Treatment of Cystine Stones: Combined Approach using open Pyelolithotomy, Percutaneous Pyelolithotripsy, Extracorporeal Shock Wave Lithotripsy and Chemolysis

Aabech, J; Andersen, Jens T.

doi:10.3109/00365599309180456

Cited by 9 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As reported by others, cystinuric patients had more procedures, but unlike some other studies, there was a significant decline in the need for both SWL and total procedures during treatment. There were significantly more SWLs in cystine SF before treatment than in the other two groups; cystine stones are poorly fragmented by SWL [24] and this may partly explain the result. However, during treatment there was no difference in the time‐adjusted rate of SWL among the three groups of patients.…”

Section: Discussionmentioning

confidence: 99%

Reduced renal function and benefits of treatment in cystinuria vs other forms of nephrolithiasis

et al. 2006

View full text Add to dashboard Cite

A significant study from the USA compares cystine stone formers and routine stone formers; the former group had a higher requirement for therapeutic procedures, but this was less if they took chelating agents, although remaining higher than in the latter group. Other interesting findings are also presented. OBJECTIVE First, to compare two types of stone formers (SF), those with cystinuria and those without, for effects of treatments for stones, as cystinuria leads to recurrent stones that are difficult to fragment with shock‐wave lithotripsy, and there is disagreement about the efficacy of current treatments. Second, to compare these two groups with respect to blood pressure (BP) and renal function, as cystine stones may be associated with more morbidity than are routine stones. PATIENTS AND METHODS Fifty‐two cystinuric patients (cystine SF) entering our programme since 1970 were compared with 3215 SF without cystinuria (routine SF), of whom 114 had a single functioning kidney (routine SF + nephrectomy). All patients had three 24‐h urine and blood samples taken to determine the risk of stones before their first clinic visit; these studies were repeated after therapy was initiated, and at regular intervals to monitor therapy. Cystine was measured in the urine samples of the cystine SF. All stone‐related procedures were recorded, and BP measured at clinic visits. Creatinine clearances (CCr) were calculated from each set of serum and urine values. Cystine supersaturation (SS) was directly measured in 16 urine samples collected before treatment and 13 afterward. RESULTS Patients were treated with increased fluid intake, potassium alkali and chelating agents such as α‐mercapto‐propionyl‐glycine, as needed. The mean (sd) CCr, corrected for age and gender, was significantly lower at entry in cystine SF than in routine SF, at 91 (6) vs 160 (1) L/day, respectively (P < 0.001), and remained so at the last CCr. Neither systolic nor diastolic BP, similarly corrected, differed between the groups, but cystine SF had significantly more procedures, corrected for time at risk, before treatment than did routine SF, at 4.0 (0.4) vs 1.86 (0.06), respectively (P < 0.001); time‐adjusted procedures decreased significantly in both groups during treatment, but remained higher in cystine SF, at 0.88 (0.14) vs 0.23 (0.02), respectively, (P < 0.001). Urine volume and pH were significantly higher in cystine SF than in routine SF, both before and during treatment. Cystine SS decreased during treatment, consistent with the increase in urine volume and decline in procedure rates during treatment. CONCLUSION Cystine SF have significantly higher procedure rates than routine SF, but procedure rates decline during therapy, although they remain higher than in routine SF. The lower CCr in cystinurics suggests that treatment to prevent stone recurrence and the need for procedures is particularly important, and emphasizes the need for a close follow‐up. Use of cystine SS measurements may allow closer monitoring of the effect of treatment on the risk of...

show abstract

Section: Discussionmentioning

confidence: 99%

Reduced renal function and benefits of treatment in cystinuria vs other forms of nephrolithiasis

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Other modalities include various combinations of treatments or chemolysis. [1][2][3][4] Full access to all the branches of a complex staghorn stone through a single track remains challenging because of the spatial anatomy of the calices, which form angles relative to each other. In this instance, we tested and make a case for a synchronous bidirectional technique combining the use of flexible instruments through the percutaneous and the retrograde approaches.…”

Section: Introductionmentioning

confidence: 99%

"Pass the Ball!" Simultaneous Flexible Nephroscopy and Retrograde Intrarenal Surgery for Large Residual Upper-Pole Staghorn Stone

Undre

Olsen

Mustafa

et al. 2004

Journal of Endourology

View full text Add to dashboard Cite

Complex staghorn calculi have conventionally been treated with percutaneous nephrolithotomy, extracorporeal lithotripsy, or, occasionally, open surgery. Access to branched calculi is difficult through a single percutaneous track. We tested and make a case for a synchronous bidirectional technique combining the use of flexible instruments through percutaneous and retrograde approaches. We present a case of "pass the ball," which may have a place in tackling large, complex, or branched staghorn calculi without the need for multiple percutaneous punctures, removing larger fragments than is possible through the ureter and avoiding multiple passes through the ureter, saving time and decreasing the possibility of iatrogenic ureteral injury.

show abstract

“…Acetylcysteïne kan alleen met de disulfidebinding reageren wanneer het direct ter plaatse van de cystinestenen wordt toegediend. Chemolitholyse met acetylcysteïne (1-2 % in natriumbicarbonaat) is beschreven in meerdere studies [3][4][5][6][7][8][9][10]. Er is geen algemene consensus over de optimale dosering.…”

Section: Discussieunclassified

Chemolitholyse: een vergeten optie voor de behandeling van cystine stenen

2016

View full text Add to dashboard Cite

Samenvatting Een adolescente jongen met persisterende cystinestenen in de hoge urinewegen werd succesvol behandeld met chemolitholyse. Wij beschrijven een casus en presenteren een overzicht van de situaties waarin percutane chemolitholyse als behandeling kan worden toegepast. Trefwoorden urolithiasis • cystinurie • chemolitholyse • percutaan Chemolitholysis: a forgotten approach in the management of cystine stones Abstract An adolescent boy with persistent cystine stones in the upper urinary tract was successfully treated with chemolitholysis. We describe the case and provide an overview of the potential use of percutaneous chemolitholysis. Keywords urolithiasis • cystinuria • chemolitholysis • percutaneous Introductie Cystinestenen komen voor bij circa 3-8 % van alle kinderen met urolithiasis in Europa [1]. De behandeling van urolidrs.

show abstract

Treatment of Cystine Stones: Combined Approach using open Pyelolithotomy, Percutaneous Pyelolithotripsy, Extracorporeal Shock Wave Lithotripsy and Chemolysis

Cited by 9 publications

References 15 publications

Reduced renal function and benefits of treatment in cystinuria vs other forms of nephrolithiasis

Reduced renal function and benefits of treatment in cystinuria vs other forms of nephrolithiasis

"Pass the Ball!" Simultaneous Flexible Nephroscopy and Retrograde Intrarenal Surgery for Large Residual Upper-Pole Staghorn Stone

Chemolitholyse: een vergeten optie voor de behandeling van cystine stenen

Contact Info

Product

Resources

About