Does Retrograde Treatment of Upper Urinary Tract Stones Necessitate Postoperative Upper Urinary Tract Drainage? Conclusions from More Than 500 Single Center Consecutive Cases

Sabler, Itay M.; Isid, Aiman; Katafigiotis, Ioannis; Lorber, Amitay; Latke, Arie; Shorka, Dorit; Harhel, Tehila; Sfoungaristos, Stavros; Yutkin, Vladimir; Hidas, Guy; Landau, Ezekiel H.; Pode, Dov; Gofrit, Ofer N.; Duvdevani, Mordechai

doi:10.1089/end.2018.0050

Cited by 7 publications

(6 citation statements)

References 13 publications

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“…The existence of metabolic disorders also leads to the weakening of the function of phagocytosis and sterilization of white blood cells, and the acute and chronic complications caused by diabetes can further aggravate the damage of immune function [25–27] . In addition, the high sugar content in the urine of diabetic patients is easy for strain growth [28] …”

Section: Discussionmentioning

confidence: 99%

Risk factors for urinary infection after retrograde upper urinary lithotripsy

Peng

Chen

2021

Medicine

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There are needs to evaluate the risk factors for urinary infection after retrograde upper urinary lithotripsy, to provide insights into the management and nursing care of patients with retrograde upper urinary lithotripsy.Patients who received retrograde upper urinary lithotripsy with a Foley 20 urinary tube insertion from June 1, 2019 to December 31, 2020 in our hospital were selected. Patients were grouped urinary infection and no infection group according to the culture results of urine, and the clinical data of the 2 groups of patients were collected and compared. Single factor and logistic regression analysis were used to analyze the risk factors of urinary tract infection after retrograde upper urinary lithotripsy.Four hundred ten patients with retrograde upper urinary lithotripsy were included, of whom 62 patients had the urinary tract infection, the incidence of urinary tract infection was 15.12%. There were significant differences in the gender, age, diabetes, stone diameter, duration of urinary tube insertion and duration of surgery between infection and no-infection group (all P < .05). The Escherichia coli (62.90%) was the most commonly seen bacterial in patients with urinary tract infection. Female (odds ratio [OR]: 1.602, 95% confidence interval 95% [CI]: 1.132∼2.472), age >50 years (OR: 2.247, 95% CI: 1.346∼3.244), diabetes (OR: 2.228, 95% CI: 1.033∼3.451), stone diameter ≥2 cm (OR: 2.152, 95% CI: 1.395∼3.099), duration of urinary tube insertion ≥3 days (OR: 1.942, 95% CI:1.158∼2.632), duration of surgery ≥90 minutes (OR: 2.128, 95% CI: 1.104∼3.846) were the independent risk factors for the postoperative urinary tract infection in patients with retrograde upper urinary lithotripsy (all P < .05).The incidence of urinary tract infection in patients undergoing retrograde upper urinary lithotripsy was high, counteractive measures targeted on those risk factors are needed to prevent and reduce the postoperative urinary infection in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Risk factors for urinary infection after retrograde upper urinary lithotripsy

Peng

Chen

2021

Medicine

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“…More than that, higher stone volume and higher stone density produce a considerable volume of bigger fragments, and postoperative drainage of the upper urinary tract was necessary. In other cases, according to our data, a stent or a UC may be omitted [5].…”

Section: Discussionmentioning

confidence: 89%

Tubeless Ureterorenoscopy. A Dangerous Adventure or “Fresh Wind” Relied on Skills, Technique and New Technology?

Sabler¹

2019

AUN

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Dramatic financial investments and technologic advancement of Endourology during the last few decades are well known and appreciated. This fact locates it at a spearhead of modern urology and medicine. New technologies and techniques are available, new approaches are developed. Tubeless upper urinary tract procedures are not new, and the necessity of postoperative drainage has been debated for decades [1]. A ureteral catheter (UC) and Double-J stent (DJS) are used routinely all other the world to avoid postoperative pain, prevent infections and strictures and facilitate fragments expulsion. The concern is obstruction secondary to intramural ureteral edema [2]. Despite that, foreign bodies left postoperatively cause symptoms that include LUTS, flank or abdominal pain and are recognized and managed at immediate postoperative and longterm periods, and sometimes demand urgent interventions. The extraction of the DJS is done by local or general anesthesia by an invasive cystoscopy. It's been shown that postoperative drainage doesn't carry any significant advantages over the tubeless procedure in stone-free, infections, morbidity or analgesia requirements after uncomplicated URS [3,4].

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“…Currently, upper urinary tract calculi are mainly treated by conservative therapy, extracorporeal shock wave lithotripsy, flexible ureteroscopy lithotripsy, percutaneous nephrolithotomy, and open surgery [10]. If stone fragments are not removed in time, they are prone to fusion or increase after 3 months, inducing obstructive or infective symptoms [11]. Although the therapies for urinary tract calculi have developed rapidly, stones still cannot be effectively removed.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi: a randomized controlled trial.

Tan¹,

Jiang²,

Song³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Introduction: Upper urinary tract calculus is a common disease of the urinary system. Aim: To compare the therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi. Material and methods: A total of 146 patients were randomly divided into control and experimental groups (n = 73). The control group received flexible ureteroscopy lithotripsy, and the experimental group underwent the same but combined with external physical vibration. The rate of finding stones in the urine on the day after treatment, clearance rate, components of stones, levels of renal function indices blood urea nitrogen (BUN) and serum creatinine (Scr), and incidence of complications were compared. The stone-free rate during 1-year follow-up was analysed by Kaplan-Meier method. Results: The rate of finding stones in the urine on the day after treatment was higher in the experimental group (100%) than that in the control group (29.73%) (p < 0.05). The clearance rates on the day, at 1 week, and at 2 weeks after treatment in the experimental group were 71.23%, 87.67%, and 95.89%, respectively, which surpassed those of the control group at corresponding time points (p < 0.05). BUN and Scr levels decreased after treatment in both groups, especially in the experimental group (p < 0.05). The stone-free rate during 1-year follow-up in the experimental group (n = 71 (97.26%)) exceeded that of the control group (n = 61 (83.56%)) (p < 0.05). Conclusions: External physical vibration combined with flexible ureteroscopy lithotripsy significantly increased the rate of finding stones in the urine the day after treatment, the clearance rate of upper urinary tract calculi, and the ameliorated renal function and reduced the stone re-formation rate.

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Does Retrograde Treatment of Upper Urinary Tract Stones Necessitate Postoperative Upper Urinary Tract Drainage? Conclusions from More Than 500 Single Center Consecutive Cases

Abstract: A tubeless approach is safe in properly selected cases. There is no difference in postoperative course compared with drained groups. Tubeless procedures may facilitate an outpatient approach for treatment of upper urinary tract stones.

Cited by 7 publications

References 13 publications

Risk factors for urinary infection after retrograde upper urinary lithotripsy

Risk factors for urinary infection after retrograde upper urinary lithotripsy

Tubeless Ureterorenoscopy. A Dangerous Adventure or “Fresh Wind” Relied on Skills, Technique and New Technology?

Therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi: a randomized controlled trial.

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