Electrohydraulic lithotripsy

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Electrohydraulic Lithotripsy (EHL) is a medical procedure which uses targeted shockwaves to break up kidney stones and gallstones. [1] This form of extracorporeal lithotripsy is unique in that the shockwaves are produced by a vaporization bubble expanding and collapsing repeatedly, creating a pressure wave. [1] The procedure is non-invasive and has a 90% success rate, [2] which makes it a first-line treatment for smaller kidney stones. [1] [3]

EHL was the first modern extracorporeal lithotripter invented in 1954 by an engineer from Kyiv, but because he was out of favor with the Stalinist government, he was banished and the use of his invention was delayed for around 10 years. [4]

This procedure is also used to treat gallstones in the bile or pancreatic ducts that are difficult to remove with other methods of lithotripsy. [5] While being less expensive than laser lithotripsy, EHL does carry a greater risk of ureteral injury. [6] When treating gallstones, EHL can be used in conjunction with a spyglass camera, [5] a camera inserted through the throat and esophagus and down into the stomach and duodenum to visualize the bile or pancreatic duct. [7]

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Kidney stone disease, also known as renal calculus disease, nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material develops in the urinary tract. Renal calculi typically form in the kidney and leave the body in the urine stream. A small calculus may pass without causing symptoms. If a stone grows to more than 5 millimeters, it can cause blockage of the ureter, resulting in sharp and severe pain in the lower back or abdomen. A calculus may also result in blood in the urine, vomiting, or painful urination. About half of people who have had a renal calculus are likely to have another within ten years.

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Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, bezoars or gallstones, which may be done non invasively. The term is derived from the Greek words meaning "breaking stones".

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Ascending cholangitis, also known as acute cholangitis or simply cholangitis, is inflammation of the bile duct, usually caused by bacteria ascending from its junction with the duodenum. It tends to occur if the bile duct is already partially obstructed by gallstones.

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Extracorporeal shockwave therapy (ESWT) is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders. ESWT sends acoustic shock waves into bone or soft tissue, in effect reinjuring the area on a cellular level and breaking up the scarring that has penetrated tendons and ligaments. The controlled reinjuring of tissue allows the body to regenerate blood vessels and bone cells. The resulting revascularization leads to faster healing and often a return to pre-injury activity levels. ESWT is mostly used for kidney stones removal, in physical therapy and orthopedics.

<span class="mw-page-title-main">Abdominal ultrasonography</span>

Abdominal ultrasonography is a form of medical ultrasonography to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall. For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs.

<span class="mw-page-title-main">Ureteral cancer</span> Medical condition

Ureteral cancer is cancer of the ureters, muscular tubes that propel urine from the kidneys to the urinary bladder. It is also known as ureter cancer, renal pelvic cancer, and rarely ureteric cancer or uretal cancer. Cancer in this location is rare. Ureteral cancer becomes more likely in older adults, usually ages 70–80, who have previously been diagnosed with bladder cancer.

Nitin Shrivastava is an Indian urologist and academic. Srivastava received training from Maulana Azad Medical College and completed his superspecialisation at AIIMS. Dr Nitin was a fellow at Department of Urology at Oxford University. His work revolves around use of robotics for renal oncology.

References

  1. 1 2 3 Manzoor, Hassan; Saikali, Shady W. (2022), "Renal Extracorporeal Lithotripsy", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32809722 , retrieved 2022-12-30
  2. Başar, H.; Ohta, N.; Kageyama, S.; Suzuki, K.; Kawabe, K. (1997-05-01). "Treatment of ureteral and renal stones by electrohydraulic lithotripsy". International Urology and Nephrology. 29 (3): 275–280. doi:10.1007/BF02550922. ISSN   1573-2584. PMID   9285297. S2CID   12662012.
  3. "Lithotripsy". National Kidney Foundation. 2016-01-07. Retrieved 2022-12-30.
  4. Tefekli, A.; Cezayirli, F. (2013). "The History of Urinary Stones: In Parallel with Civilization". The Scientific World Journal. 2013: 423964. doi: 10.1155/2013/423964 . PMC   3856162 . PMID   24348156.
  5. 1 2 "Electrohydraulic Lithotripsy Procedure | Aurora Health Care". www.aurorahealthcare.org.
  6. Begun, F. P. (February 16, 1994). "Modes of intracorporeal lithotripsy: ultrasound versus electrohydraulic lithotripsy versus laser lithotripsy". Seminars in Urology. 12 (1): 39–50. PMID   8197336 via PubMed.
  7. "Spyglass Endoscopic Camera Probe | Aurora Health Care". www.aurorahealthcare.org.