Factors That Predict Spontaneous Passage of a Small Distal Ureteral Stone &lt;5 mm

Hwang, Eugene; Kim, Young Ho; Yuk, Seung Mo; Sul, Chong Koo; Lim, Jae Sung

doi:10.1089/end.2010.0092

Cited by 21 publications

(19 citation statements)

References 17 publications

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“…In der Humanmedizin ist in Analogie zur lithogenen Urethritis des Hundes eine lithogen induzierte polypoide Ureteritis ausführlich beschrieben. Mit dieser verbindet man Schleimhautödeme, eine submukosale Steinverlagerung sowie eine Spongiofibrose des submukösen Bindegewebes bis hin zu einer narbigen Striktur mit permanenter Obstruktion des Ureterlumens [13].…”

Section: Originalartikelunclassified

Management von Urethralsteinen beim Hund mittels pneumatischer und laserenergetischer Lithotripsie

Pantke¹

2019

Tierarztl Prax Ausg K

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Zusammenfassung Gegenstand und Ziel Beschreibung der klinischen Erfahrungen mit zwei verschiedenen Lithotripsieverfahren zur Behandlung von Harnröhrensteinen beim Hund. Material und Methoden Retrospektive Auswertung (Oktober 2016 bis November 2017) klinischer Daten von Hunden mit Harnröhrensteinen, bei denen eine transurethrale pneumatische oder laserenergetische Lithotripsie erfolgte. Ergebnisse Im genannten Zeitraum wurde bei 28 Rüden und 5 Hündinnen mit Harnröhrensteinen eine pneumatische (39 %) oder eine laserenergetische (61 %) Lithotripsie durchgeführt. In der Harnröhre konnten mit beiden Verfahren Steinfreiheitsraten von 100 % bei Hündinnen und von 85 % bei Rüden erreicht werden. Bei 3 der 28 Rüden (11 %) zeigte sich das endoskopische Bild einer hochgradigen polypoiden Urethritis, die das Urethralumen trotz Konkremententfernung weiter einengte und die Anlage einer Urethralfistel erforderte. Bei 8 der 28 Rüden (29 %) und bei 1 der 5 Hündinnen (20 %) wurde zusätzlich eine Zystolithotomie notwendig, um eine vollständige Steinfreiheit im unteren Harntrakt zu erreichen. Schlussfolgerung und klinische Relevanz Eine transurethrale Lithotripsie von Harnröhrensteinen lässt sich beim Hund mit relativ hoher Erfolgsquote sowohl pneumatisch als auch laserenergetisch durchführen. Bei gravierenden Gewebeveränderungen der Harnröhrenschleimhaut können zusätzliche chirurgische oder interventionelle Maßnahmen zur Wiederherstellung der Harnröhrenfunktion erforderlich werden.

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Section: Originalartikelunclassified

Management von Urethralsteinen beim Hund mittels pneumatischer und laserenergetischer Lithotripsie

Pantke¹

2019

Tierarztl Prax Ausg K

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“…In the correlation of secondary signs on initial CT scan with the presence of lesions on ureteroscopy, only the tissue rim sign reached statistical significance (P = 0.003). Based on these findings, the authors suggest that patients with secondary signs on initial CT scan, and in particular a high-grade tissue rim sign, may benefit from earlier definitive treatment instead of medical management [6].…”

Section: Medical Managementmentioning

confidence: 99%

“…As opposed to the early dilate and wait technique, ureteral dilating balloons ranging from 4 to 10 mm in diameter and 4 to 10 cm in length are now commonly used to dilate the ureteral orifice to permit introduction of a ureteral access sheath or a rigid or flexible ureteroscope for definitive treatment (Figs. 6,7,8,9). They are also used to dilate benign ureteral strictures to allow for upper tract instrumentation including lithotripsy and stone retrieval [91].…”

Section: Ureteral Dilating Balloonsmentioning

confidence: 99%

Urological Aspects of Management

Miller

Stoller

2011

Clinic Rev Bone Miner Metab

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Renal colic describes the acute, severe, and paroxysmal pain caused by the obstruction, distension, and resultant increase in intraluminal pressure of the urinary tract. The treatment of renal colic is aimed at relief of symptoms, facilitating urinary drainage to preserve renal function and treat infection and ultimately removal or passage of the obstructing stone. The medical management of renal colic is directed at mitigating, through pharmacologic intervention, one or more of the complex processes contributing to the clinical sequelae of obstruction including pain, nausea, vomiting, and irritative voiding symptoms. Numerous medications and combinations of medications have been employed with varying degrees of clinical success. Urgent interventions are typically directed at bypassing ureteral obstruction in order to palliate the patient until such time as definitive treatment may be accomplished or facilitate drainage to further the treatment of urinary tract infection. Timing and mode of urgent intervention are dependent on clinical factors, clinician expertise, and preference and the availability of specialized equipment. Definitive management of ureteral stones is typically performed in an elective fashion and seeks to balance the risks of intervention with the clinical benefits of the various treatment modalities. Treatment approaches vary according to clinical indications, patient preference, clinician expertise, and the availability of facilities and equipment. This section covers current supporting evidence and rationale, indications and techniques for the medical management, urgent intervention, and definitive management of acute renal colic caused by ureteral stones.

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“…Studies performed in adults have demonstrated spontaneous passage of 39-98% of ureteral stones smaller than 4 mm, while only 25-53 % of stones of ≥5 mm in diameter could pass spontaneously. [20][21][22][23] Stones larger than 10 mm had no chance of spontaneous passage. [24] In the light of available data, in adults, suitability of MET for ureteral stones with a diameter of 5-10 mm has been indicated.…”

Section: Introductionmentioning

confidence: 99%

Medical expulsive treatment in pediatric urolithiasis

Atan

Balcı

2015

Turkish Journal of Urology

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The frequency of stone disease in childhood ranges between 0.1-5 percent. Stone disease occurs as a result of enviromental, metabolic, anatomical, infectious and nutritional factors. Percutaneous nephrolitotomy, uretherorenoscopy, laparoscopic surgery, open surgery and extracorporeal shock wave lithothripsy are treatment alternatives for stone disease during childhood. However, these methods are not completely innocent. Some complications may occur after these procedures. These procedures are generally not cost-effective. Even invasive procedures have high success rates, so medical expulsive treatment modalities have become an alternative for a group of patients. Nonsteroidal anti-inflammatory drugs, antimuscarinic drugs, phospodiesterase type 5 inhibitors, steroids, calcium channel blockers and alpha blockers are treatment alterneatives used for this modality in the literature. The drug is chosen according to the location, size, and composition of the stone, recent technology, cost, surgeon's experience and surgeon's and the parents' preferences. In this review article the following topics will be discussed such as "Why medical expulsive treatment is needed during childhood? Which drug should be chosen for which stone type? How long should a treatment of urolithiasis last?

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Factors That Predict Spontaneous Passage of a Small Distal Ureteral Stone <5 mm

Abstract: The secondary signs on UHCT such as high degree of tissue rim sign, hydronephrosis, and perinephric fat stranding seem to be useful signs in predicting the presence of concurrent ureteral lesions. In those cases, early intervention might have better outcomes than conservative therapy.

Cited by 21 publications

References 17 publications

Management von Urethralsteinen beim Hund mittels pneumatischer und laserenergetischer Lithotripsie

Management von Urethralsteinen beim Hund mittels pneumatischer und laserenergetischer Lithotripsie

Urological Aspects of Management

Medical expulsive treatment in pediatric urolithiasis

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