Stone-free Outcomes of Flexible Ureteroscopy for Renal Calculi Utilizing Computed Tomography Imaging

York, Nadya; Zheng, Mengmeng; Elmansy, Hazem; Rivera, Marcelino; Krambeck, Amy E.; Lingeman, James E.

doi:10.1016/j.urology.2018.09.005

Cited by 40 publications

(25 citation statements)

References 29 publications

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“…Moreover, the use of the CT scan to assess RFs has had the important effect of reducing the SFR, which is almost always evaluated with KUB and US. 23,24 The CT scan can also indirectly identify different stone type compositions with the use of the Hounsfield Unit 13,25 and produces useful information regarding the ureteropelvic junction (UPJ) characteristics and the course of ureters. In the past, the CT scan was prescribed before active intervention or at immediate follow–up; however, employment of this method is also growing in the mid-term follow-up.…”

Section: Diagnosis Of Rfsmentioning

confidence: 99%

Stone residual fragments: A thorny problem

et al. 2019

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Urolithiasis represents a widespread and common disorder among the world population, with a predicted increase in affected patients in the coming years. Treatment of renal and ureteral stones varies widely, and achieving true stone-free status in all patients is still difficult. Moreover, imaging used to assess residual fragments following procedure impacts the diagnosed stone-free rate percentage considerably. In particular, the use of computed tomography scans has led to a better evaluation of residual fragments as well as so-called clinically insignificant residual fragments, which in a considerable number of cases are, despite their definition, causes of adverse urological events, thus creating a thorny problem for both patients and urologists. Currently, there is no gold standard or validated protocol regarding the management, clearance and prevention of residual fragments. In this article, we review the current literature regarding residual fragments, clinically insignificant residual fragments and their natural history, reporting on diagnostic methods, incidence, complications and outcome with the use of less invasive procedures, taking into consideration viable treatment and management of patients affected.

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Section: Diagnosis Of Rfsmentioning

confidence: 99%

Stone residual fragments: A thorny problem

et al. 2019

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“…At the very best, SFRs were at the bottom end of the range of previous reports of first-line SWL or RIRS. [9][10][11]24,25 Some of the explanation for that is we report SFR mainly based on NCCT (81.8% of the SWL group and 100% of the RIRS group), whereas other reports were based mainly on ultrasound plus KUB. 26 Other possible explanation is that standard PCNL may alter normal collecting system anatomy and influence SFR of a second-line therapy.…”

Section: Residual Fragments After Pcnl: Swl Vs Rirsmentioning

confidence: 71%

Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery

Danilovic

Torricelli

Marchini

et al. 2021

Journal of Endourology

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Background: Despite technology incorporation to percutaneous nephrolithotomy (PCNL), residual stone fragments (RSFs) may still persist after PCNL and need to be addressed to avoid regrowth or ureteral obstruction. The objective of this study was to compare the outcomes of retrograde intrarenal surgery (RIRS) to extracorporeal shockwave lithotripsy (SWL) for treating patients with RSFs after a previous standard PCNL. Materials and Methods: Adult patients with RSF after a standard PCNL submitted to RIRS or SWL in our Institution from January 2017 to January 2020 were retrospectively studied. Stone-free rate (SFR) was evaluated on postoperative day (POD) 90 by noncontrast CT (NCCT) or ultrasound and kidney, ureter, and bladder radiograph (KUB) for each renal unit. Surgical complications based on Clavien-Dindo classification during the 90 days of follow-up were recorded. Sample size was calculated for a power of 80% and a significance level of 0.05, assuming SFR of 20% for SWL and 50% for RIRS. Results: Thirty-three patients treated by SWL were compared with 36 patients treated by RIRS. Hospitalization time was longer in the RIRS group (4.18 vs 12.33 hours, p = 0.001). SFR and success rate were lower in SWL than RIRS group (24.2% vs 58.3%, p = 0.007 and 30.3% vs 72.2%, p = 0.004, respectively), using POD 90 NCCT in 81.8% and ultrasound and KUB in 18.2% of the SWL group and using POD 90 NCCT in 100% of the RIRS group. Minor complications (Clavien-Dindo < III) occurred in 11 of 36 (30.6%) patients submitted to RIRS and in 2 of 33 (6.1%) patients submitted to SWL group ( p = 0.025). Two patients (6.1%) of the SWL group had Clavien-Dindo IIIb complication owing to Steinstrasse and were submitted to ureteroscopy. Emergency room visits were similar between groups (6.1% vs 8.3%, p = 1.0). Conclusions: RIRS has better SFR, higher minor complications, and lower major complications than SWL for the treatment of RSFs after standard PCNL.

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“…[27] The major constituents of the stones were calcium and oxalate, findings that are in keeping with previous studies conducted across various parts of the world . [12,19,25] This study is based on a simple qualitative biochemical study. This technique is simple and feasible for developing countries in terms of financial strength and available manpower.…”

Section: Resultsmentioning

confidence: 99%

“…There are variety of treatment options for KSD, including open surgery, percutaneous nephrolithotomy, super-mini percutaneous nephrolithotomy, ureteroscopy, extracorporeal shock wave lithotripsy, and conservative intervention/measures. [18][19][20][21][22][23]…”

Section: Introductionmentioning

confidence: 99%

The Mineral Composition of Urinary Tract Stones in Khost, Afghanistan

Abdali

Janatzai

2020

J App Pharm Sci Res

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Background: The urinary tract stones include renal (nephrolithiasis), ureter (ureterolithiasis), and urinary bladder stones (cystolithiasis). The knowledge of the mineral composition of the urinary tract stone is important for the treatment, patient education, and to develop preventative strategies. Aim: This study aims to characterize the proportion of different types of urinary tract stones and their chemical composition in Khost province. Material and Methods: A retrospective, the hospital-based study design was used. The stones were analyzed using simple qualitative biochemical tests. A total of 63 patients were included in this study from Sept 2016 to Aug 2019. The stones were checked for the presence of calcium, magnesium, ammonium, oxalate, phosphate, uric acid, and cystine. Results: The results obtained showed the incidence of the kidney (48 stones), ureteric (4 stones), urinary bladder (11 stones) at the age group of 18-75 years (mean 56.2). The incidence in men was higher than women, male to female ratio being 3:1. The chemical analysis of overall stones has shown that 88.21% had mixed compositions, and 11.79% presented a unique composition. The majority of stones obtained from women was cystine (70%) and oxalate (72%) stones, whereas the majority of stones in men were that of calcium oxalate (76%) and uric acid (74%) stones. Eight of the stones were pure of calcium oxalate, five were pure uric acid, 7 were pure cystine, and 43 were mixed stones. Among the mixed stones, oxalate was present in 32 samples (43 of total), calcium was present in 36 samples, uric acid was seen in 17, phosphate was present in 23, and cysteine was present in 14 stones. Conclusion: This study showed that the most common type of mineral composition found in different urinary stones is calcium oxalate (81%), followed by cystine and uric acid. Further broader and large scale studies are required to assess the mineral base of the urinary tract stones in Afghanistan to develop preventive strategies and promote public awareness about dietary recommendations.

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Stone-free Outcomes of Flexible Ureteroscopy for Renal Calculi Utilizing Computed Tomography Imaging

Cited by 40 publications

References 29 publications

Stone residual fragments: A thorny problem

Stone residual fragments: A thorny problem

Residual Stone Fragments After Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery

The Mineral Composition of Urinary Tract Stones in Khost, Afghanistan

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