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1
Kim, Myung Ki, Jae Hyung You, and Young Gon Kim. "Flexible ureteroscopic renal stone extraction during laparoscopic ureterolithotomy in patients with large upper ureteral stone and small renal stones." Canadian Urological Association Journal 8, no. 9-10 (September 9, 2014): 591. http://dx.doi.org/10.5489/cuaj.1806.
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Introduction: We describe laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy. We describe its efficacy through a laparoscopic port and a ureterotomy site in patients with large upper ureteral stone and small renal stones.Methods: Between January 2009 and February 2012, we performed laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy in 11 patients who had upper ureteral and renal stones. The retroperitoneal approaches were used in all patients using 3-4 trocars.Results: All procedures were performed successfully without significant complications. Mean operative time was 78.5 minutes (range: 52-114 minutes). The mean size of ureteral stone was 19.91 mm (range: 15-25 mm). In addition, 25 renal stones (mean size 7.48 mm, range: 2-12 mm) were removed from 11 patients. The mean length of hospital stay was 3.5 days (range: 2-6 days).Conclusions: Laparoscopic ureterolithotomy with renal stone extraction using a stone basket under flexible ureteroscopy can be considered one of treatment modalities for patients with large upper ureteral stones accompanied by renal stones who are indicated in laparoscopic ureterolithotomy.
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Hasnain, Muhammad Ali Zul, Malik Muhammad Khalid, Saima Perveen, and Saima Perveen. "RENAL COLIC PATIENT." Professional Medical Journal 22, no. 01 (January 10, 2015): 040–48. http://dx.doi.org/10.29309/tpmj/2015.22.01.1410.
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Objectives: To compare Un-enhanced Helical Computed Tomography (UHCT),Ultrasonography (US) + Plain X-Ray and Intravenous Urography (IVU) in the evaluation ofpatients with suspected renal colic. Subjects: In 70 patients with renal colic US, plain X-ray,IVU and UHCT were performed to demonstrate urinary stones and other relevant pathologies.Patients were then followed-up to stone passage or removal, and the course of clinicalsymptoms were noted. Results: 57 patients had ureteral stones based on stone passageor removal. 13 patients did not have ureteral stones based on failure to recover a stone,disappearance of symptoms, and diagnosis unrelated to stone disease. Un-enhanced helicalcomputed tomography was found to be the most useful method in the demonstration of ureteralstones with a sensitivity of 97%. Reformatted images clearly depicted the intraureteral locationof stones in most cases. Spiral UHCT showed renal calculi in 15 patients, USG + KUB in 12 andIVU in 9 patients. Conclusions: Non-contrast axial and reformatted spiral CT (UHCT) imageswere found superior to USG + KUB and IVU in the depiction of ureteral and renal calculi.Reformatted images offer a good alternative to IVU in problematic cases.
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Cakıroglu, Basri, Akif Nuri Dogan, Tuncay Tas, Ramazan Gozukucuk, and Bekir Sami Uyanik. "A Case of Recurrent Renal Aluminum Hydroxide Stone." Case Reports in Urology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/212314.
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Renal stone disease is characterized by the differences depending on the age, gender, and the geographic location of the patients. Seventy-five percent of the renal stone components is the calcium (Ca). The most common type of the stones is the Ca oxalate stones, while Ca phosphate, uric acid, struvite, and sistine stones are more rarely reported. Other than these types, triamterene, adenosine, silica, indinavir, and ephedrine stones are also reported in the literature as case reports. However, to the best of our knowledge, aluminum hydroxide stones was not reported reported before. Herein we will report a 38-years-old woman with the history of recurrent renal colic disease whose renal stone was determined as aluminum hydroxide stone in type. Aluminum mineral may be considered in the formation of kidney stones as it is widely used in the field of healthcare and cosmetics.
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Kakizaki, Hidehiro, Katsuya Nonomura, Tomohiko Koyanagi, Masami Nantani, Kotaro Taniguchi, and Tadashi Matsuno. "Endourological Evaluation and Management of Leukoplakia of the Renal Pelvis." Diagnostic and Therapeutic Endoscopy 2, no. 3 (January 1, 1996): 167–74. http://dx.doi.org/10.1155/dte.2.167.
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Since August 1989, we have seen 4 patients with leukoplakia of the renal pelvis associated with a longstanding renal stone. In 2 of them, excretory or retrograde pyelography revealed multiple filling defects in the left renal pelvis as well as a renal stone, although urine cytological examination was negative. One of the other 2 patients underwent extracorporeal shock wave lithotripsy (ESWL) for the renal stone, but this was not followed by the passage of stone fragments. The renal stone in the remaining patient was associated with staghorn calculi. For stone extraction as well as endoscopic evaluation of the intrapelvic lesion, percutaneous nephroscopy was performed. A small to large amount of tissue-like white debris in sheets characteristic of leukoplakia was found in the renal pelvis with stones embedded in it and was removed directly by forceps or suction and then by irrigating with saline. We propose that 1) the endourological approach should be recommended for patients with renal pelvic lesions associated with longstanding renal stones or for patients who show difficulty in passing stone fragments after ESWL and 2) this entity of leukoplakia should be kept in mind for the differential diagnosis of renal pelvic lesions associated with renal stones.
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Kaya, Coskun, Yurdaer Kaynak, Aral Karabag, and Aykut Aykaç. "The Predictive Role of Abdominal Fat Parameters and Stone Density on SWL Outcomes." Current Medical Imaging Formerly Current Medical Imaging Reviews 16, no. 1 (January 6, 2020): 80–87. http://dx.doi.org/10.2174/1573405614666180927112127.
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Background: Our aim was to detect the role of radiological abdominal fat parameters by tomography and stone density by plain X-ray on extracorporeal Shock Wave Lithotripsy (SWL) stone-free rate. Methods: The patients who had undergone SWL for a single opaque renal stone < 2 cm in diameter and proximal ureteric stone < 1 cm in diameter were collected retrospectively. The characteristics of patients and stones were recorded. The stone attitude, HU, abdominal fat parameters, paraperirenal fat area, perirenal infiltration and severity of hydronephrosis with pre-treatment Non- Contrast Computed Tomography (NCCT) and stone density with radiography were evaluated by a radiologist. Four weeks after the last SWL; all patients were evaluated by plain X-ray and categorized as Stone Free (SF) and Residual Fragment (RF) group. Results: 51 patients with renal stones and 88 patients with proximal ureteral stones were included in the study. 24 (47%) and 63 (71%) patients were classified as SFfor renal and ureteral stones respectively. Only stone size was an independent predictor for stone-free rates after SWL for renal and proximal ureteral stones on multivariate analysis. The Receiver Operating Characteristic (ROC) curves for renal calculi revealed that creatinine level, stone size, stone attitude, Houns-Field Unit (HU) and Skin-to-Stone Distance (SSD) were the predictive factors for the SWL outcome (p< 0.05). The ROC curve for ureteral calculi demonstrated that HU, stone size and attitude were the predictive factors (p< 0.05). Conclusion: All abdominal fat parameters and the stone density were not related to SWL failure. A large follow-up with more patients is essential to confirm the role of radiological parameters on the outcome of SWL.
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El-Assmy, Ahmed, Ahmed R. El-Nahas, Mohamed E. Abo-Elghar, Ibrahim Eraky, Mahmoud R. El-Kenawy, and Khaled Z. Sheir. "Predictors of Success after Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Calculi Between 20—30 mm: A Multivariate Analysis Model." Scientific World JOURNAL 6 (2006): 2388–95. http://dx.doi.org/10.1100/tsw.2006.370.
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The first-line management of renal stones between 20—30 mm remains controversial. The Extracorporeal Shock Wave Lithotripsy (ESWL) stone-free rates for such patient groups vary widely. The purpose of this study was to define factors that have a significant impact on the stone-free rate after ESWL in such controversial groups. Between January 1990 and January 2004, 594 patients with renal stones 20—30 mm in length underwent ESWL monotherapy. Stone surface area was measured for all stones. The results of treatment were evaluated after 3 months of follow-up. The stone-free rate was correlated with stone and patient characteristics using the Chi-square test; factors found to be significant were further analyzed using multivariate analysis.Repeat ESWL was needed in 56.9% of cases. Post-ESWL complications occurred in 5% of cases and post-ESWL secondary procedures were required in 5.9%. At 3-month follow-up, the overall stone-free rate was 77.2%. Using the Chi-square test, stone surface area, location, number, radiological renal picture, and congenital renal anomalies had a significant impact on the stone-free rate. Multivariate analysis excluded radiological renal picture from the logistic regression model while other factors maintained their statistically significant effect on success rate, indicating that they were independent predictors. A regression analysis model was designed to estimate the probability of stone-free status after ESWL. The sensitivity of the model was 97.4%, the specificity 90%, and the overall accuracy 95.6%.Stone surface area, location, number, and congenital renal anomalies are prognostic predictors determining stone clearance after ESWL of renal calculi of 20—30 mm. High probability of stone clearance is obtained with single stone ≤400 mm2 located in renal pelvis with no congenital anomalies. Our regression model can predict the probability of the success of ESWL in such controversial groups and can define patients who would need other treatment modality.
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Kati, Bulent, Ergin Kalkan, Eyyup Sabri Pelit, Ismail Yagmur, and Halil Çiftçi. "Do dental calculi predict the presence of renal stones?" Archivio Italiano di Urologia e Andrologia 90, no. 3 (September 30, 2018): 159–62. http://dx.doi.org/10.4081/aiua.2018.3.159.
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Objective: Pathological calcifications that occur in various parts of the body may cause stone formation over time. The structure of these stones is similar in many regions of the body. We have studied the relationship between dental calculi and kidney stones. Material and methods: A total of 183 patients with dental stone complaints or dental calculi were included between April and August 2016 in the Cagri Dental Hospital, Elazig, Turkey. Patients were evaluated with regard to a urinary tract ultrasonography, urinalysis, oral hygiene, and stone and surgical disease history. All information was statistically investigated. Results: The age of the patients in the kidney stones group was significantly higher than the non-kidney stone patients (p < 0.05). In the group with kidney stones, the percentage of dental calculus formation was significantly higher than the group without stones (p < 0.05). In the groups with and without kidney stones, dental stone recurrence rates did not differ significantly (p < 0.05). Urinary pH was significantly lower in the group with stones than the group without stones (p < 0.05). Conclusions: During a physical examination, the formation of a visible stone, such as a dental calculus, may be an indicator of other types of stones, such as kidney stones, and this should be further investigated.
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Joshi, HN, Rm Karmacharya, R. Shrestha, B. Shrestha, IJ De Jong, and RKM Shrestha. "Outcomes of Extra Corporeal Shock Wave Lithotripsy in Renal and Ureteral Calculi." Kathmandu University Medical Journal 12, no. 1 (October 12, 2015): 51–54. http://dx.doi.org/10.3126/kumj.v12i1.13639.
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Background Since the introduction in early 1980s, Extracorporeal Shockwave Lithotripsy (ESWL) became the accepted first line treatment modality for renal and upper ureteric stones. It is simple, safe and effective noninvasive procedure which can be performed without anaesthesia in outpatient basis. The objective of this study was to determine the efficacy of ESWL to achieve complete stone clearance in the patients with different sizes of renal and upper ureteric stones.Objective The aim of this study was to assess the outcome, efficacy and complications of ESWL in the treatment for renal and ureteric stones in terms of the site and the size of the stone in the patients presented at Dhulikhel Hospital Kathmandu University Hospital.Method In this prospective study a total of 430 (214 renal and 216 ureteric) cases of urinary stone disease in 257 male and 173 female patients treated by ESWL at Dhulikhel Hospital, Kathmandu University Teaching Hospital during time period of May 2010 to June 2012 were included. Data of patients with renal and ureteric stones were evaluated for stone site, size, and number of sessions. Data were analyzed using spss 13.0.Result Out of 430 cases, the overall stone free rate in after 1st session was 341 (79.3%) at one month and in three months follow up (3 sessions) it was increased up to 414 (96.3%). In 16 (3.7%) patients treatment was failed. Average size of the stone was 12.24 (SD± 3.65) mm.Stone free rate was 154 (72%) in the case of renal and 187 (86.6%) in the case of ureteric stones in first session. In three months follow up (three sessions) it was 204 (95.4%) and 210 (97.2%) respectively for renal and ureteric stones. In relation to size the stone free rate in <10mm, 10-15mm and > 15mm was 97%, 97% and 90%.Conclusion ESWL is the first line preferred choice for renal and upper ureteric stones which provides the maximum stone free rate in the case of stone size smaller than 1.5cm.Kathmandu University Medical Journal Vol.12(1) 2014: 51-54
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Hossain, TMS, M. Asaduzzaman, MN Uddin, MH Rahman, MU Jahan, and AKMZI Bhuiyan. "Percutaneous nephrolithotomy-a versatile technique for both simple and complex renal stone." Bangladesh Medical Research Council Bulletin 39, no. 3 (September 4, 2014): 99–103. http://dx.doi.org/10.3329/bmrcb.v39i3.20308.
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Percutaneous Nephrolithotomy is currently the preferred first line treatment for simple & complex renal calculi. The technique also being used increasingly for smaller stones that have failed ESWL. Aim of the study is to share our experience in PCNL in course of time. This study was conducted from January 2009 to December 2012, 131 patients with 142 renal units of 5-75 yrs of age, PCNL were performed in NIKDU, BSMMU & JBFH. Stone were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete staghorn stones, renal pelvic stone with accompanying calyceal stones). The stone size was 1.5-5cm approximately. We asses our initial puncture technique, need for multi-tract, supra 12th rib access, stone free rate, operative duration, postoperative complication, number of transfusion and hospital stay. Operative durations were 60 min -180 minutes. Puncture technique improved in course of time. 14 patients need multi-puncture and tract, all are supra 12th access. Out of 142 renal units 120 (83%) were stone free after first procedure, another 22 need and auxiliary procedure, (5 2nd look PCNL, 6 URS, 11 ESWL) to become stone free result in a 95% stone free rate. Complications occurred in 17 procedures which dealt accordingly. This study revealed PCNL is an effective, versatile safe and cosmetically acceptable procedure for all age groups in simple and complex renal stone. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20308 Bangladesh Med Res Counc Bull 2013; 39: 99-103
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Naznin, Lubna, Debashish Saha, Md Jahangir Chowdhury, Yasmin Akter, Most Sarmin Sultana, and Ashif Chowdhury. "Composition of Renal Stone– An experience at Armed Forces Institute of Pathology." Journal of Armed Forces Medical College, Bangladesh 12, no. 2 (December 1, 2016): 21–25. http://dx.doi.org/10.3329/jafmc.v12i2.41080.
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Introduction: In Asia the stone belt has been reported to stretch across our neighbouring countries Pakistan, India, Myanmar etc signifies a higher incidence of renal stone disease in Bangladesh.
Objective: To determine the pattern of chemical composition of renal stones by semi-quantitative technique in patients presented to Armed Forces Institute of Pathology (AFIP) and to evaluate the predominant constituent present in them.
Materials and Methods: This descriptive study was conducted at Armed Forces Institute of Pathology (AFIP), Chemical pathology department from October 2013 to October 2014. Renal stones of 37 Urolithiasis patients were analyzed chemically, using DiaSys analysis kit, employing titrimetric method for estimation of calcium and colorimetric method for Oxalate, Ammonium, Phosphate, Magnesium, Uric Acid and Cystine. Concentration of each individual component then was expressed in percentage and used to interpret renal stone composition using the calculation scale.
Results: Males were more prone to renal stone disease, having male to female ratio 5.2:1. Urinary stones occur in all age groups, in this study age ranged from 4 to 72 years with mean age 38.8±16.0 years and mostly affected was the working age group 21 to 50 years (70.2%). Mixed components (i.e. mixed stone) rather than a single component was the commonest type constituting 83.8% of all renal stones. The commonest mixed stone found was Calcium Oxalate with Apatite (41.9 %). Pure Calcium Oxalate was the 2nd most common (10.8%) variant followed by Struvite stones (5.4%). Cystine and Brushite were the least common renal stones in this study.
Conclusion: Calcium Oxalate was the most predominant chemical component in renal stones (94.6%). More research is needed to assess the frequency, types, and correlation of renal stones with environmental, dietary and genetic factors in Bangladesh.
Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 21-25
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Mobilio, G., G. Bianchi, G. Malossini, P. Beltrami, and G. Carluccio. "Staghorn renal stone: Which therapeutic strategy?" Urologia Journal 59, no. 3 (June 1992): 53–55. http://dx.doi.org/10.1177/039156039205900310.
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We report our experience in the treatment of renal staghorn stones. 74 patients were treated with PCNL followed, when necessary, by one or more ESWL treatments for residual fragments, achieving a stone-free status in 64/74 patients (86.5%). Treatment with ESWL monotherapy (6 cases) resulted in a stone-free status in 3 patients (50%). According to our experience, PCNL followed by ESWL, is the most adequate treatment for staghorn kidney stones. We reserve PCNL with multiple percutaneous access and ESWL monotherapy for selected patients.
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Merchant, Michael L., Timothy D. Cummins, Daniel W. Wilkey, Sarah A. Salyer, David W. Powell, Jon B. Klein, and Eleanor D. Lederer. "Proteomic analysis of renal calculi indicates an important role for inflammatory processes in calcium stone formation." American Journal of Physiology-Renal Physiology 295, no. 4 (October 2008): F1254—F1258. http://dx.doi.org/10.1152/ajprenal.00134.2008.
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Even though renal stones/calculi occur in ∼10% of individuals, they are an enormous economic burden to the entire US health system. While the relative metabolic composition of renal calculi is generally known, there is no clear understanding of the genetics of renal stone formation, nor are there clear prognostic indicators of renal stone formation. The application of proteomics to the analysis of renal calculi axiomatically holds that insight into renal stone pathobiology can be gained by a more comprehensive understanding of renal calculus protein composition. We analyzed isolated renal stone matrix proteins with mass spectrometric and immunohistochemical methods identifying 158 proteins with high confidence, including 28 common proteins. The abundant proteins included those identified previously in stones and proteins identified here for the first time, such as myeloid lineage-specific, integral membrane and lipid regulatory proteins. Pathway analyses of all proteins identified suggested that a significant fraction of the most abundant matrix proteins participate in inflammatory processes. These proteomic results support the hypothesis that stone formation induces a cellular inflammatory response and the protein components of this response contribute to the abundant stone matrix proteome.
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Öhman, Sten, Lasse Larsson, and Hans-Göran Tiselius. "Clinical Significance of Phosphate in Calcium Oxalate Renal Stones." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 29, no. 1 (January 1992): 59–63. http://dx.doi.org/10.1177/000456329202900108.
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We analysed calcium, magnesium, oxalate, citrate, urate and creatinine in urine and calculated risk factors in patients who had formed stones composed of calcium oxalate, and calcium phosphate, alone or as a mixture. Patients producing pure calcium oxalate stones (< 0·1% phosphate) had a higher oxalate, and lower calcium excretion than stone-free subjects and patients forming other stone types. In contrast, patients producing calcium oxalate stones containing phosphate, even in trace amounts (> 0·1%) had no increase in oxalate excretion, but a higher calcium excretion than stone-free subjects. We could not correlate any computed variable (e.g. AP(CaOx) index) to stone composition. We conclude that pure CaOx stones may be the result of a high oxalate excretion, and that other calcium containing stones may have another and probably more complex aetiology, including primary precipitation of calcium phosphates.
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Subramonian, Subiksha, Somasundari Gopalakrishnan, and Yuko Smith. "Trends in Renal Stone Clearance after Ureteroscopy: A Review." Journal of Endoluminal Endourology 2, no. 4 (December 23, 2019): e44-e50. http://dx.doi.org/10.22374/jeleu.v2i4.72.
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Background and ObjectivesStone clearance rate in ureteroscopy has varied over the years. This study aims to review the stone clear-ance rate over the last 25 years and assess the change over time. We have analyzed the reasons for the peaks and troughs in stone clearance rate to see if it correlates with any factors such as the introduction of new technology like the holmium laser, flexible ureteroscopy, access sheaths, and digital ureteroscopy. Material and MethodsWe performed a PubMed search (August 2019) for papers including the terms “lithiasis”, “stone clear-ance”, “calculi”, “kidney stone”, “ureteric stone”, “ureteroscopy”, “holmium laser”, “retrorenal surgery” in their title and published between the years 1994 and 2019. The stone size, stone clearance rate and mode of imaging to determine clearance rates were recorded. For data analysis, only prospective studies with a minimum of 50 patients and ureteroscopy arm of prospective randomized controlled trials were included. ResultsWe reviewed 16 papers with a total of 1,689 patients with renal stones. Average stone clearance was 80% and the median stone size was 11.0mm. Stone clearance was determined by either: Computed tomography (CT) scan (8 studies), x-ray alone (3 studies), x-ray and ultrasound (3 studies) or not mentioned (2 studies). CT scan yielded lower stone clearance rates than x-ray due to the increased detail shown on CT. For studies that used absolute clearance with no residual stones, average clearance was 52%, and this stone clearance rate increased as the cut-off size used to determine the stone-free rate was increased.ConclusionThis study highlights that stone clearance rate after ureteroscopy varies significantly amongst different pa-pers because of the stone size used to define ‘stone-free rate’ and the method of imaging used to determine stone clearance. The study also shows that stone clearance rates have not improved significantly over time, despite the introduction of advances in technology.
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Somani, Rushabhkumar C., and Chirag K. Sangada. "Study of the safety and efficacy of minimally invasive percutaneous nephrolithotomy in the management of large and complex renal stone." International Surgery Journal 7, no. 3 (February 26, 2020): 725. http://dx.doi.org/10.18203/2349-2902.isj20200812.
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Background: Nephrolithiasis is highly prevalent across all demographic groups in the india and beyond, and its incidence rates are rising. In addition to the morbidity of the acute event, stone disease often becomes a lifelong problem that requires preventative therapy to diminish ongoing morbidity. Objective of this study to evaluate the safety and efficacy of minimally invasive percutaneous nephrolithotomy (PCNL) in the management of large and complex renal stone.Methods: This retrospective study includes 75 renal calculi patients with 100 renal units with large and complicated stone >20 mm. Stones were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete stag horn stones, renal pelvis stones with accompanying calyceal stones). Then various parameter like decrease haemoglobin, surgical complication, creatinine level, duration of surgery etc were compared between simple and complex stones patients by calculation p value using online student t test calculator. P value less than 0.01 considered as a difference of significance.Results: The mean stone size was 35.5±20.37 mm and mean operative duration was 60±35.3 min. In all, cases 60 (80%) were stone-free after the first procedure and another 10 needed an auxiliary procedure (5 second-look PCNL, 3 extracorporeal shockwave lithotripsy-ESWL, 2 ureterorenoscopy, and) to become stone-free, resulting in a 93.33% stone-free rate. Complications occurred in 9 procedures (12%).Conclusions: From this study, it would be concluded that Minimally invasive PCNL provided significantly higher stone-free rate and efficiency quotient for management of urinary calculi. Overall complications are usually observed in patients having intraoperative hypotension and increased intra operative time.
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Sapkota, Prakash, Y. B. Tambey, Sunil Thapa, and Rajan Shakya. "Initial Experience of Percutaneous Nephrolithotomy at Lumbini Medical College." Journal of Lumbini Medical College 1, no. 1 (June 30, 2013): 35. http://dx.doi.org/10.22502/jlmc.v1i1.11.
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Introduction: Renal stone disease is a challenging problem in urologic practice especially in our locality because of large stone burden and recurrence. Since ,the early 1980s when percutaneous nephrolithotomy (PCNL) was established for management of renal stones, open surgical procedures have virtually been replaced. PCNL is a safe, effective and minimally invasive approach compared to open surgery for patients with large single, multiple or staghorn stones. The aim of this prospective study was to evaluate and to review our experience with PCNL in management of renal and upper ureteric stones.
Methods: Prospective study carried out at Lumbini Medical College and Teaching Hospital during 1stJanuary 2011 to 31st October 2011. Sixty patients were evaluated and subjected to PCNL. After clinical investigations like ultrasonography (USG) and intravenous urography (IVU), once patients were found to have renal or upper ureteric stones they were informed and explained about PCNL, its likely complications, probable hospital stay, the cost of treatment and data were recorded along with the operative time, estimated blood loss, stone burden, stone-free rate, length of hospitalization and complications .Patients were followed up after three months to rule out recurrence of stones by plain abdominal x-ray of kidney, ureter and bladder and USG.
Results: Out of 60 patients 35 were male and 25 were female (M: F=1.4:1) with mean age of 37 years and were subjected to PCNL monotherapy. With the average stone size of 3.26cm, the mean operative time was 78 minutes. Complete stone removal achieved by PCNL alone in 60 cases, with insignificant residual small stones we achieved 97% stone clearance rate. The mean hospital stay was 3.7 days. No Serious complications were encountered, 9 (15%) patients required blood transfusion and 3 (5%) patients developed transient post-operative pyrexia.
Conclusion: PCNL is the first line treatment option for management of large renal stones which as monotherapy has advantages in removal of renal and upper ureteric stones and achieving excellent results with minimal morbidity.
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Meher, Shireen, Norma Gibbons, and Ranan DasGupta. "Renal stones in pregnancy." Obstetric Medicine 7, no. 3 (June 16, 2014): 103–10. http://dx.doi.org/10.1177/1753495x14538422.
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Diagnosis and treatment of renal stones during pregnancy is a complex problem. Risks to the fetus from ionising radiation and interventional procedures need to be balanced with optimising clinical care for the mother. Management of such patients requires a clear understanding of available options, with a multidisciplinary team approach. In this review, we discuss the role of different diagnostic tests including ultrasound, magnetic resonance urography, and computerized tomography. We also provide an update on recent developments in the treatment of renal stones during pregnancy. Expectant management remains first-line treatment. Where definitive treatment of the stone is required, new evidence suggests that ureteroscopic stone removal may be equally safe, and possibly better than traditional temporising procedures.
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Celik, Orcun, Tufan Suelozgen, Salih Budak, and Yusuf Ozlem Ilbey. "Post-renal acute renal failure due to a huge bladder stone." Archivio Italiano di Urologia e Andrologia 86, no. 2 (June 30, 2014): 146. http://dx.doi.org/10.4081/aiua.2014.2.146.
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A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.
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Diri, Akif, Tolga Karakan, Mustafa Resorlu, Mucahit Kabar, and Cankon Germiyanoglu. "Intraperitoneal stone migration during percutaneos nephrolithotomy." Archivio Italiano di Urologia e Andrologia 86, no. 4 (December 30, 2014): 293. http://dx.doi.org/10.4081/aiua.2014.4.293.
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Percutaneos nephrolithotomy (PNL) is the standard care for renal stones larger than 2 cm. The procedure has some major and minor complications. Renal pelvis laceration and stone migration to the retroperitoneum is one of the rare condition. We report the first case of intraperitoneal stone migration during PNL.
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Cobley, Jonathan, Yih Chyn Phan, and Wasim Mahmalji. "Matrix Stone Occupying an Entire Renal Collecting System: A Case Report and Video of Diagnostic Ureterorenoscopy." Case Reports in Urology 2018 (2018): 1–3. http://dx.doi.org/10.1155/2018/5892438.
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Renal matrix stones are a rare phenomenon and they present a diagnostic challenge due to their atypical radiological appearances in comparison to more commonly encountered renal tract calculi. We describe a case of known stone former presenting with loin pain and recurrent urinary tract infections who was diagnosed with a matrix stone. The video of the diagnostic flexiureterorenoscopy demonstrating the matrix stone occupying almost the entire right renal collecting system is also presented.
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Streem, S. B. "Renal Stone Disease." Cleveland Clinic Journal of Medicine 52, no. 1 (March 1, 1985): 1. http://dx.doi.org/10.3949/ccjm.52.1.1.
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Bahn, DK, RK Brown, AA Reidinger, PA Duhamel, KY Shei, H. Gontina, and RM Brenner. "Renal stone ileus." American Journal of Roentgenology 150, no. 1 (January 1988): 145–46. http://dx.doi.org/10.2214/ajr.150.1.145.
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Pal, Raj P., and J. Kilian Mellon. "Renal stone disease." Foundation Years 4, no. 5 (September 2008): 199–203. http://dx.doi.org/10.1016/j.mpfou.2008.06.025.
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Ajayi, Leye, Philippe Jaeger, William Robertson, and Robert Unwin. "Renal stone disease." Medicine 35, no. 8 (August 2007): 415–19. http://dx.doi.org/10.1016/j.mpmed.2007.05.014.
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Johri, Nikhil, Philippe Jaeger, William Robertson, Simon Choong, and Robert Unwin. "Renal stone disease." Medicine 39, no. 7 (July 2011): 371–77. http://dx.doi.org/10.1016/j.mpmed.2011.04.005.
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Ferraro, Pietro M., William Robertson, and Robert Unwin. "Renal stone disease." Medicine 43, no. 8 (August 2015): 427–30. http://dx.doi.org/10.1016/j.mpmed.2015.05.003.
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Ferraro, Pietro Manuel, William Robertson, and Robert Unwin. "Renal stone disease." Medicine 47, no. 9 (September 2019): 537–40. http://dx.doi.org/10.1016/j.mpmed.2019.06.006.
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Sayer, John A. "Renal Stone Disease." Nephron Physiology 118, no. 1 (2011): p35—p44. http://dx.doi.org/10.1159/000320902.
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Smith, Charles L. "Renal stone analysis." Current Opinion in Nephrology and Hypertension 7, no. 6 (November 1998): 703–10. http://dx.doi.org/10.1097/00041552-199811000-00014.
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McKay, C. P. "Renal Stone Disease." Pediatrics in Review 31, no. 5 (April 30, 2010): 179–88. http://dx.doi.org/10.1542/pir.31-5-179.
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Tonyali, Senol, and Ahmet M. Aydin. "Evaluation of Deceased Kidney Donors for Renal Stone Disease: Is Computed Tomography Needed?" Current Urology 11, no. 3 (2017): 113–16. http://dx.doi.org/10.1159/000447204.
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Objective: To investigate the clinical consequences of neglected risk of urolithiasis in deceased kidney donors in routine clinical practice, this study focused on different management options for transplanted allograft stones, and tried to find new solutions for more accurate detection of urolithiasis in deceased kidney donors prior to renal transplantation. Methods and Results: The overall prevalence of stone disease in endemic countries is between 7 and 29%. Because of the increased risk for stone disease in epidemic countries, screening renal grafts from deceased donors necessitates more sensitive imaging tests. Despite well established procedures on preoperative living related renal donor evaluation, there is no consensus on a preoperative imaging tool in cadaveric renal donor evaluation. The most commonly used imaging modality in deceased renal donors is ultrasonography. The overall sensitivity and specificity of ultrasonography for kidney stones are 45 and 88%, respectively. Use of a computed tomography scan for renal diseases, especially for urinary stones is now almost a routine test in clinical practice. Its sensitivity for renal stones < 3 mm is 85%, whereas for renal stones > 3 mm it is 100%. Conclusion: The use of radiological modalities i.e. computed tomography with higher sensitivity in deceased donors prior to renal transplantation seems reasonable in urinary stone epidemic countries.
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Peco-Antic, Amira. "Pediatric renal stone disease." Srpski arhiv za celokupno lekarstvo 146, no. 3-4 (2018): 218–25. http://dx.doi.org/10.2298/sarh170711159p.
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Pediatric renal stone disease is manifested as nephro/urolithiasis (UL) and/or nephrocalcinosis (NC). Compared to adults, UL in childhood is less common, and it is believed to be around 5% in industrialized countries, while the incidence of NC is even lower except for critically ill premature infants in whom it may reach 64%. The formation of UL and NC is caused by increased concentration of relevant solutes, and their aggregations and adherence to the renal tubules cell is facilitated by factors such as urine pH, inability of natural crystallization inhibitors, stasis of urine as well as renal tubule damage. UL is associated with significant morbidity because of pains, susceptibility to urinary tract obstruction and infections, and the necessity of surgical procedures. NC is usually asymptomatic but is frequently progressive, and more often than UL, leads to chronic renal failure. Although other imaging modalities can be used in the diagnosis of renal stone disease, ultrasound has the least risk and is most cost-effective. The majority cases of UL and NC in children are of metabolic origin and thus they are prone to recurrence and may cause chronic renal damage. Therefore, they deserve, even after their initial presentation a detailed metabolic evaluation. Genetic source of renal stone disease is suspected in the following conditions: early onset, familial prevalence, familial consanguinity, multiple or recurrent stones, and NC. For all UL/NC etiologies early identification and personalized treatment of the basic disorder is the most important.
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Stansbridge, Elizabeth M., Damian G. Griffin, and Valerie Walker. "Who makes uric acid stones and why—observations from a renal stones clinic." Journal of Clinical Pathology 66, no. 5 (March 1, 2013): 426–31. http://dx.doi.org/10.1136/jclinpath-2012-201373.
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AimsExcessively acidic urine is the dominant factor in uric acid stone formation. Recent evidence implicating insulin resistance has revived interest in its causation. We reviewed data on uric acid stone formers attending a general stones clinic to find out whether this supports and adds to current concepts.MethodsA retrospective database study of 1504 stone formers investigated at the Southampton renal stones clinic from 1990 to March 2007. Uric acid stone formers and idiopathic calcium stone formers were compared using non-parametric tests.ResultsFifty-nine patients (3.9%; 43 men) had uric acid stones. In men the commonest associated conditions were diabetes (20%), gout (20%) and an ileostomy (15%); in women, diabetes (33%), urinary infections (27%) and hyperparathyroidism (20%). Most patients with diabetes (85% of men, 75% of women), however, produced calcium stones. Risk factors did not differ significantly between calcium and uric acid stone formers with diabetes, gout or ileostomies. The median urine pH of men with idiopathic calcium stones was 6.20, idiopathic uric acid stones 5.47, diabetes 5.68, gout 6.05, diabetes and gout 5.20 and ileostomy 5.10. Plasma urate was higher with gout and idiopathic uric acid stones. Urate excretion was increased in gout. Oxalate excretion was lower with idiopathic uric acid stones (new finding). Urine volume decreased and oxalate concentration increased with ileostomy.ConclusionsUric acid stones are increased in diabetes, but most patients with diabetes make calcium stones. Different mechanisms may explain low pH with diabetes, gout and idiopathic stones. Low oxalate excretion with idiopathic urate stones needs confirmation.
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Xu, Chen, Ri-jin Song, Min-jun Jiang, Chao Qin, Xiao-lan Wang, and Wei Zhang. "Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients." Urologia Internationalis 94, no. 1 (July 29, 2014): 93–98. http://dx.doi.org/10.1159/000365578.
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Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.
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Patel, Bhavisha Bhupendrabhai. "Herbal Alternative for Kidney Stone Diseases." Journal of Drug Delivery and Therapeutics 9, no. 4-s (August 15, 2019): 702–4. http://dx.doi.org/10.22270/jddt.v9i4-s.3245.
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Kidney stone disease is an increasing disorder of humans. It affects about 12% of the world population. Epidemiological data have shown that calcium oxalate is the predominant mineral in a majority of kidney stones. [1] It has been associated with an increased risk of end-stage renal failure. Kidney stones result from a succession of several physicochemical events including super saturation, nucleation, growth, aggregation, and retention within the kidneys. Kidney stones may cause extreme pain and blockage of urine flow .The average life time risk of stone formation has been reported in the range of 5-10 %.Recurrent stone formation is a common part of the medical care of patients with stone disease.[2] Kidney stone disease is usually treated with medications that may cause a number of side-effects. Even improved and besides the high cost that imposes, compelling data now suggest that exposure to shock waves in therapeutic doses may cause acute renal injury, decrease in renal function and an increase in stone recurrence. Data from in vitro, in vivo and clinical trials reveal that phytotherapeutic agents could be useful as either an alternative therapy in the management of urolithiasis. The present review therefore critically explains the potential usefulness of herbal medicines in the management of urolithiasis.
Keywords: Kidney stones, Calcium oxalate, Herbal plant extracts, Alternative medicine
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Hameed, Athar, and Khazir Hayyat Gondal. "Use of non-contrast computed tomography determined urinary stone fragility in predicting the outcome of extracorporeal shockwave lithotripsy treatment: a single-center study." Journal of Fatima Jinnah Medical University 14, no. 2 (July 15, 2020): 59–63. http://dx.doi.org/10.37018/xivf1000.
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Background: Renal stones represent a common urological pathology where standard treatment advised is ESWL in current practice. However, NCCT based determination of stone fragility may help to predict the outcome of ESWL treatment, hence optimizing its clinical use. Therefore, this study evaluated the role of NCCT determined urinary stone fragility in predicting the outcome of ESWL treatment in local clinical settings.
Patients and methods: One hundred patients with single renal calculus of 0.6-2 cm in size were included. NCCT based determination of stone fragility in HU units was done for all patients. Patients were then subjected to ESWL, with a maximum of 3000 shock waves given per ESWL session. Plain film and/or ultrasonography was used to monitor ESWL treatment progress with a final NCCT evaluation at 12 weeks to determine the clearance of the calculi for each patient. Association of NCCT based stone fragility and outcome of ESWL was statistically analyzed using Fisher exact test.
Results: The mean age of the patients was 37.7 ± 10.9 years with 54% being male. Decreasing stone fragility on NCCT (high = <500HU, moderate = 500-1000HU, and high = 1000HU) required more number and intensity of ESWL sessions (1-2 visits and 3000-6000 shock waves for high stone fragility group, 3-5 visits and 7000-18000 shock waves for the moderate group, and 6 visits and >18000 shock waves for low fragility group, respectively) necessary for clearance of urinary stones (p<0.001). In 98% of patients, the clearance of urinary stones was excellent.
Conclusion: Renal stone patients with NCCT determined high and moderate stone fragility show an optimal response after ESWL treatment, whereas, for low fragility renal stones attenuative treatment like percutaneous nephrolithotomy and/or ureteroscopy should be considered instead of ESWL. This approach can enable patient stratification before ESWL therapy ensuring better clinical management of the renal stone disease.
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Gervasoni, Jacopo, Aniello Primiano, Pietro Manuel Ferraro, Andrea Urbani, Giovanni Gambaro, and Silvia Persichilli. "Improvement of Urinary Stones Analysis Combining Morphological Analysis and Infrared Spectroscopy." Journal of Chemistry 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/4621256.
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Daudon et al. have developed a complex morphoconstitutional classification of renal stone in six different morphological types and several subtypes. According to this classification, a precise correspondence exists between causes of renal stones and subtypes with a great clinical relevance and can be considering a sort of shortcut for the metabolic diagnosis in renal stone patients. Now the diagnosis of causes of renal stones generally requires repeated biochemical investigations on urine and blood samples and usually remains presumptive. We analyzed 150 urinary stones both by stereoscopic microscopy and Fourier transform infrared spectroscopy. The comparison of 150 stones did not reveal any disagreement. We have only 20 partial agreement, and clinicians agreed that the imprecise information obtained with morphological analysis alone would have missed an important clinical finding only in 3 cases. In conclusion, in our opinion, the analysis of urinary stone must combine two different analytical techniques: morphological analysis by stereomicroscope and biochemical analysis with the FT-IR.
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Pattarawongpaiboon, Suppasek, and Manint Usawachintachit. "Predictive factors of stone-free status in renal stone treatment with flexible ureterorenoscopy." Insight Urology 42, no. 1 (June 1, 2021): 21–26. http://dx.doi.org/10.52786/isu.a.18.
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Objective: Flexible ureterorenoscopy (fURS) is one of the standard treatments for renal calculi up to 20 mm. This study aims to identify factors associated with stone-free status. Materials and Methods: We included patients undergoing fURS for treatment of small to medium-size renal stone (no single stone larger than 20 mm) from April 2017 to September 2019 at King Chulalongkorn Memorial Hospital. All patients had a preoperative CT scan and postoperative imaging for comparison. We collected patient characteristics (sex, age, previous ipsilateral urinary tract surgery, preoperative ureteral stent placement), stone factors (total stone burden, stone number, stone density) and renal factors (anatomical abnormalities, stone location in a lower pole, number of caliceal involvement) and correlated the data against postoperative stone-free status (defined as residual fragment ≤ 2 mm). Results: The overall stone-free rate was 53.3%. From the univariate analysis, previous surgery, total stone burden, stone number, stone location in the lower pole, and the number of caliceal involvement were associated with stone-free status. However, only the total stone burden remained statistically significant in the multivariate analysis (p-value < 0.05). The stone-free rates were 75.9%, 57.1%, and 11.1% in the total stone burden ≤ 10 mm, 11-20 mm, > 20 mm, respectively. Conclusion: Following treatment of renal stones ≤ 20 mm with fURS, the stone-free rate was 53.3% and was significantly associated with the preoperative total stone burden.
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Rakib, Md Abdur, Md Shahidul Islam, and SM Shameem Waheed. "Evaluation of Factors Influencing Outcome of Extracorporeal Shock Wave Lithotripsy (Eswl) for Renal Stone in Adult." Bangladesh Journal of Urology 22, no. 2 (November 3, 2020): 141–50. http://dx.doi.org/10.3329/bju.v22i2.50102.
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Background: Renal stone disease is a common disorder with a prevalence ranging from 4-15% in different parts of the world. Modalities of kidney stone management includes drug therapy, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), Retrograde intrarenal surgery ureteroscopy (RIRS) and open surgery. ESWL is an acceptable technique and widely used because it is a non-invasive treatment and does not require anesthesia and usually done on an outpatient basis. Generally, ESWL is the treatment of choice for kidney stones <1 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50%-87%, depending on various factors. This study was conducted in order to evaluate thefactors affecting renal stones treatment by extracorporeal shock wave lithotripsy (ESWL).On the basis of different variables andfactors affecting the renal stones treatment by ESWL was evaluated.
Objectives: To evaluate the factors affecting the outcome of Extracorporeal Shock Wave Lithotripsy (ESWL) in the treatment of renal stone in adults.To assess the success and failure rate by using ESWL for treatment of renal stone, to determine the effects of stone related factors to correlate the success rate with characteristics of the patients condition of the urinary tract and stone features; to observe the patient groups most likely to benefit from or fail an initial intervention with ESWL and to evaluate the post ESWL complications.
Materials and methods: This is a prospective observational and analytical, hospital based study. Total 500 patients with single or multiple radio-opaque renal stones were treated with ESWL monotherapy using Siemens MODULARIS Variostarlithotriptor. This study was carried out inthe Department of Urology, Combined Military Hospital, Dhaka for a period of two years between 01 July 2015 to 31 July 2017. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<3mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density).
Results: At 3-months follow-up, the overall success rate is 87.6%. Among them, repeated ESWL sessions were required in 266 patients (53.2%). Post-ESWL complications were recorded in 62 patients (12.4%). Using the chi-square test, only four factors have a significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (136/136; 100%) and lowest for those located in lower calyx 104/78; 75%) (p=0.001). Stone with a largest diameter of <10mm are associated with a success rate of 93.6% (307/328), compared to 76.2% (131/172) for those with a diameter of >10mm (p=0.001). The success rate was also higher for single stone (396/437; 90.6%) than multiple stones (42/63; 66.7%) (p=.001). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=.001). Other factors including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate.
Conclusion: The success rate of ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patients BMI.
Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.141-150
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Botti, C., R. Olmi, V. Bertoni, A. Filoni, B. Baisi, and P. Ferrari. "Indications and Percutaneous Treatment of Renal Staghorn Stones." Urologia Journal 65, no. 4 (August 1998): 540–42. http://dx.doi.org/10.1177/039156039806500413.
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The treatment of renal staghorn stones by PCN-monotherapy or PCN-debulking with subsequent ESWL is reported. From 1984 to 1997, 111 patients were treated for staghorn stones, 69 of whom had pyelitic stones involving one calyx only while more than one calyx was involved in the remaining 35 as follows: 32 simple (pyelic stone + 2 or more calyces involved) and 3 complex (all calyces involved). Of the 104 patients treated with PCN-monotherapy or combined with subsequent ESWL, 86 became stone-free (82.6%). Furthermore there were few complications, less morbidity and greater preservation of renal function compared to open surgery.
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Shrestha, Samir, and Pukar Maskey. "Outcomes of Retrograde Intra-Renal Surgery." Nepalese Medical Journal 2, no. 2 (December 17, 2019): 220–23. http://dx.doi.org/10.3126/nmj.v2i2.26478.
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Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.
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Rathee, Vazir Singh, Vivek HC, Sartaj Wali Khan, AK Singh, Pushpendra Kumar Shukla, Ashish Verma, Sameer Trivedi, and Udai Shankar Dwivedi. "Role of computed tomography morphodensitometry in predicting the outcome of shock wave lithotripsy." Journal of Clinical Urology 11, no. 5 (March 15, 2018): 325–30. http://dx.doi.org/10.1177/2051415818764539.
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Objectives: The objective of this study was to predict the outcome of shock wave lithotripsy (SWL) on the basis of computed tomography (CT) morphodensitometry for ureteral and renal stones. We also assessed the possibility that Hounsfield unit (HU) values and the location of the stones could be used to predict the outcome of SWL. Material and methods: A prospective study was performed to measure stone size, location, composition, surface area, surface volume, stone burden, the skin-to-stone distance and the HU for solitary renal and ureteral stones by non-contrast CT studies (NCCT) from August 2013 to September 2015. Success of SWL was defined as: (1) being stone-free or (2) residual stone fragments < 4 mm by radiography/NCCT. Results: Of the 100 assessed patients, 68 patients (68%) were stone-free, 12 (12%) had residual stone fragments < 4 mm (clinically insignificant residual fragments) and 20 (20%) had residual stone fragments ≥ 4 mm/ancillary procedures. Multivariate analysis revealed that stone location and mean HU were significant predictors of SWL success. Receiver operating characteristic curves defined cut-off values for predicting treatment outcome. Treatment success rates were significantly higher for stones < 800 HU than with stones > 800 HU ( p = 0.160). Conclusion: Evaluation of stone HU values and stone location prior to SWL can predict treatment outcome and aid in the development of treatment strategies. Level of evidence 2 & 4
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Ismail, Siti Fairus Che, Jamil Abdullah, Mohd Fadliyazid Ab Rahim, Mohammad Irsyadiee B. Mohd Saiful, and Roziana Ramli. "A successful delivery of giant bladder stone by obstetric forceps: a case report." International Surgery Journal 8, no. 5 (April 28, 2021): 1589. http://dx.doi.org/10.18203/2349-2902.isj20211835.
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Giant bladder stone is a rare phenomenon. Surgical treatment which involves open vesicolithotomy and delivery of the bladder stone is usually straightforward. Herein, we report a 69-year-old gentleman with a neglected giant bladder stone complicated by obstructive uropathy and acute renal failure. After medical condition was stabilized, he underwent open vesicolithotomy. At surgery, delivery of the giant bladder stone was difficult both manually and with stone forceps. The stone was later delivered successfully by Wrigley’s obstetrics forceps. We report this case to highlight the rare cause of acute renal failure and the use of obstetrics forceps in the management of giant bladder stones.
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Eissa, Ahmed, Maged Ragab, Giampoalo Bianchi, and Ayman Hassan. "Retrograde intrarenal surgery in the management of solitary large renal stones, 2-3 cm: a single center experience." International Surgery Journal 8, no. 3 (February 25, 2021): 939. http://dx.doi.org/10.18203/2349-2902.isj20210515.
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Background: Nephrolithiasis represents a major health burden worldwide. Several treatment options are available for renal stones such as open stone surgery, percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shockwave lithotripsy. PCNL is considered the gold standard treatment for large renal stones (>2 cm); however, it is associated with higher blood loss, complication rates, and longer hospitalization. In this setting, we aimed to assess the value of RIRS in the management of single large renal stones between 2-3 cm. Methods: The database of our center was reviewed to include all the patients who underwent RIRS for single large renal stone (2-3 cm) between February 2018 and April 2019. All the patients were evaluated by preoperative computed tomography to evaluate the stone size, site, and density. Furthermore, the following variables were also collected; pre- and post-operative hemoglobin and creatinine, the operative time, stone free rate (SFR), and duration of hospital stay. All the statistical analysis was performed using SPSS version 20.Results: Overall, the data of 31 patients were retrieved for the current study. The mean age of the patients was 56.9±12.9 years, and the mean stone size was 22.6±7 mm. The mean operative time was 96.4±37.3 minutes and the SFR was 74.2% after single session of RIRS. No major postoperative complications were reported in the current series.Conclusions: RIRS is a safe and efficient alternative to PCNL in the management of single renal stones between 2-3 cm; however, further prospective studies are required to confirm these findings.
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Geterud, K., Ch Henriksson, S. Pettersson, and B. F. Zachrisson. "Computed Tomography after Percutaneous Renal Stone Extraction." Acta Radiologica 28, no. 1 (January 1987): 55–58. http://dx.doi.org/10.1177/028418518702800111.
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Eighty patients were examined with computed tomography (CT) of the kidney and the retroperitoneal space after percutaneous stone extraction. Most examinations were done within a week after the operation. The morphologic changes were usually small or none. In 7 patients minor renal or perirenal fluid collections were found. Their operations had been complicated by bleeding or leakage. In 66 patients CT was compared with conventional radiographs. Residual stones were more often detected by CT. They were usually small. Percutaneous renal stone extraction is considered a safe and efficient method.
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Yaseen, Shukur Mahmood, Saad Ahmed Ali Jadoo, Ayad Aziz Abdullah, Anmar Shukur Mahmood, and Wassan Nasrat Abd Al-wahaab. "Predictive factors of successful extracorporeal shockwave lithotripsy (ESWL) for renal stones: evidence of retrospective study." Journal of Ideas in Health 2, no. 1 (May 17, 2019): 60–64. http://dx.doi.org/10.47108/jidhealth.vol2.iss1.11.
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Background:
Extracorporeal shockwave lithotripsy (ESWL) has proved to be effective in treating ureterolithiasis. This study aimed to investigate the predictive factors related to success ESWL among patient presented with renal stone.
Methods:
A retrospective study was conducted among 40 patients who underwent ESWL at the urology department, Baquba Teaching Hospital, Diyala University, Iraq. Data was collected between1st October 2018 and 31st January 2019 for renal stones diagnosed by non-enhanced spiral computed tomography (NCCT). The success rate defined as no stone or the remnant stones < 4 mm. We analyzed predictive factors by using multiple linear regression.
Results:
The success rates ranged from 50-90%. In the univariate analysis, body mass index (BMI), skin-to-stone distance (SSD)and the renal stone-attenuation value (in Hounsfield units, HU) were found to be significantly correlated with the outcome of ESWL (p<0.05). However, in the multiple linear regression, only the HU (B = -0.619, P < 0.0001; 95% confidence interval [CI]:0.03 to 0.07) was theindependent predictive factor.
Conclusion:
Hounsfield Unit is an independent predictive factor influencing the success of ESWL for treating renal stones.
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Qadri, Syed Javid F., Mufti Mahmood Ahmed, Zafar Saleem Khanday, and Asim Leharwaal. "Percutaneous nephrolithotomy for large renal stones in anomalous kidneys." International Surgery Journal 7, no. 12 (November 27, 2020): 3971. http://dx.doi.org/10.18203/2349-2902.isj20204967.
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Background: Percutaneous nephrolithotomy (PCNL) is an important surgical method for managing renal stones of any size. Anomalous kidneys pose additional technical challenge to the operating surgeon to perform PCNL in these anatomically abnormal kidneys especially if the stone load is large. The aim of this study is to present the efficacy and limitations of PCNL in managing stones >2 cm in size in anomalous kidneys.Methods: This was a retrospective single centre study of PCNL in anomalous kidneys with stones >2 cm in size.Results: 30 patients of kidney stones >2 cm underwent PCNL. Our series of patients included 19 (63.32%) cases of horseshoe kidneys, 9 (30%) malrotated kidneys, 1 (3.34%) pelvic and 1 (3.34%) crossed fused ectopia. We achieved complete stone clearance in 26 (86.67%) patients. Presence of staghorn calculus was the most important statistically significant factor limiting complete clearance.Conclusion: PCNL is an effective procedure for management of patients with large stones in anomalous kidneys. Appropriate preoperative evaluation especially imaging, appropriate selection of cases and most importantly excellent technical expertise is needed to achieve high stone clearance rates with minimal morbidity.
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Haque, Abul Hasanat Muhammad Afzalul, Md Waliul Islam, Humayun Kabir Kallol, Md Shaful Alam Babul, and Muhammad Habibur Rahman. "Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy." Bangladesh Medical Journal 46, no. 2 (February 14, 2019): 1–6. http://dx.doi.org/10.3329/bmj.v46i2.40214.
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ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors. This study was conducted to evaluate factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL). The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number and radio density). At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate. The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI.
Bangladesh Med J. 2017 May; 46 (2): 1-6
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Haque, Abul Hasanat Muhammad Afzalul, Md Waliul Islam, Humayun Kabir Kallol, Md Shaful Alam Babul, Muhammad Habibur Rahman, and Shafiqul Alam Chowdhury. "Factors Affecting the Success Rate of Renal Stone Treatment by Extracorporeal Shock Wave Lithotripsy." Journal of Dhaka Medical College 27, no. 1 (November 21, 2018): 72–78. http://dx.doi.org/10.3329/jdmc.v27i1.38950.
Full textAbstract:
ESWL is one of the treatment modalities for kidney stones smaller than 2 cm. However, not all ESWL treatments are successful. The success rate has been reported to be between 50% to 87%, depending on various factors.
Aim: This study was conducted to evaluate Factors affecting the success rate of renal stone treatment by extracorporeal shock wave lithotripsy (ESWL).
Materials and methods: The study was carried out for a period of one year where total 96 patients with single or multiple radio-opaque renal stones treated with ESWL monotherapy using Stortz Modulith SLX-F2 lithotriptor were included. The results of treatment were evaluated after 3 months of follow-up. Treatment success was defined as complete clearance of the stones or presence of clinically insignificant residual fragments (<4mm). The results of treatment were correlated with the patient characteristics (age, sex, body mass index) and stone features (size, site, number & radio density).
Results: At 3-months follow-up, the overall success rate was 76%. Among them, repeated ESWL sessions were required in 19 patients (53.9%). Post-ESWL complications were recorded in 8 patients (12.5%). Four factors had statistically significant impact on the success rate, namely stone site, size (the largest diameter of the stone), stone number, BMI (body mass index) of the patient. The success rate is highest for stones located in the upper calyx (26/26; 100%) and lowest for those located in lower calyx (15/20; 75%) (p=0.019). Stone with a largest diameter of <15mm are associated with a success rate of 93.6% (59/63), compared to 75.82% (25/33) for those with a diameter of >15mm (p=0.01). The success rate is also higher for single stone (76/ 84; 90.5%) than multiple stones (8/12; 66.7%) (p=0.02). Patients with lower BMI (<24) have a better success than higher BMI (>25) (p=0.001).Other factor including age, sex and stone radio density compared to ipsilateral 12th rib have no significant impact on the success rate.
Conclusion: The success rate for ESWL for the treatment of renal stones can be predicted by stone size, location, number, and patient BMI.
J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 72-78
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Dongol, Udaya Man Singh, and Yugal Limbu. "Safety and Efficacy of Percutaneous Nephrolithotomy in Children." Journal of Nepal Health Research Council 15, no. 2 (September 15, 2017): 130–34. http://dx.doi.org/10.3126/jnhrc.v15i2.18192.
Full textAbstract:
Background: Renal stone disease is a common problem in children in developing countries. Its prevalence in children varies from 5% to 15%. It is suggested that anatomic abnormalities, recurrent urinary tract infections, metabolic disturbances, dietary and environmental factors are the predisposing factors.The aim of this study is to evaluate the safety and efficacy of percutaneous nephrolithotomy in children.Methods: Between May 2012 and Dec 2016, 25 children with renal stone diseases underwent percutaneous nephrolithotomy and were evaluated for stone free rate, complications, blood transfusion rate, sandwich therapy, etc.Results: The mean age of children was 9.3 years (7-15 years) and the mean size of the stone was 20 mm (13-27 mm). The anatomical location of stone was important in terms of stone clearance. Three patients needed blood transfusion. The overall stone free rate was 88% before discharge. Three patients had residual stones and were treated with extracorporeal shockwave lithotripsy. Complications included fever, haematuria, ileus and urine leak. No major complications were noted. There were no significant differences in haemoglobin and creatinine levels before and 12 hours after the surgery.Conclusions: Percutaneous nephrolithotomy (PCNL) can be considered a safe, effective and feasible modality of treatment for children with an average of 2 cm sized renal stones.