Non-surgical treatment of urinary stone

被引:0
作者
Kim, Hyung Joon [1 ]
机构
[1] Konyang Univ, Dept Urol, Coll Med, Daejeon, South Korea
来源
JOURNAL OF THE KOREAN MEDICAL ASSOCIATION | 2020年 / 63卷 / 11期
关键词
Urinary stone; Treatment; Drug therapy; Lithotripsy; SHOCKWAVE LITHOTRIPSY; URETERAL CALCULI; 2007; GUIDELINE; MANAGEMENT; UROLITHIASIS; TIME;
D O I
10.5124/jkma.2020.63.11.668
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Some patients with urinary stones can be managed non-surgically through observation, medication, or extracorporeal shockwave lithotripsy (ESWL). Symptomatic urinary stones can initially be treated conservatively using analgesics and hydration. When uncontrolled pain or infection is present, immediate diversion via either percutaneous nephrostomy or ureteral stenting may be necessary. Medical expulsive therapy utilizing alpha-blocker may benefit a selected group of patients with stones larger than 5 mm. Oral or percutaneous chemolysis is a well-established non-invasive option with a reasonable success rate for patients with a certain component such as uric acid. When medical treatment is applied, its unintended side effects should be considered and routinely monitored. Extracorporeal shockwave lithotripsy is a highly effective and safe modality in treating urinary stones when adequately indicated. In addition to the size and location of the stone, information obtained from non-enhanced computed tomography such as stone density, stone heterogenicity index, and stone-to-skin distance can be applied to predict the possibility of ESWL failure. Modifications in shock wave delivery by altering shock rate and voltage can improve shock wave efficacy. Urinary stones can be managed effectively and safely using non-surgical approaches.
引用
收藏
页码:668 / 676
页数:9
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