Issue 9/2023
Ivanov, А. Belov, P. Antonov
Department of urology and general medicine, Medical university- Plovdiv
Kidney stone disease (KSD) is a pathology that has accompanied human civilization since ancient times. Endoscopic treatment techniques began at the beginning of the 20th century with the creation of the first endoscopic visualization systems with Hopkins optical lenses. A revolutionary method in the treatment of KSD is extracorporeal shock waves lithotripsy. It presents excellent results for stones with a diameter between 5-10 mm and localization in the kidney or ureter. Retrograde ureterorenoscopy with laser lithotripsy is a treatment method in which the natural course of the urinary tract is followed and, under visual control, the disintegration of stones between 10 and 20 mm in size takes place. With the development of laser technologies and optical image transport systems, the transfer of large amounts of energy for the disintegration of large stones is ensured, hospital stay and intra- and postoperative complications are reduced. Percutaneous nephrolithotomy is a method introduced at the end of the 1990s, in which the pyelo-caliceal system of the kidney is reached through an opening in the skin and, again using laser energy, stones larger than 20 mm in size are disintegrated with the possibility of aspirating the available fragments. After the manipulation, a nephrostomy tube is usually placed. Compared to retrograde intrarenal surgery, complications are more significant and hospital stay is longer. The use of all methods makes it possible to apply a personalized approach in the treatment of urolithiasis.
Key words: kidney stone disease, treatment, personalized approach
Address for correspondence:
Dr. Atanas Ivanov, MD
UMBAL „St. Georgi“, fl. 9, Clinic of Urology
Blvd. Peshtersko Shosse 66,
4000, Plovdiv
Tel.: 0886 740 407
e-mail: atanasivanovmd@yahoo.com