In-situ ESWL in the treatment of ureteral stones

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 100-102 ◽  
Author(s):  
E. Frego ◽  
M. Scanzi ◽  
B. Taher ◽  
M. Tosana ◽  
S. Cosciani Cunico
Keyword(s):  
Effective Treatment ◽  
Open Surgery ◽  
Ureteral Stones ◽  
Treatment Rate ◽  
Stone Size ◽  
Successful Technique

— 185 patients with ureteral stones were treated with ESWL (118 with lumbar ureteral stones, 63 pelvic, 4 sacroiliac). 182 patients (98.3%) were treated with ESWL in-situ by means of a Dornier MFL-5000 lithotriptor. Stone size varied from 0.6 to 1.4 cm (mean 0.9 cm); 145 patients (86.9%) were stone-free after one treatment. The re-treatment rate was 13% for lumbar ureteral stones, 25% for sacroiliac and 12.5% for pelvic stones. We report no complications. 11 patients (6.04%) had to be treated subsequently with ureteroscopic fragmentation and 4 (2.19%) with open surgery. We conclude that in-situ ESWL is also a safe and effective treatment for distal ureteral stones, for which ureteroscopy is also a successful technique but with higher morbidity, and should therefore be performed in case of failure of ESWL. We have more chance of success if the in-situ treatment is performed as soon as possible.

The inhaled pin inaccessible to the bronchoscope: a management conundrum

2009 ◽  
Vol 123 (12) ◽  
pp. 1399-1401 ◽  
Author(s):  
D V T Harischandra ◽  
J Swanevelder ◽  
R K Firmin
Keyword(s):  
Open Surgery ◽  
Left Lung ◽  
Treatment Protocol ◽  
Emergency Unit ◽  
Combined Approach ◽  
Unique Challenge ◽  
Basal Segment ◽  
Accident And Emergency ◽  
Sharp Foreign Body

AbstractObjective:The inhaled sharp foreign body is usually amenable to bronchoscopic extraction. When this fails, management poses a challenge. We present a logical approach to the inhaled pin inaccessible to the bronchoscope.Case report:A 12-year-old girl presented to the accident and emergency unit after accidentally inhaling a pin. Multiple attempts with both rigid and flexible bronchoscopy failed to access the pin, which had lodged distally in the anteromedial basal segment of the left lung. Eventually, the pin was extracted at thoracotomy.Conclusion:We discuss the reasons for extracting such pins, as opposed to leaving them in situ, and when to proceed from endoscopy to open surgery. Such knowledge is useful, not only to guide the multidisciplinary team in their combined approach to this unique challenge, but also to explain to the patient the rationale for the proposed treatment protocol.

Detection of Ureteral Stones in Kidney Ureter Bladder Radiography: Usefulness of Digital Post-processing

2021 ◽  
Vol 17 ◽  
Author(s):  
Sang Lim Choi ◽  
Sung Bin Park ◽  
Seungwook Yang ◽  
Eun Sun Lee ◽  
Hyun Jeong Park ◽  
...  
Keyword(s):  
Detection Sensitivity ◽  
Ureteral Stones ◽  
Data Sets ◽  
Post Processing ◽  
Stone Size ◽  
Data Set ◽  
Detection Rates ◽  
Exact Test ◽  
Significant Difference ◽  
Exact Size

Purpose: Kidney, ureter, and bladder radiography (KUB) has frequently been used in suspected urolithiasis, but its performance is known to be lower than that of computed tomography (CT). This study aimed to investigate the diagnostic performance of digitally post-processed kidney ureter bladder radiography (KUB) in the detection of ureteral stones. Materials And Methods: Thirty patients who underwent digital KUB and CT were included in this retrospective study. The original digital KUB underwent post-processing that involved noise estimation, reduction, and whitening to improve the visibility of ureteral stones. Thus, 60 digital original or post-processed KUB images were obtained and ordered randomly for blinded review. After a period, a second review was performed after unblinding stone laterality. The detection rates were evaluated at both initial and second review, using CT as reference standard. The objective (size) and subjective (visibility) parameters of ureteral stones were analyzed. Fisher’s exact test was used to compare the detection sensitivity between the original and post-processed KUB data set. Visibility analysis was assessed with a paired t-test. Correlation of stone size between CT and digital KUB data sets was assessed with Pearson’s correlation test. Results: The detection rate was higher for most reviewers once stone laterality was provided and was non-significantly better for the post-processed KUB images (p > 0.05). There was no significant difference in stone size among CT and digital KUB data sets. In all reviews, visibility grade was higher in the post-processed KUB images, irrespective of whether stone laterality was provided. Conclusion: Digital post-processing of KUB yielded higher visibility of ureteral stones and could improve stone detection, especially when stone laterality was available. Thus, digitally post-processed KUB can be an excellent modality for detecting ureteral stones and measuring their exact size.

scholarly journals Do stone size and impaction influence therapeutic approach to proximal ureteral stones?

2009 ◽  
Vol 66 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Radulovic ◽  
Aleksandra Vuksanovic ◽  
Dragica Milenkovic-Petronic ◽  
Bozo Vavic
Keyword(s):  
Therapeutic Approach ◽  
Ureteral Stone ◽  
Treatment Success ◽  
Ureteral Stones ◽  
Stone Size ◽  
Extracorporeal Shock Wave ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Proximal Ureteral Stone

Background/Aim. Primary therapeutic approach to lumbar ureteral stones is still contraversial. The aim of the study was to investigate the influence of stone impaction and size on the effectiveness of proximal ureteral stone lithotripsy. Methods. A total of 123 patients with proximal ureteral stones were investigated in this prospective study performed in a 10- month period. The patients were divided into the group I - 86 patients treated with extracorporeal shock wave lithotripsy (ESWL) and the group II - 37 patients treated with 'Swiss' Lithoclast. In the group I, 49 stones (57%) were classified as impacted, while 20 stones (23.3%) were larger than 100 mm2. In the group II, 26 stones (70.3%) were impacted, and 11 stones (29.7%) were larger than 100 mm2. Stones were defined as impacted by the radiographic, echosonographic as well as endoscopic findings in the group II of patients. Stone size was presented in mm2. Chemical composition of stones were almost the same in both groups of the patients. Results. Generally, there was no statistically significant difference in the treatment success between the groups. However, stones larger than 100 mm2 were statistically more successfully treated endoscopically, while there was no statistical difference in the treatment success of impacted stones between these two groups. Conclusion. ESWL can by considered as primary first therapeutic approach in treatment of all proximal ureteral stones except for stones larger than 100 mm2 that should primarily be treated endoscopically.

scholarly journals Complications in Minimally Invasive Versus Open Surgery for Intermediate- to High-Grade Spondylolisthesis: A 10-Year Retrospective, Multicenter Experience

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Asad Mehmood Lak ◽  
Abdullah M Abunimer ◽  
Amina Rahimi ◽  
Ian Tafel ◽  
Hasan Aqdas Zaidi
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Open Reduction ◽  
Open Surgery ◽  
No Reduction ◽  
High Rate ◽  
High Grade ◽  
Neural Injury ◽  
Reduction Group

Abstract INTRODUCTION High-grade spondylolisthesis is a relatively uncommon condition. The optimal surgical approach for management remains debatable. Although in-situ fusion is preferred due to its lower risk of neural injury, it does not correct spinal alignment. In contrast, reduction corrects the deformity and provides a high rate of fusion, but has the potential for high rates of neural injury. We herein report our experience and surgical outcomes following minimally invasive versus open management of intermediate- to high-grade spondylolisthesis. METHODS A multicenter, retrospective cohort analysis of adult patients aged more than 18 yr with grade II or higher spondylolisthesis, who underwent surgery from January 2008 until February 2019, was performed. RESULTS Sixty-two patients were included in the final analysis. A total of 41 patients were treated with an open approach and 21 with a minimally invasive surgical approach (MIS). More specifically, 18 patients underwent in-situ fusion, 11 underwent MIS reduction, and 33 had an open reduction. The total rate of complications was 40.3%. The rate of complications in the MIS group was 52.3% compared to 34.1% in the open surgery group (P = .166). The rate of complications was 27.8% in the in-situ fusion group, 72.7% in the MIS-reduction group, and 36.4% in the open-reduction group. Our comparisons of the rate of complications in the no-reduction group vs the MIS-reduction group, and the MIS-reduction group vs the open-reduction group were statistically significant (P = .027 and P = .07, respectively). However, there was no statistically significant difference between the rate of complications in the no-reduction group vs the open-reduction group (P = .757), nor between the rate of complications in the MIS group vs the open surgery group (P = .166). CONCLUSION MIS reduction is associated with a high rate of complications in the management of high-grade spondylolisthesis.

scholarly journals Urolithiasis in male patients: A pilot study on the ethnic differences and clinical profile

2014 ◽  
Vol 4 (4) ◽  
pp. 393-98
Author(s):  
Jayadevan Sreedharan ◽  
LJ John ◽  
HAM Aly Freeg ◽  
J Muttappallymyalil
Keyword(s):  
Uric Acid ◽  
Calcium Oxalate ◽  
Calcium Oxalate Monohydrate ◽  
Dietary Factors ◽  
Clinical Profile ◽  
Urinary Stones ◽  
Ureteral Stones ◽  
Stone Size ◽  
Uric Acid Stones ◽  
Male Patients

Background   Ethnicity play a role in the occurrence of urinary stones, probably related to climatic, environmental and dietary factors in ethnic groups. The association between ethnicity, age, clinical profile, stone size with type of ureteric stones among males with urolithiasis was studied.   Materials and Methods Male patients (>18 years) with lower ureteral stones size <10mm attending outpatient department of Urology, at a private hospital, Ajman over a period of one year were included. Ethics approval was obtained from Institutional Ethics Committee. Data was retrieved from the case records which included socio-demographic variables (age, ethnicity), clinical profile (ureteric colic, duration of pain, other complaints), and laboratory investigations (type of stone, stone size). Descriptive and inferential statistics were performed with SPSS-20 and p values <0.05 considered significant. Results 185 male patients were included. Mean age was 41.5 (7.3) years, range (22-71) years. Out of the total, 81 (43.8%) patients were Asians, 81(43.8%) Arabs and 23 (12.4%) were of other ethnicity. Most patients (95.1%) presented with ureteric pain. 49 (26.5%) had family history of stone disease where calcium oxalate monohydrate and uric acid stones were common, with majority being first degree relation. Data on stone type was available for 90 patients; of which, 21 were calcium oxalate monohydrate, 33-calcium oxalate dehydrate, 24-uric acid and remaining 12 other form of stones. Average age for different types of stone was 38.3, 41.6, 39.4 and 42.8 years for calcium oxalate monohydrate, calcium oxalate dehydrate, uric acid and other types respectively. Conclusion Uric acid stones were more prevalent among Asians and calcium oxalate-dehydrate stones among Arabs. Future studies can be conducted among multiethnic population focusing on dietary pattern and stone analysis.DOI: http://dx.doi.org/10.3126/nje.v4i4.11359 Nepal Journal of Epidemiology 2014; 4(4):393-98

scholarly journals Factors associated with urinoma accompanied by ureteral calculi

2019 ◽  
Vol 91 (1) ◽  
pp. 11-15
Author(s):  
Ercan Öğreden ◽  
Ural Oǧuz ◽  
Mehmet Karadayı ◽  
Erhan Demirelli ◽  
Alptekin Tosun ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Ureteral Stone ◽  
Ureteral Calculi ◽  
Ureteral Stones ◽  
Stone Size ◽  
Macroscopic Hematuria ◽  
Factors Associated ◽  
Group I ◽  
Group Ii ◽  
Tract Infections

Objective: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. Material and methods: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. Results: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). Conclusions: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.

Sign in / Sign up

Export Citation Format

Share Document