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Renal calculi

Ahmed Mohey, Mohamed Alhefnawy, Mostafa Mahmoud, Rabea Gomaa, Tarek Soliman, Shabieb Ahmed, Yasser A Noureldin
INTRODUCTION: To assess the conversion rate during fluoroless-ureteroscopy (URS) and evaluate the feasibility, safety, and efficacy of fluoroless-URS as a definitive management of distal ureteral calculi. MATERIAL AND METHODS: Between May 2013 and August 2015, patients with radio-opaque distal ureteral calculi of ≤ 1 cm in size were randomized to undergo fluoroless-URS or standard URS. Patients with previous ureteral surgery, ureteral kinking, ureteral stricture, single kidney, additional proximal ureteral or renal calculi, uncontrolled coagulopathy, and/or congenital anomalies of the urinary tract were excluded...
February 2018: Canadian Journal of Urology
Xiaowei Zhang, Daniela Castanotto, Xueli Liu, Amotz Shemi, Cy A Stein
Oligonucleotide (ON) concentrations employed for therapeutic applications vary widely, but in general are high enough to raise significant concerns for off target effects and cellular toxicity. However, lowering ON concentrations reduces the chances of a therapeutic response, since typically relatively small amounts of ON are taken up by targeted cells in tissue culture. It is therefore imperative to identify new strategies to improve the concentration dependence of ON function. In this work, we have identified ammonium ion (NH4+) as a non-toxic potent enhancer of ON activity in the nucleus and cytoplasm following delivery by gymnosis...
March 7, 2018: Nucleic Acids Research
Hikmat Jabrayilov, Murat Yavuz Koparal, Serhat Gürocak, Bora Küpeli, Mustafa Özgür Tan
In this study, we aimed to determine factors affecting the success rate of percutaneous nephrolithotomy (PNL) in children. The series consisted of 41 consecutive children operated on by the same surgical team for renal calculi with PNL between June 2002 and May 2015 in our institution. A single calyx or pelvic stone was described as simple, while calculi located in more than one location (calyx and pelvis or more than one calices) or staghorn stones were described as complex. The procedure was deemed successful if the patient was completely stone-free (SF) or had residual fragments <4 mm...
March 4, 2018: Journal of Clinical Medicine
Daniel J Lama, Shoaib Safiullah, Albert Yang, Zhamshid Okhunov, Jaime Landman, Ralph V Clayman
The concept of adipose tissue as an organ unto itself represents a new medical construct; already differences in the volume of perirenal fat around a tumor-bearing kidney have been described. We hypothesized that renal calculi may have similar impact on perirenal fat or alternatively abnormalities in urinary metabolites may be the result of perirenal fat affecting renal metabolism and subsequent stone formation. Accordingly, we conducted a study utilizing three-dimensional imaging software to evaluate perirenal fat volume (PFV) in patients with nephrolithiasis...
March 2, 2018: Urolithiasis
A Narváez, C Torrecilla, S Colom, J M Cuadrado, J Fernández-Concha, L Riera, F Vigués
OBJECTIVES: To evaluate the effectiveness and safety of simultaneous bilateral percutaneous nephrolithotomy performed in patients affected with bilateral renal calculi. MATERIALS AND METHODS: This is a prospective study from September 2012 to November 2016. Patients diagnosed of bilateral kidney stones with abdominal CT scan were included. Surgical technique prone position, renal puncture guided by fluoroscopy and tract dilation up to 24Ch. We reviewed demographic and stone characteristics, stone free rate, clinical success, complications and follow-up...
February 27, 2018: Actas Urologicas Españolas
Mittul Gulati, Justin Cheng, Jerry T Loo, Matt Skalski, Harshawn Malhi, Vinay Duddalwar
Ultrasound (US) is the first-line imaging modality for evaluating azotemic patients for urinary obstruction and renal size. US is also valuable for distinguishing congenital variants and simple cystic lesions from renal masses. Doppler US is effective in detection of renal calculi and evaluation of vascular pathology. Unfortunately, renal US is limited in distinguishing causes of medical renal disease. The kidneys have a complex internal architecture with a highly variable appearance on US. This article illustrates non-neoplastic renal conditions, including normal and embryological variants, parenchymal, cystic, and vascular diseases...
February 16, 2018: Clinical Imaging
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
Bowei Yang, Jiongming Li, Jianhe Liu, Yuepan Bao, Prashant Mishra, Haixiang Guo, Pei Li, Yongming Jiang
We have tried to establish a safe and effective method to treat the peripelvic renal cyst combined with renal calculi. The key points are as follows: choose the appropriate target calyx; find the gap between cyst and renal pelvic; put a nephrostomy tube to stimulate the closing of cystic cavity.
February 2018: Clinical Case Reports
F D Bai, H F Wu, J M Wen, N Zhang, Y C Zheng, J M Chen, C J Du
Objective: To evaluate the clinical application and effect of preseting Double-J ureteric stent in percutaneous nephrolithotripsy. Method: 74 cases of renal calculi treated with PCNL in our hospital during June 2014 to February 2017 were retrospectively analyzed. Of 74 cases, 54 was male, 20 was female. All cases were aged 27 to 78, the mean age was (49.5±12.3) years old. The diameter of the stone was 20 to 59 mm, and the mean diameter was of (29.4±4.3) mm.Our Surgical methods was first putingFr6 double J tube in abnormal ureteral in advance in lithotomy position, then indwellingthree-way Foley catheter and clipping drainage port, perfusingirrigation port with 3 000 ml saline from 60-80 cm height...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Patrick Fox, Michael C Ost
In recent years, the incidence of nephrolithiasis in the pediatric population appears to be increasing.1 This has placed a new emphasis on surgical management of stones in children. In the past, extra-corporeal shockwave lithotripsy (ESWL) was the preferred management technique for stones in children.2 More recently, though, advances in endoscopy have allowed ureteroscopy to be adapted to the pediatric population and this approach has become more frequently utilized not just for lower ureteral calculi but also for proximal ureteral and renal stones...
February 8, 2018: Journal of Endourology
Kandarp Priyakant Parikh, Ravi Jineshkumar Jain, Aditya Parikh Kandarp
Introduction: Success of any modality for stone disease needs to be evaluated in terms of Stone Free Rates (SFR), auxiliary procedures needed; complications and follow up. SFR in RIRS is subject to parameters like stone burden, location, number, hardness, composition; calyceal and ureter anatomy; use of ureteric access sheath (UAS); surgeon experience etc. Methods: The aim of this study is to evaluate the efficacy and safety of RIRS for managing upper tract stones...
January 2018: Urology Annals
K M Muhammed Shameem, Arun Chawla, Madhukar Mallya, Bijay Kumar Barik, V K Unnikrishnan, V B Kartha, C Santhosh
Presence of renal calculi (kidney stones) in human urethra is being increasingly diagnosed over the last decade and is considered as one of the most painful urological disorders. Accurate analysis of such stones plays a vital role in the evaluation of urolithiasis patients and in turn helps the clinicians toward exact etiologies. Two highly complementary laser-based analytical techniques; Laser Induced Breakdown Spectroscopy (LIBS) and micro-Raman spectroscopy have been used to identify the chemical composition of different types of renal calculi...
February 7, 2018: Journal of Biophotonics
Sergio Landa-Juárez, Bárbara M Rivera-Pereira, Ana M Castillo-Fernández
BACKGROUND: Minimally invasive procedures have become the standard option for treatment of urinary stones; the use of more invasive techniques is not a common practice currently. This emergent technology is not always available and laparoscopy is the alternative option. There are few reports of laparoscopic management for urinary lithiasis in pediatric patients. This study is about the use of laparoscopic surgery combined with pyeloscopy as a feasible first-line treatment for pediatric urolithiasis in renal and proximal ureteral locations...
February 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mohammed Kamil Quraishi, Yih Chyn Phan, Wael Asaad, Naing Lynn
A staghorn calculus is a calculus accommodating the majority of a renal calyx extending into the renal pelvis. A conservative approach to its treatment may lead to high morbidity and mortality rates. Such morbidity usually manifests with renal failure, obstructed upper urinary tractand/or life-threatening sepsis. Prostatic abscesses have never been associated with staghorn calculi in the literature. We report a case of a 70-year-old man who presented with sepsis, which was found to originate from a complex prostatic abscess...
February 1, 2018: BMJ Case Reports
Huaming Zhang, Guimin Zhuang, Dongchong Sun, Tianxing Deng, Jiawei Zhang
RATIONALE: Spontaneous renal rupture is rupture of the renal parenchyma, collecting system, or renal blood vessel, which often occurs in pathological kidney and is clinically less common. Postoperative long-term renal rupture is rarely reported in flexible ureteroscopy treatment of calculus in the upper urinary tract. PATIENT CONCERNS: A 58-year-old man complained of right lower abdominal pain with hematuria for 3 hours after flexible ureteroscopy, combined with holmium laser lithotripsy of right renal calculi was performed 1 month ago...
December 2017: Medicine (Baltimore)
Yang Liu, Jad AlSmadi, Wei Zhu, Yongda Liu, Wenqi Wu, Junhong Fan, Yu Lan, Wayne Lam, Wen Zhong, Guohua Zeng
PURPOSE: To compare the efficacy and safety of Super-mini percutaneous nephrolithotomy (SMP, F12-F14) and Miniperc (F18) in the treatment of renal stones of 2-4 cm in size. METHODS: A prospective comparative analysis of outcomes of patients who underwent SMP and Miniperc for treatment of 2-4 cm renal stones was conducted between July 2014 and January 2017. Demographic data, stone criteria, operative technique, complications, blood transfusion, hemoglobin decrease, stone-free rate (SFR) and length of hospital stay were compared between the two groups...
January 31, 2018: World Journal of Urology
Robert Case, Brian Wentworth, Grant Jester
A 33-year-old male with poorly controlled chronic tophaceous gout and chronic kidney disease (CKD) with estimated glomerular filtration rate (GFR) of 37 cc/min. His uric acid was 11 mg/dL despite maximal dosing of febuxostat. He had previously failed pegloticase infusions as well. This patient had a reduction in his uric acid level to less than 6 mg/dL following addition of probenecid to his febuxostat regimen. Most guidelines recommend against utilisation of probenecid therapy in patients with GFR <50, but there is no obvious contraindication to its use, provided renal calculi do not develop...
January 31, 2018: BMJ Case Reports
Jessica E Paonessa, James Caldwell Williams, James E Lingeman
INTRODUCTION: We hypothesized that adding sodium bicarbonate (bicarb) to normal saline (NS) irrigation during ureteroscopy (URS) in patients with uric acid (UA) nephrolithiasis may assist in dissolving small stone fragments produced during laser lithotripsy. In vitro testing was performed to determine if dissolution of UA fragments could be accomplished within one hour. MATERIALS AND METHODS: 100% UA renal calculi were fragmented, filtered, and separated by size...
January 31, 2018: Journal of Endourology
Liang Huang, Yong Lin, Zhengyan Tang, Dongjie Lie, Zhao Wang, Hequn Chen, Guilin Wang
The aim of the present study was to summarize the management of upper urinary tract calculi in crossed fused renal ectopia (CFRE). Two patients were retrospectively studied in Xiangya Hospital (Changsha, China) and all relevant literature published in English between 1996 and 2016 was reviewed. All patients, including those reported in the literature, were characterized by age, sex, manifestation, therapy history, ectopic side, stone location, surgery and outcome. The patients had a mean age of 42.3±18.5 years, a male: Female ratio of 5:4 and the ratio of renal ectopic side was 9:8 (left:right)...
January 2018: Experimental and Therapeutic Medicine
Enrique Diaz-Convalia, Miguel Angel Arrabal-Polo, Maria Del Carmen Cano-Garcia, Alejandro Dominguez-Amillo, Nelson Canales-Casco, Miguel Arrabal-Martin
PURPOSE: To determine whether androgen blockade produces metabolic changes in urine and increases the risk of calculi after 1 year of treatment. MATERIALS AND METHODS: The study included 38 patients, from the period April 2015 to June 2016, diagnosed with locally advanced prostate cancer or lymph node metastasis, and with an indication of androgen blockade. Androgen blockade was started with luteinising hormone-releasing hormone (LHRH) analogues, and a blood specimen, a fasting urine and 24-h urine were collected at the time of inclusion, and then at 1 year of follow-up...
January 27, 2018: International Urology and Nephrology
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