Management of upper urinary tract calculi with ureteroscopic techniques

Tawfiek, Ehab R.; Bagley, Demetrius H.

doi:10.1016/s0090-4295(98)00462-2

Cited by 162 publications

(82 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, our study revealed the number of sessions were less and most of the patients responded to one session of lithotripsy only. In the present research, 131 subjects (68.6%) were having opaque stones which support reports of Bihl & Meyers, 2001;Tawf iek & Bagley, 1999. Like other studies, no other ancillary procedures such as DJ stenting were required for our subjects (Mobley et al, 1994;Ashraf et al, 2010).…”

Section: Discussionsupporting

confidence: 88%

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Barzegarnezhad¹,

Kerigh²,

Azizi³

2016

AMBIENT SCIENCE

View full text Add to dashboard Cite

In nowadays Extracorporeal Shock Wave Lithotripsy (SWL) is one of the most accepted and minimally invasive therapeutic options for the treatment of urinary stones. Unfortunately, till date, only a handful studies have regarded the extrusion rate of stones located in the middle and lower part of the ureter via SWL. We evaluated the success rate of this procedure in the treatment of ureteral calculi by conducting a descriptive study carried out through the analysis of the f iles and radiographs of 191 patients with urolithiasis who underwent lithotripsy.. Success rates were recorded on the basis of the location of stones which were as follows: 89.4% with urolithiasis in the upper part of the ureter responded to one session of lithotripsy. The success rate in those with calculi located in the middle and the lower part of the ureter was 90.9% and 88.1%, respectively. Gross hematuria and pyelonephritis were observed in 90.05% and 2.61% of patients, respectively. AbstractIntroduction:

show abstract

Section: Discussionsupporting

confidence: 88%

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Barzegarnezhad¹,

Kerigh²,

Azizi³

2016

AMBIENT SCIENCE

View full text Add to dashboard Cite

show abstract

“…These results resemble those from current studies on electively scheduled URS, which range from 86.6% to 94.6% for all ureteral stones, increasing to 95.6% to 100% for distal ones. [13][14][15][16][17][18] Our study has some limitations, namely its retrospective design and that no comparison with a control group was done. Still, to our knowledge, this is the first report focusing on ureteroscopic management of ureteral stones in emergency situations.…”

Section: Commentmentioning

confidence: 99%

“…The routine placement of a ureteral stent after ureteroscopic stone removal has been widely recommended, 17 the rationale being a reduction of postoperative pain and ureteral obstruction at the stone impaction site and possibly facilitating the passage of small stone fragments. With the recent development of small-caliber ureteroscopes and more effective intracorporeal lithotripsy devices, it is now possible to perform URS in most patients without dilation.…”

Section: Commentmentioning

confidence: 99%

Emergency Ureteroscopic Management of Ureteral Stones: Why Not?

Osório

Lima

Soares

et al. 2007

Urology

View full text Add to dashboard Cite

OBJECTIVESTo describe a single-center experience in the emergency ureteroscopic management of ureteral stones. METHODSWe retrospectively considered the data from 144 patients (mean age 49.6 years, range 23 to 82) who had had obstructive ureteral stones and had undergone emergency ureteroscopy with stone retrieval. Intracorporeal pneumatic lithotripsy was performed when necessary. At the end of the procedure, a ureteral catheter was systematically left in place in 100 patients (69.4%) and removed within 24 hours. In the remaining 44 patients, a double-J stent was preferred and was removed within 30 days, depending on the clinical course. Stone-free status was defined as the complete absence of fragments at 1 month of follow-up. RESULTSThe calculi were more frequently localized in the distal ureter than in the proximal one (90.3% versus 9.7%, respectively). The overall mean stone diameter was 9.1 mm (range 5 to 20). The overall stone-free rate was 92.4%. A greater stone-free rate was obtained in those with stones less than 10 mm (95.8%) than in those with stones larger than 10 mm (89%, P ϭ 0.002). Similarly, a significantly better outcome occurred for those with stones located in the distal ureter (94.6%) than for those with stones in the proximal one (71.4%, P ϭ 0.004). The overall complication rate was 4.2%. The mean hospital stay was 2.5 days (range 1 to 7 R enal colic is often caused by ureteral stones, with most of them located in the distal ureter. 1 When conservative drug therapy does not resolve the symptoms, the placement of a ureteral catheter or nephrostomy tube represents the classic procedure performed for renal colic due to acute ureteral obstruction. These maneuvers can offer a prompt relief from pain for the patient, and they are usually followed by ureteroscopy (URS) or extracorporeal shockwave lithotripsy (ESWL), which currently represents the mainstay of treatment for ureteral stones. 2 Although URS is a more invasive treatment option than ESWL, the success rate of the latter is probably lower, especially for mid and distal ureteral stones. 3,4 To date, ESWL, as a first-line therapeutic option, applied rapidly after the onset of renal colic, has been given very limited attention. Only two randomized trials have been reported, both with encouraging results, even if most cases were of proximal ureteral stones. 5,6 Emergency ESWL is an attractive proposition, because it can result in both stone disintegration and relief from acute obstruction.Recently, the miniaturization of ureteroscopes, together with the introduction of the holmium laser, has improved stone-free rates and decreased the complication rates, widening the indications for URS. 7 Similar to ESWL, emergency URS can result in both stone disintegration and relief from colic pain. However, significant data on the ureteroscopic management of ureteral stones in an emergency setting are completely lacking.We describe our experience in the emergency ureteroscopic management of ureteral stones. The outcome, complications, and supposed advantag...

show abstract

“…18 The low complication rate is similar to that in other reports. [4][5][6] Complications were higher in older series where 9.8-F to 10.8-F scopes were used probably because of the larger diameters of the instruments. 19 One patient with a solitary kidney developed a lower ureteric stricture.…”

Section: Discussionmentioning

confidence: 99%

Flexible ureterorenoscopy: prospective analysis of the Guy's experience

Ms¹,

Mf²,

Rc³

et al. 2004

Ann R Coll Surg Engl

View full text Add to dashboard Cite

Objective: To report our outcomes with small diameter, actively deflectable flexible ureterorenoscopy from a prospective database. Patients and Methods: 114 flexible ureterorenoscopies were performed in 105 patients (mean age, 49.5 years; range, 19-85 years; 71 males, 34 females) over a 9-month period. Of these, 101 were for refractory stones following failed ESWL and 13 for diagnostic reasons. An Olympus URF P3 flexible ureteroscope with pressure irrigation was used. Electrohydraulic lithotripsy was used to fragment stones and the fragments were retrieved with Graspit, triradiate graspers or tipless baskets. Results: Stents had previously been placed in 53% and dilatation of the ureteric orifice was necessary in 15%. In the stone group, the median operating time was 55 min (range, 15-210 min) and the median screening time 2.2 min (range, 0.3-9.1 min). Success was defined as complete stone clearance or good fragmentation to 2 mm or less. Overall success in this group was 72.3%. There was no statistically significant difference between lower and other calyces (P = 0.83 Chi-square test). Successful outcome was achieved in 72% for stone size 10 mm or less, 80% for 11-20 mm and 50% for greater than 20 mm. Two or more procedures were needed in 8 patients. In the diagnostic group, the median operating time was 45 min (range, 20-60 min) and the median screening time 2 min (range, 0.3-8.3 min). The majority were for upper tract filling defects. Access and successful diagnosis was achieved in all cases. The major complication rate was 2.6%. The ureteroscope needed repair once during this series. Conclusions: Flexible ureterorenoscopy is an effective diagnostic and therapeutic tool in a select group of patients. It should be considered for ESWL-resistant upper tract stones but the results are poor in stones larger than 20 mm and percutaneous nephrolithotomy may be a better option in these patients.

show abstract

Management of upper urinary tract calculi with ureteroscopic techniques

Cited by 162 publications

References 37 publications

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Extracorporeal Shock Wave Lithotripsy for the treatment of ureteral stones : a Critique on Success rate

Emergency Ureteroscopic Management of Ureteral Stones: Why Not?

Flexible ureterorenoscopy: prospective analysis of the Guy's experience

Contact Info

Product

Resources

About