The Clinical Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy in the Treatment of Patients with Urinary Calculi.

Objective: To evaluate the clinical efficacy of extracorporeal shock wave lithotripsy (ESWL) for urinary calculi and precautions of postoperative complications. Methods: 90 patients with urinary calculi at our hospital were randomly recruited between July 2019 and July 2020 and were allocated (1 : 1) to receive either ESWL (observation group) or conventional surgery (control group). Clinical efficacy was the primary endpoint, whereas adverse events were the secondary endpoint. Results: The operation time, early activity time, and hospitalization time of the observation group were significantly lower than those of the control group (P < 0.05). ESWL resulted in less postoperative pain in patients versus conventional surgery (P < 0.05). ESWL was associated with a significantly higher total clinical efficacy (97.78%) versus conventional surgery (82.22%) (P < 0.05). The eligible patients given ESWL had a lower incidence of complications (11.12%) versus those given conventional surgery (31.12%) (P < 0.05). Conclusion: Hematuria prevention requires precise localization of stones as well as adjustment of pulse energy and the number of impacts due to stone changes. Precautions against renal colic necessitate complete comminution of stones intraoperatively, more postoperative water intake, moderate exercise, or injection of antispasmodic drugs and cathartics for pain relief. Nausea and vomiting precautions require preoperative recording of previous medical history and corresponding treatment, intraoperative real-time adjustment of voltage pulse frequency, and duration depending on the magnitude of intraoperative reaction. Urinary tract infection prevention requires preoperative prevention and proper postoperative anti-infection and anti-inflammatory treatment, along with enough water intake and bed rest. Other precautions include thorough comminution of the calculi, proper anti-infection and anti-inflammatory treatment, no early exercise or excessive activity after surgery, and proper postoperative care. ESWL is effective in treating patients with urinary calculi with a simple, safe, and quick operation and a low incidence of adverse events, as it effectively reduces the incidence of complications, accelerates the recovery of patients and improves their quality of life.

Endoscopic combined intrarenal surgery in the prone-split leg position for successful single session removal of an encrusted ureteral stent: a case report.

BACKGROUND: The most serious complication of ureter stent is long-term retention of ureteral stent and stone formation around the stent. CASE PRESENTATION: A 51-year old female patient with left ureteral stent placed 2 years before developed both pyelic and vesical stones on the two ends of the double J was admitted to our hospital. Intravesical lithotripsy, retrograde ureteroscopy, and percutaneous nephrolithotripsy were performed with the patient in the prone split-leg position. All the stones and the ureteral stent were successfully removed in a single session. CONCLUSIONS: Combined endoscopic techniques in the prone split-leg position can effectively and safely manage severely encrusted stents.

Psychometric validation of the Chinese version of the Illness Perception Questionnaire-Revised for women with stress urinary incontinence.

AIM: The aim of this study was to examine the reliability and validity of the Illness Perception Questionnaire-Revised (IPQ-R) in patients with stress urinary incontinence (SUI). METHODS: A total of 256 patients with SUI and 76 patients with myoma of the uterus were recruited to complete the Chinese IPQ-R. For the reliability, the key tests included Cronbach's α coefficient and intraclass correlation coefficients. For the validity, the key tests included factor analysis, Spearman's correlation coefficient, and the Student's t-test. RESULTS: Cronbach's α values ranged from 0.68 to 0.90 for each subscale and the intraclass correlation coefficients ranged from 0.80 to 0.94. The results of the confirmatory factor analysis showed that the seven-factor structure as proposed by the original IPQ-R fit the data poorly. Although removal of three items improved the model's fit, the goodness-of-fit statistics were still below acceptable standards. We identified an acceptable seven-factor solution from the 38 items on Illness Beliefs using an exploratory factor analysis (EFA), which accounted for 68.12% of the variance. For the concurrent validity, Consequences and Emotional Representation both had good correlations with anxiety and depression (r = 0.52-0.62) and better quality of life (r = 0.58-0.73). The inter-correlation coefficient of the seven factors ranged from 0.05 to 0.59, suggesting acceptable discriminant validity. There were significant differences on the scale scores of Disease Identity (t = 9.39, P < 0.01), Timeline-Acute/Chronic (t = 3.69, P < 0.01), Consequences (t = 4.53, P < 0.01), Illness Coherence (t = 7.73, P < 0.01), Timeline-Cyclical (t = 6.48, P < 0.01), Emotional Representation (t = 6.40, P < 0.01), and Cause (t = 4.29, P < 0.01) between the patients with SUI and with myoma of the uterus, which also indicated acceptable discriminant validity. CONCLUSION: The findings of this study supported the Chinese IPQ-R as being a reliable and valid tool for measuring illness perception among patients with SUI.