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Veld, Joyce, Nadine van Huijgevoort, Marja Boermeester, Marc Besselink, Otto van Delden, Paul Fockens y Jeanin van Hooft. "A systematic review of advanced endoscopy-assisted lithotripsy for retained biliary tract stones: laser, electrohydraulic or extracorporeal shock wave". Endoscopy 50, n.º 09 (10 de julio de 2018): 896–909. http://dx.doi.org/10.1055/a-0637-8806.
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Abstract Background When conventional endoscopic treatment of bile duct stones is impossible or fails, advanced endoscopy-assisted lithotripsy can be performed by electrohydraulic lithotripsy (EHL), laser lithotripsy, or extracorporeal shock wave lithotripsy (ESWL). No systematic review has compared efficacy and safety between these techniques. Methods A systematic search was performed in PubMed, the Cochrane Library, and EMBASE for studies investigating EHL, laser lithotripsy, and ESWL in patients with retained biliary tract stones. Results After screening 795 studies, 32 studies with 1969 patients undergoing EHL (n = 277), laser lithotripsy (n = 426) or ESWL (n = 1266) were included. No randomized studies were available. Although each advanced lithotripsy technique appeared to be highly effective, laser lithotripsy had a higher complete ductal clearance rate (95.1 %) than EHL (88.4 %) and ESWL (84.5 %; P < 0.001). In addition, a higher stone fragmentation rate was reported for laser lithotripsy (92.5 %) than for EHL (75.5 %) and ESWL (89.3 %; P < 0.001). The post-procedural complication rate was significantly higher for patients treated with EHL (13.8 %) than for patients treated with ESWL (8.4 %) or laser lithotripsy (9.6 %; P = 0.04). Data on the recurrence rate of the biliary tract stones were lacking. Conclusion This systematic review revealed that laser lithotripsy appeared to be the most successful advanced endoscopy-assisted lithotripsy technique for retained biliary tract stones, although randomized studies are lacking.
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Abedi, Amir Reza, Mohammad Reza Razzaghi, Farzad Allameh, Fereshte Aliakbari, Morteza FallahKarkan y Arash Ranjbar. "Pneumatic Lithotripsy Versus Laser Lithotripsy for Ureteral Stones". Journal of Lasers in Medical Sciences 9, n.º 4 (17 de septiembre de 2018): 233–36. http://dx.doi.org/10.15171/jlms.2018.42.
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Introduction: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. In this study we studied 250 subjects who had ureteroscopic pneumatic lithotripsy (PL) or laser lithotripsy (LL). Methods: Two-hundred fifty patients with ureteral stones underwent ureteroscopic lithotripsy (115 subjects in the PL group, 135 subjects in the LL group) from August 2010 to April 2016. The purpose of this investigation was to evaluate stone-free rate (SFR), mean operation time (MOT), mean hospital stay (MHS), stone migration and complications. Results: Two groups were similar in age, gender, mean size of stones, side of stone, and complications. There was a statistical difference in terms of SFR, stone migration and MHS in favor of the LL group (P ≤ 0.05, P ≤ 0.05 respectively), and MOT in favor of the PL group (P ≤ 0.05). Conclusion: Both the PL and LL techniques were effective and safe for ureteral stones, however a slightly higher SFR was found in the LL group.
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Pardalidis, N., C. Tsiamis, A. Diamantis, N. Andriopoulos y N. Sofikitis. "Methods of Lithotripsy in Ancient Greece and Byzantium". Journal of Urology 178, n.º 4 (octubre de 2007): 1182–83. http://dx.doi.org/10.1016/j.juro.2007.05.124.
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Angsuwatcharakon, Phonthep, Santi Kulpatcharapong, Wiriyaporn Ridtitid, Chaloemphon Boonmee, Panida Piyachaturawat, Pradermchai Kongkam, Wattana Pareesri y Rungsun Rerknimitr. "Digital cholangioscopy-guided laser versus mechanical lithotripsy for large bile duct stone removal after failed papillary large-balloon dilation: a randomized study". Endoscopy 51, n.º 11 (20 de febrero de 2019): 1066–73. http://dx.doi.org/10.1055/a-0848-8373.
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Abstract Background Endoscopic papillary large-balloon dilation (EPLBD) allows for the complete removal of large common bile duct (CBD) stones without fragmentation; however, a significant proportion of very large stones and stones floating above a tapering CBD require lithotripsy. Mechanical lithotripsy and cholangioscopy-guided laser lithotripsy are both effective for stone fragmentation. This study aimed to directly compare, for the first time, the efficacy of these two techniques in terms of stone clearance rate, procedure duration, patient radiation exposure, and safety. Methods 32 patients with very large CBD stones or with stones floating above a tapering CBD, and in whom extraction after standard sphincterotomy and/or EPLBD had failed, were randomly assigned to mechanical lithotripsy or cholangioscopy-guided laser lithotripsy at two tertiary referral centers. Crossover was allowed as a rescue treatment if the assigned technique failed. Results Patients’ demographic data were not different between the two groups. Mechanical lithotripsy had a significantly lower stone clearance rate in the first session compared with laser lithotripsy (63% vs. 100%; P < 0.01). Laser lithotripsy rescued 60% of patients with failed mechanical lithotripsy by achieving complete stone clearance within the same session. Radiation exposure of patients was significantly higher in the mechanical lithotripsy group than in the laser lithotripsy group (40 745 vs. 20 989 mGycm2; P = 0.04). Adverse events (13% vs. 6%; P = 0.76) and length of hospital stay (1 vs. 1 day; P = 0.27) were not different. Conclusions Although mechanical lithotripsy is the standard of care for a very large CBD stone after failed EPLBD, where available, cholangioscopy-guided laser lithotripsy is considered the better option for the treatment of this entity as it provides a higher success rate and lower radiation exposure.
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Yassin, Musaab, Abigail Cressey, Louise Goldsmith, Ben Turney y John Reynard. "Emergency “Hot” Shock Wave Lithotripsy". Journal of Endoluminal Endourology 3, n.º 2 (19 de mayo de 2020): e16-e19. http://dx.doi.org/10.22374/jeleu.v3i2.58.
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Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, safe and effective treatment for urinary tract lithiasis
Ureteroscopy and extracorporeal shock wave lithotripsy (ESWL) are two widely used methods for the treatment of ureteric and pelviureteric junction (PUJ) stones. ESWL remains the only non-invasive therapy modality for the treatment of urinary stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive,safe and effective treatment for urinary tract lithiasis
ObjectivesTo evaluate the effectiveness of emergency “hot” shock wave lithotripsy in treating symptomatic ureteric/ PUJ stones.
Materials and MethodsA retrospective study looking at the emergency referrals for shock wave lithotripsy to the Churchill Hos-pital between June 2013 to Dec 2017. The Lithotripsy Database and patients’ electronic records were used to complete this project. Emergency referrals triaged by the on-call urology team and go through a renal colic clinic.
ResultsIn total, 201 patients underwent emergency shock wave lithotripsy for ureteric/PUJ stones.The mean stone size was 7.7mm (SD 2.9). 12.4% (25) were PUJ, 45.3% (91) proximal and 42.3% (85) distal ureteric stones. 1% (2) were bilateral ureteric stones. 9% (18) had previous lithotripsy treatment before being referred.The number of shocks used was 4000 in 52.7%, >=3000 in 40.3%, >=2000 in 4.5% and >=1000 in 2.5%. The median shock frequency was 2 Hz. The median number of treatments for the targeted stone was 2. Stone fragmentation was visible in 27.4% (55), possible in 30.8% (62) and not visible in 41.8% (84).In terms of follow up, 48.3% (97) were discharged stone-free, while 17.4% (35) were discharged with residual fragments. 21.8% (44) had further clinic follow up while 12.4% (25) had no follow-up information available, possibly because they were referred from different hospitals. 19.9% (40) needed ureteroscopy, while 7% (14) needed further lithotripsy sessions.
ConclusionsEmergency extracorporeal lithotripsy can be offered as an effective and safe treatment for patients with symptomatic stones.
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Wong, John, Raymond Tang, Anthony Teoh, Joseph Sung y James Lau. "Efficacy and safety of novel digital single-operator peroral cholangioscopy-guided laser lithotripsy for complicated biliary stones". Endoscopy International Open 05, n.º 01 (enero de 2017): E54—E58. http://dx.doi.org/10.1055/s-0042-118701.
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Abstract Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy. Stone clearance rate and incidence of adverse events were determined. Results Seventeen patients (10 men, 7 women; median age 76 years) with a median biliary stone size of 2 cm underwent predominantly holmium:yttrium aluminum garnet laser lithotripsy, achieving a 94 % stone clearance rate over 1 median procedure. Lithotripsy was performed in 8 of 17 patients due to an impacted biliary stone. The remaining patients underwent lithotripsy due to prior failure of the basket mechanical lithotripter to capture or crush their stones. Post lithotripsy, 2 patients developed cholangitis and 1 patient with underlying COPD developed respiratory distress, all resolved with conservative management. There were no hemobilia, perforations, pancreatitis nor any deaths. Conclusion SpyGlass DS peroral cholangioscopy-guided laser lithotripsy is an efficient and safe modality for management of complicated biliary stones.
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Jin, Hao, Jinrui Fan, Wei Li y Min Cui. "Percutaneous transhepatic cholangioscopic lithotripsy using soft fiber-optic choledochoscope". Zeitschrift für Gastroenterologie 57, n.º 10 (octubre de 2019): 1196–99. http://dx.doi.org/10.1055/a-0991-0747.
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AbstractMany patients with intrahepatic cholelithiasis need surgical treatment during their life. For patients with hepatolithiasis, conventional therapy methods suggest partial hepatectomy or hepatic transplantation, while both kinds of surgery carry a considerable risk and trauma. Under such conditions, percutaneous transhepatic cholangioscopic lithotripsy provides an alternative method for hepatolithiasis treatment. Conventional rigid choledochoscope applied in percutaneous transhepatic cholangioscopic lithotripsy often lack sufficient flexibility for complete intrahepatic bile duct inspection. In this article, we report a case of one patient with complex hepatolithiasis and choledocholithiasis who received percutaneous transhepatic cholangioscopic lithotripsy using the newly-developed soft fiber-optic choledochoscope. This treatment represents a safe and effective outcome. We came to the conclusion that soft fiber-optic choledochoscope guided percutaneous transhepatic cholangioscopic lithotripsy seems a promising treatment option for selected patients with hepatolithiasis, especially for those who cannot accept conventional methods.
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Wicaksono, Dillon Martino, Doddy Moesbadianto Soebadi, Wahjoe Djatisoesanto y Fikri Rizaldi. "COMPARISON OF EFFICACY BETWEEN LASER AND PNEUMATIC LITHOTRIPSY FOR URETERAL STONE MANAGEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS". Indonesian Journal of Urology 28, n.º 2 (15 de julio de 2021): 187–93. http://dx.doi.org/10.32421/juri.v28i2.743.
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Objective: This study aimed to evaluate the efficacy of ureteroscopy lithotripsy (URS) using laser lithotripsy compared to pneumatic lithotripsy for ureteral stone management. Material & Methods: A systematic search was conducted in PubMed and ScienceDirect. The search and screening process in this study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline to include relevant RCTs. The included studies were assessed for their risks of bias using the Cochrane risk of bias tool 2 (RoB 2). The comparison of outcomes, which includes stone-free rate, DJ-Stent use, and mean fragmentation time between laser and pneumatic lithotripsy was analyzed using Review Manager 5.4. Results: A total of 11 RCTs evaluating a total of 235 patients with ureteral stone were analyzed in this review. Compared to pneumatic lithotripsy, laser lithotripsy has a significantly higher stone-free rate (OR 2.39, 95% CI 1.78-3.21, p < 0.001), longer mean fragmentation time (MD 4.11, 95% CI 3.17-5.04, p < 0.001), and lower DJ stent use rate (OR 0.53, 95% CI 0.36-0.76) based on the forest plot analysis. Conclusion: Patients undergoing laser lithotripsy have a higher stone-free rate, a lower DJ stent use rate, and albeit a longer mean fragmentation time compared to pneumatic lithotripsy.
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Kakar, Muhammad Musa, Asadullah ., Masha Khan y Ijaz Ur Rehman. "Comparison of Slow Rate versus Fast Rate Extracorporeal Shock Wave Lithotripsy in Patients with Urolithiasis". Pakistan Journal of Medical and Health Sciences 15, n.º 6 (30 de junio de 2021): 1921–23. http://dx.doi.org/10.53350/pjmhs211561921.
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Objectives: To compare the success of slow rate with fast rate extracorporeal shock wave lithotripsy in patients undergoing treatment of urolithiasis. Study design: Randomized controlled trial Place & Duration of Study: This study was conducted in Urology Department of Sandeman Civil Hospital, Quetta for one year duration from 1stApril 2020 to 30thMarch 2021. Methods: Total ninety patients who were divided in two equal groups i.e. Group A in which patients received treatment with slow rate extracorporeal shock wave lithotripsy and group B in which patients received treatment with fast rate extracorporeal shock wave lithotripsy. Results: There were 32 (71.1%) male patients and 13 (28.9%) female patients in group A. In group B, there were 28 (62.2%) male patients and 17 (37.8%) female patients. Mean age in group A was 35.61+4.19 years while in group B, the mean age was 34.11+69.32 years. The success rate of slow rate extracorporeal shock wave lithotripsy was 36 (80%) and that of fast rate extracorporeal shock wave lithotripsy was 21 (46.7%) (p-<0.05). Conclusions: The slow rate extracorporeal shock wave lithotripsy is better than fast rate extracorporeal shock wave lithotripsy for elimination of urolithiasis. Keywords: Extracorporeal shock wave lithotripsy, Slow rate ESWL, Fast rate ESWL
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Francesca, F. "Lasers in Urology: Stone disease". Urologia Journal 63, n.º 1 (febrero de 1996): 97–99. http://dx.doi.org/10.1177/039156039606300117.
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— Laser devices for endoscopic lithotripsy differ in their technical aspect from those designed for other urological applications. Their main characteristic is represented by the Q switched output to avoid the thermal effect, which is always associated with the continuous wave output of other lasers. The wave length allows the selective absortion of energy by the stone, greatly reducing the risk of tissue damage. At present three types of laser are available for endoscopic lithotripsy: pulsed dye laser (coumarine green); wave length: 504 nm. Pulsed dye laser (rodamine); wave length: 594 nm. Alexandrite laser; wave length: 750 nm. The pros and cons of laser lithotripsy compared to other methods for endoscopic lithotripsy are highlighted.
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Tiwari, Kabir, Amit Mani Upadhaya, Ashok Kuwar y Sanjesh Bhakta Shrestha. "Semi-rigid Ureteroscopy for the Management of Ureteric Calculi: Our Experience and Complication Encountered". Journal of Nepal Health Research Council 17, n.º 2 (4 de agosto de 2019): 233–37. http://dx.doi.org/10.33314/jnhrc.v0i0.1696.
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Background: Semi-rigid ureteroscopy lithotripsy have become standard of treatment for ureteral calculi. The aim of this study isto review outcome of Semi-rigidureteroscopy lithotripsy and to report the complications encountered. Methods: After approval from institutional committee of Public Health Concern Trust Nepal,we retrospectively reviewed the chart of all patients of ureteral stone who underwent ureteroscopy and pneumatic lithotripsy at Kathmandu Model Hospital between January 2013 and September 2017. Patient characteristics, stone size, success rate and complications were assessed. Intraoperative complications were graded using modified Satava classification system and the postoperative complications graded according to modified Clavien classification system. The success rate was based on stone free status after primary semi-rigid ureteroscopy lithotripsy, without the need of any other secondary procedures.Results: Total 232 patients underwent semi-rigidureteroscopy lithotripsy. Mean age was 46 (16-76) years, with 128 males and 104 females. Size of the stone ranges from 5-18mm. The success rate of primary semi-rigidureteroscopy lithotripsy was in218 (93.9%) cases.Most intraoperative complications were modified Satava grade I (41.7%) andII(3.87%).Four(1.7%) patient had grade III complication, requiring conversion to open surgery. Ureteral avulsion was seen in 1(0.43%) patient, requiring ureteral reimplantation.The postoperative complication were modified Clavien grade I(10.7%), grade II(5.17%), grade III (4.6%) and grade IV(0.43%). Double J stents were inserted in all the patients postoperatively.The mean hospital stay was 2.2(1-14)days.Conclusions: Semi-rigid ureteroscopy lithotripsy for the management of ureteral stones is efficacious and have a lesser major complications.Keywords: Ureteric calculus; ureteroscopic lithotripsy; Semi-rigid ureteroscopy lithotripsy.
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Aboutaleb, Hamdy, Mohamed Omar, Shady Salem y Mohamed Elshazly. "Management of upper ureteral stones exceeding 15 mm in diameter: Shock wave lithotripsy versus semirigid ureteroscopy with holmium:yttrium–aluminum–garnet laser lithotripsy". SAGE Open Medicine 4 (1 de enero de 2016): 205031211668518. http://dx.doi.org/10.1177/2050312116685180.
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Objectives: We conducted a retrospective study to evaluate the efficacy and outcome of shock wave lithotripsy versus semirigid ureteroscopy in the management of the proximal ureteral stones of diameter exceeding 15 mm. Methods: During the 2009−2014 study period, 147 patients presenting with the proximal ureteral stones exceeding 15 mm in diameter were treated. Both shock wave lithotripsy and ureteroscopy with laser lithotripsy were offered for our patients. A 6/8.9 Fr semirigid ureteroscope was used in conjunction with a holmium:yttrium–aluminum–garnet laser. The stone-free rate was assessed at 2 weeks and 3 months post-treatment. All patients were evaluated for stone-free status, operation time, hospital stay, perioperative complications, and auxiliary procedures. Results: Of the 147 patients who took part in this study, 66 (45%) had undergone shock wave lithotripsy and 81 (55%) underwent ureteroscopy. At the 3-month follow-up, the overall stone-free rate in the shock wave lithotripsy group was 39/66 (59%) compared to 70/81 (86.4%) in the ureteroscopic laser lithotripsy group. Ureteroscopic laser lithotripsy achieved a highly significant stone-free rate ( p = 0.0002), and the mean operative time, auxiliary procedures, and postoperative complication rates were comparable between the two groups. Conclusion: In terms of the management of proximal ureteral stones exceeding 15 mm in diameter, ureteroscopy achieved a greater stone-free rate and is considered the first-line of management. Shock wave lithotripsy achieved lower stone-free rate, and it could be used in selected cases.
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Joshi, H. N., A. K. Singh, N. Koirala y R. M. Karmacharya. "Outcome of Uretero Renoscopic Lithotripsy (URSL) with Holmium LASER Vs Pneumatic Lithotripter for Lower Ureteric Stones, Experience from University Hospital of Nepal". Kathmandu University Medical Journal 18, n.º 1 (6 de enero de 2020): 49–53. http://dx.doi.org/10.3126/kumj.v18i1.33360.
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Background There are various methods of endoluminal ureteral stone fragmentation. Among various modalities Laser lithotripsy and Pneumatic lithotripsy are commonly used and have shown comparable outcomes.
Objective To compare the efficacy and outcome of laser and pneumatic lithotripsy in a patient with lower ureteric calculi. The comparison will be done in stone free rate, migration of stone and complication of the procedure.
Method This is a prospective comparative study in a cohort of patients at University Hospital with Lower Ureteric stone. Ninety patients were randomized in to two groups (Laser Lithotripsy Vs Pneumatic Lithotripsy) during the study period. The purpose of this study was to measure the immediate stone free rate, intra-operative complications, mean operative time, post-operative complication and if any stone retention after six weeks follow up.
Result Both the groups were similar in Age and Gender. Immediate stone free rate was slightly higher in Laser lithotripsy group (97.77%) in comparison to Pneumatic lithotripter group (84.44%) with p=0.507 which is not statistically significant. There was statistical difference in terms of stone migration rate, mean operation time in favor of Laser Lithotripsy group (p<0.01, in both parameters). There were no immediate complications in both the group however there were three cases of short segment ureteric strictures (6.66%) in case of Pneumatic lithotripsy on six weeks follow up which was managed conservatively.
Conclusion Both LASER lithotripter and Pneumatic lithotripter are equally efficacious modality of endoluminal URSL in lower ureteric stone with similar Stone Free Rate. Laser lithotripsy showed lower frequency of stone migration and had shorter procedure time.
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Jakobs, Ralf, Julio C. Pereira-Lima, Aline W. Schuch, Lucas F. Pereira-Lima, Axel Eickhoff y Juergen F. Riemann. "Endoscopic laser lithotripsy for complicated bile duct stones: is cholangioscopic guidance necessary?" Arquivos de Gastroenterologia 44, n.º 2 (junio de 2007): 137–40. http://dx.doi.org/10.1590/s0004-28032007000200010.
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BACKGROUND: Endoscopic papillotomy is successful in more than 95% of the cases of choledocholithiasis. For patients with difficult bile duct stones not responding to mechanical lithotripsy, different methods for stone fragmentation have been developed. AIM: To compare the results of laser lithotripsy with a stone-tissue recognizing system, when guided by fluoroscopy only or by cholangioscopy. METHODS: Between 1992 and 2002 we have treated 89 patients with difficult bile duct stones by endoscopic retrograde cholangiopancreatography and laser lithotripsy. Unsuccessful extracorporeal shock-wave lithotripsy and electrohydraulic were also performed before laser in 35% and 26% of the cases, respectively. RESULTS: Laser was effective in 79.2% of 72 patients guided by cholangioscopy and in 82.4% of 17 cases steered by fluoroscopy. The median number of impulses in the latter was 4,335 and 1,800 with the former technique. Two parameters influenced the manner of laser guidance. In cases of stones situated above a stricture, cholangioscopic control was more effective (64.7% vs. 31.9%). When the stones were in the distal bile duct, fluoroscopic control was more successful. CONCLUSION: In cases of difficult stones in the distal bile duct, laser lithotripsy under fluoroscopic control is very effective and easily performed. Cholangioscopic guidance should be recommended just in cases of intrahepatic stones or in patients with stones situated proximal to a bile duct stenosis. In these cases, cholangioscopy should be performed either endoscopically or percutaneously.
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Radulovic, Slobodan, Aleksandar Vuksanovic, Dragica Milenkovic-Petronic y Bozo Vavic. "The influence of lithotripsy methods on the incidence of auxiliary procedures after ureteric stone desintegration". Vojnosanitetski pregled 65, n.º 8 (2008): 619–25. http://dx.doi.org/10.2298/vsp0808619r.
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Introduction/Aim. Localization of ureteric stones and the difference in disintegration success are the most important but not the only factors in choosing the first treatment approach to ureteric stones. The aim of the study was to investigate the incidence of auxiliary procedures after different ureteric stones lithotripsy modalities. Methods. In a prospective bicentric study 260 patients with ureteric stones were analyzed. The patients were divided into two groups: group I - 120 patients subjected to extracorporeal shock ware lithotripsy (ESWL) treatment and group II - 140 patients treated endoscopicly with ballistic lithotripsy using "Swiss" Lithoclast. Results. Endoscopic treatment of all distal ureteric stones was significantly more successful than ESWL, but not significantly more successful than ESWL regarding proximal ureteric stones except for stones larger than 100 mm2 that were significantly better treated with endoscopic method. There was no general significant difference in auxiliary procedures rate after lithotripsy between the two groups. In the group I auxiliary procedures were significantly more performed than in the group II after the lithotripsy of stones larger than 100 mm2, calcium-oxalat-monohydrate stones and highly significantly more performed after the treatment of stones located in the iliac ureteric portion and impacted stones. After the lithotripsy of lumbar ureteric stones and multiple stones situated in different ureteric portions additional procedures were highly significantly more necessary in the goup II than in the group I. Conclusion. Being significantly more successful comparing to ESWL, ureteric stone treatment with "Swiss" Lithoclast should be considered the first therapeutic option for all, especially impacted stones located in iliac and pelvic ureter. In spite of a statistically significant difference in success rate, ESWL should be performed as the first treatment option in all cases of lumbar stones as well as multiple stones located in different ureteric portion because of lower auxiliary procedures rate except for stones larger than 100 mm2 that should be primarily treated endoscopicly. .
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Basnet, Robin Bahadur, Sanjay Bikram Shrestha, Jitendra Shrestha y Bipin Shrestha. "Use of Intravenous Furosemide to Prevent Febrile UTI Following Flexible Ureterorenoscopic Laser Lithotripsy". Nepal Medical Journal 2, n.º 2 (17 de diciembre de 2019): 49–52. http://dx.doi.org/10.37080/nmj.70.
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Introduction: Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. However, flexible ureterorenoscopic laser lithotripsy is not without complications and urinary tract infection is the most common reported complication. Prophylactic antibiotic use, access sheath, low pressure irrigation are few methods to reduce incidence of urinary tract infection. We have studied whether routine use of intravenous furosemide reduces the incidence of febrile urinary tract infection.
Methods: A total of 70 patients were randomized into two groups where one received intravenous furosemide at the beginning of the procedure and another did not. Flexible ureteroscopic holmium laser lithotripsy was done and patients were followed up for development of febrile urinary tract infection within one week of the procedure.
Results: 14% of patients who received furosemide and 20% of patients who did not receive developed post- operative febrile urinary tract infection within one week. Two patients in each group had bacteriuria.
Conclusions: Although the incidence of febrile UTI is lesser with routine use of intravenous furosemide during flexible ureterorensocopic laser lithotripsy, statistical significance could not be proved.
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Xu, Lei, Moe Htet Kyaw, Yee Kit Tse y James Yun Wong Lau. "Endoscopic Sphincterotomy with Large Balloon Dilation versus Endoscopic Sphincterotomy for Bile Duct Stones: A Systematic Review and Meta-Analysis". BioMed Research International 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/673103.
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The safety and efficacy of endoscopic sphincterotomy with large balloon dilation (EPLBD) are unclear. This study compares the safety and efficacy between EPLBD and endoscopic sphincterotomy (EST).Patients and Methods. Literatures were searched for randomized controlled trials in PUBMED, EMBASE, and Cochrane Library. Outcome measurements included adverse events; stone removal rate; requirement of mechanical lithotripsy.Results. Four RCTs with a total of 596 patients were included. Three RCTs compared EPLBD versus EST alone for stone removal; one RCT compared EPLBD versus EST plus mechanical lithotripsy for stone removal. Pooled data from three RCTs showed that there was no significant difference in the adverse event of ERCP. A significantly higher cholangitis rate was seen in patients who received EST plus mechanical lithotripsy, compared to those treated with EPLBD (13.3% versus 0.0,P=0.026). No statistical difference was found between EPLBD and EST for stone removal rate. Significant differences in requirement of mechanical lithotripsy were seen with removal of large stones (>15 mm), with EPLBD reducing the use of mechanical lithotripsy (RR: 0.73; 95% CI: 0.54–0.99).Conclusions. EPLBD and EST have similar efficacy and safety for bile duct stones clearance. With larger stones, EPLBD can reduce requirement of mechanical lithotripsy.
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Mi, Qiwu, Xiangjun Meng, Linghui Meng, Derong Chen y Shaowei Fang. "Risk Factors for Systemic Inflammatory Response Syndrome Induced by Flexible Ureteroscope Combined with Holmium Laser Lithotripsy". BioMed Research International 2020 (24 de marzo de 2020): 1–5. http://dx.doi.org/10.1155/2020/6842479.
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Objective. To investigate the risk factors of systemic inflammatory response syndrome (SIRS) induced by flexible ureteroscope combined with Holmium laser lithotripsy. Patients and Methods. The clinical data from 216 consecutive patients who had undergone flexible ureteroscope combined with Holmium laser lithotripsy between August 2015 and May 2019 were retrospectively analyzed. To identify the risk factors of systemic inflammatory response syndrome induced by flexible ureteroscope combined with Holmium laser lithotripsy, the cases were divided into two groups according to whether they developed postoperative SIRS: SIRS group (21 cases) and non-SIRS group (195 cases). Age, gender, body mass index, stone size, surgery time, stone location, hydronephrosis, urine culture, hospital stay, stone-free rate, ureteral access sheath, and diabetes mellitus were collected. Univariate analysis was performed to calculate the potential factors. In order to determine the independence of the various factors, factors that potentially contributed to SIRS were compared between the SIRS group and the non-SIRS group. Furthermore, multivariate logistic regression analysis was used to identify the risk factors of systemic inflammatory response syndrome induced by flexible ureteroscopic lithotripsy. Results. All patients were successfully treated with flexible ureteroscopic lithotripsy. The incidence of SIRS after flexible ureteroscopic lithotripsy was 9.7%. The univariate analysis demonstrated the potential risk factors of systemic inflammatory response syndrome induced by flexible ureteroscopic lithotripsy were stone size (p=0.002), surgery time (p=0.01), urine culture (p≤0.001), and ureteral access sheath (p=0.001). Multivariable logistic regression analysis showed that stone size (p=0.002, OR=1.618; 95% CI, 0.452-0.844), surgery time (p≤0.001, OR=1.025; 95% CI, 1.016-1.034), urine culture (p≤0.001, OR=25.795; 95% CI, 22.131-30.065), and ureteral access sheath (p≤0.001, OR=6.101; 95% CI, 5.109-7.284) were independent risk factors for SIRS induced by flexible ureteroscopic lithotripsy. Conclusions. Stone size, surgery time, urine culture, and ureteral access sheath are independent risk factors for SIRS induced by flexible ureteroscopic lithotripsy. Patients with these high-risk factors should be carefully evaluated to reduce systemic inflammatory response syndrome.
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McCarty, Thomas R., Zain Sobani y Tarun Rustagi. "Per-oral pancreatoscopy with intraductal lithotripsy for difficult pancreatic duct stones: a systematic review and meta-analysis". Endoscopy International Open 08, n.º 10 (octubre de 2020): E1460—E1470. http://dx.doi.org/10.1055/a-1236-3187.
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Abstract Background and study aims Per-oral pancreatoscopy (POP) with intraductal lithotripsy via electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) facilitates optically-guided stone fragmentation of difficult pancreatic stones refractory to conventional endoscopic therapy. The aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy and safety of POP with intraductal lithotripsy for difficult pancreatic duct stones. Methods Individualized search strategies were developed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. This was a cumulative meta-analysis performed by calculating pooled proportions with rates estimated using random effects models. Measured outcomes included pooled technical success, complete or partial stone fragmentation success, complete duct clearance after initial lithotripsy session, and adverse events (AEs). Results Ten studies (n = 302 patients; 67.72 % male; mean age 55.10 ± 3.22 years) were included with mean stone size of 10.66 ± 2.19 mm. The most common stone location was in the pancreatic head (66.17 %). Pooled technical success was 91.18 % with an overall fragmentation success of 85.77 %. Single lithotripsy session stone fragmentation and pancreatic duct clearance occurred in 62.05 % of cases. Overall, adverse events were reported in 14.09 % of patients with post-procedure pancreatitis developing in 8.73 %. Of these adverse events, 4.84 % were classified as serious. Comparing POP-EHL vs POP-LL, there was no significant difference in technical success, fragmentation success, single session duct clearance, or AEs (P > 0.0500). Conclusions Based on this systematic review and meta-analysis, POP with intraductal lithotripsy appears to be an effective and relatively safe procedure for patients with difficult to remove pancreatic duct stones.
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Shrivastava, Nitin, Brusabhanu Nayak, Prabhjot Singh, Prem N. Dogra, Rakesh Kumar y Maroof A. Khan. "Punctures versus shocks: a comparison of renal functional and structural changes after percutaneous nephrolithotomy and shockwave lithotripsy for solitary renal stone". Journal of Clinical Urology 13, n.º 4 (10 de diciembre de 2019): 254–60. http://dx.doi.org/10.1177/2051415819888083.
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Objective: To evaluate renal functional and structural changes following percutaneous nephrolithotomy and shockwave lithotripsy for solitary non-obstructing non-staghorn renal stone. Materials and methods: Patients with solitary unilateral non-staghorn renal stones who were planned for percutaneous nephrolithotomy (20 patients) and shockwave lithotripsy (20 patients) were prospectively evaluated for renal functional and structural changes 60 days after the procedure and complete clearance of stones. Tc99-dimercaptosuccinic acid was used to assess cortical scarring and Tc99-diethylenetriamine pentaacetic acid and Tc99-levo levo ethylecysteine were used for glomerular filtration rate calculations, respectively. Results: The mean stone size was 24.4 mm and 13.7 mm in the percutaneous nephrolithotomy group and the shockwave lithotripsy group, respectively. No new cortical scars developed in either of the groups on Tc99-dimercaptosuccinic acid scan. Both the treated and untreated kidneys showed an overall insignificant fall in glomerular filtration rate in both the groups. The number of patients showing significant deterioration in the individual glomerular filtration rate in both the treated and untreated renal unit was more in the shockwave lithotripsy group. Conclusion: Both percutaneous nephrolithotomy and shockwave lithotripsy are comparable in terms of adverse effects on renal parenchyma and renal function. Level of evidence: Not applicable for this multicentre audit.
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Franzini, Tomazo, Renata Moura, Priscilla Bonifácio, Gustavo Luz, Thiago de Souza, Marcos dos Santos, Gustavo Rodela et al. "Complex biliary stones management: cholangioscopy versus papillary large balloon dilation – a randomized controlled trial". Endoscopy International Open 06, n.º 02 (febrero de 2018): E131—E138. http://dx.doi.org/10.1055/s-0043-122493.
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Abstract Background and study aims Endoscopic removal of biliary stones has high success rates, ranging between 85 % to 95 %. Nevertheless, some stones may be challenging and different endoscopic methods have evolved. Papillary large balloon dilation after sphincterotomy is a widely used technique with success rates ranging from 68 to 90 % for stones larger than 15 mm. Cholangioscopy allows performing lithotripsy under direct biliary visualization, either by laser or electrohydraulic waves, which have similar success rate (80 % – 90 %). However, there is no study comparing these 2 techniques. Patients and methods From April 2014 to June 2016, 100 patients were enrolled and randomized in 2 groups, using a non-inferiority hypothesis: cholangioscopy + electrohydraulic lithotripsy (group 1) and endoscopic papillary large balloon dilation (group 2). The main outcome was complete stone removal. Adverse events were documented. Mechanical lithotripsy was not performed. Failure cases had a second session with crossover of the methods. Results The mean age was 56 years. 74 (75.5 %) patients were female. The initial overall complete stone removal rate was 74.5 % (77.1 % in group 1 and 72 % in group 2, P > 0.05). After second session the overall success rate achieved 90.1 %. Procedure time was significantly lower in group 2, – 25.2 min (CI95 % – 12.48 to – 37.91). There were no significant differences regarding technical success rate, radiologic exposure and adverse events. Conclusion Single-operator cholangioscopy-guided lithotripsy and papillary large balloon dilation are effective and safe approaches for removing complex biliary stones.
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Vozianov, Oleksandr. "The reasons of unsatisfactory results of extracorporeal shock wave lithotripsy in patients with ureterolithiasis". EUREKA: Health Sciences, n.º 4 (30 de julio de 2021): 48–53. http://dx.doi.org/10.21303/2504-5679.2021.001797.
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The article dedicate to the problem of failure of extracorporeal shockwave lithotripsy in patients with ureterolithiasis and reveal the changes which appear in the ureter in the location of the stone.The aim. Analysis of the results of treatment in patients, suffering ureteric stones, using the ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy.
Materials and methods. In 137 patients with ureteric stones, whom ureterolithotripsy procedure after failure extracorporeal shockwave lithotripsy was conducted, the symptoms of the disease, the diagnostic methods value, efficacy of surgical treatment and reasons of the failure of previous method of treatment were analyzed.
Results. In 135 patients endoscopic removal of stones has been succeeded, in 2 patients because of total obliteration of the ureter, uretero-ureteral anastomosis has been performed. If the symptoms, with are characteristic of ureterolithiasis, persists up to one week stones don’t cause significant macroscopic changes to the ureter wall. If the stone persists in the ureter longer than a week we identified local appearing of oedema. Long–term (more than two months) ureteric stone persistence increase the risk of intramucosal “ingrowth” of the calculi greatly.
Conclusion. The URS and ESWL are high effective and minimal invasive methods of surgical intervention for patients with ureterolithiasis, guaranteeing high level of postoperative “stone free rate”. Prolongation of the stone insertion time in the ureter causes the ureteric wall changes, complicating performance of minimal invasive interventions (ureterolithotripsy and extracorporeal shock–wave lithotripsy) and reduce its efficacy.
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Chowdhury, Md Ashif, Md Shahidul Islam, SM Shameem Waheed, Md Abdur Rakib, Faruk Hossain y Md Habibur Rhaman. "Comparative Study Between Holmium: Yag Laser and Pneumatic Lithotripsy in the Management of Upper Ureteric Stone". Bangladesh Journal of Urology 22, n.º 2 (4 de noviembre de 2020): 160–65. http://dx.doi.org/10.3329/bju.v22i2.50109.
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Background:Among various intracorporeal lithotripters, Pneumatic lithotriptorhas become the widely used tool for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones.
Objective: To compare the treatment of upper ureteric stone between laser and pneumatic lithotripsy.
Materials and methods: One hundred patients with upper ureteric stone who underwent ureteroscopic lithotripsy in the Department of Urology, CMH, Dhakafrom October 2012 to September 2015 were enrolled in this study. Patients were divided into two groups. Group A (LL) were treated with holmium: YAG laser and Group B (PL) were treated with pneumatic lithotripsy. Two procedures were compared in term of stone fragmentation, stone clearance rate, duration of lithotripsy, complications and duration of post operativehospital stay. Patients were monitored as outpatients after one month and after three months with a kidney ureter and bladder radiograph and ultrasonograph. Patients with migrated fragments or incomplete clearance underwent an auxiliary procedure such as Extra Corporeal shock wave lithotripsy (ESWL).
Results: Mean stone size was 1.36 ± 0.36 cm in group A (LL) and 1.37± 0.36 cm in group B (PL). The immediate stone clearance rate was significantly higher inGroup A (94.0%) than Group B (76.0%). Fragments proximal migration were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipments (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05) and stone fragments clearance requiring auxiliary procedures were 6% and 24% (p<0.05) in LL and PL group respectively. The mean lithotripsy time 40.46 ± 19.25 min and 36.86 ± 14.83 min and mean period of post operative hospital stay was 2.32 ± 1.22 days and 2.44 ± 1.18 days in the LL and PL group respectively. Periprocedural complications like hemorrhage, mucosal disruption/ perforation were almost same in both groups.
Conclusion: In this study stone clearance and fragmentation of stone in Holmium:YAG assisted ureteroscopy was significantly higher than pneumatic lithotripsy group. The need for auxiliary procedure like ESWL for proximally migrated fragments was significantly less inHolmium:YAG assisted ureterocopy compared with pneumatic lithotripsy.
Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.160-165
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Rashid, Harun Or, Md Shahidul Islam, SM Shameem Waheed, Md Abdur Rakib, Md Ashif Chowdhury, Md Shafiul Alam, ATM Nurul Amin y Muhammed Alam. "Comparative Study Between Holmium Laser versus Pneumatic Ureteroscopic Lithotripsy for Proximal Ureteric Stones Close to Pelvi-ureteric Junction (PUJ) -A Prospective Trial". Bangladesh Journal of Urology 23, n.º 2 (15 de noviembre de 2020): 188–92. http://dx.doi.org/10.3329/bju.v23i2.50313.
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Objective: To compare the outcomes of ureteroscopic lithotripsy with pneumatic lithotripter versus Holium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in the management of upper ureteric stones.
Materials and methods: Patients who underwent ureteroscopic lithotripsy with pneumatic lithotripter or Ho:YAG laser for upper ureteric stones were reviewed. Patients with urinary tract infection, ,loss of follow-up, concurrent middle or lower third ureteral stones or acute renall failure were excluded. Patient age, stone size and burden (based on KUB or computerized tomography), stone upward migration, double J stent insertion rate, stone free rate and secondary intervention rate for residual stones were compared in both groups.
Results: There were 70 patients with upper ureteric stones (35 in pneumatic group and 35 in laser group) meeting the study criteria. Patients’ age, gender, stone size and burden were similar in both groups. The Ho:YAG laser lithotripsy group had better stone free rate, less double J stent insertion rate and less upward migration and secondary intervention rate, sepsis as compared with pneumatic lithotripsy (94.2% vs. 60%; 85% vs. 100%; 5.7% vs 40%; 5.7% vs 34.2%; 2.8 vs 2.8 respectively, all p < 0.05). In patients with stones sizes 8-10 mm, Ho:YAG laser lithotripsy had significantly lower upward migration rate, lower double J stent insertion rate, higher stone free rate and less secondary intervention rate.
Conclusions: Ho:YAG laser lithotripsy is better and much effective than pneumatic lithotripsy in the management of upper ureteric stones in terms of, stone free rate and secondary intervention rate for stones of sizes about 8 to 10 mm.Although the access of upper ureter is difficult but our small calibre (4.5 fr) ureteoscope and gentle manuevre have made the procedures safe and successful.
Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.188-192
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Radulovic, Slobodan, Dragica Milenkovic-Petronic, Aleksandar Vuksanovic y Bozo Vavic. "Influence of lithotripsy modalities on complication rate". Srpski arhiv za celokupno lekarstvo 137, n.º 5-6 (2009): 259–65. http://dx.doi.org/10.2298/sarh0906259r.
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Introduction. Localization of ureteric stones and difference in disintegration success are the most important factors in determining the first treatment approach for ureteric stones. Objective. The aim of our study was to evaluate the difference in complication rate between different ureteric stone lithotripsy modalities. Methods. Two hundred sixty patients with ureteric stones were analyzed in a prospective bicentric study that lasted 1 year. The patients were divided into two groups: I - 120 patients who underwent ESWL (extracorporeal shockwave lithotripsy) treatment and II - 140 patients who were treated endoscopically with ballistic lithotripsy. Results. Ureteroscopic lithotripsy of all pelvic and iliac stones was significantly more successful comparing to ESWL, while lumbar ureteric stone treatment with ureteroscopic lithotripsy was not significantly more successful than ESWL, except for lumbar stones larger than 100mm2 that were significantly better treated endoscopically. In the I group complications after lithotripsy were recorded in 64 (59.3%) and in the II group in 58 (42.0%) patients, meaning that complications were statistically significantly more frequent in the I than in the II group. In the II group complications were significantly more often recorded after treatment of proximal comparing to ureteric stones of other localizations, while in the I group complications were significantly more often detected after treatment of impacted stones than in the II group. Conclusion. Being significantly successful comparing to ESWL, ureteric stone treatment with ureteroscopic lithotripsy should be considered as the first therapeutic option for all, especially impacted stones located in the iliac and pelvic ureteric portion. In spite of absent statistical difference in the success rate, ESWL should be chosen as the first treatment option in all cases of lumbar ureteric stones due to lower complication rate except for stones larger than 100mm2 that should be primarily treated endoscopically.
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Jovanovic, Mirko, Vesna Suljagic y Vladimir Bancevic. "Postoperative urinary tract infection after ureteroscopic lithotripsy in patients with asymptomatic bacteriuria". Vojnosanitetski pregled 77, n.º 9 (2020): 917–22. http://dx.doi.org/10.2298/vsp180918163j.
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Background/Aim. Postoperative urinary tract infection (UTI) is one of the most common infective complications of ureteroscopic lithotripsy. Preoperative asymptomatic bacteriuria is not a contraindication for performing ureteroscopic lithotripsy but it can be a significant risk factor for occurrence of severe forms of postoperative urinary infection. Methods. From January 2010 until December 2014 at the Urology Clinic of the Military Medical Academy in Belgrade, 389 patients undergoing ureteroscopic lithotripsy were analyzed, and their postoperative infective complications were monitored. From the group, the incidence of posteoperative urinary infection was analysed in 52 patients with preoperative asymptomatic bacteriuria. Results. Infective complications occured in 18.7% of patients, and postoperative UTI in 10% of patients. Out of 52 patients with preoperative asymptomatic bacteriuria, 36.5% had postoperative urinary tract infection (?2 = 46.773; p < 0.001). In these patients, we registered higher frequency of severe forms of postoperative UTI, systemic inflammatory response syndrome (SIRS) and sepsis. Conclusion. Preoperative asymptomatic bacteriuria represents a significant risk factor for developing postoperative UTI following ureteroscopic lithotripsy and is associated with increased risk for occurence of severe forms of SIRS and sepsis. It is desirable that every patient with indicated ureteroscopic lithotripsy has sterile urine culture, and if this is impossible to achieve, a special caution and an adequate antibiotic therapy and prophylaxis are needed before and during the surgical procedure
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Biloruskyi, Bogdan-Boris Olegovich. "TREATMENT ADVANTAGES OF PATIENTS WITH URETEROLITHIASIS BY LITHOTRIPSY CONTACT METHODS IN COMPARISON WITH OPEN SURGERY". International Medical Journal, n.º 4 (26 de febrero de 2020): 40–43. http://dx.doi.org/10.37436/2308-5274-2019-4-9.
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One of the most effective methods of treatment of ureteral concretions is ureteroscopy with contact lithotripsy. The study analyzed the results of treatment of 96 patients with urolithiasis they were as follows: 44 patients underwent laser ureterolithotripsy, 52 persons had an open ureterolithotomy. When comparing different treatments for patients with ureterolithiasis, it has been found that the average duration of surgery when performing laser ureterolithotripsy was shorter and averaged 53 minutes. As for open ureterolithotomy it lasted in average 102 minutes. The average length of patients staying in clinic when performing laser ureterolithotripsy in average was 2.5 days, during open ureterolithotomy that index was 20 days. This is a significant advantage of endoscopic treatment of ureterolithiasis versus an open surgery (especially when a holmium laser is used in lithotripsy). By using endoscopic methods of treatment of ureteral concretions instead of an open surgery (ureterolithotomy), it has been possible to reduce the in−patient staying 8 times. Lithotripsy with a holmium laser occurred to be an effective method of destroying the ureteral concretions of any mineral composition, if the dimensions of these calculi did not exceed 2 cm. It should be emphasized that under these conditions, the localization of a stone and the duration of its stay in the ureter are also not important. In addition, the use of a holmium laser minimizes an injury to the ureter wall. The advantages of lithotripsy when it used with a holmium laser consist in its high efficiency in destruction of solid fixed and the ingrown stones. In case of combination of both a stone and ureteral stricture and in the presence of ligature calculi, the treatment with a holmium laser is also prescribed. Key words: ureterolithiasis, laser ureterolithotripsy, open ureterolithotomy, holmium laser.
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Hemmant, Joshua, Graham Young, Christos Pournaras, Emma Foster y Karyee Chow. "A model to guide patient selection when managing ureteric stones with shockwave lithotripsy". Journal of Clinical Urology 13, n.º 4 (3 de febrero de 2020): 295–302. http://dx.doi.org/10.1177/2051415819890471.
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Introduction: The aim of this study was to create a model based upon significant prognostic factors to guide patient selection for shockwave lithotripsy. Patients and methods: We identified 150 patients attending for shockwave lithotripsy for ureteric stones between October 2010–February 2016. Data was collected retrospectively from electronic case notes and radiological images. All patients were treated with an on-site Storz Modulith SLX-F2 lithotripter. A model was created using computer software ‘R’. Results: One hundred and thirty-three patients were treated and 66% of those were deemed radiologically stone-free with shockwave lithotripsy. Four factors were found to be independently statistically significant with regards to stone-free status; age ( p=0.003), Hounsfield units ( p=0.002), prior nephrostomy insertion ( p=0.022) or prior stent insertion ( p=0.002). Our resulting model is:[Formula: see text] Discussion and conclusions: Our shockwave lithotripsy success would likely increase with improved patient selection. Age appears to be a novel significant factor in stone passage. This is an interesting observation worthy of further study given ageing populations in the developed world. The model will require further validation in order to confirm our findings, however the results have proven very encouraging. Level of evidence: 2c
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Sen, Haluk, Omer Bayrak, Sakip Erturhan, Gokhan Urgun, Seval Kul, Ahmet Erbagci y Ilker Seckiner. "Comparing of Different Methods for Prevention Stone Migration During Ureteroscopic Lithotripsy". Urologia Internationalis 92, n.º 3 (2014): 334–38. http://dx.doi.org/10.1159/000351002.
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Ivanova, L. Yu, V. P. Chernenko y V. S. Boshchenko. "A Study of Electrohydraulic and Electric Pulse Methods of Contact Lithotripsy". Biomedical Engineering 47, n.º 2 (julio de 2013): 65–67. http://dx.doi.org/10.1007/s10527-013-9336-7.
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Hernandez-Graulau, Jose M., Wilfrido Castaneda-Zuniga, David Hunter y John C. Hulbert. "Management of cystine nephrolithiasis by endourologic methods and shock-wave lithotripsy". Urology 34, n.º 3 (septiembre de 1989): 139–43. http://dx.doi.org/10.1016/0090-4295(89)90249-5.
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TAHIR, MUHAMMAD MUZAMMIL, SHAFI GHAURI y MUHAMMAD USMAN KHAN. "EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY;". Professional Medical Journal 15, n.º 02 (10 de marzo de 2008): 193–99. http://dx.doi.org/10.29309/tpmj/2008.15.02.2808.
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Treatment of renal stone is always a challenge. High incidence ofrecurrence of renal stone compels the treating physician to opt for minimally invasive treatment. With the advent of extracorporeal shock wave lithotripsy the treatment has been completely revolutionized. The treatment of lower polar stoneis always tiring, and usually involves multiple modalities, the low lie of the stone, difficult clearance, narrow infundibulum,and higher incidence of regrowth make it difficult to treat. Objectives: We assessed the role of diuretic in the clearanceof lower polar stone after shock wave lithotrispsy, (SWL). Material and Methods: 60 patients were selected from bothsexes and divide them in two equal groups, with age 20-75 Y for group 1, and 5-72 Y for group II. Stone size from 5-20mm were included in our study. The patients underwent ESWL. The group I was offered inj Frusemide 20 mgintravenously after shock wave lithotripsy, while patients in group II were kept as control.Results: The stone clearancein group I was 73.3, and 60% in group II. Which is quite significant. Conclusion: The use of diuresis after ESWLsignificantly increases the clearance rate for lower polar stones.
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Merlo, F., E. Cicerello, L. Maccatrozzo, A. Fandella, L. Faggiano y G. Anselmo. "Treatment of Ureteral Stones: Intracorporeal Or Extracorporeal Lithotripsy?" Urologia Journal 65, n.º 1_suppl (enero de 1998): 47–50. http://dx.doi.org/10.1177/039156039806501s11.
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Over the last 15 years the treatment of ureteral stones has been considerably revolutionised thanks to new, less invasive technologies compared to traditional surgery. The urologist is, however, faced with a dilemma: whether to cure the patient with easy-to-perform extracorporeal lithotripsy (ESWL) without anesthesia in Day Surgery, but which often requires more than one session to clear the stones completely, or to carry out ureteroscopy and intracorporeal lithotripsy, which resolves most cases in just one treatment but is more invasive in that it requires general anesthesia and hospitalisation. The authors present their experience and compare the two methods.
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Bieszczad, Claudio Francisco Kluppel, Rodrigo Florêncio Da Silva, Renata Rothenbuhler, Angelo Contar Palmar y José Carlos Ludwig. "The use of extracorporeal shock wave therapy at patients with spasticity related to cerebrovascular accident". Fisioterapia Brasil 21, n.º 1 (8 de marzo de 2020): 69. http://dx.doi.org/10.33233/fb.v21i1.3273.
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Introduction: This research aims to show the reduction of muscular tonus by using extracorporeal shock wave lithotripsy in order to recover normal movements. Methods: 10 patients over 50 and under 80 years of age presenting stroke with spasticity participated in this pilot study, which used three methods: 1) the Ashworth scale, 2) the digital goniometer and 3) the displacement of muscle belly, before and after the shock waves. To check the displacement of muscle belly, a current pulse was applied, measured by LTM 165 class 2 Laser. This approach is similar and consists of measuring the displacement on a laser sensor basis. The Ortho-lithotripsy equipment used was a Direx Integra. The dose/intensity was 1000 cps – 0.030 mJ/mm². Results: We also observed a better quality of muscle contraction (Scale Ashworth p=0.05). At digital goniometry, the shoulder abduction developed 35° in 7 of the patients and 15° in 3 of them (p<0.05). Conclusion: The muscles do not become hypotonic with the shock waves treatment, (they present an adequate tonus). The patients who presented micro-shortening and did not undergo to regular physiotherapy showed a minor improvement (15° goniometry).Keywords: stroke, spasticity, lithotripsy.
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Koch, Michael, Mirco Schapher, Konstantinos Mantsopoulos, Miguel Goncalves y Heinrich Iro. "Intraductal Pneumatic Lithotripsy after Extended Transoral Duct Surgery in Submandibular Sialolithiasis". Otolaryngology–Head and Neck Surgery 160, n.º 1 (9 de octubre de 2018): 63–69. http://dx.doi.org/10.1177/0194599818802224.
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Objective Persistent, residual, or recurrent stones after transoral duct surgery are always associated with hilar to intraparenchymal and/or multiple sialolithiasis, causing difficulties in the treatment. This study was performed to assess the value of intraductal lithotripsy in the treatment of persistent, residual, or recurrent sialolithiasis after extended duct surgery in the submandibular gland. Study Design Retrospective study covering February 2015 to June 2018. Study Setting Tertiary referral center for salivary gland diseases. Subjects and Methods After extended ductal surgery, 39 patients presenting with persistent, residual, or recurrent stones were treated. Four patients had persistent stones; 16 had residual stones; and 19 presented with recurrent stones. Among these patients, 50 stones were treated with intraductal pneumatic lithotripsy. Fragmentation rate, stone-free rate, and symptom-free rate after treatment with intraductal lithotripsy were outcome measures. Results Of the 39 patients, 97.4% became stone-free, and all were symptom-free. Ninety-eight percent of the stones were completely fragmented. For 23.1% of the patients, >1 stone was treated with intraductal lithotripsy. All patients with persistent stones, 93.7% of those with residual stones, and all with recurrent stones became stone-free and symptom-free. No severe complications developed. Conclusions This study shows that patients presenting with difficult and/or multiple sialolithiasis after extended transoral submandibular duct surgery can be treated with success rates >97%. For multiple sialolithiasis in particular, a multimodal treatment approach with interventional sialendoscopy and intraductal lithotripsy as a central element is a prerequisite for success, as this enables the most difficult part to be performed with high success rates.
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Glybochko, Peter Vitalevich, Yuri Gennadevich Alyaev, Vadim Igorevich Rudenko, Leonid Mikhailovich Rapoport, Vagarshak Aramaisovich Grigoryan, Denis Victorovich Butnaru, Anna Nikolaevna Perekalina, Igor Georgievich Kraev y Dmitry Olegovich Korolev. "The clinical role of X-ray computed tomography to predict the clinical efficiency of extracorporeal shock wave lithotripsy". Urologia Journal 86, n.º 2 (26 de marzo de 2018): 63–68. http://dx.doi.org/10.1177/0391560317749422.
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Aim: To evaluate the clinical efficiency of computed tomography for diagnostics of patients with urolithiasis and the choice of treatment strategy. Material and methods: The study was carried out at the Urological Clinic of I.M. Sechenov First Moscow State Medical University and included 1044 patients with urinary stones. The ultimate goal of this study was to predict the clinical efficiency of extracorporeal shock wave lithotripsy using a combination of computed tomography and densitometry. Extracorporeal shock wave lithotripsy was performed on “Siemens Lithostar Plus,” “Siemens Modularis Uro,” and “Dornier Gemini” lithotripters. Statistical analysis of clinical data included evaluation of individual sampling groups and calculation of weighted arithmetic mean ( M). Results: The efficiency of extracorporeal shock wave lithotripsy has been determined primarily using X-ray analysis of the concrement outlines and the structure (homogeneous or heterogeneous) of its central zone. However, in terms of efficiency and repetition rate (the number of fragmentation procedures required for complete clearance) of extracorporeal shock wave lithotripsy, the mean density of the concrement along the whole length of its three-dimensional structure (expressed in Hounsfield units) appeared to be the most reliable and informative predictive index in this study. Conclusion: The combination of computed tomography with densitometry in the treatment of patients with urolithiasis allows one (1) to determine the exact localization, size, X-ray structure, and structural density of urinary stones and (2) to predict, on the basis of densitometric data histograms, the clinical efficiency and repetition rate of extracorporeal shock wave lithotripsy with due regard to the X-ray structure of peripheral and central zones, and mean density (in Hounsfield units) of urinary concrements.
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Ryazantsev, V. E., I. I. Antipkin, E. V. Ryazantsev, A. M. Khoshnaw y V. S. Larina. "PNEUMATIC CONTACT TRANSURETHRAL ureterOLITHOTRIPSY in emergency urological practice". Bulletin of the Russian Military Medical Academy 21, n.º 1 (15 de diciembre de 2019): 143–47. http://dx.doi.org/10.17816/brmma13069.
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Relevance. Minimally invasive methods of removing the ureteral calculus in urological practice have steadily taken the leading position. According to the Russian clinical recommendations the indications for endoscopic correction of ureteral calculus are concrements with a low probable passage, constant pain symptomatic on the background of adequate analgesia, the varying degrees of obstruction severity and impaired renal function. The purpose of the work is to assess the efficacy of transurethral pneumatic contact lithotripsy of ureteral calculus in emergency urological practice. The research tasks included the refinement of the endoscopic lithotripsy results, depending on the localization level among men and women. Materials and methods. The results of endoscopic treatment of ureteral calculus among 360 patients of both sexes, hospitalized in a urological hospital with emergency indications of a renal colic diagnosis, are presented. Results. The efficiency of retrograde pneumatic contact ureterolithotripsy reached 91.8 %. The most optimal this method is with the localization of calculus in the lower third of the ureter, regardless of the concrement size and sex. The percentage of the calculus fragmentation of the middle third of the ureter among men and women was 91.6 and 93.4 respectively. The lithotripsy in the upper part of the ureter was 23.6 % more effective among women. Operational complications were registered in 7.5 % cases.
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Fang, You-qiang, Jian-guang Qiu, De-juan Wang, Hai-lun Zhan y Jie Situ. "Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones". Acta Cirurgica Brasileira 27, n.º 3 (marzo de 2012): 266–70. http://dx.doi.org/10.1590/s0102-86502012000300011.
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PURPOSE: To compare the curative effects of ureteroscopic lithotripsy and laparoscopic ureterolithotomy for unilateral upper ureteral stones, and to explore optimal surgical indications and skills. METHODS: Fifty cases of unilateral upper ureteral stones were randomly divided into two groups: one group underwent ureteroscopic holmium laser lithotripsy under epidural or lumbar anesthesia (n=25), and another group underwent laparoscopic ureterolithotomy under general anesthesia (n=25). Double-J stent was routinely indwelled in both groups. Operating time, postoperative hospitalization time, stone clearance rate and perioperative complications were compared. RESULTS: Operation was successfully performed in all 50 cases, and no open surgery was converted in any case. In the ureteroscopy and laparoscopy groups, the mean operating time was 49.0±10.7 min and 41.8±8.0 min (t=2.68, P=0.00999), respectively, their hospitalization time was 2.8±1.3 days vs. 2.9±0.8 days (t =-0.40, P=0.69413), and stone clearance rate was 88.0% (22/25) vs. 100% (25/25). Stone moved to the renal pelvis in three cases in the ureteroscopy group, and residual stones were removed by extracorporeal shock-wave lithotripsy (ESWL). All patients were followed up for more than three months, and no serious complications such as ureterostenosis occurred. CONCLUSIONS: Laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy. Laparoscopic ureterolithotomy is one safe and effective treatment on unilateral upper ureteral stones.
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Zogovic, Jezdimir. "Extracorporeal shock waves lithotripsy of urinary organs in patients with one kidney". Srpski arhiv za celokupno lekarstvo 130, n.º 9-10 (2002): 312–15. http://dx.doi.org/10.2298/sarh0210312z.
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Extracorporeal Shock Waves Lithotripsy (ESWL) is a method of choice in the treatment of lithiasis. Surgical treatment is reduced to minimum, which in our case means 1-2%. Contraindications for using this method are: blood coagulation disorders, manifest tuberculosis, pregnancy, over obesity. Thanks to appropriate indications and technique which is used in an adequate way as well as to various endurological manipulations, removal of a stone by this method is safe, trauma is minimised, which is very important for patients with one kidney. During the last three years, usually in hospital conditions, 57 patients were treated in this way. Removal of a stone was performed by Extracorporeal Shock Waves Lithotripsy as mono therapy in 30 (53%) patients; Extracorporeal Shock Waves Lithotripsy by using Double-J catheter in 16 (28%) patients; Extracorporeal Lithotripsy with urine derivation by percutaneous nephrostome in 11 (19%) patients. Endurological methods were used in 27 patients. Disintegration of stone was performed in the proper way. Full success was reached. Two patients had incrustation of ureteral catheter which had to be removed by surgery. In two other patients with inferior function of one kidney, after brief obstruction, hemodialisis was performed. Our results confirm that this method is nonaggressive, tech nically perfect for disintegration of urineorgans stone on all levels followed by small complications which are often solved by endoscopie manipulations.
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Xu, Chen, Ri-jin Song, Min-jun Jiang, Chao Qin, Xiao-lan Wang y Wei Zhang. "Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients". Urologia Internationalis 94, n.º 1 (29 de julio de 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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Khan, Shariful Islam, Md Nurul Hooda, Md Safiul Alam Babul, Mohammad Habibur Rahman, Anup Roy Chowdhury, Md Moynul Hoque Chowdhury y Mohammad Zia Uddin. "Outcome of Stone Fragmentation with Pneumatic and Ultrasonic Lithotripter During Percutaneous Nephrolithotomy". Bangladesh Journal of Urology 23, n.º 2 (15 de noviembre de 2020): 129–35. http://dx.doi.org/10.3329/bju.v23i2.50303.
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Background of the study: Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for kidney stones larger than 2 cm. PCNL has replaced open surgical removal of large or complex calculi at the most institutions. The success of PCNL is related to the ability to achieve an optimum access tract and proper fragmentation. A wide range of lithotripsy techniques are currently available. One of these is ultrasonic lithotripsy, in which the stones are fragmented and sucked out simultaneously. This technique induces minimal tissue injury and could be considered as a standard modality for PCNL. The pneumatic lithotripter uses pneumatic ballast, which crushes the stones without producing any thermal effects. Because this mechanical energy passes along the metal wire to the stone, the probe works like a chisel on the stone surface. This modality destroys all stones, regardless of their composition. There were very few studies had been done in this context in our country, so I had decided to do this study to compare the outcome of stone fragmentation with pneumatic and ultrasonic lithotripter during percutaneous nephrolithotomy.
Objective: To compare the outcome of stone fragmentation with pneumatic and ultrasonic lithotripter during percutaneous nephrolithotomy.
Materials & Methods: This Prospective Interventional Study (Quasi Experimental Trial) was performed in Department of Urology, National Institute of Kidney Diseases and Urology, Sher-E- Bangla Nagar, Dhaka during the period from December 2014 to May 2016. A total of 60 subjects will be selected with renal calculi (as per inclusion & exclusion criteria), among these, half of the patients will be group A (using pneumatic lithotripsy) & rest of the patients will be group B (using ultrasonic lithotripsy). The study subjects were underwent PCNL under general anesthesia, half of which used pneumatic lithotripter and rest used ultrasonic lithotripter for stone fragmentation. Above mentioned outcome variables were assessed both per-operative and post-operatively. Data were collected, processed & analyzed. Statistical analysis of relevant variables was done by unpaired Student’s T test and Chi Square test. P value Â0.05 was considered significant.
Results: Total 60 patients were selected for study according to the selection criteria. Of the 60 subjects, 30 patients, those who were done PCNL by pneumatic lithotripsy were labeled as Group A and 30 patients, those who were done PCNL by ultrasonic lithotripsy, were labeled with Group B. Distribution of respondents in terms of different parameters is shown in tabulated form and statistical analysis was done in both groups to see statistical significance, p value less than 0.05 was considered significant. The mean stone fragmentation time was 27.23±4.78 (18-38) min in PCNL by pneumatic lithotripsy and those were 23.80±5.30 (13-34) min in by ultrasonic lithotripsy which is statistically significant. Other variables of interest which includes stone clearance rate, post operative haematuria and post operative hospital stay, were not statistically significant.
Conclusion: Comparing the findings of the present study, results indicate that stone fragmentation time is lesser in ultrasonic lithotripsy than pneumatic lithotripsy in PCNL which decreases the overall operative time.
Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.129-135
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Hosmer, Amy, Mohamed Abdelfatah, Ryan Law y Todd Baron. "Endoscopic ultrasound-guided hepaticogastrostomy and antegrade clearance of biliary lithiasis in patients with surgically-altered anatomy". Endoscopy International Open 06, n.º 02 (febrero de 2018): E127—E130. http://dx.doi.org/10.1055/s-0043-123188.
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Abstract Background and study aims Endoscopic retrograde cholangiography (ERC) in patients with complex surgically-altered anatomy (SAA) is technically demanding and has limitations. Developments in EUS-guided procedures allow alternative approaches for patients with altered gastrointestinal anatomy and biliary lithiasis. Patients and methods Single-center, retrospective review of prospectively entered patients with SAA who underwent EUS-guided hepaticogastrostomy (HGS) followed by an interval antegrade endoscopic clearance of biliary lithiasis. Results 9 patients with Roux-en-Y anatomy underwent HGS to allow clearance of biliary lithiasis after a mean of 2.5 procedures. Technical success was achieved in 100 % of patients utilizing subsequent antegrade endoscopic techniques after HGS including: balloon sweep (9), transpapillary balloon dilation (8), cholangioscopy with electrohydraulic lithotripsy (4), and mechanical lithotripsy (1). HGS stents were removed in all patients. 1 adverse event (cholangitis) occurred after cholangioscopy and prolonged intraductal electrohydraulic lithotripsy. Conclusion EUS-guided antegrade therapy for the management of biliary lithiasis in patients with altered gastrointestinal anatomy appears efficacious with a low risk of adverse events. These preliminary results suggest this approach should be considered at centers with available expertise.
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Shrestha, Naresh Man. "A Comparative Study of Percutaneous Nephrolithotripsy and Extracoeporeal Shockwave Lithotripsy For The Treatment of Lower Pole Kidney Stone of Size 10-20 mm". Journal of Nepalgunj Medical College 18, n.º 2 (9 de agosto de 2021): 39–43. http://dx.doi.org/10.3126/jngmc.v18i2.38893.
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Introduction: A renal stone is commonly found at the Lower-pole of the kidney. Studies have reported various opinions about efficacy and safety of Percutaneous Nephrolithotripsy and Extracoeporeal Shockwave Lithotripsy for the treatment of lower pole stone of size 10-20 mm.
Aims: The present study aimed to compare between Percutaneous Nephrolithotripsy and Extracoeporeal Shockwave Lithotripsy for safe and effective treatment of lower pole stone of size 10-20 mm.
Methods: It is a prospective study conducted from December 2019 to November 2020 in the Urology Department of Nepalgunj Medical College. Total 66 patients under inclusion criteria were divided into two groups. Group I (32 patients) was allocated for patients who were treated under Percutaneous Nephrolithotripsy while Group II (34 patients) was allocated for patients who were treated with Extracoeporeal Shockwave Lithotripsy. Two groups were compared for stone free rate, retreatment rate, auxiliary treatment (%), operation time, hospital stay, haematuria, blood transfusion, obstruction and fever.
Results: The stone free rate was significantly higher in Group I when compared to Group II. While the rate of retreatment and auxiliary treatment were significantly lower in Group I than Group II. However, mean hospital stay, mean operation time and the rate of haematuria was significantly higher in Group I when compared to group II. There were no statistically significant differences between Group I and Group II for post-operative complications such as, blood transfusion, obstruction and fever.
Conclusion: Stone free rate was significantly higher in Group I while retreatment rate and auxiliary treatment rate were significantly higher in Group II. Therefore, Percutaneous Nephrolithotripsy is more effective for the treatment of the lower pole stone of size 10-20mm when compared to Extracoeporeal Shockwave Lithotripsy. However, duration of hospital stay and operation time were longer and incidence of haematuria was higher in Percutaneous Nephrolithotripsy than Extracoeporeal Shockwave Lithotripsy.
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Bantis, Athanasios, Georgios Tsakaldimis, Athanasios Zissimopoulos, Stilianos Giannakopoulos, Christos Kalaitzis, Michail Pitiakoudis, Alexandros Polichronidis y Stavros Touloupidis. "Can Tumor Necrosis Factor-α and Interleukin-6 Be Used as Prognostic Markers of Infection following Ureteroscopic Lithotripsy?" ISRN Urology 2014 (30 de enero de 2014): 1–5. http://dx.doi.org/10.1155/2014/457063.
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Introduction. Ureteroscopic lithotripsy (URS) although highly effective for the treatment of ureteral stones is associated with certain complications, the more common of which are postoperative fever and infection. In the present study we aimed to evaluate the levels of serum cytokines in patients undergoing ureteroscopic lithotripsy and investigate any possible correlation between levels of cytokines and infectious complications after URS. Materials and Methods. Thirty patients (19 males, 11 females), with a mean age of 47 (range: 26–68) that underwent URS lithotripsy for ureteral stones, and 10 healthy volunteers serving as the control group were enrolled in this study. Serum samples for TNF-α and IL-6 were obtained before surgical intervention and after 1, 24, and 48 hours and 2 , 24, and 48 hours, respectively. The preoperative and postoperative levels were compared and correlated with the possible complications after URS. Results. Serum TNF-α levels were statistically significant, increased 1 hour (P=0.0083) and 48 hours (P<0.001) after operation. IL-6 levels were found statistically significant, elevated after 2 and 24 hours from the URS (P<0.001). In 2 patients we observed postoperative fever (>38.5°C). These two patients had high preoperative values of TNF-α and IL-6 ( 30 and 50 pg/mL, resp.) and these values increased postoperatively. Conclusion. High preoperative levels of serum TNF-α and IL-6 may indicate a predisposition for postoperative inflammation and infection following URS lithotripsy.
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Marchini, Giovanni Scala, Fábio Cesar Miranda Torricelli, Eduardo Mazzucchi, Miguel Srougi y Manoj Monga. "Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique". Canadian Urological Association Journal 9, n.º 7-8 (17 de julio de 2015): 494. http://dx.doi.org/10.5489/cuaj.2852.
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The management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy, cystolithopaxy, rigid or flexible ureteroscopy with intracorporeal lithotripsy, percutaneous nephrolithotomy, open surgery, and a combination of those methods. In this study we describe the management of severe forgotten encrusted ureteral stents in 3 female patients using a prone splitleg position. This position allows us to effectively treat any site and degree of stent encrustation in a single-session approach with the patient in the same position during the whole procedure. All patients were rendered stent and stone free. No complications occurred.
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Iskhakova, R. S. y A. G. Gilmanov. "Characteristic Curves and Criterion of Critical Difference in Assessing the Informativeness of Markers of Renal Damage in Lithotripsy". Russian Sklifosovsky Journal "Emergency Medical Care" 9, n.º 4 (22 de enero de 2021): 593–97. http://dx.doi.org/10.23934/2223-9022-2020-9-4-593-597.
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Aim of study. Determination of the diagnostic significance of laboratory biomarkers of renal tissue damage in remote nephrolithotripsy in patients with urolithiasis.Material and methods. On the basis of the urology department of the Republican Clinical Hospital (Ufa), 35 patients with urolithiasis were examined, who underwent remote shock wave lithotripsy sessions. The laboratory parameters were determined in patients: the number of erythrocytes, leukocytes in the blood, the level of lipocalin and microalbumin in the urine, as well as alpha2-microglobulin and cystatin C in the blood serum. The control group included 14 healthy donors. To determine the diagnostic efficacy of biomarkers of renal injury, characteristic curves were plotted, and lipocalin level shifts were interpreted taking into account the data on the critical difference criterion value.Results. When studying the urinary level of lipocalin in patients with urolithiasis, it was found that the difference in the concentration of the biomarker in them and in healthy individuals is statistically insignificant (0.68 pg/ml versus 0.4 pg/ml). After the first session of extracorporeal lithotripsy, an increase in urinary excretion of lipocalin by 5 times is noted, after the second - by an additional 1.6 times, and after the third - by another 1.7 times (the differences are statistically significant). To analyze the prognostic efficiency of markers of renal injury, characteristic curves were plotted. The area under the ROC curve for lipocalin varied from 0.77 to 0.80 depending on the number of sessions, which indicates a high diagnostic efficiency of this biomarker. The determination of the criterion of critical difference (CCD) showed that an increase in the level of lipocalin in the urine after the first session of lithotripsy more than 2.1 times is statistically significant. The concentration of the specified biomarker in urine exceeding 4.5 pg/ml, 6 pg/ml and 10 pg/ml after the first, second and third sessions of lithotripsy, respectively, can be considered as a basis for changing treatment tactics (delaying the second procedure) or performing lithotripsy in another way.Conclusion. Urinary lipocalin, associated with neutrophil gelatinase, is an informative biomarker of renal injury in the assessment of complications associated with the lithotripsy procedure.
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Hamal, Bhairab Kumar, Bharat Bahadur Bhandari y Narayan Thapa. "Extracorporeal Shock Wave Lithotripsy in Management of Urolithiasis". Journal of Patan Academy of Health Sciences 1, n.º 1 (20 de julio de 2015): 4–7. http://dx.doi.org/10.3126/jpahs.v1i1.13007.
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Introductions: Since 1980, when Chaussy in West Germany first demonstrated the efficacy of Dornier prototype lithotripsy HM1, extra corporeal shock wave lithotripsy has become a convenient, noninvasive, outpatient procedure used to fragment urinary stones. It is a standard internationally accepted first line preferred option for the management of renal stone less than 2.5 cm size. Methods: A cross sectional study was conducted in the department of surgery of Shree Birendra Hospital on outpatient department basis during the period of March 2002 to February 2012. All consecutive patients presenting with renal and upper ureteric stones detected either on X-ray or ultrasound of the Kidney- Ureter-Bladder who were treated with extra corporeal shock wave lithotripsy. Descriptive analysis included age, sex, stone location, need of total session, use of double J stent and complications. Results: Total 710 diagnosed cases of urolithiasis were taken for the study. The youngest age was 16 years and oldest 69 years of age. Overall stone clearance rate was 73.52%. The stone free rate for upper, middle, and lower calyx were 85.94%, 90.20% and 50.52% respectively. Conclusions: Extracorporeal shock wave lithotripsy was successful in the management of the stones smaller than 2.5 cm in all caliceal locations and minimal morbidity.Plain Language Summary ESWL with new generation Lithotripter was safe and effective in adult out patients with urolithiasis less than 2.5 cm in functioning kidney without distal obstruction or urine infection. Stone clearance was 70%. DJ stenting was done in stone larger than 2 cm. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13007 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):4-7
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Hussain, Khalid, Attiq-ur-Rehman Khan, Rao Nouman Ali, Maria Tariq, Salman Shahid y Muhammad Khalid Butt. "Incidence of Stone Retropulsion in Ureteroscopic Pneumatic Lithotripsy for lower ureteric stones by using stone cone." Professional Medical Journal 26, n.º 12 (10 de diciembre de 2019): 2169–72. http://dx.doi.org/10.29309/tpmj/2019.26.12.3693.
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Objectives: To measure the incidence of stone Retropulsion and its complication in ureteroscopic pneumatic lithotripsy for lower ureteric stones by using stone cone. Study Design: Observational cross sectional study. Setting: Gujranwala Medical College, Gujranwala. Period: January 2017 to December 2018. Material & Methods: Consecutive simple random sampling technique was used. Total 120 patients were treated with URS pneumatic lithotripsy for single ureteric stone were enrolled in study. The diagnosis was established by plain spiral CT scan in all patients. The incidence of stone Retropulsion and complications of procedure were noted. Data was analyzed using SPSS 22.0, chi square test was used to check stratification of data, p value less than 0.05 was taken significant. Results: The stone was in lower ureter in all patients who were included in study regardless of side. The mean age of patients was 46±2.6 years and 65% (78) patients were male while 35% (42) patients were females. Success rate of 97.5% (116) achieved in patients in which stone cone was used. Conclusion: Use of stone cone gives high success rate in preventing stone Retropulsion by using pneumatic lithotripsy.
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Cordes, Jens, Felix Nguyen, Birgit Lange, Ralf Brinkmann y Dieter Jocham. "Damage of Stone Baskets by Endourologic Lithotripters: A Laboratory Study of 5 Lithotripters and 4 Basket Types". Advances in Urology 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/632790.
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Background. In some cases, the ureteral stone is simultaneously stabilized by a stone basket when endourologic lithotripsy is performed. This stabilization can be either on purpose or by accident. By accident means that an impaction in the ureter occurs by an extraction of a stone with a basket. A stabilization on purpose means to avoid a retropulsion of the stone into the kidney during lithotripsy. At this part of the operation, stone baskets have been frequently damaged. This severing of wires can lead to ureteral trauma because of hook formation.Material and Methods. In a laboratory setting, the time and the pulse numbers were measured until breaking the wires from four different nitinol stone baskets by using five different lithotripsy devices. The endpoint was gross visibledamage to the wire and loss of electric conduction.Results. The Ho:YAG laser and the ultrasonic device were able to destroy almost all the wires. The ballistic devices and the electrohydraulic device were able to destroy thin wires.Conclusion. The operating surgeon should know the risk of damagefor every lithotripter. The Ho:YAG-laser and the ultrasonic device should be classified as dangerous for the basket wire with all adverse effects to the patient.
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Lesovyi, V. М., R. V. Stetsyshyn y D. V. Shchukin. "Comparison of the contact ureterolithotripsy methods in treatment of ureterolithiasis". Klinicheskaia khirurgiia 85, n.º 7 (26 de julio de 2018): 71–74. http://dx.doi.org/10.26779/2522-1396.2018.07.71.
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Objective. Comparative analysis of results of the ultrasound and laser contact ureterolithotripsy in treatment of «сomplex» ureteric calculi.
Маterials and methods. In 257 patients, suffering «сomplex» calculi a contant lithotripsy was conducted, using ultrasound lithotriptor, and in 265 patients – a laser one.
Conclusion. Application of laser contact ureterolithotripsy promotes improvement of the treatment results in «сomplex» ureteric calculi, and reduction of the іntra– and postoperative morbidity rate.