Ureteroscopy in patients with coagulopathies is associated with lower stone-free rate and increased risk of clinically significant hematuria

Elkoushy, Mohamed A.; Violette, P.; Andonian, Sero

doi:10.1590/s1677-55382012000200007

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…110,[117][118][119] However, this is associated with lower stone-free rates and increased risk of postoperative gross hematuria necessitating admission and bladder irrigation. 111,120 Therefore, risks and benefits of withholding anticoagulation or proceeding with URS while anti-coagulated should be discussed with the patient and his/her cardiologist or hematologist. Recommendations: SWL and PCNL are contraindicated in patients with uncorrected coagulopathies.…”

Section: Anti-coagulationmentioning

confidence: 99%

CUA Guideline: Management of ureteral calculi

Ordon

Andonian²,

Blew³

et al. 2015

CUAJ

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The focus of this guideline is the management of ureteral stones. Specifically, the topics covered include: conservative management, medical expulsive therapy, active intervention with either shockwave lithotripsy (SWL) or ureteroscopy (URS), factors affecting SWL treatment success, optimizing success, and special considerations (e.g., pregnancy, urinary diversion). By performing extensive literature reviews for each topic evaluated, we have generated an evidence-based consensus on the management of ureteral stones. The objective of this guideline is to help standardize the treatment of ureteral stones to optimize treatment outcomes.

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Section: Anti-coagulationmentioning

confidence: 99%

CUA Guideline: Management of ureteral calculi

Ordon

Andonian²,

Blew³

et al. 2015

CUAJ

Self Cite

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“…Ureterorenoscope is clearly superior to SWL and PNL for upper ureteric stones in some situations e.g. patients with bleeding disorders or continued antithrombotic therapy 9 .…”

Section: Discussionmentioning

confidence: 99%

Frequency and Predictors of Access Failure in Patients Undergoing Ureterorenoscopy for Upper Urinary Tract Calculi

Rafi

Aziz

Ather

2021

PAFMJ

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Objective: To determine the frequency and factors responsible for access failure during primary ureteroscopy (URS). Study Design: Cross-sectional study. Place and Duration of Study: Aga Khan University, Karachi Pakistan, from Jan to Jul 2019. Methodology: All patients undergoing Ureterorenoscopy for upper urinary tract urolithiasis were included. Ureterorenoscopy was performed with either semi rigid, rigid digital or fiber opticflexible ureterorenoscope as appropriate. Data was collected for demographics, history of stone passage, previous Ureterorenoscopy /double J stenting and history of stent placement. Preoperative imaging reviewed for stone location, size and number. Level of access failure (proximal/mid/distal ureter) was noted. Post-operative complications and need of ancillary procedure was noted. Results: We included 250 participants undergoing ureteroscopy for the upper urinary tract calculi. Mean age of the patients was 44.15 ± 13.76 years. Mean stone size was 9.12 ± 4.23mm. Overall access failure rate was found to be 8% (20/250), all required an ancillary procedure. None of the patients with previous history of endoscopic intervention or stone passage had access failure. On univariate and multivariate analysis only stone location was found to be significant factor predicting access failure. Conclusion: Failure to access is not uncommon during primary ureteroscopy. Access failure is more common in proximal ureteral stone and in patients with no previous episode of ureteral stones and procedure. Information from this study will help in counseling patients’ pre-operatively and may be a guide to urologists on pre stenting of selected patients at high risk of access failure.

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“…160,[167][168][169][170] However, this is associated with lower SFRs and increased risk of postoperative gross hematuria necessitating admission and bladder irrigation. 161,171 Therefore, risks and benefits of withholding anti-coagulation or proceeding with URS while anti-coagulated should be discussed with the patient and his/her cardiologist or haematologist.…”

Section: Anti-coagulationmentioning

confidence: 99%