxalate stones and calcium phosphate stones, are the most common types of kidney stones. Calcium oxalate stones are more common than calcium phosphate stones.
Calcium in food does not increase your chance of developing calcium oxalate stones. Normally, the extra calcium that your bones and muscles don’t use goes into your kidneys and is excreted in your urine. When this does not happen, calcium remains in the kidneys and joins with other waste products to form kidney stones.
Uric acid stones
Uric acid stones may form when urine contains too much acid. Eating a lot of fish, shellfish, and meat, especially organ meats such as liver and spleen, may increase uric acid in the urine.
Struvite stones may form after you have a urinary tract infection. It can develop suddenly and become large quickly.
Cystine stones are caused by a disorder called cystinuria that runs in families. Cysteinuria causes the amino acid cysteine to leak through the kidneys and into the urine.
Who is most likely to get kidney stones?
- Men are more likely to get kidney stones than women. If you have a family history of kidney stones, you are more likely to develop them. You’re also more likely to get kidney stones again if you’ve had them once.
- You may also be more likely to get kidney stones if you don’t drink enough fluids.
- People with certain conditions. You’re more likely to develop kidney stones if you have certain conditions, including:
- Urinary tract obstruction.
- Chronic or long-term inflammatory bowel disease.
- Cystic kidney disease, which are disorders that cause fluid-filled sacs to form on the kidneys.
- Cystinuria, a condition in which urine contains high levels of the amino acid cysteine. If cysteine is not dissolved in the urine, it can build up to form kidney stones.
- Digestive problems or a history of gastrointestinal surgery.
- Gout, a disorder that causes painful swelling in the joints.
- hypercalciuria, a condition that occurs in families in which urine contains unusually large amounts of calcium; This is the most common condition in people who form calcium stones.
- Hyperoxaluria, a condition in which urine contains unusually large amounts of oxalate.
- Hyperparathyroidism, a condition in which the parathyroid glands secrete too much parathyroid hormone, causing an excess of calcium in the blood.
- Hyperuricemia, a disorder in which there is too much uric acid in the urine.
- Recurrent urinary tract infection.
- Renal tubular acidosis, a disease that occurs when the kidneys fail to remove acids in the urine, causing a person’s blood to remain very acidic.
- People taking certain medications, such as diuretics and calcium-based antacids.
Complications of kidney stones
Complications of kidney stones are rare if you seek treatment from a health care professional before problems occur.
Kidney stones, if not treated, can cause:
- blood in the urine;
- Sharp pain.
- Urinary tract infections, including kidney infections.
- Decreased kidney function.
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