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Objective To determine the predictive parameters of impacted ureteral stones and evaluate the predictive value of ureteral wall thickness for impacted ureteral stones.Methods A total of 93 patients with proximal ureteral stones from January 2017 to December 2017 were included in the study [71 males and 22 females,aged 30-80 years,and body mass index (23.7 ± 2.7) kg/m2].Both clinical and computed tomography urography (CTU) data were compared between patients with or without impacted ureteral stone,including sex,age,body mass index,renal pelvic diameter,longitudinal size of stone,transverse size of stone,stone surface area,stone volume,hounsfield units of stone,diameter of the ureter proximal to the stone,and ureteral wall thickness at the impacted ureteral stone site.The receiver operating characteristic curve (ROC) was used to analyze the performance of each of the above-mentioned parameters for predicting the impacted ureteral stones.Multivariate logistic regression analysis was used to select the independent risk factors of impacted ureteral stones.Results Among 93 patients,38 (40.8％) patients were with impacted stones and 55 (59.1％) without impacted stones.Univariate analysis showed significant difference in ureteral wall thickness (t =6.344,P ＜ 0.001),diameter of the ureter proximal to the stone (U =607.5,P =0.001),longitudinal size of stone(U =580.5,P ＜0.001),transverse size of stone(t =4.172,P ＜0.001),stone surface area(U =508.5,P ＜ 0.001),stone volume (U =508.5,P ＜ 0.001) and hounsfield units of stone (t =6.344,P =0.006) between patients with or without impacted stones.Ureteral wall thickness(UWT)showed the largest area under curve (AUC) among those parameters (AUC =0.825,P ＜ 0.001),followed by stone surface area and stone volume.The optimal cut-off value of ureteral wall thickness was 3.16 mm,with sensitivity of 71.1％ and specificity of 85.5％.Multivariate analysis showed that ureteral wall thickness (Wald =18.709,P ＜ 0.001) and stone volume (Wald =8.391,P =0.004) were independent predictors of impacted stones.Conclusion Ureteral wall thickness was related to the presence of impacted ureteral stones and could be used for predicting impacted ureteral stones.
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Objective To investigate the safety,efficacy and feasibility of flexible ureteroscopic holmium laser lithotripsy without preoperative stent treating ureteral stone in tortuous ureter.Methods 69 patients with ureteral stone in tortuous ureter retrospectively analyzed from March 2017 to December 2018 were enrolled and analyzed retrospectively.There were 30 males and 39 females,aged from 19 to 67 years old,with an average age of 45 years.The burden of ureteral stones was 0.6-3.0 cm,with an average of 1.1 cm.24 patients with CT scan or intravenous urography showed tortuous ureter at the distal end of the ureteral calculi.The remaining 45 patients were found to have tortuous ureter during surgery.None of patients had preoperative ureteral stents.All preoperative urine cultures were negative.During the operation,the ureteral sheath was placed in the distal position of tortuous ureter,and the flexible ureteroscope was inserted into the ureter via sheath.Under continuous perfusion,the flexible ureteroscope was curved and pushed along the direction of the ureteral tortuosity.After through the tortuous position,the stone was pushed back to the kidney and crushed.For stones that could not be pushed,the stones were broken into pieces in the ureter and pushed back to the kidney for further pulverization.The ureteral stent was routinely placed at the end of surgery.Results Among a total of 69 patients,64 patients were treated by flexible ureteroscopic holmium laser lithotripsy without preoperative stent,and the success rate was 92.8％.Among the 5 patients who failed the operation,1 patient underwent ureterolithotomy because the tortuous ureteral wall was weak,resulting in ureteral perforation by flexible ureteroscope;in 1 case,after the flexible ureteroscope passed through the tortuosity,the calculi could not be pushed back to kidney and the in situ lithotripsy could not be performed because of the huge size of calculi(3.0 cm),so ureterolithotomy were performed;1 patient underwent PCNL because flexible ureteroscope could not pass through the tortuosity;1 patient failed to insert the ureteral sheath because of ureterostenosis and underwent flexible ureteroscopic lithotripsy after stent implantation;1 patient underwent stent implantation because of infective urine.Among the 64 patients who had successful operations,the stone clearance rate at the first month and the third month after surgery were 90.6％ (58/64)and 95.3％ (61/64).4 patients had fever after the surgery,and 1 patient had renal area pain.Clavien classification grade Ⅰ-Ⅱ.The complication rate was 7.8％.Conclusions Flexible ureteroscopic holmium laser lithotripsy without preoperative stent was a safe,effective and feasible treatment for patients with ureteral stone in tortuous ureter.
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To analyze the effectiveness and safety of intermittent lung inflation combined with rigid ureteroscopy in the treatment of upper ureteral stones that were not fully visible. The clinical and imaging data of 56 patients with upper ureteral stone undergoing rigid ureteroscopic lithotripsy combined with intermittent lung inflation in Zhejiang Quhua Hospital from March 2016 to October 2017 were retrospectively analyzed.Intermittentt lung inflation was used to change and stabilize the position of ureteral calculi during the operation,so as to ensure the visual field of ureteroscopy.Holmium laser lithotripsy was performed to remove the stones.Urinary tract abdominal plain X-ray or CT urography was performed 1 and 3 months after the operation to evaluate the residual stones and the clinical efficacy. Stones were successfully removed after a single attempt in 48 patients.In 5 patients,stones escaped into the kidney during ureteroscopic lithotripsy,and thus flexible ureteroscopy were performed.In 3 patients,a second session of auxiliary procedure was required,among whom 2 patients received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy+ureteroscopic lithotripsy.The stone-free rates 1 and 3 months after surgery were 94.6%(53/56)and 100%(56/56),respectively.No severe complication such as ureter perforation,gross hematuria,septic shock,or pneumothorax occurred during and after surgery. Intermittent lung inflation in tracheal intubation under general anesthesia in patients with proximal ureteral stones that can not be fully visible during rigid ureteroscopic lithotripsy was feasible and reliable.It can effectively change the location of stones and thus enable safe and effective lithotripy.It expands the indications of rigid ureteroscopy for treating upper ureteral stones.
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Humans , Lithotripsy, Laser , Retrospective Studies , Ureteral Calculi , Diagnostic Imaging , Ureteroscopes , UreteroscopyABSTRACT
Objective To investigate the clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 kidney calculi patients with ureteral stone-street complications after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed. The patients were divided into observation group (extubating the double-J tube 2 weeks after the surgery) and control group (retaining the double-J tube) with 32 cases in each group. The calculi clearance results and complication were compared between 2 groups. Results The success rate of stone removal in observation group was significantly higher than that in control group: 100.0% (32/32) vs. 65.6%(21/32), the calculi elimination time was significantly shorter than that in control group:(26.4 ± 6.6) d vs. (45.3 ± 10.9) d, the treatment cost was significantly lower than that in control group:(768.4 ± 152.6) yuan vs. (1 262.3 ± 156.8) yuan, the incidences of irritation symptoms of bladder and macroscopic hematuria were significantly lower than those in control group: 15.6% (5/32) vs. 90.6%(29/32) and 15.6% (5/32) vs. 100.0% (32/32), and there were statistical differences (P0.05). Conclusions Removing the double-J tube 2 weeks after flexible ureteroscope lithotripsy results in higher stone clearance rate and less complications compared with retaining the double-J tube. It can reduce the occurrence of irritation symptoms of bladder, macroscopic hematuria and treatment cost.
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Objective To investigate the efficacy and safety of ultra-mini percutaneous nephrolithotomy for the treatment of renal or upper ureteral stones.Methods The data of 32 patients diagnosed as renal or upper ureteral stones were retrospectively reviewed,who underwent ultra-mini percutaneous nephrolithotomy from June to October,2015,including 29 kidney stones,3 upper ureteral stones,of which 21 single stone,7 multiple stones,and 4 staghorn stones.There were 8 cases with inferior calyx stones,10 with renal pelvis stones,3 with upper ureteral stones,10 with renal pelvis stones plus inferior calyx stones and 1 with renal pelvis stones plus upper calyx stones.The mean stone size was (20.1 ±7.6) mm (ranging from 10 to 41mm).The mean Hounsfield unit (HU) was (1 125.9 ±225.9) Hu (ranging from 520 to 1 550Hu).In this cohort,13 cases had mild hydronephrosis,2 moderate hydronephrosis,1 severe hydronephrosis while no hydronephrosis identified in the other 16 patients.One case had concomitant kidney and ureter duplication malformation,and 1 case had residual stones after laparoscopic nephrolithotomy.Results All of the patients were treated by single tract UMP.Among them,middle calyceal puncture was performed in 9 cases,and the other 23 cases underwent lower calyceal puncture,including 4 cases of intercostal puncture,and 28 subcostal puncture.The mean operating time was (30.3 ± 15.0) min (ranging from 10 to 90 min).The mean postoperative hospital stay was (1.9 ± 1.0)days (ranging from 1 to 5 days).The mean hemoglobin decrease was(14.6 ±8.4)g/L (ranging from 1 to 46 g/L).No analgesics were used.Peri-operative complication rate was 3.13％ (1/32) with 1 case of collection system perforation.There was no fever,severe bleeding,urinary extravasation,pleural injury,or blood transfusion.The SFR was 93.75％ (30/32) and 96.88％ (31/32) on the first day and the first month after the operation,respectively.Conclusions UMP could be a safe and effective method for the treatment of renal or upper ureteral stones,especially for inferior calyceal stones less than 2cm.It offers high stone clearance rate,minimally invasiveness,quick recovery,short length of hospital stay and improved quality of life.
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Objective To investigate the clinical value of shortening double-J stent indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy . Methods Clinical data of 38 cases of ureteral stone-street complications following flexible ureteroscope lithotripsy from January 2012 to December 2013 in our hospital were retrospectively analyzed.The patients were divided into Group A (extubating the double-J stent two weeks after the surgery ) and Group B (retaining the double-J stent) with 19 cases in each group .The stone clearance results were compared . Results All the urinary calculus in Group A had been removed successfully , including 2 cases of renal colic , 3 cases of irritative symptoms of bladder and 3 cases of gross hematuria.Hospital cost was (766.5 ±153.7) yuan.Urinary calculus were successfully removed in 13 cases in Group B, including 19 cases of gross hematuria and 17 cases of irritative symptoms of bladder.No renal colic occurred.The hospital cost was (1251.2 ± 155.6) yuan.Compared with Group B , Group A has higher success rate of stone clearance , lower hospital cost and lower rate of bladder irritative symptoms and gross hematuria (P0.05). Conclusions Removing the double-J stent 2 weeks after flexible ureteroscope lithotripsy resulted in higher stone clearance rate and less complications compared with retaining the double -J stent.It can reduce the occurrence of irritative symptoms bladder and gross hematuria .
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Objective To compare the therapeutic effects of transureteroscope holmium laser lithotripsy ( URL) and retroperitoneal laparoscopic ureterolithotomy ( RLU) for unilateral upper ureteral calculi and evaluate the selection of indications and clinical value of URL and RLU .Methods 37 patients were enrolled into the study . 14 patients received URL ,23 patients received RUL .Double-J stent was routinely indwelled in both groups .The oper-ation time,hospitalization time,clearance rate of the stone and incidence of postoperative complications .Results The stone clearance rate after postoperation of RLU group was 100%, which was significantly higher than that of URL group 64.4%(χ2 =4.15,P0.05).Two cases converted to operation in URL group ,while only 1 case converted to operation in RLU group.Conclusion Laparoscopic ureterolithotomy has a higher stone clearance rate and shorter operation time compared with ureteroscopic lithotripsy .Laparoscopic ureterolithotomy is a safe and effective therapeutic method for unilateral upper ureteral stones .
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La extravasación espontánea de orina, descrita por Albarrán y publicada por Sole se consideraba como un hallazgo radiológico poco frecuente y la definió en 198 como la salida de orina fuera del tracto urinario en ausencia de trauma, de intervención quirúrgica previa o reciente y tampoco sin antecedente de instrumentación urológica o de urografía excretora practicada con compresión externa. Se presenta a un paciente de 28 años, sin antecedentes de interés, que acudió con cuadro astenia de 1 mes de evolución, asociado a dolor en fosa lumbar izquierda. Que fue estudiado mediante ecografía y tomografía computarizada (TC). Las exploraciones radiológicas identificaron múltiples litiasis en uréter proximal y distal izquierdo. Voluminosa colección de baja densidad rodeando al riñón izquierdo, limitada por la fascia pararrenal sugestiva de urinoma, identificando solución de continuidad en cáliz superior, que se comunica con el urinoma. El tratamiento inicial del paciente fue la colocación de Nefrostomía percutánea de urgencia, para realizar posteriormente, ureteroscopia con ascensión de las litiasis y extracción de estas mediante pielolitotomía abierta. Conclusión: El conocimiento de la clínica y de los hallazgos radiológicos de la extravasación urinaria espontánea por litiasis ureteral en las distintas pruebas de imágenes son cruciales para el manejo de los pacientes afectados por esta infrecuente complicación...
Spontaneous extravasation of urine, described by Albarran and published by Sole was considered a rare radiological finding in 198 and defined as the flow of urine out of the urinary tract in the absence of trauma, previous surgery or recent nor no history of urological instrumentation or excretory urography performed with external compression. We report a patient of 28 years, with no history of interest came with asthenia of 1 months duration, associated with pain in left lumbar fossa. That was studied by ultrasound and computed tomography (CT). The radiological identified multiple stones in proximal and distal left ureter. Collection bulky low density surrounding the left kidney limited by suggesting pararenal urinoma fascia, identifying continuity solution upper calyx, which communicates with the urinoma. The patients initial treatment was percutaneous nephrostomy placement of urgency for later ascension of the stones with ureteroscopy and removal of these by open pyelolithotomy. The knowledge of the clinical and radiological findings of spontaneous urinary extravasation with ureteral stones in various imaging tests are crucial for the management of patients affected by this rare complication...
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Humans , Male , Adult , Kidney Diseases/etiology , Urine , Urologic Surgical Procedures/methods , Ureterolithiasis/surgery , Ureterolithiasis/complications , UrinomaABSTRACT
Objective To compare the safety and clinical efficiency between minimally invasive percutaneous nephrolithotomy(MPCNL)in supine position and flexible ureteroscopy(FURS)in management of proximal ureteral calculi.Methods From Oct.2010 to May.2012,76 patients with single proximal ureteral calculus between 10-20 mm failed in SWL or other conservative therapy accepted MPCNL (32 cases)or FURS(44 cases).There was no significant difference between the groups in base-line parameters.Stone sizes were(15.6±2.5)mm and(14.9±2.3)mm,P＞0.05.Procedural time,post-operative hospitalization stay,complication rates(Clavien degree Ⅱ or over)and stone free rates were compared.Results In these two groups,procedural time was(49.3± 11.7)and(67.2± 17.3)min,P＜0.05,postoperative hospitalization stay were(4.2±1.1)and(1.8±0.8)days,P＜0.05,complication rates were 12.5％ and 6.8％,P＞0.05 and stone free rates(residual fragments≤3 mm)were 93.7％ and 84.1％,P＞0.05.Conclusions For patients with surgically indicated proximal ureteral calculi,both minimally invasive percutaneous nephrolithotomy in supine position and flexible ureteroscopy are effective and safe therapeutic modalities.Patients treated with flexible ureteroscopy have faster postoperative recovery.
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The unique clinical syndrome of the uterus didelphys, a unilateral partially or completely obstructed vagina, and ipsilateral renal agenesis is quite rare, and observed on the right side in greater frequency than on the left. The case of fifteen year old girl with uterus didelphys, unilateral partially obstructed vagina and acute renal failure associated with ureteral stone in unilateral kidney is described. Extracorporealshock wave lithotripsy (ESWL) and evacuation of the hematocolpos and excision of the vaginal septum were done. Aware of this relatively rare condition is mainstay of prompt diagnosis which will prevent permanent renal failure and unnecessary and destructive surgery.
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Female , Acute Kidney Injury , Congenital Abnormalities , Hematocolpos , Kidney , Kidney Diseases , Lithotripsy , Renal Insufficiency , Ureter , Uterus , VaginaABSTRACT
Background: Untill now, many minimal invasive methods have been applied in treating ureteral stones such as the endoscopic ureterolithotripsy technique of Perez-Castro and Martinez-Pinero (1980), the tetroperitoneal laparoscopic ureterolithotomy technique of Wickham (1979) and so on. Retrograde endoscopic ureterolithotripsy with holmium laser has been applied in management of ureteral stones at the Post hospital I Hanoi since 2003. Objective: To show results of retrograde endoscopic ureterolithotripsy with holmium laser in management of ureteral stones at the Post hospital I Hanoi. Subjects and method: A retrospective study was conducted in 183 patients who underwent retrograde endoscopic ureterolithotripsy with holmium laser at the Post hospital I Hanoi, from July/2003 to July/2005. Results:In 183 patients, female was more than male (54.7% versus 45.4%); the mean age was 45.4 (range 14-77). There were total 212 lithotrity stones, of which the rate of left, right, upper-third, middle-third and lower-third ureteral stone was respectively 51.9%, 48.1%, 43.2%, 22.4% and 34.4%. The mean size of ureteral stone was 15.1mm x 11.17mm and the average time of ureterolithotripsy was 48.1 minutes (range 15 -120). Conclusion: The rate of success for etrograde endoscopic ureterolithotripsy with holmium laser was high (92.9%), especially the success rate for lower-third ureteral calculi (100%) and the success rate for upper-third ureteral stones (84.8%). However, 5/165 patients (3%) who had follow-up examination for 2-4 years after surgery had ureteral stenosis. This complication was resulted from burned mucous membrane during endoscopic ureterolithotripsy with laser.
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Ureterolithiasis , Therapeutics , Endoscopy , LasersABSTRACT
Objective To summarize the management experience for difficult access during rigid transurethral ureteroscopy.Methods Rigid transurethral ureteroscopy was conducted in 640 patients with ureteral stones from January 1995 to November 2004.Difficult ureteroscope access was encountered in 72 patients and overcame by adjusting the pressure of hydraulic irrigation,changing the position of patient,dilating the ureter,or performing the percutaneous nephrostomy.Results Of the 72 patients with difficult retrograde access,successful ureteroscopy was achieved in 54 patients and conversions to open ureterolithotomy were required in 18 patients.Intraoperative complications included partial mucosal laceration in 10 patients and ureteral perforation in 6 patients.Follow-up examinations with intravenous pyelography for 13~36 months(mean,16 months) in 56 patients revealed patent ureter.Conclusions The key to successful retrograde access of rigid ureteroscope lies in the acquaintance with normal and pathologic anatomy and physiology of the ureter and urologist's operative skills and experience.
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Objective To investigate the efficacy of Holmium laser for upper urinary tract diseases.Methods A total of 101 patients with urinary tract stricture or calculus in the lower or middle ureter were treated with holmium laser by ureteroscopy from January 2005 to June 2007 in our hospital.For the patients with stones in the upper urinary tract or the kidney,percutaneous nephrolithotripsy(PNL) with holmium laser by ureteroscopy was performed.Results No patients developed perforation,urinary leakage,or infection after the operation.In the 23 cases of ureteral stricture,6 were cured,10 were improved,5 were failed,and 2 were deteriorated or even developed hydronephrosis.The two who were deteriorated after the operation was converted to open surgery because of pain in the kidney area and refractory infection.They were cured after resection of the strictured segment and end-to-end anastomosis.Follow-up was available for 3 to 24 months(mean,12 months);none of the patients had recurrence during the period.In the 40 patients with lower or middle ureteral stones,nephrolithotripsy was completed successfully in all but 7,in whom the stones moved into the kidney during the procedure.These 7 patients were then cured by extracorporeal shock wave lithotripsy.The 40 patients were followed up for 3 to 18 months(mean,15),none of them had recurrence.In the 24 cases of upper urinary tract stones and 14 patients with renal calculus,the stones were removed completely by the first PNL in 36;2 patients received a second operation after indwelling renal cannula for 1 week because of intraoperative hemorrhage.These 38 patients achieved a follow-up of 3 to 24 months(mean,18),no one of them showed residual stones,or recurrent calculus or stricture of the ureter.Conclusions Holmium laser by ureteroscopy is safe,effective,and minimally invasive for patients with upper urinary tract disorders.The treatment is worth being used thanks to a low rate of intra-and postoperative complications.
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Hypertensive encephalopathy is an acute neurologic syndrome that occurs in association with abrupt and marked elevation of blood pressure and is characterized by headache, vomiting, seizure, visual disturbances and altered mental status. Hypertensive encephalopathy is most commonly associated with renal disease in children, including acute glomerulonephritis, renovascular hypertension, and end-stage renal disease. Hypertensive encephalopathy associated with nephrolithiasis has not been reported. We have experienced a 10-year-old boy with hypertensive encephalopathy associated with ureteral stone.
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Child , Humans , Male , Blood Pressure , Glomerulonephritis , Headache , Hypertension, Renovascular , Hypertensive Encephalopathy , Kidney Failure, Chronic , Nephrolithiasis , Seizures , Ureter , VomitingABSTRACT
PURPOSE: In situ ESWL is the most attractive treatment for mid-ureteral stones as it is non-invasive and effective. X-ray fluoroscopy is usually used to localize the mid-ureteral stones for in-situ ESWL, since it is easy to manipulate, although a radiation hazard and high maintenance costs are involved. We report our experience of in-situ ESWL, using an ultrasonographic localization system, for the treatment of mid-ureteral stones. MATERIALS AND METHODS: Between June 1992 and June 2001, the mid-ureteral stones overlying the pelvic bone were treated with a Siemens Lithostar Ultra lithotriptor using a Sonoline SL-1 (Siemens, Germany) ultrasonographic localization system, with no anesthesia nor pain control. The mid-ureteral stones, located at the upper half of the pelvic bone, were treated in the prone position, with the shock waves delivered through the back wall using the kidney, renal pelvis and ureter, as landmarks for targeting. The mid-ureteral stones, located at the lower half of the pelvic bone, were treated in supine position, with the shock waves delivered through the abdominal wall using a filled bladder as the landmark for targeting. The localization success, stone free, ESWL success rates, and complications, were evaluated. RESULTS: Of the 96 patients, with mid-ureteral stones, we failed to localize the stone in only 2 patients. Therefore, the success rate for the stone localization was 97.9% (94/96). The stone free rate at 3 months after completion of the in-situ ESWL was 97.9% (92/94). Therefore, in-situ ESWL success rate was 95.8% (92/96). The mean ESWL sessions needed to be free of stones were 1.3+/-0.8 (126 sessions/92 patients). Some patients had hematuria and colicky pain, but serious complications, such as febrile UTI or severe hematuria requiring a transfusion were not encountered. CONCLUSIONS: In-situ ESWL, using an ultrasonographic localization system, is a non- invasive and effective treatment for mid-ureteral stones.
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Humans , Abdominal Wall , Anesthesia , Abdominal Pain , Fluoroscopy , Hematuria , Kidney , Kidney Pelvis , Lithotripsy , Pelvic Bones , Prone Position , Shock , Supine Position , Ultrasonography , Ureter , Urinary BladderABSTRACT
Objective To study the treatment of middle and lower ureteral stone with polyp by pneumatic lithotripter under ureterscopy. Methods 56 cases of middle and lower ureteral stone with polyp treated from Feb-ruary 2000 to August 2002 were retrospectively analyzed. Results All patients were successfully operated on and no complication occurred. Conclusions Middle and lower ureteral stone with polyp can be treated by pneumatic lithotripter under ureterscopy.
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PURPOSE: We retrospectively reviewed the cases of ureteroscopic stone removal at our hospital and defined the efficacy, safety and the skilled experience of the surgeon. MATERIALS AND METHODS: Ureteroscopic stone removal was done in 510 cases. Sixty eight stones were located in the upper ureter, 114 stones in the mid ureter, and 328 stones in the lower ureter. The stone size was less than 5mm in 210 cases, from 5 to 10mm in 241 cases and more than 10mm in 59 cases. The objective cases were categorized into three groups according to the experience of the surgeon, and then compared to each group. RESULTS: The overall success rate was 94.5%. The success rates of upper, mid and lower ureteral stones were 86.7, 90, and 96.9%. The success rate was 95.7% in stones less than 5mm, 94.1% in 5 to 10mm and 91.5% in more than 10mm. The operation results were improved and stabilized after 50 cases. There were 48 cases (9.4%) of complications which were treated successfully with conservative treatment except for 2 cases. CONCLUSIONS: Our study suggests that the ureteroscopic stone removal technique of the surgeon is improving by accumulating operation experience, and stabilized skillful technique will be achieved after experience of more than 50 cases.
Subject(s)
Retrospective Studies , Ureter , UreteroscopyABSTRACT
Objective To study therapeutic effects of ureteroscopic treatment for ureteral stones after failed extracorporeal shock wave lithotripsy (ESWL). Methods A total of 23 patients with ureteral stones received ureteroscopic treatment after the ESWL had failed. By using pneumatic lithotripter and self-made needle-shaped electrotome, stones were fragmented and removed, and polyps were resected. Results Two patients with stones fragmented but surrounded by granuloma tissue received a polyp resection and stone extraction.Pneumatic ballistic lithotripsy and stone removal was conducted in 16 patients with stones partly fragmented.In 4 patients with stones adherent to the ureteral wall and polyps,the polyps were removed by using self-made needle-shaped electrotome and the stones were fragmented and extracted.And in 1 patient with stones embedded beneath the ureteral mucous membrane, which was difficult to be expelled,the mucous membrane covering the stones was opened by using the needle-shaped electrotome and the stones were fragmeathed and extracted.The procedure duration was 30~55 min(mean,42 min).Re-examination 6 months postoperatively found no residual stones. Conclusions After the ESWL had failed, patients with ureteral stones can be treated ureteroscopically by using pneumatic lithotripsy and self-made needle-shaped electrotome.
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Objective To explore the therapeutic efficacy of pneumatic lithotripsy combined with extracorporeal shock wave lithotripsy (ESWL) in patients with ureteral stones. Methods Pneumatic lithotripsy combined with ESWL was employed in the treatment of 365 cases of ureteral stones. Results Of the 365 cases,the operation succeeded in 360 cases and failed in 2 cases,and ureteral perforation occurred in 3 cases.ESWL was required in 80 cases after pneumatic lithotripsy. Conclusions Pneumatic lithotripsy combined with ESWL offers advantages of high efficacy,minimal invasion and broad indications.
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Objective To evaluate the treatment of ureteral stones with pneumatic lithotripter under ureterscopy and the prevention of complications. Methords 43 cases of ureteral stones that had been treated with pneumatic lithotripter under ureteroscopy was reviewed. Results 93.0%(40/43)of the stones were fragmented on one session,93.0%(40/43)of the stones were expelled within 7 days afer the procedure.No complications occurred. Conclusions Treatment of ureteral stones with pneumatic lithotripter under ureterscopy is safe and effecive.