This video is designed to remind me of clinical knowledge I picked up during my term of urology at the Ballarat Base Hospital when rotating 3 year 2014.Parmi the many subjects you’ll encounter in the urology, calculations or stones will be one of the most courantes.La pain renal colic presentations is taught very well in most medical schools – I will not elaborate on this lot vidéo.À provided the diagnosis was made, we turn to the management of the stone. In general, small stones can be managed conservatively – more than 4 mm diameter, while larger stones must be functionally managed – about 5mm. Of course, many factors are taken into account, including the history of past stones, the presence of an obstruction, etc. douleurLe degree of conservative treatment is basically waiting for the stone to pass naturally. Normal analgesia can and must be given. In addition to the normal analgesia, PR indomethacin 200mg BD is a staple in the hospital, I was working. On an interesting note, why renal colic causes nausea and vomiting is because the same nerves that supply the stomach also provide nerves. Essentially, vomiting get is a “symptom referred.” Stones managed conservatively should also be strained to and sent for analysis of the stone, because it has effects on the operational management pierre.Gestion for freestone “average” is cystoscopy +/- ureteroscopy pyeloscopy +/- +/- +/- laser Stone cart recovery +/- JJ stent insertion. If the calculation is in the ureter, we do a ‘ureteroscopy’. If the calculation can be found in the renal pelvis or more ‘pyeloscopy’ can be done. Once inside, the stone can be laser etched and the fragments ‘trawled’ out, similar to a fishing trawler. In about 50% of cases, the ureter may be too tight, and a DD stent to be inserted. As my registrar used to say, “It’s like trying to do the splits.” Essentially, JJ stent is a tube that connects the kidney and bladder, which expands slowly ureter, while maintaining a patent flow between the kidney and bladder. The patient can go home after the insertion of a stent JJ, and then come back in two weeks for ureteroscopy définitive.Pour larger stones, ESWL or PCNL are generally used. LEC tends to be used for seated directly in the kidney stones I found. high intensity shocks are used to blast the stone outside the body, and the fragments are to be urinated naturally. A unfortunate side effects, is something called “steinstrausse” or “stone street” This is where the ureter connects with debris after the LEC and requires réintervention.Les massive stones are for PCNL. – percutaneous nephrolithotomy . This involves a cut in the side, where a tube is inserted to go directly in the renal pelvis. One patient I had had 3cm calculations staghorn bilaterally. She needed 2 PCNLs take an excessive amount of stone. The two operations would have taken up to 8-9 hours all together. They tend to be big business, and take any AM / PM theater list. At the end of a PCNL, CT nephrostogram is done. This ensures the permeability of the kidney stones uretère.Et here in a nutshell.

Female Urology in New York, urological Institut.Urologue Dr. Yuly Chalik MD (Americas Top urologist) and a specialist wife Lyudmila Emag NP
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