Renal Lithiasis
"In the Clinica we have all the existing minimally invasive treatments to solve renal lithiasis".
DR. FERNANDO RAMÓN DE FATA CHILLÓN
SPECIALIST. UROLOGY DEPARTMENT
Renal lithiasis is a chronic disease characterized by the formation of stones in the urinary system, whose treatment is not based solely on medical or surgical measures.
Most patients have some disorder in the absorption, metabolism or excretion of the components of the stones, of the substances inhibiting their formation or of the pH of the urine.
Recent studies indicate that 60% of patients who have had a stone will have another one within 10 years, 35% within 5 years and 15% within 1 year of the first episode.
In the Urology Department we have the latest technology for immediate diagnosis and all the minimally invasive treatment options currently available to eliminate kidney stones.
What are the symptoms of renal lithiasis?
The clinical presentation of renal lithiasis varies depending on the size, location and composition of the stones in the urinary system. Some may be less symptomatic.
- Nephritic colic: very intense pain, produced by the obstruction of the exit of urine of the kidney, appears in the lumbar zone and radiates towards the previous abdomen and the genitals. It is an intermittent, unsettling pain associated with nausea, vomiting, and sweating. It can even give fever.
- Hematuria: is the appearance of blood in the urine. It can be visible to the naked eye or not. It is produced by the lesions produced by the stone in its passage through the urinary tract.
- Urinary infections: kidney stones can be the cause or consequence of frequent urinary infections.
The most common symptoms are:
- Pain.
- Hematuria.
- Urinary infections.
Do you have any of these symptoms?
You may have renal lithiasis
What are the causes?
In recent decades, substantial progress has been made in the knowledge of the physiopathological mechanisms responsible for lithiasic disease, which has made it possible to develop effective and rational programs, both for its treatment and for the prevention of recurrence.
With the current knowledge, it is possible to alter the chain of events that ends in the formation of stones, changing some environmental factors, such as the diet (eating habits) of the patients, to whom comprehensive rules can be indicated for each specific type of lithiasic disorder.
Most patients have some disorder in the absorption, metabolism or excretion of the components of the stones (calcium, oxalate, uric acid), of the inhibitors of the formation of stones (citrate and magnesium) or alterations in the pH of the urine.
Who can suffer from it?
Renoureteral lithiasis (97% of stones in industrialized countries) is the third most frequent condition of the urinary system. For a life expectancy of 70 years, the probability of developing a stone is estimated at 15% (5% in women, 12% in men). In terms of clinical manifestations, men are more symptomatic than women, at a ratio of 3 men to every woman.
Probably, there is a lithiasic inheritance, difficult to put in evidence by the coexistence of numerous extrinsic factors, mainly food and environmental. Although there is no age, country or ethnic group protected against this common disease, the peak of incidence is between 40 and 50 years old, in the hot months (from June to September) and in people with professions with intense physical activity, living in humid environments or exposed to high temperatures.
Recent studies indicate that 60% of patients who have had a stone will have another one within 10 years, 35% within 5 years and 15% within 1 year of the first episode.
How is it diagnosed?
The diagnosis of renal lithiasis (kidney stones) is made by clinical symptoms and urine analysis. The location, size and impact of the stone are assessed with imaging methods: ultrasound, simple abdominal radiography and abdominal CT. The composition of the expelled stones is done by specific analysis.
The main constituents of the stones are various organic or inorganic substances. Calcium oxalate is the most common, as it appears in 65% of the stones.
Depending on the composition of the stones and other factors, a metabolic-mineral study should be carried out to rule out the reappearance of lithiasic disease or the presence of diseases associated with them.
How do we treat it?
We have a High Resolution Litiasis Program to solve it in the most precocious way
80% of the stones located in the ureter are spontaneously expelled in the first 3 or 4 weeks, depending on their size and location. Any stone not expelled within 1-2 months usually requires therapeutic action.
Currently, most stones can be removed by minimally invasive procedures:
- Endourological treatment (endoscopic stone removal by semi-rigid or flexible ureteroscopy) and minimally invasive percutaneous nephrolithotomy (percutaneous endoscopic access and laser lithotripsy to remove larger stones).
- Extracorporeal shock wave lithotripsy, which consists of breaking the stones into small fragments that can be more easily expelled.
The goal of medical treatment of lithiasis is to prevent recurrence, especially in young patients under 40 years of age with multiple, bilateral lithiasis or recurrent disease.
Several general dietary measures can allow better control of lithiasis disease, such as increasing fluid intake, preferably water (the first and simplest of the measures to prevent lithiasis disease), following a diet not exceeding 2,000 Kcal, with little salt, limiting animal proteins, sugars and alcohol.
Through the High Resolution Lithiasis Program we offer an immediate diagnosis and make available all the minimally invasive treatment options currently available to eliminate lithiasis within a maximum of 1 week:
- Extracorporeal shock wave lithotripsy.
- Semi-rigid ureteroscopy.
- Flexible digital ureteroscopy.
- Endoscopic treatment of bilateral renal and/or ureteral lithiasis.
- Percutaneous nephrolithotomy: Percutaneous nephrolithotomy system of reduced caliber minimally invasive, which allows to treat large renal lithiasis, without the need for transfusion and without postoperative nephrostomy with an incision < 1 cm.
- Endoscopic lithotripsy with Holmium laser (Lumenis 120W)
- Combined endoscopic approach through flexible ureteroscopy and percutaneous mini-nephrolithotomy.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Urology
of the Clínica Universidad de Navarra
The Department of Urology of the University of Navarra Clinic offers the patient a medical team, composed of first-rate professionals, and state-of-the-art diagnostic and therapeutic means such as the Da Vinci® robotic surgery.
The Department of Urology possesses the certificate of accreditation of the European Board of Urology, a reinforcement of the excellence of the service at the level of care, teaching and research, which in Spain only three hospital centers possess.
Diseases we treat:
- Prostate Cancer
- Kidney Cancer
- Bladder Cancer
- Testicular Cancer
- Benign prostatic hyperplasia
- Urinary Incontinence
- Renal Lithiasis
- Genitourinary Prolapses
- Pediatric Urology
Why at the Clinica?
- A team of top-level professionals trained in international centers.
- State-of-the-art technology for diagnosis and treatment.
- In 24-48 hours you can start the most appropriate treatment.
