Gout Treatment

• In chronic tophaceous gout, surgical options are considered in the following conditions:
  • Advanced tophi deposition resulting in major joint destruction
  • Loss of involved joint movements associated with severe pain
  • Tophi collection causing pressure symptoms (eg carpal tunnel syndrome at the wrist)
  • Tophaceous ulcer
  • Cosmetic (eg ear lobe tophi)
  • Uncontrolled infection

Debridement 

• Ulceration overlying tophi collection may require debridement depending on the state of the ulcer and/or if there is secondary infection
• Debridement may need to be repeated and frequent dressings are usually required

Extracorporeal Shockwave Lithotripsy and Percutaneous Nephrolithotomy

• For treatment of intrarenal stones measuring 5-15 mm or complex staghorn stones