Dr. Morales Pinto, Stalin Fabricio
Especialista en Urología
Lithiasis is a disease characterised by the formation stones in the kidney or bladder.
The prevalence of lithiasis in Spain is approximately 12% of the population, mostly affecting young adults between the ages of 15 and 45, being rare in adults over the age of 65 and more common in men than women.
It has a high recurrence rate; according to the Spanish Association of Urologists 50% of patients who have suffered renal colic will have a further episode throughout their life.
HC Marbella possesses the equipment required to monitor and treat lithiasis. Our urologists will recommend the best treatment option for the individual treatment of lithiasis using minimally invasive techniques so that you can recover as soon as possible.
Stones are solid masses formed through crystallisation and which vary in size, bringing together the different substances excreted in the urine. Depending on the place in which they are formed they can be bladder or kidney stones.
There are several types of stone. The most frequent are calcium stones (70%-80%), followed by uric acid stones (10%), struvite stones (2-15%) and cystine stones (genetic cause).
The formation of kidney stones can depend on several factors including:
Depending on the location, size and composition of the stones they will present different symptoms or even be completely asymptomatic.
Depending on the patient’s symptoms, different diagnostic tests may be performed such as:
Conservative treatment of stones
Not all stones require treatment, treatment is only required if they are causing pain, discomfort or obstruction and are not expelled naturally in the urine.
If the stone is small, does not cause any discomfort, and it is likely that due to its size, shape, and location it will be expelled naturally, your doctor may prescribe medication to control symptoms and facilitate expulsion. This is called medical expulsive therapy (MET). Your doctor may tell you to drink 2-3 litres of water, well distributed throughout the day and to walk. You may also be prescribed alpha blockers, drugs that help relax the muscles of the ureters to facilitate the expulsion of the kidney stone.
If this option is chosen, you will need regular visits to see whether the stone has moved and to make sure it causes no complications.
Active treatment of calculi
If the stone is not passed or complications occur, active treatment is required. Some of the techniques used are:
Extracorporeal shock wave lithotripsy (ESWL): ESWL is performed with an external lithotripsy machine that generates high-energy shock waves directed at the stone, the stone absorbs the energy and fragments into smaller pieces. These fragments are expelled in the following days or weeks. This procedure does not require an anaesthetic but has limitations in the localisation and fragmentation of some stones.
Ureteroscopy (URS). This is done with the help of a ureteroscope (small bore endoscope) which is inserted through the urethra into the bladder and is then passed into the ureter. Once the stone is located, it is broken up by laser into small pieces which are removed with a special small basket. This procedure is carried out in theatre under general or spinal anaesthetic. As this is a minimally invasive technique, the patient is usually discharged within 24 hours.
Percutaneous nephrolithotomy (PCN).This is indicated in large kidney stones. Through a small incision made on the flank, the kidney is directly accessed with a nephroscope and the stone is fragmented and pulverised by the laser. This procedure is carried out in theatre under general anaesthetic.
Retrograde intrarenal surgery (RIRS). This minimally invasive surgery is performed under general anaesthetic. Under radiological guidance, the specialist inserts a sheath from the urethra to the kidney, passing a sophisticated flexible endoscope. Once located the stone is fragmented with a 200-270 micron laser fibre, removing the small fragments with a special small basket.
It is technically a very complex procedure which requires very sophisticated instrumentation, but the success rates are high and the risk of complications is low. Being a minimally invasive technique, the patient is usually discharged within 24 hours.
Innovación técnologica al servicio de la salud
Equipo multidisciplinar experto
Las mejores opciones terapéuticas posibles, tratamientos personalizados.
Un trato humano de excelencia.
Rapidez en el diagnóstico y tratamiento.
Dr. Morales Pinto, Stalin Fabricio
Especialista en Urología
Dr. Antuña Calle, Francisco Manuel
Especialista en Urología
Dr. Fernández Montero, José Manuel
Especialista en Urología
Dr. Hughes, Paul
Especialista en Urología
Dr. Rivera Sánchez, Ernesto
HC Marbella Radiology Specialist
Dr. Arrazola, Tomás
Especialista en Farmacia Hospitalaria
Especializado en terapia contra el cáncer, certificado por la Sociedad Americana de Farmacéuticos de Hospital
Dr. Villatoro Roldán, Rosa Mª
Specialist in Medical Oncology
Dr. Sedano Ferreras, Paula
Radiotherapy Oncology Specialist
Dr. García Baltar, José Antonio
Especialista en Radiofísica Hospitalaria
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La importancia del chequeo urológico en los hombres, por el Dr. Stalin Morales
Sorry, this entry is only available in Español.
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