Patient position and semi-rigid ureteroscopy outcomes

Korkes, Fernando; Lopes-Neto, Antonio C.; Mattos, Mário Henrique Elias de; Pompeo, Antônio Carlos Lima; Wroclawski, Eric Roger

doi:10.1590/s1677-55382009000500005

Cited by 15 publications

(4 citation statements)

References 23 publications

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“…Despite its effectiveness SWL, clearance of stones is usually injured by chronic inflammatory reaction related to polyps and inflammation associated with inflammation [10–12]. Ureteroscopic methods, on the other hand, have limited success especially in men due partly to difficulties in accessing stones, but mostly secondary to common ureteral lesions associated with impacted stones, such as edema, polyps, and strictures [13]. In such cases, a long history of impacted stones has been considered as a predictor [10].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

Topaloğlu

Karakoyunlu

Sarı

et al. 2014

BioMed Research International

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Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones. Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed. Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.; P = 0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.; P = 0.039). Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

Topaloğlu

Karakoyunlu

Sarı

et al. 2014

BioMed Research International

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“…SWL or ureteroscopy were performed for larger stone fragments, calculi causing moderate/severe hydronephrosis, when infection was suspected, with severe and untreatable pain or who refused to undergo medical expulsive therapy (15)(16)(17). Our study has some limitations.…”

Section: Discussionmentioning

confidence: 99%

Steinstrasse predictive factors and outcomes after extracorporeal shockwave lithotripsy

Lucio¹,

Korkes²,

Lopes-Neto³

et al. 2011

Int. braz j urol.

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Purpose: Urinary stone disease is a common medical problem. Extracorporeal shockwave lithotripsy (SWL) has been applied with high success and low complication rates. Steinstrasse (SS) is a possible complication after SWL. The aim of the present study was to prospectively evaluate the factors and outcomes associated with SS after SWL. Materials and Methods:We have prospectively evaluated 265 SWL sessions (2005265 SWL sessions ( -2009. Two lithotriptors were used randomly: Siemens Lithostar and Dornier Compact S. All patients had imaging exams after 30 and 90 days or according to symptoms. Results: SS was observed in 14 (5.3%) out of 265 SWL procedures (n = 175 patients, 51.5% women/48.5% men, mean ± SD age = 46.3 ± 15.5 years). SS was more common after SWL for pelviureteral calculi rather than caliceal stones (p = 0.036). There was a trend toward more occurrences of SS after SWL for larger stone area (> 200 mm 2 , p = 0.072). Preoperative ureteral stent didn't prevent SS. SWL machine, intensity, number of pulses and frequency were not associated with SS formation. Post-SWL pain, fever and gravel elimination were factors associated with SS (p = 0.021; p = 0.011; p = 0.078). When SS occurred, treatment modalities included Medical Expulsive Therapy (MET), ureteroscopy and SWL. Conclusions: Steinstrasse is an uncommon event after SWL and seems to occur more frequently with larger pelviureteral stones. Impaction of stones is more frequent in the middle ureter. All patients should be followed after SWL, but SS should be specially suspected if there is macroscopic gravel elimination, flank pain and/or fever. When SS occurs, treatment should be promptly introduced, including medical expulsive therapy, surgical approach or SWL in selected cases. Further prospective studies are awaited to evaluated preventive measures for SS occurrence.

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“…Trata-se de um procedimento diagnóstico e terapêutico para litíase urinária, estenose de ureter e neoplasias do ureter 1,3 . A ureterolitíase é a condição clínica mais comum que necessita de ureteroscopia para tratamento 4 .…”

Section: Introductionunclassified

Curva de aprendizado em ureteroscopia semi-rígida em cálculos de pequenas dimensões: quantos casos são necessários?

Ilias

Passerotti

PONTES

et al. 2022

Rev. Col. Bras. Cir.

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RESUMO Introdução: ureteroscopia semi-rígida é o procedimento de escolha para o tratamento da ureterolitíase, mas necessita de uma curva de aprendizado para ser executada com segurança. Objetivo: descrever uma estimativa da curva de aprendizado para realização da ureterorrenolitotripsia semi-rígida em pacientes com ureterolitíase de pequena dimensão e estimar o número mínimo de procedimentos necessários para realizar o procedimento cirúrgico com segurança. Métodos: trata-se de um estudo prospectivo avaliando a curva de aprendizado de um residente de urologia nas primeiras 60 ureteroscopias semi-rígidas em pacientes com ureterolitíase até 1cm. Os pacientes foram divididos em três grupos: Grupo I uma a vinte cirurgias, Grupo II vinte e uma a quarenta cirurgias e Grupo III quarenta e uma a sessenta cirurgias. As cirurgias foram gravadas e analisadas por dois urologistas experientes em endourologia. Foi feita uma análise qualitativa baseada em uma ferramenta previamente validada e uma análise quantitativa. Resultados: todas as variáveis qualitativas tiveram variação significativa entre os Grupos I e II (p<0.001), e entre os Grupos I e III (p<0.001). Houve diferença no tempo para acesso ao ureter, passagem de cateter duplo J e tempo operatório total entre os Grupos I e II (p<0.001) e nos Grupos I e III (p<0.001). Conclusão: após 40 casos parece haver pouco incremento tanto na avaliação quantitativa bem como na avaliação qualitativa em performance cirúrgica para a realização de ureterolitotripsia semi-rígida com segurança em cálculos de até 1cm.

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Patient position and semi-rigid ureteroscopy outcomes

Cited by 15 publications

References 23 publications

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

Steinstrasse predictive factors and outcomes after extracorporeal shockwave lithotripsy

Curva de aprendizado em ureteroscopia semi-rígida em cálculos de pequenas dimensões: quantos casos são necessários?

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