The urologists have several options for treating ureteral stones in the range of 8-15mm. Of that range, this study makes a comparison between ESWL and ureteroscopic holmium laser lithotripsy in the treatment of ureteric stone. In spite of that ureteroscopy and ESWL are invasive procedures, still there is controversy which of them is more suitable for treating ureteral stones condition. Study Aim: This study conducts a review to compare the effectiveness, safety and complications of using ureteroscopic holmium laser lithotripsy and ESWL in treating of ureteral stones. Study Methods: Eighty ureteroscopic holmium laser lithotripsy or ESWL-treated patients between April 2016 and April 2017 in Al-Diwaneyah teaching hospital who is having 8–14mm single radiopaque ureteral stone, were assessed. All of the patients in the study sample were subjected to follow-up period of seven months using ultrasonography. Then, comparison was made to identify stone clearance rate, potential complications and cost. Study Results: Results show that There is resemblance in treatment time and stone clearance rate between the two treatments. Generally, the total cost, the procedural time and analgesia requirements and were noticeably variant. Additionally, gross hematuria and renal colic were more frequent with ESWL procedure, while the voiding symptoms show more frequency with ureteroscopy procedure. The two procedures that were applied for the treatment of 8-14mm range ureteral stones proved to be the least invasive and secure.
Phenoxybenzamine proved useful in reducing bladder outlet resistance after spinal cord injury, provided that detrusor bladder contractions were present. It is useful in controlling detrusor-sphincter dyssynergia and autonomic hyperreflexia. It was not useful in areflex bladders, perhaps due to the development of spasticity of the striated muscle component of the external sphincter. The presence of bladder neck (internal sphincter) dysfunction may modify or abolish its effect.
Lower pole renal stones present a significant challenge in urologic practice due to difficulty in accessing the calyx and eliminating fragments. Management options for these stones include watchful waiting for asymptomatic stones, extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), and percutaneous nephrolithotomy (PCNL). Mini-PCNL is a newer modification of conventional PCNL. The study aimed to assess the feasibility of mini-PCNL in treating lower pole renal stones equal to or less than 20mm that were not responsive to ESWL therapy. We included 42 patients (24 male and 18 female) with a mean age of 40±2.3 who underwent mini-PCNL at a single urology center between June 2020 and July 2022 and assessed operative and postoperative outcomes. The mean total operative time was 47±3.11 minutes, ranging from 40 to 60 minutes. The stone-free rate was 90%, and the overall complication rate was 26%, which included minor bleeding (5%), hematuria (7%), pain (12%), and fever (2%). The mean hospital stay was 80±3.34 hours (3-4 days). Our findings suggest that mini-PCNL is an effective treatment option for lower pole renal stones that are not responsive to ESWL therapy. The immediate stone-free rate was high, with minimum non-serious complications.
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