How to crush kidney stones with laser rays - Let's talk about Laser Lithotripsy!

Have you ever had a kidney stone and experienced the severe pain it causes? Or have you seen a family member or friend suffering from this pain? It is truly a very difficult pain to bear. So, today there are very advanced treatment methods to remove stones that form in the urinary system. One such treatment method that many people talk about, and which is very successful, is to use laser beams to crush and remove these stones. Let us talk about this in detail today.

Simply put, what is Laser Lithotripsy?

Laser Lithotripsy is a medical procedure that uses a high-powered laser to break up and remove stones in your urinary tract. This refers to your entire urinary tract, which includes your kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), the bladder, and the tube that carries urine from the bladder to the outside of the body (urethra) . This procedure can remove stones anywhere along the way.

Imagine a laser beam being sent through a very fine tube, no bigger than a hair, to precisely where the stone is and shatter it. This is usually done by a urologist. He inserts a very flexible, thin tube (scope) with a camera attached into it, down your urethra, and finds the stone. Then he sends a laser fiber through the tube, shines the laser beam on the stone, shattering it into tiny pieces, like grains of sand. Finally, the stone is removed with a very small basket-like device.

Sometimes, to remove very large kidney stones, a surgery called ``percutaneous nephrolithotomy`` is performed through a small incision in the back. Even then, there are times when this laser method is used to break up the stone once it has been inserted.

Is this a major operation?

No. Laser Lithotripsy is generally considered a minimally invasive procedure . Therefore, we do not consider it a major, serious surgery.

What is the difference between Laser Lithotripsy and Shock Wave Lithotripsy?

You've probably heard of both of these methods. Although the goal of both is to crush rocks, there is a big difference in how they are done. To understand this difference, take a look at the table below.

Simply put, Laser Lithotripsy is the most effective method for stones that are too large, hard, or in a slightly more complex location to be broken down by shock wave.

What happens before and during surgery?

Preparation before treatment

Your doctor will give you a clear set of instructions before this treatment. It is very important to follow these instructions exactly to minimize complications.

• You will be asked not to eat or drink anything for 8 hours before the surgery (fasting).
• Some medications you take, especially blood thinnersThey will tell you to stop taking them for a few days. Don't forget to tell your doctor about all the medications you take, even vitamins.
• After the surgery, you will be asked to bring someone to take you home because you will not be able to drive due to the anesthesia.

Sometimes, if your ureter is a little narrow, it may be difficult to insert the instruments right away. In such cases, the doctor will first place a temporary tube (a `ureteral stent`) to widen the tube, and then schedule a day for laser treatment two to three weeks later.

What happens during treatment

• First, you will be fully anesthetized and put to sleep so that you will not feel any pain.
• Next, the doctor inserts a thin tube (scope) with a camera attached through the urethra.
• Through that tube, the laser fiber is sent close to the stone.
• Laser beams break the stone into small pieces.
• Those stone fragments are collected in a delicate basket and taken out.
• Finally, a temporary tube (a ureteral stent) is placed to allow the remaining stone particles and urine to flow more easily down the ureter. This is removed by the doctor in the clinic after a few days or weeks.
• Then the entered scope is removed.

This entire process usually takes about an hour or two .

What happens after treatment? What are the benefits and risks?

After the treatment, you will be kept in an observation ward for a while, and then allowed to go home after you fully wake up from the anesthesia. You will be given pain medication, medication for any discomfort caused by the stent, and antibiotics for a few days to prevent infection.

How long does it take to heal?

Most people can return to their normal activities after about a week . However, if you have a stent, you may experience some pain when you exercise, lift heavy objects, or pass some blood in your urine. Ask your doctor about this.

When should you see a doctor?

If you experience any suspicious symptoms after you go home from treatment, call your doctor immediately. Be especially aware of the following:

• If you have a high fever (over 101°F).
• If you have burning sensation when urinating for more than two days .
• If you have dark red blood in your urine, or if you have been passing pink blood for more than two or three days.
• If you are experiencing unbearable pain .
• If you feel like you are stuck and unable to urinate .

In such a situation, immediately call the doctor who treated you. Or go to the Emergency Department (ETU) of the nearest hospital.

Kidney stones, urinary stones, laser treatment, Laser Lithotripsy, ureteroscopy, kidney disease, bladder, surgery