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https://www.readbyqxmd.com/read/29468199/a-large-stone-within-a-ureteroceles-a-diagnostic-pitfall-and-the-utility-of-holmium-laser-deroofing-as-a-viable-surgical-option
#1
Hanna Jamil El-Khoury, Hau Choong Aw, Daniel Gilbourd, Madalena Ian-Pim Liu
We describe a case of a partial unilateral duplex system and ureterocele containing a 4 cm stone in a 66-year-old woman who presented with renal colic. Cystoscopic stone removal and deroofing of the ureterocele were performed and a ureteral stent was placed for a total of 6 weeks. Our case is unique as it highlighted the diagnostic pitfalls of ureteroceles, especially when obscured by a large calculus. We also described the use of a Holmium laser to simultaneously incise the ureterocele and fragment the calculus...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29463207/effects-of-flexible-ureteroscopy-on-renal-blood-flow-a-prospective-evaluation
#2
Tarik Emre Sener, Yiloren Tanidir, Saeed Bin Hamri, Ibrahim Halil Sever, Burcu Ozdemir, Abdulla Al-Humam, Olivier Traxer
OBJECTIVE: This study aimed to investigate the effects of flexible ureteroscopy (F-URS) on renal blood flow using renal Doppler ultrasound (US). MATERIALS AND METHOD: Patients undergoing F-URS were scheduled for Doppler US preoperatively and postoperatively. Peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were reported. Technical details, operation time, stone characteristics and complications were recorded...
February 20, 2018: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/29459607/forgotten-encrusted-ureteral-stents-removal-multimodal-endourologic-approach
#3
P K Saha, M S Hossain, K C Ghosh, M S Alam, S Nabi, B K Saha, F H Pathan
Ureteral stent placement is a common procedure in urologic practice. Forgotten, encrusted D/J stents represent a difficult problem for urologists. The major complications are infection, impaired renal function, migration, encrustation, stone formation and multiple fragmentation of stent. A consensus on the best therapeutic approach is still lacking. Here we present our experience with endoscopic management of this challenging problem and discuss the multimodal endourologic approaches for treating forgotten, encrusted ureteral stents...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29458917/chinese-herbal-medicine-to-treat-urolithiasis-in-a-patient-with-right-flank-pain-and-hematuria-a-case-report
#4
Hsiang-Chun Lai, Hung-Jen Lin, Sheng-Teng Huang
OBJECTIVE: Urolithiasis is a common medical condition affecting the urinary tract. Typical symptoms reported by patients include colic pain and hematuria. Some patients may undergo surgical intervention or lithotripsy to remove the stones. In this case, we demonstrated that Chinese herbal medicine (CHM) was an effective modality to remove stones in a patient with urolithiasis. CLINICAL FEATURES AND OUTCOME: A 47-year-old man suffered from right flank pain and hematuria for three months and was diagnosed with an upper third ureteral stone obstruction with right hydronephrosis...
February 2018: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29439607/septic-shock-following-surgical-decompression-of-obstructing-ureteral-stones-a-prospective-analysis
#5
Victor Srougi, Paulo R Moscardi, Giovanni Scala Marchini, Ricardo Haidar Berjeaut, Fabio Cesar Miranda Torricelli, José Luiz Borges Mesquita, Miguel Srougi, Eduardo Mazzucchi
PURPOSE: To investigate risk factors for septic shock and death in patients with obstructive pyelonephritis due to ureteral stone, who underwent urinary tract decompression. PATIENTS AND METHODS: We prospectively enrolled patients who presented at the emergency department of our institution with clinical signs of pyelonephritis, systemic inflammatory reaction syndrome (SIRS) and obstructive ureteral stone confirmed by computed tomography scan. Forty patients that underwent urinary tract decompression were included...
February 14, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29439267/radiation-exposure-during-ureterorenoscopy-and-laser-lithotripsy-an-analysis-of-stone-characteristics
#6
Marios Hadjipavlou, Vincent Lam, Jai Seth, Faqar Anjum, Seshadri Sriprasad
INTRODUCTION AND OBJECTIVES: Stone formers often have a chronic exposure to significant quantities of ionising radiation from radiological investigations and interventions. Predicting radiation exposure would allow the clinician to quantify expected cumulative radiation and find strategies to minimise exposure. We evaluated radiation exposure during ureteroscopy and laser lithotripsy (URS + LL) for a single stone episode and correlated the results to stone characteristics. METHOD: Data was collected retrospectively for all patients undergoing URS + LL in our institution over a 1 year period...
February 13, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29438579/consequences-of-relying-on-statistical-significance-some-illustrations
#7
Ben Van Calster, Ewout W Steyerberg, Gary S Collins, Tim Smits
BACKGROUND: Despite regular criticisms of null hypothesis significance testing (NHST), a focus on testing persists, sometimes in the belief to get published and sometimes encouraged by journal reviewers. This paper aims to demonstrate known key limitations of NHST using simple nontechnical illustrations. DESIGN: The first illustration is based on simulated data of 20,000 studies that compare two groups for an outcome event. The true effect size (difference in event rates) and sample size (20 to 100 per group) were varied...
February 13, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29429259/-clinical-analysis-for-preset-double-j-tube-in-percutaneous-nephrolithotripsy
#8
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]
https://www.readbyqxmd.com/read/29421922/pediatric-ureteroscopy
#9
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
https://www.readbyqxmd.com/read/29416281/comparative-efficacy-of-tamsulosin-versus-tadalafil-as-medical-expulsive-therapy-for-distal-ureteric-stones
#10
Suresh Kumar Goyal, Vikash Singh, Himanshu Pandey, Mahaveer Kumar Chhabra, Satinder Pal Aggarwal, Amilal Bhat
Objective: The objective of this study was to compare the relative efficacy of tamsulosin and tadalafil as medical expulsive therapy for distal ureteric stones. Patients and Methods: This was a prospective study performed between December 2014 and February 2016. A total of 123 adult patients (>18 years of age) presenting with distal ureteric stones sized 6-10 mm were randomized to treatment with tamsulosin 0.4 mg once daily (Group A) or tadalafil10 mg once daily (Group B)...
January 2018: Urology Annals
https://www.readbyqxmd.com/read/29416272/is-retrograde-intrarenal-surgery-the-game-changer-in-the-management-of-upper-tract-calculi-a-single-center-single-surgeon-experience-of-131-cases
#11
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
https://www.readbyqxmd.com/read/29410081/the-impact-of-preoperative-%C3%AE-adrenergic-antagonists-on-ureteral-access-sheath-insertion-force-and-the-upper-limit-of-force-required-to-avoid-ureteral-mucosal-injury-a-randomized-controlled-study
#12
Kyo Chul Koo, Jun-Ho Yoon, No-Cheol Park, Hye Sun Lee, Hyun Kyu Ahn, Kwang Suk Lee, Do Kyung Kim, Kang Su Cho, Byung Ha Chung, Chang Hee Hong
PURPOSE: Excessive bulking force during primary access of the ureteral access sheath (UAS) may induce ureteral injury. To investigate the efficacy of preoperative α-blockade for reducing UAS insertion forces (UASIF) and to determine the upper limit required to avoid ureteral injury. MATERIALS AND METHODS: In a randomized controlled trial, 135 patients from a single institution, who had ureteropelvic junction or renal pelvis stones and were planned to undergo retrograde intrarenal surgery (RIRS), were prospectively enrolled from December 2015 to January 2017...
February 1, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29406799/management-of-pediatric-urolithiasis-using-a-combination-of-laparoscopic-lithotomy-and-pyeloscopy
#13
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
https://www.readbyqxmd.com/read/29406057/urinary-stone-disease-diagnosis-medical-therapy-and-surgical-management
#14
REVIEW
Wesley W Ludwig, Brian R Matlaga
Clinical suspicion of urolithiasis should be evaluated with low-dose computed tomography as the first-line imaging modality for nonpregnant, adult patients. A period of observation may be appropriate for ureteral stones less than 10 mm, and medical expulsive therapy may be beneficial for facilitating passage of distal ureteral stones. Regardless of stone type, patients should adhere to a low-sodium diet and attempt to achieve a urine volume of more than 2.5 L daily. Individuals with calcium stones should maintain a normal calcium diet, and if stones persist, citrate therapy or thiazide diuretics in the setting of hypercalciuria may be indicated...
March 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29399315/evaluation-of-200-mm-365-mm-and-500-mm-fibers-of-ho-yag-laser-in-transurethral-lithotripsy-of-ureteral-a-randomize-control-trial
#15
Morteza Fallah Karkan, Saleh Ghiasy, Arash Ranjbar, Babak Javanmard
Introduction: Presently, different holmium: yttrium aluminum garnet (Ho:YAG) laser calibers are used for endoscopic stone treatment, which include 200, 365, 500 and 1000 Mm fibers. Currently, there are not enough studies to compare the performance of these fibers. In this retrospective investigation, we compared the outcome of 200, 365 and 500 Mm fibers of Ho:YAG laser in transurethral lithotripsy of ureteral stone. Methods: From January 2016 to June 2017, 74 subjects with mean age of 35.3 ± 5.6 were randomly allocated to 3 groups according to the caliber of laser, 200, 365 and 500 Mm for transurethral lithotripsy...
2018: Journal of Lasers in Medical Sciences
https://www.readbyqxmd.com/read/29399012/value-of-magnetic-resonance-urography-versus-computerized-tomography-urography-ctu-in-evaluation-of-obstructive-uropathy-an-observational-study
#16
Saeed M Bafaraj
Background: Obstructive uropathy is a common public health issue that requires imaging research for providing necessary information. The data is important for determining treatment options, and may influence selective management choices. Objective: The aim of the study is to determine whether magnetic resonance urography or computerized tomography urography is the best imaging modality among patients with suspected obstructive uropathy. Methods: Seventy patients; referred from the emergency department for the evaluation of renal colic or hematuria that highly suggested urinary tract abnormalities, were prospectively enrolled...
February 2018: Current Medical Imaging Reviews
https://www.readbyqxmd.com/read/29396787/the-effect-of-corticosteroid-on-postoperative-early-pain-renal-colic-and-total-analgesic-consumption-after-uncomplicated-and-unstented-ureteroscopy-a-matched-pair-analysis
#17
Nurullah Hamidi, Erdem Ozturk, Taha Numan Yikilmaz, Ali Fuat Atmaca, Halil Basar
PURPOSE: To evaluate the effect of corticosteroid (CS) on early postoperative pain, renal colic and total analgesic consumption after uncomplicated and unstented ureteroscopy (URS). METHODS: Data of 397 patients who underwent URS and stone fragmentation for symptomatic distal ureteral stone (≤ 15 mm) were retrospectively evaluated. After exclusion, 72 patients who received methylprednisolone (Group I) after non-stenting uncomplicated URS were matched with another 72 patients who did not receive CS (Group II)...
February 2, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29392185/loss-of-renal-function-after-retrograde-ureteral-placement-of-an-allium-stent-for-severe-ureteral-stricture
#18
Stefano Salciccia, Alessandro Sciarra, Milena Polese, Alpi Giorgio, Martina Maggi, Alessandro Gentilucci, Mauro Ciccariello, Giuseppe D'Eramo, Houssain Shahabadi, Silvia Lai, Gian Piero Ricciuti
Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium® ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary to an ureteroscopy for stone disease...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29389928/review-of-acute-symptomatic-urolithiasis-in-auckland
#19
Stephanie Loeff, Manmeet Saluja, Michael Rice
AIM: To evaluate the incidence of acute symptomatic urolithiasis in the Auckland region. Associated epidemiological factors and stone characteristics were also studied and compared to previous research conducted in order to analyse trends. METHOD: All patients that presented acutely with symptomatic urolithiasis to the Auckland District Health Board (AHDB) between July 2014 and June 2015 were studied. Clinical data was obtained from medical records and population data was based on estimates provided by the Ministry of Health...
February 2, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29385947/on-medical-treatment-for-ureteral-stone-expulsion
#20
Dan Holmlund
There is evidence that α-adrenoceptor (α-AR) antagonists facilitate the passage of ureteric stones, but the mechanism behind this effect has not been established. If one accepts that it is the friction between a ureteral stone and the mucosa that hampers the passage of the stone, and that the passage traumatizes the mucosa, the aim of treatment must be to reduce this friction. Elevated pressure above an obstructing stone results in an increase in tension in the wall of the upper urinary tract, including the tension at stone level, which causes an increase in friction and ureteric colic...
February 1, 2018: Scandinavian Journal of Urology
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