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Intervention

Intervention. Interventions. Conservative observation Dissolution agents Relief of Obstruction Extracorporeal Shockwave Lithotripsy (ESWL) Ureteroscopic stone extraction Percutaneous Nephrolithotomy Open stone surgery Pyelolithotomy Anatrophic Nephrolithotomy Radial Nephrotomy

shaeleigh-kemp
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Intervention

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  1. Intervention

  2. Interventions • Conservative observation • Dissolution agents • Relief of Obstruction • Extracorporeal Shockwave Lithotripsy (ESWL) • Ureteroscopic stone extraction • Percutaneous Nephrolithotomy • Open stone surgery • Pyelolithotomy • Anatrophic Nephrolithotomy • Radial Nephrotomy • Ureterolithotomy • others

  3. Conservative management • Majority of stones pass out within a 6 week period after the onset of symptoms • depends on the size of the calculi and its location Dissolution agents • Use alkalinizing agents • Given oral, IV or intrarenal Relief of the Obstruction • Emergent drainage in patient with signs of UTI

  4. Extracorporeal Shockwave Lithotripsy (ESWL)

  5. Extracorporeal Shockwave Lithotripsy (ESWL)

  6. Consideration • excessive weight (>300 lb) may severely limit or preclude ESWL. • Pregnant women and patients with large abdominal aortic aneurysms or uncorrectable bleeding disorders should not be treated with ESWL. • Individuals with cardiac pacemakers should be thoroughly evaluated by a cardiologist.

  7. Ureteroscopic stone extraction • Highly effective for lower ureteral calculi • Stone may be extracted using a wire basket • Or lithotrites may be placed through the ureteroscope to fragment the calculi

  8. Percutaneous Nephrolithotomy • the treatment of choice for large (>2.5 cm) calculi; renal and proximal ureteral calculi, those resistant to ESWL, select lower pole calyceal stones with a narrow, long infundibulum and an acute infundibulo- pelvic angle, and instances with evidence of obstruction • Rapid cure

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