Castleman�s Disease - Clinical, Histological and Therapeutic Features

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Reno-ureteral lithiasis is a common pathology especially in socio-economically developed countries and may pose serious problems with renal function impairment. Urology is currently one of the surgical branches that benefit from a wide range of therapeutic options in reno-ureteral lithiasis, that revolutionized the criteria and indications of the lithiasis pathology, increasing the success rate and decreasing the number of days of hospitalization but which cannot provide satisfactory results if not complemented by imaging examinations. Non-contrast computer tomography is a key element in determining the best method of treatment by measuring the density of stones and increasing the stone-free rate of patients. Measurement of the stones density is done by Hounsfield units (HU), and patients who have had a [500 HU density have pleaded in over 90% for the uric acid composition. We included in our study a batch of 364 patients with reno-ureteral lithiasis and the treatment method was chosen based on the density of the stones: 64.83% of the patients with a density between 200-700 HU performed semi-rigid ureteroscopy and ballistic lithotripsy, 3.57% of patients with density between 700-1000 HU benefited from flexible ureteroscopy and laser lithotripsy, 17.58% of patients with density between 400-700HU performed ESWL and 13.73% with density]1000 HU have benefited from PCNL.

Section: Resultsmentioning

confidence: 99%

“…Computed tomography (CT) with no contrast is considered the gold standard investigation in reno-ureteral lithiasis pathology [6][7][8][9], providing information on localization, density and size of the stones [10][11][12][13].…”

Section: Abstract: Non-contrast Computer Tomography Stones Densitymentioning

confidence: 99%

Non-Contrast Computed Tomography and the Impact of Stone Density to Choose Minimal Invasive Treatment

Scarneciu¹,

Banuta²,

Maxim³

et al. 2019

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“…The risk factors for developing kidney stones can be classified into three groups: endogenous causes (metabolic dysfunctions, endocrine diseases like hyperparathyroidism, tumors [13], gastric hypoacidity, etc. ), renal causes (kidney dysfunction, tubular disorders), and post-renal causes (malformations and urinary tract obstruction by extrinsec compresion or invasion [14][15][16][17], bladder pathology [18,19] or subvesical obstruction [20,21], post-surgical procedures [22,23], bacterial infections) [24].…”

mentioning

confidence: 99%

Does the Composition of the Stones Counts in Patients Who Underwent Percutaneous Nephrolithotomy?

Todea-Moga¹,

Martha²,

Scârneciu³

et al. 2019

The aim of this study is to highlight the importance of percutaneous nephrolithotomy (PCNL) in the treatment of kidney stones with different chemical composition. We included in this study 200 patients with kidney stones who underwent PCNL. In most of the cases the stones were composed by calcium, usually calcium oxalate followed by struvite and uric acid component. The stones were mostly localized in the renal pelvis (142), inferior calyx (46) and ureteropelvic junction (4) and 28 cases with staghorn stones. Intraoperative complications were: migrating fragments (22%), hemorrhage (12%), lesions of the renal pelvis and difficulties of percutaneous access or dilatation (6%). The postoperative complications were: bleeding (20%), obstruction caused by stone fragments (22.5%), hydronephrosis (18%), fistula (13%). The average length of hospitalization after PCNL was 5.58 +/- 2.69 days SD. Stone-free rate was: 77.5%. PCNL is a safe and effective method of treatment for large and complex stones. Intra and postoperative complications after PCNL are not influenced directly by the chemical composition of the stones. It is important to evaluate the chemical composition of the stones in order to establish the treatment management and to recommend a proper conservative treatment in order to prevent the recurrence of the disease.

“…Current indications for stent placement include relief of ureteral obstruction, whether the cause is intrinsic (from a calculus, clot, or urothelial carcinoma, metastasis) or extrinsic (from external compression or mass effect) [5][6][7][8][9][10][11][12]. Most of these stents are placed for 2-3 weeks, but there are situations that require a longer period up to years.…”

mentioning

confidence: 99%

Ureteral JJ Stent � Which One is Better?

Spînu¹,

Marcu²,

Socea³

et al. 2018

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Ureteral stents represent a minimally invasive alternative to preserve urinary drainage whenever the ureter is damaged or is under a significant risk to be occluded due to extrinsic or intrinsic etiology, even due to iatrogenic cause. Ureteral obstruction caused by extrinsic compression is often associated with intra-abdominal neoplasms. The first-line therapy to relieve such obstructions is usually internal drainage with ureteral stents. Ureteral stents made of different materials have been designed to achieve the best drainage possible. In this study, we tried to compare different JJ stent materials � which are better and their pros and cons. The ideal stent that would combine perfect long-term efficacy with no stent-related morbidity is still lacking and stent usage is associated with several adverse effects that limit its value as a tool for long-term urinary drainage. Several new ideas on stent design, composition material and stent coating are currently under evaluation, and are trying to eliminate the drawbacks of ureteral stent usage. Almost every clinician is familiar with the drawbacks that are associated with stents, including infection, encrustation, pain and discomfort.