Lithiasis Clinic. Advanced Endourology Project

The increase in the incidence of Lithiasis in the urinary tract in recent years has generated multidisciplinary management options for prevention, care, and medical treatment.

The causes are not established, but the theories of lithiasis formation in the urinary tract to summarize are given by genetic, nutritional, and environmental predisposition.

Based on studies, the main factors that increase the risk of renal Lithiasis are high temperatures, dehydration, poor management of drinking water, an increase of carbonated water and excess consumption of salt (sodium chloride), not drinking enough water, high consumption of red meat, and genetic predisposition.

The formation of kidney stones is carried out by problems of absorption, excretion, or metabolism since there are substances such as calcium, oxalate, and uric acid that do not inhibit the formation of crystals. Many times the pH of the urine cannot dilute the substances mentioned.

The usual symptomatology depends on the size and location of the stones.

• Nephritic colic: lumbar area with repercussions on the abdomen and genitals. It can present nausea, vomiting, fever, and sweating.
• Hematuria: blood in the urine caused by the passage of the stone in the urinary tract.
• Recurrent urinary tract infections.

The appearance of stones is the main problem in the urinary system; the incidence is from 40 to 50 years old. They occur 5% in women and 12% in more symptomatic men.

The recurrence is very high: 60% of patients will have the problem again in 1 year. -35% in 5 years - 15% in 1 year.

The Lithiasis Clinic is a comprehensive form of management of this disease taken from a research protocol that is carried out in international hospitals such as Boston Memorial (USA), Puigvert Foundation (Barcelona), National Institute of Nutrition and Medical Sciences (CDMX), and has been implemented in private hospitals promoting the continuous assessment of patients with this pathology.

The Lithiasis Clinic consists mainly of these services:

• Urology (Endourology)
• Internal Medicine
• Critical Care Medicine (severe cases of urosepsis)
• Nutrition 
• Radiology

The management of patients is carried out in conjunction with these specialties depending on the degree of complexity of the Lithiasis to be studied.

• Urology assessment
• Pain management
• Timely diagnosis
• Imaging studies and laboratories

According to the diagnostic parameters of Lithiasis found in the American and European guidelines for the treatment of Lithiasis in the Urinary Tract, it depends on the location, size, and degree of kidney damage and whether the patient is a candidate for expelling therapy or some invasive treatment for its resolution.

The protocol is based on pain and urgency after the disease is detected. The patient is sent to the services of Internal Medicine to assess some type of associated pathology such as gout (uric acid stones), glomerulopathies, etc. 

The Nutrition department make changes in their lifestyle to avoid the formation of stones and the Urology service to assess treatments for expulsion, dissolution by medication, or performance of any surgical intervention. 

An oral treatment for expulsion can be carried out in 2 to 3 weeks, and if in 1-2 months it does not work, a minimally invasive procedure must be performed.

Endourology - endoscopic stone removal

Percutaneous minimally invasive nephrolithotomy

Costamed has high technology for diagnosis and treatment. 

The Multidisciplinary Clinic of Renal Lithiasis provides comprehensive care to the patient with assessment packages, basic laboratories required, Imaging (radiology) for evaluation, where they are assessed by ultrasound, simple abdominal radiography or CT of the abdomen.

The standards of integral management are recognized worldwide thanks to the advanced endourological management (minimal invasion in endoscopic urology) that Costamed offers.