RESUMO
Objective: To compare the effectiveness of laser lithotripsy [LL] and pneumatic lithotripters [PL] in calcium oxalate [CaOx] and calcium phosphate [CaP] stones and assess whether these stone compositions affect the outcomes of LL and PL
Study Design: Comparative, descriptive study
Place and Duration of Study: Istanbul Training and Research Hospital, Turkey, from August 2010 to August 2015
Methodology: A total of 114 patients underwent ureteroscopy using LL and PL. Fifty-eight [50.9%] had CaOx stones and 56 [49.1%] had CaP stones. The lithotripters were compared in stone composition groups, and stone compositions were compared in lithotripter groups. Patient characteristics, perioperative parameters, and postoperative complications were compared
Results: The baseline patient and stone characteristics were similar in all groups. The operation time of the PL and LL for the patients with CaP stones [68.75 +/- 32.88 and 44.48 +/- 34.37 minutes, respectively] was significantly shorter than the operation time of the PL and LL for the patients with CaOx stones [91.56 +/- 30.54 and 65.75 +/- 37.74 minutes, [p=0.012 and p=0.009, respectively]. Moreover, the patients with CaOx or CaP treated with LL [65.75 +/- 37.74 and 44.48 +/- 34.37 minutes, respectively] had significant shorter operation time than the PL [91.56 +/- 30.54 and 68.75 +/- 32.88 minutes, [p=0.046 and p=0.01, respectively]. Stone-free rates were similar in all groups. The PL for the patients with CaP stones caused more postoperative fever and infection than the other groups [p=0.050]
Conclusion: Though both PL and LL are effective in the treatment of CaOx and CaP stones, LL had a significantly shorter operation and hospitalization time and complication rates in patients with CaOx and CaP stones. So LL is a more feasible and safer modality in the treatment of recurrent CaP stones
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cálculos Urinários/química , Lasers de Estado Sólido , Litotripsia , Litotripsia a Laser , Oxalato de Cálcio , Fosfatos de Cálcio , Cálculos Ureterais , Urolitíase , Resultado do TratamentoRESUMO
PURPOSE: This study aimed to verify the efficacy and safety of intravesical treatment with sodium chondroitin sulfate (CS) in patients with overactive bladder (OAB) who are refractory to previous antimuscarinic treatment. METHODS: This study was performed between June 2012 and January 2015 and included 31 consecutive women (mean age, 42.10+/-7.34 years) with OAB who had been previously treated with two types of antimuscarinic drugs. The results of gynecologic and cystoscopic examinations were normal, and OAB comorbidity was absent. Treatment with intravesical instillations containing 40 mL CS (0.2%; 2 mg/mL) was administered for 6 weeks; after weekly treatments, monthly treatments were administered. The OAB-validated 8 (OAB-V8) symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry were evaluated for all the patients. The values obtained before the treatment were statistically compared with those obtained six months after the treatment. RESULTS: The duration of the symptoms was 18.36+/-6.19 months. A statistically significant improvement of the patients' conditions was observed in terms of the OAB-V8 symptom scores, nocturia, frequency, urgency, urge incontinence, and urinary volumes measured by uroflowmetry after the treatment. CONCLUSIONS: Despite the limitations of this study, the outcomes confirmed that CS therapy is safe and effective for the treatment of OAB.