Worried about getting ureter or kidney stones again in the future? There’s a 35 to 40% chance that it can recur in the next few years. However, with the recent innovation in urology, there will be some new treatments available for you in the future. Learn what new innovative ureteral stone treatment techniques will be available for your treatment. You can contact us by visiting our clinic or visiting our website at https://www.urologistbrooklyn.com.
Recent advancements in ureteral stone treatment
Here are the major recent advancements in ureteral stone treatment that you should know about:
- Extracorporeal Shockwave Lithotripsy (ESWL):
This treatment method uses high-frequency ultrasound delivered from outside the body to smash the stones into a passable dust-like size. While its ability to deal with kidney stones is good, some large stones even after being smashed create problems in passing through the ureter. For that reason, urologic surgeons need to perform another procedure called percutaneous nephrolithotomy, where they use endoscopic instruments through the back to access the patient’s kidney to remove stones with a laser or other tools.
However, with recent significant improvements, now its precision is enhanced, targeting kidney stones with unprecedented accuracy, which reduces the risk of damaging the surrounding tissues. Additionally, laser lithotripsy has become a powerful tool to precisely fragment stones using laser energy, thus reducing the need for invasive surgeries.
- Ureteroscopy (URS):
This surgical option gets better with time, by replacing older technology scopes with modern scopes with unique characteristics. Switching from fiber optic to digital systems allows surgeons to get a better visual anatomy. Digital scopes have sensors inside them that are less sensitive to image flickering caused by laser energy-induced shockwaves, which offer an unobscured view. However, the only drawback of digital scopes is the cost, and sensors come in specific sizes which hinder it fitting in the digital scopes.
Single-use flexible scopes have also been introduced for some years to get clinical outcomes that are comparable with reusable scopes. This device has superior ergonomics, which lowers the fatigue levels of surgeons without compromising scope functionality in multiple studies. Additionally, there is no risk of contamination, which is on the 12.1% higher side with reusable scopes even after following strict sterilization protocols. However, it does have high costs when it comes to repairability after usage. Regardless, it still offers certain benefits, especially in cases of unfavorable anatomy for patients who are at risk of urosepsis and also for endoscopic treatment of upper urinary tract urothelial carcinoma. These scopes enhance the success rate of ureteroscopy.
- Percutaneous Nephrolithotomy:
This procedure is used for larger kidney stones to break and remove them. The surgeons make small incisions in the lower back and use a small camera and instruments to break and remove the stones. It is also known as mini PCNL or mini perc, incisions and instruments are smaller.
With recent advancements, the kidney can now be accessed through a single puncture wound through the skin, making it less traumatic with less cutting. This also means less bleeding and pain during recovery. Instruments and probes are passed into the kidney by using X-rays, ultrasound, CT, or fluoroscopy guidance.
- Miniaturization of PCNL Sheaths – Innovations in PCNL Lithotripters:
Technological advancements allow the refinement of instruments used during PCNL. One of the most important shifts comes in miniaturization access of sheaths from standard to mini-PCNL. The main advantage of using mPCNL is less bleeding and transfusion rate, which increases up to 75 to 80% with a tubeless procedure. This also reduces hospital stays because of faster recovery. However, the cost increases due to laser lithotripsy used during mPCNL.
Back then, the main equipment used for PCNL for lithotripsy was ultrasonic and ballistic energy, using two probes (dual-probe and dual-energy lithotripters). Recently, single probe- dual-energy (SPDE) lithotripters have emerged and proved their effectiveness in preclinical studies. In a recent systematic review and meta-analysis, SPDE lithotripters are safe and efficient based on bench studies, however, preliminary clinical data show similar SFRs, bleeding complications, and increased operative time compared to both laser lithotripsy and stone fragmentation using older generation devices. SPDE devices provide the simultaneous application of two forms of energy which improves ergonomics and surgeon satisfaction and proved superior. However, more data is required to get approval for public use.
- Computer-aided surgery for PCNL:
With the latest advancements, target structures of surgery and surrounding tissues are looked at as preoperative data by using image segmentation algorithms or computer graphics (direct volume or surface rendering). This image-processed data can be converted into real-time intraoperative video or static preoperative volume data (navigation software). The surgical tools get an update of motion tracking systems such as the Polaris infrared camera or the Aurora electromagnetic system, in real-time and with millimetric precision.
These are new innovative ureteral stone treatment techniques that introduce some new methods or improve the existing ones to be more precise and less invasive which boosts recovery time and causes less damage to surrounding tissue. With these innovations, treatment options become more convenient and reliable for the public.
Need help with ureteral stone? Visit our urology clinic in Brooklyn to get professional medical help. You can schedule an appointment with Doral Health and Wellness Urology Center’s best urologist in Brooklyn and inquire about your concerns. Our specialists will work with you in managing your condition. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call 1-347-384-5690. You can also visit our website at https://www.urologistbrooklyn.com/.
