Urinary Stone Disease(USD) Or Urolithiasis Treatment In Lucknow

Urinary stone disease (urolithiasis) is a ubiquitous problem; no place or person of any age is exempt from it. Most stones form within the kidney; only a few form primarily in the bladder. The problem has ever increasing over the last few decades, largely due to changes in our diet and lifestyle. Kidney stone disease not only poses a threat to the functioning of the body by causing pain, urinary infection (which may be life-threatening), loss of kidney function, and kidney failure (with the need for dialysis/transplantation), but their treatment causes humongous economic burden to the self as well as the health system of the respective country. For example, data from the USA revealed annual expenditure of $2.1b in 2000 which increased to 4.5b in 2012, and it is ever increasing.

Management of stones involves not only retrieving the existing stones but also taking measures to prevent recurrence; up to 50% of stone formers have at least one recurrence in their lifetime. Kidney stones form when urine becomes concentrated with stone-forming elements or stone-preventing elements are deficient. Habits like drinking less amount of water/liquids, avoiding milk products (e.g. milk, paneer, curd, buttermilk, etc.), taking too much salt, animal proteins (meats), refined sugar, high-oxalate foods (e.g. spinach, dark chocolate, nuts, potato, yam, etc.), fast food and avoiding citrus fruits contribute to stone formation. In addition, the stone disease is associated with metabolic syndrome (i.e. diabetes mellitus, hypertension, coronary artery disease, obesity, high uric acids in the blood), certain hereditary diseases, hormone disturbances urinary tract infections, etc. Therefore, the evaluation is kidney stones is not restricted to imaging (x-ray, ultrasound, CT); a detailed assessment of dietary habits and specialized blood/urine tests is mandatory. All stone patients should habituate themselves to certain dietary and lifestyle modifications to prevent recurrence; taking enough liquids (for producing ~2.5L urine every day), avoiding excessive salt, meat, sugar, and fast-food intake, taking enough milk products with food, taking citrus fruits, regular exercise to avoid obesity are simple measures for keeping stone recurrence at bay.

In the pre-endoscopy era, most stones would require major open surgery to remove stones. However, with continuous advancements taking place in the technology of endoscopy and lasers, nowadays most stones can be managed by endoscopic methods (eponym ENDOUROLOGY). For large stones in the kidneys, a passage is created (<1cm size) through the skin directly into the kidney, and the stone is broken down using an endoscope. This procedure is called PCNL. Most stones in the ureter (tube connecting kidney with bladder) can be managed by an endoscopic procedure done through a natural passage (urethra) called ureteroscopy; no cut is required in this procedure. Stone are broken and fragments are left to pass by themselves. With recent advances even stones in the kidneys can be broken through the natural passage using laser and flexible (bendable) instruments (called RIRS, the retrograde intrarenal surgery). With laser, stones can be reduced to tiny particles like dust/sand, thus improving clearance.

Most of the urinary calculi can be managed with the endoscopic methods mentioned above. However, there are circumstances where these methods may be inappropriate, for example in the presence of a structural block in the urinary passage, persistent urinary tract infection, or advanced kidney disease. In such a situation, laparoscopic (keyhole) surgery can be utilized providing the benefit of conventional open surgery but with minimized morbidity.

Dr. Mayank Mohan Agarwal provides kidney stone treatment in and around the people who are living in Lucknow, Kanpur, Faizabad, Varanasi, Gorakhpur, Deoria, Jaunpur, Ballia, Jhansi, Bareilly, Agra, Aligarh, Gomti Nagar, Golf City, Hazratganj, Mahanagar, Prayagraj(Allahabad), Gwalior.