Percutaneous Nephrolithotomy (PCNL)
For kidney and ureteral stones that are too large (usually larger than 2 centimeters), too numerous, or too dense to be treated by extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy, PCNL (percutaneous nephrolithotomy or stone extraction) offers a minimally invasive method of removing these stones.
Historically, large kidney and ureteral stones were removed through open surgery, requiring a large flank incision. Percutaneous nephrolithotomy is performed through a 1-cm skin incision and thus minimizes incision size, pain, blood loss, blood transfusions and shortens hospitalization. This technique also has a higher success rate for clearing all stones in one setting than other techniques such as ESWL, which often require several procedures.
Ureteral Reimplantation Surgery?
The ureters are the tubes that carry urine from the kidneys to the bladder. The connection where one or both of your child’s ureters attach to the bladder isn’t completely developed. This can cause urine to flow from the bladder back up into the kidney. This is called vesicoureteral reflux (VUR). VUR doesn’t cause pain. But it can increase your child’s risk for urinary tract infections (UTIs). Over time, it can also damage your child’s kidneys. With ureteral reimplantation surgery, one or both ureters are moved so their connection to the
bladder is stronger.
Transurethral resection of the prostate (TURP)
Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems that are caused by an enlarged prostate.
An instrument called a the tip of your penis and into the (BPH) tube that carries urine from your bladder (urethra). The resectoscope helps your doctor see and trim away excess prostate tissue that’s blocking urine flow.
Retrograde Intrarenal Surgery (RIRS)
RIRS is performed to remove stones without making any incisions on the kidney while using a laser and a viewing tube called a fiberoptic endoscope that goes through the urethra into the kidney. It is performed under general, local or spinal anesthesia. This procedure requires a specialized urologist who is specifically trained in RIRS.
To perform this procedure, the scope is placed through the urethra, into the ureter and finally into the urine-collecting part of the kidney. The scope is therefore moved retrograde, i.e. up the urinary tract system to within the kidney, i.e. intrarenal. Once the scope is in place, the doctor can see the stone and can proceed to manipulate or crush it by an ultrasound probe or be evaporated by a laser probe or even grabbed by small forceps.
There are several advantages of opting for RIRS over open surgery like achieving quicker resolution of problems, elimination of prolonged post-surgery pain and a much faster recovery period.
What is AV fistula?
An AV fistula is a surgical connection made between an artery and a vein, created by a vascular specialist. An AV fistula is typically located in your arm, however, if necessary it can be placed in the leg. With an AV fistula, blood flows from the artery directly into the vein, increasing the blood pressure and amount of blood flow through the vein. The increased flow and pressure causes the veins to enlarge. The enlarged veins will be capable of delivering the amount of blood flow necessary to provide an adequate hemodialysis treatment. AV fistulas are the preferred vascular access for long-term dialysis because they last longer than any other dialysis access types, are less prone to infection and clotting, and can be relied upon for predictable performance.
What is a Pyeloplasty?
This operation removes a blockage that is keeping urine (pee) from reaching the bladder. In most cases, pyeloplasty physically cuts out a blocked part of the tube for urine (called the ureter). These blockages often happen right where the urine leaves the kidney to go down the tube toward the bladder due to an abnormality in how the tube developed. This area is called the uretero-pelvic junction, or the UPJ. In other cases, another body part is blocking or pushing externally on the UPJ, preventing urine from easily passing.
For example, a blood vessel may cross over top of the urine tube, narrowing an area. This can lead to kidney pain, often felt as back or side pain. In these cases, pyeloplasty involves cutting the urine tube and pulling it out from behind the blood vessel. The tube is then reconnected over top of the blood vessel so that the flow of urine is no longer blocked.
What is a Urethroplasty?
Urethroplasty is surgery performed on your urethra, a part of your urinary system. The urethra is a tube that carries urine from your urinary bladder to the outside of your body. In men, the urethra also carries semen outside of their bodies.
Why is a urethroplasty done?
Urethroplasty is done to repair or replace your urethra when scar tissue forms inside it. Your surgeon connects two ends of your ureth after cutting out the scar tissue, or may borrow tissue elsewhere in your body to rebuild the portion of your urethra that’s blocked.
You may need urethroplasty if:
- You have a urethral stricture. This means that some part of your urethra has become narrower, blocking the flow of urine. Urinary strictures are much more common in men than women.
- You have epispadias or hypospadias, congenital conditions that affect your urethra, which were repaired in childhood. Blockages are especially common in urethras that have previously been rebuilt.
- You’ve had gender affirmation surgery.
What Are the Different Types of Urethroplasty?
Excision and primary anastomosis (EPA) urethroplasty
A short segment of the bulbar urethra (between the scrotum and the prostate) is excised and the cut ends of the urethra are sewn back together.
Graft Urethroplasty
A piece of tissue, typically from the extra-genital skin or from the inner lining of the mouth (buccal graft), is used as a patch to increase the size of the urethra.
Penile Flap Urethroplasty
A flap of penile skin is used to patch a urethral stricture.
Staged Urethroplasty
The scarred urethra is surgically removed and replaced with a buccal or skin graft. This replaced urethra heals over the course of a few months; once the graft is healed, a second surgery forms the graft into a tube to reconstruct the urethra.
What is a kidney transplant?
A kidney transplant is a surgical procedure that’s done to treat kidney failure. The kidneys filter waste from the blood and remove it from the body through your urine. They also help maintain your body’s fluid and electrolyte balance. If your kidneys stop working, waste builds up in your body and can make you very sick.
People whose kidneys have failed usually undergo a treatment called dialysis. This treatment mechanically filters waste that builds up in the bloodstream when the kidneys stop working.
Some people whose kidneys have failed may qualify for a kidney transplant. In this procedure, one or both kidneys are replaced with donor kidneys from a live or deceased person.
There are pros and cons to both dialysis and kidney transplants.
Undergoing dialysis takes time and is labor- intensive. Dialysis often requires making frequent trips to a dialysis center to receive treatment. At the dialysis center, your blood is cleansed using a dialysis machine.
If you’re a candidate to have dialysis in your home, you’ll need to purchase dialysis supplies and learn how to use them
What is Cystolithotripsy?
It is an endoscopic surgery performed to crush a urinary bladder stone into smaller pieces and remove it from the body. It is a safe and quick procedure for treating all types of bladder calculi (stones).
Percutaneous cystolithotomy?
Percutaneous cystolithotomy is a minimally invasive form of removing bladder calculi. It entails making a small abdominal incision to expose the bladder. Then, a stab incision (6 mm) is made into the bladder to allow the cystoscope to evaluate the bladder and remove the calculi. The magnified evaluation via scope significantly decreases the chances of calculi being left behind.
