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Stavros Sfoungaristos, Ioannis Mykoniatis, Ayman Isid, Ofer N Gofrit, Shilo Rosenberg, Guy Hidas, Ezekiel H Landau, Dov Pode, Mordechai Duvdevani
Objective. To evaluate and compare the efficacy and safety of retrograde versus antegrade ureteroscopic lithotripsy for the treatment of large proximal ureteral stones. Patients and Methods. We retrospectively analyzed the medical records of patients with proximal ureteral stones >15 mm, treated in our institution from January 2011 to January 2016. Intraoperative parameters, postoperative outcomes, and complications were recorded and compared between the two techniques. Results. Our analysis included 57 patients...
2016: BioMed Research International
Shih-Yi Lin, Cheng-Li Lin, Chao-Hsiang Chang, His-Chin Wu, Wen-Chi Chen, I-Kuan Wang, Yao Lung Liu, Fung-Chang Sung, Yen-Jung Chang, Chia-Hung Kao
Large cohort studies on whether any association existed between urological interventions for urolithiasis and the development of CKD are lacking. From claims data of the National Health Insurance (NHI) program of Taiwan, we identified 54,433 patients newly diagnosed with urolithiasis during 1998-2010. For each case, four individuals without urolithiasis were randomly selected and frequency matched by age, sex, and diagnosis year. Both groups were followed up until the end of 2010. Incident CKD events were identified by the International Classification of Diseases, Ninth Revision (ICD-9) code in the NHI registration database...
October 19, 2016: Urolithiasis
Mustafa Resorlu, Murat Tolga Gulpinar, Gurhan Adam
Subcapsular or perirenal hematoma is an unusual complication after semirigid ureteroscopy using pneumatic lithotripsy to treat ureteral stones. We present a patient who developed a large subcapsular and perirenal hematoma following ureteroscopy administered to a stone in the right ureter.
September 1, 2016: Folia Medica
Ben H Chew, Dirk Lange
Open ureterolithotomy and pyelolithotomy used to be first line therapy for treating kidney and ureteral stones. With the advent of shockwave lithotripsy, open stone surgery became less prevalent, but once ureteroscopy became more prevalent, open stone surgery became all but extinct. Advances in smaller, more flexible endoscopes and improvements in intracorporeal lithotripters, ureteroscopy has become a mainstay of therapy for kidney stones. The holmium:YAG laser can be utilized through flexible instruments and fragments any stone no matter what it is composed of...
October 19, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sarah Mozafarpour, Natalia Hernandez, Michael Lipkin, Brian Eisner
Over the past 2 decades, ureteroscopy has changed from a procedure considered second-line to shockwave lithotripsy to a commonly performed procedure for renal and ureteral stones. The increase in the use of ureteroscopy is due largely to improvements in technique and technology during this time period. Herein we review outcomes of ureteroscopy in terms of success rates, complications, and unique patient populations. This work will synthesize the data as it pertains to the practice of ureteroscopy for all endourological indications, including stone disease and management of upper tract urothelial carcinoma, as well as review state-of-the-art techniques...
October 12, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Patrick Jones, Bhavan Prasad Rai, Anngona Ghosh, Bhaskar K Somani
No abstract text is available yet for this article.
2016: Central European Journal of Urology
I Schwartzmann, J M Gaya, A Breda
OBJECTIVE: The development of smaller diameter ureteroscopes, along with the advance in surgical techniques has allowed ureteroscopy to be progressively less traumatic. The considerable morbidity produced by a ureteral stent makes it advisable to question routine placement. METHODS: We performed a review of the literature searching for systematic reviews, meta-analysis and prospective randomized clinical trials. RESULTS: Three systematic reviews and meta-analysis along with 14 clinical trials were included in our review...
October 2016: Archivos Españoles de Urología
Mary E Westerman, Joseph A Scales, Vidit Sharma, Derek J Gearman, Johann P Ingimarsson, Amy E Krambeck
OBJECTIVE: To analyze bleeding related complications among patients on long term anticoagulation (AC) undergoing ureteroscopy (URS). Current AUA/ICUD guidelines state it is safe to continue AC in routine URS; however, these recommendations are based on small case series. PATIENTS AND METHODS: 4,799 URS procedures performed at our institution between June 2009 and February 2016 were identified. Records were then retrospectively reviewed to confirm AC use and identify periprocedural complications...
October 5, 2016: Urology
Hazem Elmansy, Jafar Hussaen, Mostafa Elhilali, Sero Andonian
Patients with pelvic kidneys are at an increased risk of developing ureteropelvic junction obstruction (UPJO) and nephrolithiasis with limited endourologic options. A 54-year-old man with a left pelvic kidney, recurrent nephrolithiasis, and 12 previous ureteroscopies presented with left UPJO and lower pole calyceal stones. After two failed ureteroscopic attempts, an open pyelolithotomy and pyelocystostomy were performed. After 30 months, he continues to be asymptomatic without recurrence of nephrolithiasis...
October 2016: Canadian Journal of Urology
Nicholas J Rukin, Zain A Siddiqui, Edmund C P Chedgy, Bhaskar K Somani
AIMS: The study aimed to determine the current trends in urolithiasis-related admissions and associated interventions in England between 2006/2007 and 2013/2014 utilizing Hospital Episode Statistics (HES) online data. MATERIAL AND METHODS: Data was extracted from the online HES data set for each year from 2006/2007 to 2013/2014 inclusive. Admissions and procedural interventions were identified from their corresponding OPCS-4 and ICD-10 codes. RESULTS: Finished consultant episodes (FCEs) for urolithiasis have increased by 20% over the last 7 years, with 93,039 FCEs in the year 2013/2014...
October 1, 2016: Urologia Internationalis
Christopher J Martin, Sean B McAdams, Haidar Abdul-Muhsin, Victoria M Lim, Rafael Nunez-Nateras, Mark D Tyson, Mitchell R Humphreys
PURPOSE: Questions still remain regarding the durability and longevity of flexible ureteroscopes (URS). The objective of this manuscript is to estimate potential economic benefits of the single use flexible digital URS compared to our recent experience with reusable flexible digital URS using cost benefit analysis. MATERIALS AND METHODS: Ureteroscopic procedures were prospectively recorded over a 12-month period (February 2014 - February 2015). All flexible ureteroscopies were performed using the Karl Storz Flex-XC™ digital ureteroscopes...
September 27, 2016: Journal of Urology
Steeve Doizi, Guido Kamphuis, Guido Giusti, Kim Hovgaard Andreassen, Thomas Knoll, Palle Jörn Osther, Cesare Scoffone, Daniel Pérez-Fentes, Silvia Proietti, Oliver Wiseman, Jean de la Rosette, Olivier Traxer
INTRODUCTION: We evaluated a new digital single-use flexible ureteroscope, LithoVue™ with respect to deflection, image quality and maneuverability. METHODS: A prospective cohort study was conducted in eight tertiary reference centers in Europe in December 2015 and January 2016. All consecutive patients included underwent flexible ureteroscopy and were 18 years or older. Deflection and image quality pre- and post-use and maneuverability were rated with a Likert scale...
September 26, 2016: World Journal of Urology
Marc A Mitchell, David D Wartinger
CONTEXT: The identification and evaluation of activities capable of dislodging calyceal renal calculi require a patient surrogate or validated functional pyelocalyceal renal model. OBJECTIVE: To evaluate roller coaster facilitation of calyceal renal calculi passage using a functional pyelocalyceal renal model. METHODS: A previously described adult ureteroscopy and renoscopy simulator (Ideal Anatomic) was modified and remolded to function as a patient surrogate...
October 1, 2016: Journal of the American Osteopathic Association
Franklin C Lee, Sarah K Holt, Ryan S Hsi, Brandon Haynes, Jonathan D Harper
OBJECTIVE: To investigate whether the use of a Belladonna and Opium (B&O) rectal suppository administered immediately prior to ureteroscopy and stent placement could reduce stent-related discomfort. METHODS: A randomized, double-blinded, placebo controlled study was performed from August 2013 to December 2014. 71 subjects were enrolled and randomized to receive a B&O (15mg/30mg) or placebo suppository after induction of general anesthesia immediately prior to ureteroscopy and stent placement...
September 19, 2016: Urology
Yiloren Tanidir, Ahmet Sahan, Mehmet Kazim Asutay, Tarik Emre Sener, Farhad Talibzade, Asgar Garayev, Ilker Tinay, Cagri Akin Sekerci, Ferruh Simsek
To differentiate ureteral stones and phleboliths by measuring density [as Hounsfield unit (HU)] and volume (as mm(3)) of the opacities in the bony pelvis on unenhanced computerized tomography (U-CT). A total of 52 patients, who underwent semirigid ureteroscopy and laser lithotripsy for distal ureteral stone and had isochoronous phleboliths in U-CT, were included. Images were reviewed for density and volume of the opacities. Data were compared, and a cut-off value was defined with receiver operating characteristics curve analysis to differentiate the nature of the opacity...
September 16, 2016: Urolithiasis
Courtney Yong, Bodo E Knudsen
The incidence of stone disease continues to rise. Surgical management options including shockwave laser lithotripsy, percutaneous nephrolithotomy, and ureteroscopy with stone extraction and/or lithotripsy. The technology associated with the ureteroscopic treatment of stones has advanced significantly over the past decade and this review focuses on many of the accessory devices that can be employed to aid in the procedure.
September 16, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Abdulla Al-Naimi, Abdulqadir Alobaidy, Ahmad Majzoub, Tarek Ahmed Amin Ibrahim
OBJECTIVE: To evaluate factors affecting semi-rigid ureteroscopy (URS) results highlighting the influence of teaching on its outcomes. MATERIAL AND METHODS: We reviewed the files of 891 adult patients who had undergone 1182 ureteroscopies at our institute during the period from July 2008 to June 2011. The outcomes of all URSs were evaluated. Outcomes were measured by stone- free rate and presence of complications, which were assessed using the Clavien-Dindo system...
September 2016: Turkish Journal of Urology
Jun Li, Jing Xiao, Tiandong Han, Ye Tian, Wenying Wang, Yuan Du
We evaluated the clinical value of flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Fifty-five infants with upper urinary tract calculi were included in this study: 41 males and 14 females. Retrograde intrarenal surgery was performed by an 8 Fr/30 cm flexible ureterorenoscope (POLY®) combined with a holmium laser. CT scanning or radiography of the kidneys, ureters, and bladder region was performed one month after the operation to confirm the clearance of calculi...
September 15, 2016: Experimental Biology and Medicine
Robert M Sweet
BACKGROUND: The challenges of training and assessing endourologic skill have driven the development of new training systems. The Center for Research in Education and Simulation Technologies (CREST) has developed a team and a methodology to facilitate this development process. METHODS: Backwards design principles were applied. A panel of experts first defined desired clinical and educational outcomes. Outcomes were subsequently linked to learning objectives. Gross task deconstruction was performed and the primary domain was classified as primarily involving decision-making, psychomotor skill or communication...
September 15, 2016: Journal of Endourology
Sara E Wobker, Manju Aron, Jonathan I Epstein
In the upper genitourinary tract of the ureter and renal pelvis, any invasion of urothelial carcinoma (UC) beyond the thin muscularis is considered pT3 disease, which may prompt adjuvant chemotherapy. Ureteroscopy is commonly used in the workup of these lesions to obtain tissue biopsies and cytology specimens, or to place stents for the relief of obstructive symptoms. The current study describes 4 cases in which the presence of small nests of urothelium in periureteral and peripelvic soft tissue was noted after ureteroscopic instrumentation, mimicking high-stage UC...
September 14, 2016: American Journal of Surgical Pathology
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