Basket device – A small instrument that can be passed
through a ureteroscope or nephroscope to entrap a stone so that
it can be removed from the patient.
Bladder – the organ where urine is stored
between the times of urination
Calyx – location in the kidney that is the
beginning of the urinary collecting system. Most kidneys have between
6 and 10 of them. During ureteroscopy and PERC, it is critical to
inspect every calyx, to be sure that no stone has been overlooked.
The plural of calyx is calyces.
CT scan – one of the most effective ways
to evaluate a patient for the presence of stones. When looking for
stones, no oral or intravenous (IV) contrast is necessary.
Cystoscope – A specialized telescope that
is passed through the urethra to look inside the bladder. Most cystoscopes
are ~5 mm in diameter.
Distal ureter – the final end of the ureter,
right before it opens up into the bladder. One of the narrowest
points of the ureter is right where it enters into the bladder,
and stones often become stuck in this location.
Infundibulum – the connection between the
calyx and the renal pelvis. In many cases a single infundibulum
will collect the urine from several calyces.
Intravenous pyelogram (IVP) – X-rays are
obtained of the abdomen prior to and then following the injection
of intravenous (IV) contrast. In the evaluation of patients with
stones, IVP has been all but replaced by CT scanning.
KUB – a plain x-ray of the abdomen, which
images the kidney, ureter, and bladder.
Laser – An acronym that stands for light
amplification by stimulated emission of radiation. The Holmium:YAG
laser is the most commonly used laser to break up stones. Stones
are broken up primarily by a thermal energy transfer.
Lithotripsy – the process of breaking up
a stone.
Lower pole – the bottom-most part of the
kidney’s collecting system. Stones in this location tend to
not respond as well to ESWL and ureteroscopy, as fragments often
persist in this location following treatment, promoting the formation
of new stones.
Middle ureter – the portion of the ureter
between the proximal ureter and the distal ureter. Anatomically,
this is the portion of the ureter that overlies the bony pelvis.
The iliac blood vessels, a very large artery and vein, cross under
the middle ureter, pressing in and slightly narrowing the ureter
at this point. As a consequence of this narrowing, stones can become
trapped at this location.
Nephroscope – A specialized telescope used
to examine the interior of the kidney and to remove stones from
the kidney. Most nephroscopes are ~8 mm in diameter.
Nephrostomy tube – a small, soft, plastic
tube used to temprorarily drain the kidney. Most nephrostomy tubes
are less than 5 mm in diameter.
Papilla – The location where urine leaves
the filtering tubules of the kidney tissue and enters the collecting
system. Many times, stones are found attached to papilla.
Pneumatic lithotripter – A jackhammer-like
device that is used to break up stones.
Proximal ureter – The portion of the ureter
between the kidney and the middle ureter.
Randall’s plaque – small deposits
of calcium phosphate on the tip of the renal papilla. Calcium oxalate
stones are frequently found attached to Randall’s plaque.
Renal colic – the severe symptoms associated
with the passage of a stone. Common symptoms include pain in the
flank or groin accompanied by nausea and vomiting.
Renal pelvis – the central point to which
all of the different infudibula drain.
Renal tubular acidosis – a disease in which
a person’s kidneys are unable to properly acidify their urine,
leading to a build-up of acid in the blood and a build-up of alkali
in the urine. These patients commonly form calcium phosphate stones.
Staghorn stone – a large kidney stone which
has grown so as to completely fill the renal pelvis, infundibula,
and calyces. So named because a stone of this configuration resembles
the horns of a deer, or stag.
Tether – a thin string, or thread, that
is affixed to the end of a ureteral stent. Pulling on the tether
will remove a ureteral stent, eliminating the need for a cystoscopic
procedure to remove the stent.
Upper pole – the top-most part of the kidney’s
collecting system.
Ureteral stent – a small plastic tube used
to temporarily drain the kidney. Most ureteral stents are ~2 mm
in diameter.
Ureteropelvic junction (UPJ) – the region
where the renal pelvis joins the ureter. The UPJ is a site where
stones may become trapped when they begin to pass out of the kidney.
Ureter – the long, narrow tube that transports
urine from the kidney to the bladder.
Ureteroscope – A specialized telescope that
is used to examine and treat stones or other disease in the ureter.
Most ureteroscopes are ~3mm in diameter.
Urethra – The tube that carries urine from
the bladder to the outside of the body.
Urinary Collecting system – The part of
the urinary tract extending from the renal calyces to the bladder.
Watchful waiting – a treatment strategy
whereby kidney stones are not actively treated, but instead are
monitored over time, with periodic x-rays, to ensure that they are
not changing or causing problems.
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