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Laser Lithotripsy
Urinary Stone Removal With The Holmium/Nd:YAG Laser
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What Are Kidney Stones? Kidney stones are one of the most common disorders of the urinary tract. Overall, 2-3% of the population will have a kidney stone at some time in their lives. For unknown reasons, the incidence of kidney stones has been increasing over the past 20 years. Men are twice more likely to develop kidney stones as compared to women. Rarely, kidney stones may occur even in children. Our two kidneys, located deep behind the abdomen towards the middle back, play a major role in maintaining proper water and salt balance in the body. They manufacture urine by filtering waste products, water and salts out of the blood plasma that enters them during circulation. Urine's primary components are urea, creatinine and acids. Crystals that form in urine and build up on the inner surfaces of the kidneys can form stones in the kidney, the ureter, or the bladder. Types of Kidney Stones Kidney stones may contain various combinations of minerals and other chemicals, some of which are derived from a person's diet. The most common (70-80%) are calcium stones, usually combined with oxalate. About 10% are made up of uric acid, while 9-17% of stones are struvite (mixed) stones. A small percentage (about 1%) of stones are made from cystine. What Causes Kidney Stones? Two factors play a role in the formation of all stones: increased concentration of crystal-forming matter in urine, and physical and chemical changes that cause these substances to precipitate and form stones. These factors are, in turn, caused or affected by genetic susceptibility, diet, drugs, metabolic disorders or other medical conditions. Struvite stones are almost always associated with certain urinary tract infections. How Serious Are Kidney Stones? Between 70-90% of crystals remain tiny enough so that they can travel through the urinary tract and pass out of the body in the urine without being noticed. When they cause symptoms, however, kidney stones have been described as one of the most painful disorders to afflict humans. Larger stones may cause obstruction of the urinary tract which, if persistent, predisposes to infection, impairment of kidney function, and complications such as hypertension, etc. Laser Lithotripsy Laser lithotripsy involves treating all types of urinary stones using small, minimally invasive telescopes, called endoscopes. These allow state-of-the-art, high energy lasers to fragment any type of urinary stone. Al Zahra Hospital's Holmium/Nd:YAG dual-wavelength laser is the latest available means of treating stone disease. Approved by the US Food and Drug Administration, it has distinct advantages over other forms of treatment. How Is Holmium Laser Lithotripsy Performed? Holmium laser lithotripsy is a safe and effective, minimally-invasive procedure that ensures removal of urinary stones with the least discomfort. Under a general anaesthetic, a narrow tube , called a ureteroscope, is painlessly introduced through the urethra into the ureter and to the stone itself. Fine (200, 365 and 500 micron thickness) fibres, passed via the ureteroscope, deliver laser energy directly to the stone causing it to shatter into small fragments. These fragments are then easily washed out through the ureteroscope. A thin plastic tube, called a stent, may be left in the ureter for about 24 hours to facilitate passage of any remaining fragments. Slight haematuria (blood in urine) may also be noticed during this period. Stone sizes of up to 2.5 cm can be treated at a single session. Larger stones may require additional treatments. Patients are usually discharged home the day following the procedure. Advantages of Holmium Laser Lithotripsy 
Holmium laser lithotripsy has several advantages over other conventional forms of treatment. Some of these are as follows:
Preventing Kidney Stones Fluid Intake. Of all preventive measure recommendations, drinking enough fluid to produce at least two and a half litres of urine each day is the most important. In general, a glass of water every four hours and one with each meal. More water is needed after exertion and during the summer period. Sodium Restriction. Because salt intake increases the amount of calcium in urine, patients with calcium stones should restrict their sodium intake. Some studies have shown that restricting sodium is the most important dietary measure for preventing stones. Dietary calcium is not believed to affect stone formation. Fibre. Fibre may be beneficial for people with kidney stones. It is, in any case, important for general health. Protein restriction. Diets high in protein, particularly animal protein, have been consistently associated with kidney stones. Purine restriction. Those who have gout or are at risk for uric acid stones should reduce their intake of beer and other alcoholic beverages, anchovies, sardines, yeast, organ meats (e.g. liver, kidneys), legumes, mushrooms, spinach, asparagus, cauliflower, and poultry. Other Laser Treatments In Urology The Holmium/Nd:YAG laser has several other therapeutic applications in urology. It is also used to treat:
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