[Urolithiasis].
In 2006, 70 to 80% of calculi are treated with extracorporeal lithotripsy, 7% with percutaneous nephrolithotomy, 5 to 15% with ureteroscopy and less than 1% with laparoscopic surgery or open procedure. Twenty years after its introduction, extracorporeal lithotripsy is still predominantly used. Today though, its indications are better defined. At the same time, considerable advances have been made in the field of intracorporeal lithotripsy, which have contributed to the development-of ureteroscopy and percutaneous nephrolithotomy. Nowadays, urologists have to master all surgical techniques to best adapt their therapeutic decisions. Finally, they should always keep in mind that treatment for urolithiasis is not limited to surgery. A medical management is essential to prevent recurrences; it concerns all patients with lithiasis, from the very first event, and it is based on a systematic screening for risk factors. This first-intention etiological study is carried out in an ambulatory setting, it is easy and cost-effective. It essentially consists in a morphological and constitutional analysis of the calculus by infrared spectrophotometry. Once risk factors for nephrolithiasis have been identified, measures to readjust patient diet and a medical treatment, when necessary, can be implemented.
Traxer
Olivier
O
Service d'urologie, hôpital Tenon, 75970 Paris Cedex 20. olivier.traxer@tnn.aphp.fr
D002137:Calculi / Q000737:chemistry; D003085:Colic / Q000209:etiology; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D053040:Nephrolithiasis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D011860:Radiography, Abdominal; D012307:Risk Factors; D013055:Spectrophotometry, Infrared; D014057:Tomography, X-Ray Computed; D018666:Ureteroscopy; D052878:Urolithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control / Q000601:surgery / Q000628:therapy