What is intra-organ lithotripsy (TUL)
Intra-organ lithotripsy or TUL is an effective way to break up stones that are stuck in the ureter. This method, which is mainly used for crushing lower and middle ureter stones, is associated with a success rate of about 75 to 95 percent.
In what cases do ureteric stones require surgical intervention
The ureter is a muscular tube that is the connection between the kidney and the bladder. After the kidney stone is formed, when it enters the ureter during excretion, it usually causes severe colic pain due to the blockage it creates in the passage of urine. In addition, when the stone gets close to the end of the ureter tube and bladder, the feeling of frequent urination, severe burning of urine and also blood in the urine occurs. Sometimes urinary tract infection and chills may occur following obstruction caused by stones.
Usually, the stones that enter the ureter tube, if they are smaller than 4 mm, there is a 90% probability, and stones between 4 and 6 mm, there is a 60% probability of being expelled by themselves. Consuming plenty of fluids and doing exercises like jumping rope helped to facilitate the passage of ureteral stones.
If these stones are not removed in spite of the above measures and within 2 to 4 weeks, there is a need to perform internal stone crushing. In addition, stones larger than 6 mils also need stone crushing due to the low probability of spontaneous removal.
Stone crushing can be done in two ways, extra-organ and intra-organ, the method of extra-organ stone crushing is the preferred option in cases of kidney and upper
ureter stones, and intra-organ stone crushing is a more suitable method for middle and lower ureter stones.
Intra-organ stone crushing of TUL
How is TUL internal stone crushing done
To perform intra-organ stone crushing, spinal anesthesia is performed first. Then, the urologist specialist inserts a ureteroscope, which is a narrow and long tube, into the bladder through the urethra and then through the ureter into the ureter.
Intra-organ stone crushing of TUL
After seeing the stone in the ureter, a very narrow instrument is inserted through the ureteroscope and the stone is crushed by a laser or pneumatic, and then the crushed stone pieces are removed with the instrument.
In some cases, a narrow catheter is inserted into the ureter to facilitate the passage of crushed stones or in the case of a narrowing at the site of the stone, and then 2 to 4 weeks later, the catheter is removed on an outpatient basis.
In what cases should intra-organ stone crushing of TUL be performed as an emergency
In cases where
1 person with a single kidney
2 Fever and chills occur.
3 stones larger than 6 miles.
4. Stopping urination or increasing the patient's creatinine blood level.
5 Obstruction and severe hydronephrosis based on the patient's ultrasound.
After stone crushing, the patient can be discharged from the hospital the next day.