Stone Center

Treating stones in the urinary tract

The Stone Center of Campus Bio-Medico University Hospital offers all the tools necessary for the diagnosis and treatment of stones in the urinary tract using cutting-edge endoscopic techniques, as well as suggestions and therapies aimed at preventing the formation of new stones. The objective of the Stone Centre is to concentrate skills, technologies and tools in the same location, so as to be able to face the various problems connected with the lithiasis pathology. Having stones in the urinary tract is in fact a multidisciplinary pathology in which the figure of the urologist is supported and completed by other figures such as the nephrologist, endocrinologist, radiologist and nutritionist.

Treatments

Urinary stones generally become symptomatic when they migrate into the ureter: in this case a renal colic may appear. Generally, when smaller than 5 mm, ureteral stones have a high probability of spontaneous expulsion, especially if encouraged by adequate medical therapy. If conservative treatment fails or there is a low probability of spontaneous expulsion, the stones must be removed.  Today, the new frontier in the treatment of stones, especially if smaller than 2 cm, is retrograde lithotripsy by ureterorenoscopy (RIRS), in which the renal cavities are reached through natural ways, using flexible and digital instruments.

The RIRS, which is carried out at Campus Bio-Medico University Hospital both privately and in agreement with the national health service, guarantees a better expulsion of the stones than “bombardment”, also involving a considerable reduction in the risk of bleeding and the average hospital stay.  Many of these operations are performed in one day surgery, with only one night of hospitalisation. This technique is less traumatic than percutaneous nephrolithotomy (PCNL), which is instead necessary to resort to in the case of staghorn stones or when, for anatomical reasons, it is not possible to travel along the ureter. PCNL, which allows direct access to the kidney from a hip, is now possible with much smaller but equally effective instruments (MINIPERC and MICROPERC).

Once the stone is removed, it will be necessary to take the right precautions to avoid new lithiasic formation; in fact, after the first episode of renal colic, half of the patients will have another in the following 10 years. The causes are very often to be found in metabolic and nutritional disorders and for this reason, in some cases, a careful evaluation by specialists such as nephrologist, nutritionist and endocrinologist is necessary.