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Objective To explore the clinical effect of the transurethral ureteroscopic holmiumlaser lithotripsy in the treatment of ureteral calculi.Methods This study conducted a retrospective analysis of 205 patients with ureteral calculi from September 2015 to June 2017 in the affiliated hospital of Panzhihua university.According to the surgical method,all the patients were divided into control group (102 cases) who were treated with conventional pneumatic lithotripsy and observation group(103cases) who received transurethral ureteroscopic holmiumlaser lithotripsy.The surgical efficacy,renal function indexes and surgical indexes of the two groups were compared and analyzed respectively.Results The total effective rate of observation group was 97.06％,the control group was 85.00％,the difference between two groups was significantly(P ＜ 0.05).There was no significant difference in Cr and BUN level before surgery between two groups (P ＞ 0.05);after treatment,the Cr and BUN levels of two groups were improved significantly (P ＜ 0.05);while the renal function improved index of observation group was significantly better than that of control group,the difference was significant(P ＜ 0.05).The intraoperative blood loss,operative time and postoperative hospital stay of the observation group were significantly lower than those of control group (P ＜ 0.05).Conclusion The transurethral ureteroscopic holmiumlaser lithotripsy and normal air pressure ballistic were both well treatment for ureteral calculi,but patients with the holmium laser lithotripsy have better renal function indexes and operation index.
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Objective:To study the curative effect of standard channel (percutaneous nephrolithotomy) PCNL combined with ultrasonic pneumatic lithotripsy in the treatment of upper urinary tract calculi under the guidance of ultrasound, and analyze the influence factors of post-operative residual calculi.Methods: The data of 94 patients with upper urinary tract calculi were researched by using retrospective analysis. All of patients underwent the treatment of standard channel PCNL combined with ultrasonic pneumatic lithotripsy for upper urinary tract calculi under the guidance of ultrasound. The curative effects of upper ureteral calculi, pelvis calculi, multiple renal calculi, kidney stone with ureteral calculi and renal staghorn calculi were observed, and the post-operative complications were further detected so as to grasp the situation of residual calculi and calculate the clearance rate of calculus. The difference of general documents between patients with residual calculi and those without residual calculi were compared, and the influence factors of residual calculi were analyzed by using Logistic regression equation.Results:The incidence of post-operative complication was 27.66%, the clearance rate of calculus was 67.2% and residual rate of calculus was 32.98%. The differences of location puncture time, establishing channel time and ostomy fistula time among the five kinds of patients were no significant (F=1.89,F=2.46, F=0.91,P>0.05). While the differences of calculus removed time, amount of bleeding in intra-operative period and length of stay among various kinds of patients were significant (F=81.90,F=35.84,F=4.17,P<0.05). Depended on the results of Logistic regression equation, the types of calculus, size of calculus, hydronephrosis, urinary tract infection and renal insufficiency were the influence factors of post-operative residual calculus of patients with upper urinary tract calculi who received the treatment of PCNL combined with ultrasonic pneumatic lithotripsy.Conclusion: PCNL combined with ultrasound pneumatic lithotripsy under the guidance of B ultrasound without major complications has better curative effect, and its clearance rate of calculus is higher. Besides, the types of calculus, size of calculus, hydronephrosis, urinary tract infection and renal insufficiency can increase the incidence of post-operative residual calculus and affect the curative effect.
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Objective To compare the effect and adverse reaction of ultrasound-guided ESWL and UPL in the treatment of ureteral stones.Methods According to the different treatment method,80 patients with ureteral stones were divided into URL group and ESWL group.The effective rate and the incidence rate of complications were compared between the two groups.Results In ESWL group,the success rate for upper gravel was 92.3％,the success rate of lower ureteral stone lithotripsy was 55.6％,there was significant difference between them(x2 =0.049,P ＜ 0.05).In UPL group,the success rate of lower ureteral stone lithotripsy was 96.0％,and the total success rate of stone was 87.5％,while those in ESWL group were 55.6％ and 75.0％,the differences were significant between the two groups(x2 =0.001,0.032,all P ＜ 0.05),but there was no significant difference in the success rate of upper gravel between the two groups(P ＞ 0.05).The incidence rate of hematuria in ESWL group was 82.5％,which was significantly lower than 97.5 ％ in the UPL group (x2 =0.034,P ＜ 0.05).The incidence rates of fever,pain in renal region,nausea and vomiting were 17.5％,42.5％,37.5％ in the ESWL group,which were significandy higher than those in the UPL group (x2 =0.023,0.033,0.004,all P ＜ 0.05).Conclusion Compared with ESWL,UPL has high success rate of lower ureteral stone lithotripsy,less complications.
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Objective To evaluate the therapy effect of pneumatic lithotripsy treatment under ureteroscopic on urinary catheter encrustation(CE).Methods Eight patients with difficulty in pulling catheter tube crustcaused were enrolled as our subjects.They were performed pneumatic lithotripsy under ureteroscope operation.The information related to operation was recorded.Results Eight cases were successful in terms of crushing catheter encrustations,and the catheters were removed smoothly.Conclusion The therapy of pneumatic lithotripsy treatment under ureteroscopic is proved to be a minimally invasive treatment with small damage,and higher safety.
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Objectives To compare the effectiveness and safety of local anesthesia and epidural anesthesia with ureteroscopic pneumatic lithotripsy at distal ureteral stone. Methods A total of 160 patients with distal ureteral stone treated with ureteroscopic pneumatic lithotripsy from December 2013 to February 2014 were included. They were divided equally into 2 groups by method of random sampling. Patients in group A (n=80) treated with local anesthesia were compared to those in group B(n=80),who were dealt with epidural anesthesia. Results The statistical difference was significant in terms of hospital stay after operation and overall cost of therapy(P0. 05)respectively. Conclusion For the identified patients,the local anesthesia in ureteral ureteroscopic pneumatic lith-otripsy is a safe,effective and economical method for distal ureteral stone.
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Objective To compare the efficacy of ureteroscopic lithotripsy ( URL) combined with occlusion devices and mini-invasive percutaneous nephrolithotomy ( MPCNL) in the treatment of upper incarcerated ureteral stones. Methods A total of 89 patients with unilateral upper ureteral calculi were enrolled from April 2011 to July 2013, 42 of which were treated with MPCNL and 47 of which were treated by rigid ureteroscopic lithotripsy combined with occlusion devices. Resuts There were no significant differences in the success rate of primary lithotripsy (97.6% vs.95.7%, χ2 =0.000, P=1.000).No marked differences were detected in the stone clearance rate (97.5% vs.95.6%, χ2 =0.000, P=1.000), complication rate (7.1% vs.8.5%, χ2 =0.000, P=1.000) and operation time [(80.2 ±11.9) min vs.(65.1 ±10.9) min, t =6.248, P=0.000] between the two groups.The hospitalization time in the URL group was (3.5 ±1.5) d, which was obviously shorter than that in the MPCNL group , in which it was (7.3 ±1.5) d(t=11.931, P=0.000). Conclusion URL combined with occlusion devices can obtain satisfactory results as well as MPCNL in the treatment of upper ureteral calculi by proper case selection and careful operation performance .
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Objective To assess the efficiency and safety of the ureteroscope pneumatic lithotripsy (UBSL) and extracorporeal shock-wave lithotripsy (ESWL) for urinary tract calculi,and to guide the clinical practice.Methods Through searching the electronic bibliographic databases,including CNKI,VIPand WANFANG database,and searching published articles by hand to assemble the random clinical trial of ureteroscope pneumatic lithotripsy and extracorporeal shock-wave lithotripsy for urinary tract calculi.The retrieval articles were all Chinese,and the time was from January 1990 to September 2012.The retrieval results were systematically evaluated.Results Three randomized clinical trials involving 124 patients were analyzed.The results of meta-analysis demonstrated:the clearance rote at one time,the rote of efficiency,the rote of operation one more time all had statistically significant difference between two methods.The incidence of renal pain,and the incidence of hematourine had no significant difference between two methods.Conclusions Ureteroscope pneumatic lithotripsy and extracorporeal shock-wave lithotripsy for urinary tract calculi can improve the clearance rote and efficiency rote as well as decrease the rate of operation one more time.However,it can not reduce the rate of complication of the operation.
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Objective To explore the safety and efficacy of ultrasound-guided minimally invasive percutaneous nephrolithotomy(mini-PCNL) for the patients with complicated upper ureteral calculus.Methods The clinical data of 28 patients with complicated upper ureteral calculus was retrospectively analyzed,all of the patients had undergone ultrasound-guided mini-PCNL.The parameters included operative time,the stone-free rate,theretention time of nephrostomy tube,the average postoperative hospital stay and the complications.Results In all the 28 case,the 16F nephrostomy tract was established and the calculus were cleared successfully in one stage.The average operative time was 40 minutes,the average estimmate intraoperative blood loss was 60ml.The stone-free rate was 100％ according to the ultrasonography or KUB after the surgery.There were no complications such as bleeding,the damage to pleura or intestines.Conclusion As the preferred treatment of complicated upper ureteral calculus,ultrasound-guided miniPCNL is a safe and effective procedure.
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Objective To evaluate the clinical effect and safety of ureteroscopic pneumatic lithotripsy combined with transurethral resection of prostate(TURP)for treatment of benign prostatic hyperplasia(BPH)with bladder calculus.Methods 68 patients of BPH with bladder calculus treated by ureteroscopic pneumatic lithotripsy combined with transurethral resection of prostate were reviewed.Results Satisfactory effects were achieved in all these 68 cases without serious complications.Conclusion Ureteroscopic pneumatic lithotripsy combined with TURP is a minimally invasive,safe and effective method in the treatment of BPH and bladder calculus.
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Objective To evaluate the therapeutic efficacy of ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi. Methods Clinical data of 56 cases with complicated ureteral calculi who were treated with ureteroscopic pneumatic lithotripsy was reviewed. Among them 15 cases were proximal ureteral calculi,41 cases were middle and distal ureteral calculi. Treatment by extracorporeal shockwave lithotripsy (ESWL) failed in 25 cases,8 cases complicated with fever. Results In 41 cases with middle and distal ureteral calculi, successful lithotripsy was achieved after the first treatment session,the success rate was 100.0% (41/41). In 15 cases with proximal ureteral calculi ,successful lithotripsy was achieved in 10 cases after the first treatment session,the success rate was 66.7%(l0/15). Calculi migrated to kidney in 3 cases who treated by ESWL for 1-2 times. The failure was due to ureteral kink in 1 case and due to ureteral perforation that required surgical repair in another case. Forty-nine cases were calculi-free after 4 weeks,the calculi-free rate was 87.5%(49/56). Emergency operation was performed in 8 cases complicated with fever. Successful lithotripsy was achieved after the first treatment session in 7 cases. In one patient,calculi migration occurred. Within all 8 cases obstruction was released and fever was allayed after operation.The complication rate was 1.8% (1/56). Conclusion Ureteroscopic pneumatic lithotripsy for treatment of complicated ureteral calculi is a safe and effective method.
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Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy (PNL) in combination with pneumatic and ultrasonic lithotripsy in the treatment of complex renal calculi. Methods Under general anesthesia,an ureteral stent was placed into the patient by cystoscopy. With the prone position,percutaneous access was established by inserting an access needle into the intended calix under the guidance of ultrasonography or fluoroscopy. Afterwards,combined pneumatic and ultrasonic probes were used by nephroscopy for lithotripsy. Results A single tract was used in 137 patients,while two or three tracts were created in the other patients (11 and 2 respectively). One-step procedure to remove the stones was achieved in 119 patients,while a second intervention was performed in 27,and three procedures was carried out in 4. The mean time of the operations were (88?34) min. After the operation,one patient developed infectious shock,and then was cured by anti-shock therapy;two patients showed secondary hemorrhage in two weeks postoperation,and was cured by conservative therapy. In this series,the rate of stone clearance was 84.7% (127/150);23 cases had residual stones,10 of them received ESWL (the stone was removed completely in 7 of the 10 cases),and the other 13 were treated by oral medicines. Six months after the operation,follow-up examination showed a stone-free rate of 89.3% (134/150). Conclusion Combination of ultrasonic and pneumatic intracorporeal lithotripsy is effective and safe for complex renal calculi,which is intractable by open surgery.
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Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy in the treatment of ureter stones.Methods A total of 186 cases ureteroscopic pneumatic lithotripsy were performed in our hospital.The outcomes of the surgery were analyzed.Results The success rate of the operation was 80.6%(29/36) for the upper ureteral calculi,92.7%(51/55) for the middle,and 100%(95/95) for the lower ones,respectively.Four weeks after the surgery,re-examination showed that the rate of stone removal was 94.1%(175/186).Injuries to the ureter occurred in 5(2.7%) of the cases.Conclusion Ureteroscopic pneumatic lithotripsy is an effective and safe method for ureteral calculi.
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Objective To evaluate the effect of pneumatic ureteroscopic lithotripsy(URSL) for ureteral calculi.MethodsA total of 378 cases of ureteral calculi received URSL in our hospital by using F8/9.8 Wolf rigid ureteroscope and EMS Ⅱ pneumatic lithotripter(Switzerland).Among the cases,213 had calculi at the left side,158 at the right side,and 7 at the both sides;81 had the stones in the upper ureter,146 in the middle segment,and 158 in the lower part.Results In the cases,313 patients(320 sides) were cured after the first operation with a success rate of 82.8%(313/378).The success rates for the upper,middle,and lower ureteral calculi were 60.5%(49/81),84.2%(123/146),and 93.7%(148/158),respectively.The stones were removed completed in 1 to 8 weeks after the procedure.Fifteen patients were converted to an open surgery.In 3 patients,the URSL were stopped due to failure in placing the ureteroscope.The main postoperative complications in our series included perforation of the ureter(8 cases) and fever(13).Conclusions USRL is a safe,minimally invasive,and effective treatment.It should be the first choice for middle and lower ureteral calculi.
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Objective To evaluate the feasibility and efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)in the lateral position.Methods A total of 48 patients with staghorn(12 cases,2.2 to 5.8 cm in diameter)or multiple renal calculi(31)or upper ureteral stones(5)were treated with MPCNL in our hospital between July 2004 to October 2007.The patients were placed in a lateral position with the head 10? lower and the feet 20? lower.The puncture was made under the guidance of X-ray or ultrasonography,and then Holmium laser or EMS lithotripter was used for stone fragmentation.The stone debris was removed by irrigation.Results The procedure was completed in all of the 48 patients except one,who was converted to a supine position because of the difficulty in puncture.Among the 47 cases,41 were cured with the first operation,the other 6 received catheterization in the first procedure,and then underwent calculi removal in a second-stage operation.None of the patients were converted to open surgery.The mean operation time in this series was(137.5?39.6)min.The one-stage cure rate in our patients was 82.9%(34/41).None of the cases had massive blood loss,or injuries to the pleura and other organs.Follow-up was available in 21 cases for 1 to 3 months.During the period,among the 17 patients who had hydronephrosis,11 were cured and 6 were improved;and among the 4 who had residual stones,1 received ESWL in 1 months after the first operation and was cured afterwards;the other 3 were treated by traditional Chinese medicine,2 of them were cured.Conclusions The MPCNL performed on the patients in the lateral position is an effective alternative for renal calculi,and favorable to intra-operative anesthesia monitor.
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Objective To evaluate the efficacy of calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi.Methods The severe hydrocalycosis was incised using electrocautery,then pneumatic lithotripsy was performed and the broken stones were taken out.For those patients with stenotic entrance to renal calyces without hydrocalycosis,we stabbed into the stones with the lithotriptic pole(1 mm in diameter) through renal parenchyma and took the broken stones out of the entrance.Results The renal pedicle were not blocked in 19 cases.The operation time was 90-150 minutes,with a mean of 120 minutes.There was no blood transfusion with the blood loss ranging form 100 to 250 ml.The procedures were successful in 17 cases without residual stones after operation;intraoperative residual sand-like calculi were found in 1 case and removed by irrigation and drainage through nephrostomy tube;intraoperative missing calyceal calculi occurred in 1 case and were cleared by extracorporeal shock wave lithotripsy(ESWL).A follow-up for 10-60 months(mean,18 months)in 15 patients showed recurrence in 2 ones,and the stones were removed by ESWL.Conclusions Calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi has the advantages of less blood loss and definite efficacy.
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443) ?mol/L) due to upper urinary calculous obstruction,urgently treated by pneumatic lithotripsy(EMS,Switzerland) under ureteroscopy,from August 2002 to April 2006 in this hospital.After stone fragmentation and removal,an indwelling double-J stent was placed into the ureter at the same time.Results The continuity of the ureter was restored after one session of lithotripsy in all the 9 cases(14 sides).The ureteral calculi were thoroughly removed on one session in 7 cases(12 sides).Few residual stones were found in the renal pelvis in 2 cases(2 sides),in one of which the stones were spontaneously expelled after oral medication,and in another,after extracorporeal shock wave lithotripsy(ESWL).No severe complications happened,such as ureteral avulsion,rupture,or perforation.Concentrations of serum creatine were decreased to normal levels within 3~7 days after operation in all the 9 cases.The gross blood urine disappeared in 1~4 days postoperatively.The patients were discharged from the hospital after 3~7 days (mean,5 days) after operation.The double-J catheter was removed at 1~2 months postoperatively.Follow-up examinations in 7 cases for 2~30 months(mean,14 months) found normal levels of serum creatine and no recurrent urinary stones under B-ultrasonography or X-ray radiography.Conclusions Ureteroscopic pneumatic lithotripsy in the treatment of acute renal failure due to upper urinary calculous obstruction is an effective treatment with short operation time,safety,and minimal trauma.By using this procedure,both sides of ureteral stones can be removed on one session.
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Objective To evaluate the clinical efficacy of pneumatic lithotripsy under ureteroscope in the treatment of ureteral calculi. Methods A total of 110 cases of ureteral calculi were treated by using 8/9.8 F Wolf rigid ureteroscope and JUN-AIR pneumatic lithotripter. Results Successful lithotripsy under ureteroscope was achieved on one session in 105 cases, with a success rate of 955% (105/110). Calculi were entirely extracted within 1~6 weeks. Conversions to open surgery were required in 2 cases because of failed ureteroscope insertion. Upper ureteral stones moved into the kidney in 3 cases, 2 of which underwent the ESWL and 1 of which received medical treatment. Postoperatively, 5 cases were complicated with urinary infection with mild hematuria lasting for 1~3 days. Conclusions Pneumatic lithotripsy under ureteroscope is an effective method for treating mid-lower ureteral calculi, with advantages of high efficiency, safety, minimal invasion, less complications and simplicity of performance.
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Objective To treat urinary calculi with pneumatic lithotripsy under non-endoscopy.Methodes We applied the pneumatic lithotripsy machine,which made in China,to treat huge or staghom nephrolith and calculi of anterior urethra under non-endoscopy,taken out stone fragmentations after lithotripsy.There was 1 case of huge nephrolith,7cases of staghom nephrolith,3 cases of anterior urethral calculi.Results Every case of nephrolith was successfully performed by using lithotrisy and extracted stones only one case.1 case in total nephrolith cases was found residual stones and sick-side renal functions were improved than before in all casws followed up for 3 moths to 2 years.the cases of anterior urethral calculi urinated fluently and had no urethral stenoses followed up 1～2 years.Conclusion This kind of operation used pneumatic lithotripsy to treat urinary calculi under non-endoscopy is safe,slight injury and curative effect is reliable.
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Objective To compare the efficacy of Holmium:YAG laser and pneumatic lithotripsy in the treatment of ureteral calculi.Methods From February 2002 to February 2007,totally 1035 patients with ureteral calculi underwent ureteroscopic lithotripsy with Holmium:YAG laser or pneumatic lithotripsy in our hospital.The data of the patients were analyzed retrospectively.Results The success rate of primary lithotripsy was 99.1%(328/331)in the patients received holmium laser,and 97.6%(687/704)in those who underwent pneumatic lithoclast(?2=2.703,P=0.100).Stone-free rate at 3 weeks was 98.2%(322/328)in the Holmium laser group,which was significantly higher than that in the pneumatic lithoclast group 88.1%(605/687),?2=28.639,P=0.000].However,significantly more ureteroscopes were damaged in the Holmium laser group than the pneumatic lithoclast group(11 vs 6,?2=8.509,P=0.004).Conclusions The stone-free rate in holmium laser group is higher than that in pneumatic lithoclast group.However,more ureteroscopes are damaged by holmium laser.
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Objective To explore the efficacy of transurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy for bladder calculus.MethodsBy using transurethral F20.8 nephroscope and EMS LithoCaster,we performed transurethral nephroscopic pneumatic lithotripsy and ultrasound lithotripsy on 69 patients with bladder calculus(63 men and 6 women)between October 2005 and May 2008.The diameter of the calculi was ranged from 1.5 to 6.0 cm.Among the patients,42 had one stone in the bladder,while 27 had multiple calculi.Fifty-five patients were complicated with BPH,14 had neurogenic bladder,and 4 showed bladder diverticulum with stones in situ.Pneumatic frequency was set at 8-12 Hz,and ultrasonic energy was 50%-60%.For the patients with BPH electrovaporization ablation was plused.ResultsAmong the 69 patients,68 were cured in one session.The mean operation time was 25 minutes(15 to 40 minutes).One patient was converted to open surgery because of rupture of the bladder during the procedure.No patient had urethral stricture,infection,or massive hemorrhage during the operation.Follow-up was available in 68 patients for 6 to 10 months(mean,9 months).During the period,no recurrent calculi was found by ultrasonography and X-ray.ConclusionTransurethral nephroscopic pneumatic lithotripsy combined with ultrasound lithotripsy is effective for bladder calculus.