Passive Dilation by Ureteral Stenting Before Ureteroscopy: Eliminating the Need for Active Dilation

Hubert, Katherine C.; Palmer, Jeffrey S.

doi:10.1097/01.ju.0000169130.80049.9c

Cited by 127 publications

(62 citation statements)

References 6 publications

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“…Small size ureteroscope permits easy negotiation and approach to upper ureter but with poor visibility and efficacy for stone removal and larger size ureteroscope requires dilatation. [4,5] Various techniques have been employed for dilatation like passive dilatation (using double j stent) or active dilatation (using balloon, sequential fascial dilator, meatal olives, etc) with the purpose of overcoming difficult negotiation but these are also not exempted from complications. [6,7] Some drugs have been also tried for easy negotiation of ureteral orifice and to decrease complications associated with ureteroscopy.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Bhattar¹,

Jain²,

Tomar³

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the safety and efficacy of silodosin and tadalafil in ease of negotiation of large size ureteroscope (8/9.8 Fr) in the management of ureteral stone. Material and methods:Between June 2015 and May 2016, 86 patients presented with ureteral stone of size 6-15 mm were on consent randomly assigned to 1 of 3 outpatient treatment arms: silodosin (Group A), tadalafil (Group B), and placebo (Group C). After two weeks of therapy 67 patients underwent ureteroscopy, and ureteral orifice configuration, ureteroscopic negotiation, ureteral dilatation, operating time, procedural complication and drug related side effects were noted in each group.Results: Ureteral negotiation was significantly better in Groups A (73.9%) and B (69.6%) as compared to Group C (38.1%) (p<0.01). Statistically significant difference was noted in the requirement for dilatation in Group C (71.4%) as compared to Groups A (26.1%) and B (39.1%) (p<0.01). Ureteral orifice was found to be more dilated in Groups A (69.6%) and B (60.9%) as compared to Group C (28.6%). Mean operating time was statistically lower in Groups A (35.2 min) and B (34.91 min) as compared to Group C (41.14 min) (p<0.01). Conclusion:Both silodosin and tadalafil not only relax ureteral smooth muscle but also help in forward propagation of large size ureteroscope (8/9.8 Fr) without any significant risk of adverse events.Keywords: Silodosin; tadalafil; ureteral stone; ureteroscope; ureteral orifice.Cite this article as: Bhattar R, Jain V, Tomar V, Yadav SS. Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in management of ureteral stone: A prosective randomized trial. Turk J Urol 2017; 43(4): 484-9

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Bhattar¹,

Jain²,

Tomar³

et al. 2017

Turkish Journal of Urology

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“…Due to possible complications, such as ureteral stricture [14] and/or postoperative vesicoureteral reflux [3,17] , active ureteral dilatation was not performed in all of our patients. Instead, we preferred passive dilatation with preoperative ureteral stent placement for initially inaccessible ureters, in agreement with Hubert and Palmer [18] . They evaluated passive dilatation through the use of stent insertion before URS.…”

Section: Discussionmentioning

confidence: 93%

Ureteroscopic Stone Management in Prepubertal Children

Özkan

Bakan²,

Mil³

et al. 2010

Urol Int

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Introduction: We retrospectively assessed our experience with ureteroscopy (URS) for ureteric calculi in prepubertal children. Patients and Methods: The records of all children who underwent URS at our institution for ureteral calculi between September 2007 and July 2009 were retrospectively reviewed. Patient demographics, stone location and size, pre- and postoperative stenting, intraoperative active dilatation, stone-free rates and complications were noted. Results: A total of 26 patients (20 males and 6 females; mean age 59.9 months) underwent 30 URS procedures with rigid ureteroscopes for 31 ureteral calculi. The mean size of ureteral stones was 8.6 mm. A total of 18 URS procedures were performed without any active ureteral dilatation, and 8 patients underwent 12 passive dilatations of initially inaccessible ureters. Stents remained in place for 2–4 weeks. The stone-free rate was 84.6% for all patients and all procedures. Postoperatively, 12 patients (46%) had stent placement for 2–5 days because of stone burden, edema of the ureteral orifice and hematuria. Conclusions: URS treatment of ureteral stones without active dilatation can be performed safely and effectively in prepubertal children. Passive ureteral dilatation might be necessary in some cases to enable ureteral access.

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“…Our aim was to have 100% clearance but in those with a narrow long infundibulum leading to the inferior calyx, residual fragments persisted radiologically. We used double J stents placed preoperatively to passively dilate the ureter and used access sheaths in all cases as recommended by Stern et al [21][22][23] We used the 165 μ laser fibre which did not affect deflection of the scope. The 200 μ fibre was seen to decrease deflection by almost 30°.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

Doddamani

Sinha

Talwar³

2011

Medical Journal Armed Forces India

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Passive Dilation by Ureteral Stenting Before Ureteroscopy: Eliminating the Need for Active Dilation

Abstract: Our study shows that passive dilation of the ureteral orifice in preparation for ureteroscopy is a straightforward, successful and beneficial technique in children, with no associated complications.

Cited by 127 publications

References 6 publications

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in the management of ureteral stone: A prosective randomized trial

Ureteroscopic Stone Management in Prepubertal Children

Efficacy of flexible fibreoptic ureteroscopy and Holmium laser in retrograde intrarenal surgery for calyceal calculi

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