RESUMO
ABSTRACT Objective To evaluate the clinical efficiency of alpha1-adrenergic antagonists on stentless ureteroscopic lithotripsy treating uncomplicated lower ureteral stones. Materials and Methods From January 2007 to January 2013, 84 patients who have uncomplicated lower ureteral stones treated by ureteroscopic intracorporeal lithotripsy with the holmium laser were analyzed. The patients were divided into two groups, group A (44 patients received indwelled double-J stents) and group B (40 patients were treated by alpha1-adrenergic antagonists without stents). All cases of group B were treated with alpha1 blocker for 1 week. Results The mean operative time of group A was significantly longer than group B. The incidences of hematuria, flank/abdominal pain, frequency/urgency after surgery were statistically different between both groups. The stone-free rate of each group was 100%. Conclusions The effect of alpha1-adrenergic antagonists is more significant than indwelling stent after ureteroscopic lithotripsy in treating uncomplicated lower ureteral stones.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Sulfonamidas/uso terapêutico , Litotripsia/métodos , Cálculos Ureterais/cirurgia , Ureteroscopia/métodos , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Complicações Pós-Operatórias , Período Pós-Operatório , Medição da Dor , Estudos Prospectivos , Reprodutibilidade dos Testes , Resultado do Tratamento , Estatísticas não Paramétricas , Lasers de Estado Sólido/uso terapêutico , Duração da Cirurgia , Tansulosina , Tempo de Internação , Pessoa de Meia-IdadeRESUMO
ABSTRACTPurpose:To evaluate the clinical value of computed tomography angiography (CTA) in reducing the risk of hemorrhage associated with mini-percutaneous nephrolithotomy (PCNL).Materials and Methods:A total of 158 patients with renal or ureter stones who had undergone mini-percutaneous nephrolithotomy were retrospectively enrolled into this study from May of 2011 to April of 2014. Group 1 (65 patients) underwent computed tomography angiography, and Group 2 (93 patients) underwent non-contrast CT. The clinical characteristics of the patients and hemorrhagic complications were recorded. The hematologic complications (transfusion rate, and preoperative and postoperative hemoglobin values) were assessed.Results:There were no statistically significant differences in age, body mass index(BMI), stone diameter, operative time, stone-free rate, and hospital stay between the 2 groups. In group 2, 1 patient (1.1%) developed a renal arteriovenous fistula and was treated with embolus therapy. In addition, Group 2 showed significantly drop in hemoglobin (3.6 g/dL vs. 2.4 g/dL, respectively; P <0.001) and more transfusions (9.7% vs. 1.5%, respectively; P <0.05) compared with Group 1.Conclusion:The study showed that patients who underwent computed tomography angiography prior to percutaneous nephrolithotomy had lower drop of hemoglobin and needed less transfusions. These findings may suggest that the use of computed tomography angiography may reduce the risk of bleeding during percutaneous nephrolithotomy.