Urinary lithiasis or urolithiasis

litiasis_HCMarbella

Lithiasis is a disease characterised by the formation stones in the kidney or bladder.
 
The prevalence of lithiasis in Spain is approximately 12% of the population, mostly affecting young adults between the ages of 15 and 45, being rare in adults over the age of 65 and more common in men than women.
 
It has a high recurrence rate; according to the Spanish Association of Urologists 50% of patients who have suffered renal colic will have a further episode throughout their life.
 
HC Marbella possesses the equipment required to monitor and treat lithiasis. Our urologists will recommend the best treatment option for the individual treatment of lithiasis using minimally invasive techniques so that you can recover as soon as possible.
 

¿Qué son los cálculos renales
 

Stones are solid masses formed through crystallisation and which vary in size, bringing together the different substances excreted in the urine. Depending on the place in which they are formed they can be bladder or kidney stones.
 
There are several types of stone. The most frequent are calcium stones (70%-80%), followed by uric acid stones (10%), struvite stones (2-15%) and cystine stones (genetic cause).

 

The formation of kidney stones can depend on several factors including:

  • Family history
  •  

  • Poor intake of water, this favours the formation of kidney stones.
  •  

  • Climate. Areas with high temperatures are associated with an increased risk of dehydration, sweating and oversaturation of mineral salts.
  •  

  • Nutrition. Diets high in animal protein or a high salt consumption also favour the formation of stones.
  •  

  • Obesity
  •  

  • Surgery or digestive diseases such as chronic diarrhoea, intestinal inflammation, cystinuria, gastric bypass…
  •  

  • Metabolic diseases such as diabetes, hypertension or metabolic syndrome.
  •  

Depending on the location, size and composition of the stones they will present different symptoms or even be completely asymptomatic.

Síntomas de piedras en el riñón
  • Renal colic: characterised by intense pain in the lower back that radiates to the abdomen and genitals. It occurs due to blockage of urine output in the kidney. It can cause vomiting, sweating, and in some cases fever, when severe.
  •  

  • Haematuria or blood in the urine from small lesions of the urinary tract produced by the stones.
  •  

  • Urine Infections.
  •  

  • Irritation on passing urine when the stone is at the end of the ureter.

historia clínica

Depending on the patient’s symptoms, different diagnostic tests may be performed such as:
 

  • Clinical History
    NThis provides us with information on the possible origin of the stone, the patient’s family history, their diet or any disease that favours stone formation.
  •  

  • Blood and urinalysis:This determines the presence of red blood cells, white blood cells, crystals in the urine and whether there is any bacteria present in both the urine and the blood (pH, urea, creatinine and electrolytes).
  •  

  • Specific metabolic study in both blood and urine. This is performed in patients who are at high risk of recurrence.

  • Abdominal X-ray.This examines the renal areas, ureters and bladder for opacities suspected of being calcium stones. Most stones are visible on X-ray
  •  

  • Ultrasound. This is a non-invasive test which uses ultrasound waves. It is indicated in patients who cannot be exposed to ionising radiation (pregnancy). It enables visualisation of the kidneys and bladder, it is not as helpful in ureteric stones
  •  

  • Computed tomography (CT). This test provides more information about the stones, providing information on their location, possible composition, hardness and size. It is capable of detecting almost 100% of stones.
  • diagnóstico_cálculos_renales_urotc.jpg

    Conservative treatment of stones
    Not all stones require treatment, treatment is only required if they are causing pain, discomfort or obstruction and are not expelled naturally in the urine.

    Tratamiento médico explusivo (TME)

    If the stone is small, does not cause any discomfort, and it is likely that due to its size, shape, and location it will be expelled naturally, your doctor may prescribe medication to control symptoms and facilitate expulsion. This is called medical expulsive therapy (MET). Your doctor may tell you to drink 2-3 litres of water, well distributed throughout the day and to walk. You may also be prescribed alpha blockers, drugs that help relax the muscles of the ureters to facilitate the expulsion of the kidney stone.
     
    If this option is chosen, you will need regular visits to see whether the stone has moved and to make sure it causes no complications.
     

    Active treatment of calculi
     
    If the stone is not passed or complications occur, active treatment is required. Some of the techniques used are:
     
    Extracorporeal shock wave lithotripsy (ESWL): ESWL is performed with an external lithotripsy machine that generates high-energy shock waves directed at the stone, the stone absorbs the energy and fragments into smaller pieces. These fragments are expelled in the following days or weeks. This procedure does not require an anaesthetic but has limitations in the localisation and fragmentation of some stones.
     
    Ureteroscopy (URS). This is done with the help of a ureteroscope (small bore endoscope) which is inserted through the urethra into the bladder and is then passed into the ureter. Once the stone is located, it is broken up by laser into small pieces which are removed with a special small basket. This procedure is carried out in theatre under general or spinal anaesthetic. As this is a minimally invasive technique, the patient is usually discharged within 24 hours.

    Nefrolitotomía percutánea (NLP).

    Percutaneous nephrolithotomy (PCN).This is indicated in large kidney stones. Through a small incision made on the flank, the kidney is directly accessed with a nephroscope and the stone is fragmented and pulverised by the laser. This procedure is carried out in theatre under general anaesthetic.

    Retrograde intrarenal surgery (RIRS). This minimally invasive surgery is performed under general anaesthetic. Under radiological guidance, the specialist inserts a sheath from the urethra to the kidney, passing a sophisticated flexible endoscope. Once located the stone is fragmented with a 200-270 micron laser fibre, removing the small fragments with a special small basket.
     
    It is technically a very complex procedure which requires very sophisticated instrumentation, but the success rates are high and the risk of complications is low. Being a minimally invasive technique, the patient is usually discharged within 24 hours.

    Cirugía retrógrada intrarrenal (CRIR).

    Doctor Antuña

    Unidad Láser

    Innovación técnologica al servicio de la salud
    Equipo multidisciplinar experto
    Las mejores opciones terapéuticas posibles, tratamientos personalizados.
    Un trato humano de excelencia.
    Rapidez en el diagnóstico y tratamiento.
     

    Consultants

    Dr. Arrazola, Tomás
    Especialista en Farmacia Hospitalaria
    Especializado en terapia contra el cáncer, certificado por la Sociedad Americana de Farmacéuticos de Hospital

    Online appointment and download of test results through My HC.

    Tel.: +34 952 908 628

    952908898 Oncology
    951829978 Diagnosis by imaging
    951829947 Gynecology
    952908897 Fertility
    951829947 Physiotherapy

     

       

       

      I agree to receive e-mails with offers and news about this and other services. *

      YesNo

       

      Responsible: HC Hospitales, S.L. Purpose: Managing the appointment process. Sending you information by newsletter, upon your acceptance. Duration: The data is deleted once the information has been provided to you, unless you contract our services or request us to contact you in the future. With regard to the newsletter, the data is deleted when you unsubscribe from it. Recipients: We do not disclose your data to any other party. Rights: To access, rectify, and delete your data, as well as further rights explained in the additional information webpage: https://clientes.prodat.es/privacidad/MLG/HCMARBELLA

       

      Patient Services

      • 900877454 Call Center
      • 952908898 Oncology
      • 951829978 Diagnosis by imaging
      • 951829947 Gynecology
      • 952908897 Fertility
      • 952908131 Hospital pharmacy

      Subscribe to our newsletter

      • HC Marbella you can access information relevant and topical written by different professionals of our medical health units.
      Subscribe