ADVANCES IN RENAL CALCULUS SURGERY: UNDERSTANDING CLINICAL MANIFESTATIONS, DIAGNOSIS, AND MODERN SURGICAL TECHNIQUES.

Abstract

Renal calculus surgery has significantly evolved in recent years due to advancements in surgical techniques, improved diagnostics, and a better understanding of clinical manifestations. Nephrolithiasis, a common condition affecting millions of people, can lead to severe complications if not properly treated. Symptoms include intense lumbar pain, hematuria, nausea, and vomiting. Early and accurate diagnosis is crucial, using imaging techniques such as computed tomography (CT), ultrasound, and abdominal radiographs. Recent advancements, such as low-dose CT, have reduced radiation exposure while maintaining diagnostic accuracy. Methodology: The research utilized scientific databases, including Google Scholar, PubMed, BVS, and SciELO, with articles published between 2015 and 2024. Original articles that provided full access to the content and directly addressed advancements in surgical and diagnostic techniques for nephrolithiasis were selected. Exclusion criteria eliminated articles over 10 years old or outside the scope of the research. Critical data analysis ensured a comprehensive and relevant systematic review, evaluating the clinical applicability of the findings. Results: Recent studies highlight the effectiveness of thulium fiber laser (TFL) lithotripsy in fragmenting renal calculi, with stone elimination rates of up to 89.37% and minimal complications. Technologies such as femtosecond laser and the Ho laser with Moses technology have proven efficient in reducing stone retropulsion and improving operative times. Robotic surgery has also shown promising results in complex procedures, such as robot-assisted pyelolithotomy, reducing hospital stays and postoperative complications. Advances in ureteroscopes, transitioning from fiber-optic to digital systems, have significantly improved visualization and navigation, reducing risks and increasing precision. Conclusions: Advances in renal calculus surgery have significantly transformed urological practice, improving clinical outcomes and patient quality of life. The introduction of technologies such as TFL, femtosecond laser, and robotic surgery offers considerable promise for more efficient and less invasive procedures. However, challenges such as high costs and the need for specialized training