Urinary Lithiasis

The treatment of urinary lithiasis may be conventional or invasive!

Urinary Lithiasis

Urinary lithiasis may be a particularly painful and complex problem for modern man. It mainly causes painful symptoms (renal colic), but it may also become complicated and turn to heavy conditions such as hydronephrosis, serious renal damage, sepsis and life-threatening conditions.

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Types of Urinary Lithiasis

There are many types of stones: calcium stones, uric acid stones, cystine stones and many other variations depending on their content (e.g. calcium oxalate). Urinary lithiasis may present itself in the whole urinary system, but is more often identified in the kidney or in the ureter and less often in the bladder, while it is rare in the urethra.


Diagnosis will be done mainly through imaging. Simple tests like KUB x-ray and ultrasound may determine the diagnosis, but are often inadequate. The method of selection is the CT pyelogram which will provide us with a set of information like stone position and size, but also important information about urinary anatomy which are often decisive as to which treatment will be selected.

In the cases of a lithiasis relapse, the patient must undergo a metabolic check in order to find out whether there is a reason why his body constantly produces stones. Otherwise, in the case of one or two infrequent lithiasis occurrences the metabolic check is not recommended, because it is usually negative

Lithiasis Symptoms

The symptoms caused depend on the position of the stone. If it does not block the flow of urine it may cause no symptom or perhaps occasionally a feeling of heaviness or unspecified discomfort. There may also be hematuria either macroscopic or more often microscopic. If however, the stone blocks the urine flow, because the urine produced in the kidneys can no more descend to the bladder, they accumulate in the urinary system behind the stone.

Gradually this part starts to swell and this swelling causes a very intense pain known as colic. Renal colic is typically located low close to the ribs of a man in the back, although it may also radiate to the front in the abdomen.   Many other symptoms may co-exist, such as frequent urination, urgency or even outside the urinary system, like nausea, vomiting and in the case of bacteria being present, high fever or even septicemia.


Urinary lithiasis treatment may be conservative or invasive. In the case of small stones, no treatment is often required. These stones are automatically eliminated without further intervention, but they may cause symptoms or even pain until they are eliminated.

In the cases of a lithiasis relapse, the patient must undergo metabolic check in order to determine whether there is a reason why his body constantly produces stones.

Percutaneous Nephrolithotripsy

Large stones, because of their volume, cannot be treated by the power of the small laser accompanying these devices. In these cases, through a small incision of 1-2 cm approx. in the skin, special instruments with larger diameter are inserted directly into the kidney. Because of their larger diameter, we can guide until the stone more powerful devices that break up even the larger stones. This technique is called percutaneous nephrolithotripsy.

In very special cases an open surgery will be necessary, where the kidney or the ureter or the bladder will be opened. These techniques are used less and less nowadays thanks to the technological progress.

Extracorporeal Lithotripsy

Larger stones, however, require intervention. The simplest form is extracorporeal lithotripsy. It regards the application of powerful shock waves on the stone resulting in its breaking up. It is a simple method, requires no anesthesia or hospitalization and presents good effectiveness. The disadvantage is that hard stones will not break and this will be found out only after treatment, unfortunately. Therefore, many sessions may be needed. Moreover, the fragments will be eliminated through urine flow and depending on the stone size there may be many fragments requiring additional treatment.

Endoscopic Methods

While the stone is growing or if we require an immediate result or if other factors are at play, like for example a blockage of the urinary tract demanding an immediate solution, extracorporeal lithotripsy does not produce results. In these cases, we apply the endoscopic methods with the urethra as a point of entry.  Special instruments enter through the urethra, reach the bladder and then are guided through the ostium of the ureter into the ureter, and the most modern ones may reach and maneuver inside the kidney. These instruments are equipped with a camera and under the guidance of the specialized urologist they identify the stone and break it up with the help of the laser they are equipped with.

Thanks to the training and the experience of the doctors of Androclinic in these operations, the treatment for lithiasis is usually done without hospitalization, the patient solves his problem on the same day and immediately returns home. These techniques are cystolithotripsy, ureterolithotripsy and flexible uretero-nephrolithotripsy.

They are special techniques and demand suitable training by the urologist.

Ureteral Stent (Pig Tail)

A complementary treatment to all the above methods is the use of a pig tail. It is a special stent which is placed endoscopically in the ureter so that one end is in the kidney and the other in the bladder. This helps initially urine descend to the bladder, in order to resolve temporarily or prevent a blockage which might be caused by the stone, in order to have safety and adequate time in whichever method we use. It may also stretch the ureter, making it easier for the endoscopic instruments to enter, but also for fragments to be eliminated.

The doctors of Androclinic besides andrology problems, are also perfectly trained in these operations and can solve all lithiasis problems modern mas has, so he can return as quickly as possible to his activities.

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 Because our doctors have more than 18 years’ experience in the sector

  Because beyond the most modern diagnostic and treatment methods that we follow, we provide simple, useful advice for your daily life, which will significantly improve your life quality

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Vasilis Protogerou

Dimitrios Mporousas

Konstantinos Makarounis