Long segment right ureteric stricture following ureterorenoscopy for upper ureteric stone: A disastrous complication of endourology

2020 ◽  
pp. 205141582095790
Author(s):  
Prajwal Paudyal ◽  
Kalpesh Parmar ◽  
Kumar Rajiv Ranjan ◽  
Santosh Kumar
Keyword(s):  
Guide Wire ◽  
Upper Urinary Tract ◽  
Ureteric Stone ◽  
Ureteric Injury ◽  
Boari Flap ◽  
Major Injury ◽  
Common Ailment ◽  
Urinary Tract Stones ◽  
The Right ◽  
Ureteric Stricture

Background: Nephrolithiasis is a common ailment in developing countries such as India. Ureteroscopic management has superseded shockwave lithotripsy as the common treatment for upper urinary tract stones. The process of miniaturizing the instrument along with improved quality of video processor has amplified its potential application, maintaining the procedure safe and effective. However, with its extensive use, complications have risen in parallel, and one should be aware of its adverse effects. Ureteric stricture though rare is a serious problem and risks the loss of renal function. Case presentation: A 37-year-old male presented with right flank pain. On evaluation, he was diagnosed with right upper ureteric stone and left renal stone. The patient suffered ureteric perforation while the right ureterorenoscopy was being performed, and an open repair was done. On postoperative follow-up, he developed long segment ureteric stricture. Boari flap ureteroneocystostomy was done. Conclusion: Iatrogenic ureteric injury following ureterorenoscopy is common, minor and managed conservatively. Important tips to prevent major injury are: placement of the safety guide wire across the length of the ureter, small-calibre scopes during access if a tight gripping sensation is present and the use of lubricant along the length of the ureteroscope.

Outcome of Upper Ureteric Stone Management by Semirigid Ureterorenoscope and Intracorporeal Pneumatic Lithotripsy

2020 ◽  
Vol 16 (2) ◽  
pp. 47-50
Author(s):  
Md Ruhul Quddus ◽  
Md Asaduzzaman ◽  
Md shariful Islam ◽  
Kaiser Ahmed ◽  
MA Awal ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Guide Wire ◽  
Ureteral Injury ◽  
Ureteric Stone ◽  
Stone Clearance ◽  
Stone Fragment ◽  
Ureteric Calculi ◽  
Ureteric Orifice ◽  
Distal Obstruction ◽  
Ureteric Stricture

Objective: To evaluate the outcome of upper ureteric stone management using semirigid URS + ICPL. Materials and Methods: Patients undergoing URS + ICPL in patient department were included in the study. Total 38 patient were included in the study from March 2009 to June 2010 in National Institute of Kidney diseases & Urology, Dhaka. Stone size was 8 mm to 1.5 cm, patients were with good renal function, well excreation on both side, without any distal obstruction, infection or multiple ureteric calculi. The procedure was done under SAB.Cystoscopy was done for identification of ureteric orifice and guide wire was passed within ureteric orifice under visual monitoring.46 cm 10 Fr Storz Uretroscope was advanced next to the guide wire.At time a tortuous portion of the ureter was encountered a second guide wire was helpful. As soon as the stone was seen the pneymatic probe was pushed toward the stone.After fixing to the stone, pneumatic source was on and stone fragmentation was started. Care was taken to avoid injury of the ureter and keeping eye one stone fragment migration within the ureter was achieved. Placement of D-J stent was done at the conclusion of the procedure in most of the cases Result: The patients were followed upto 3 months post-operatively. Within immediate complications fever occured in 10 (26.3%) patients, severe haematurea occured in 8 (21.3%) patients, ureteral injury in 8 (21.3%) & ureteric perforation in 2 (4.8%) patients underwent URS+ ICPL. Stone clearance rate after 01 month of intervention was 30 (78.9%). Almost half of the patients developed UTI after 01 month of intervention. Pyelonephritis occured in 2 ( 4.8%) patient in this group. After 03 months of intervention 84.2% patients exibited complete clearance of stone. Only 02 (4.8%) patients developed ureteric stricture. Conclusion: For management of selective sized upper ureteric stone ureterorenoscopy with semirigid one using pneumatic source of energy is a good option for it’s high stone clearance & resonably low complications. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.47-50

scholarly journals Off-pump coronary artery bypass concomitant with retrieval of broken guide wire stuck in the brachial artery: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuan Xue ◽  
Lu Dai ◽  
Wenjian Jiang ◽  
Hongjia Zhang
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Brachial Artery ◽  
Guide Wire ◽  
Artery Bypass ◽  
Effective Means ◽  
Coronary Intervention ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
The Right

Abstract Background The broken guide wire could get stuck anywhere during coronary artery angiography, but the broken guide wire in the brachial artery is extremely rare. Case presentation In this report, we describe our experience with a case of off-pump coronary artery bypass (OPCABG) concomitant with the retrieval of a broken guide wire stuck in the brachial artery: a 56-year-old male patient was referred to our hospital because of tri-vessel disease and a broken guide wire stuck in the right brachial artery. He received OPCABG concomitant with the retrieval of the broken guide wire stuck in the brachial artery under general anesthesia. The patient was discharged uneventfully, and 12 months follow-up showed an excellent surgical outcome. Conclusion Open surgery is an effective means for treating patients with a guide wire stuck in the brachial artery during percutaneous coronary intervention.

Cost-Effectiveness Study of the Extracorporeal Shock-Wave Lithotriptor

1990 ◽  
Vol 6 (4) ◽  
pp. 623-632 ◽  
Author(s):  
Evi E. Hatziandreu ◽  
Karen Carlson ◽  
Albert G. Mulley ◽  
Milton C. Weinstein
Keyword(s):  
Shock Wave ◽  
Cost Effectiveness ◽  
Meta Analysis ◽  
Time Frame ◽  
Upper Urinary Tract ◽  
Extracorporeal Shock Wave ◽  
Probability Estimates ◽  
Urinary Tract Stones ◽  
Ultrasonic Lithotripsy ◽  
Cost Effectiveness Study

AbstractWe performed a cost-effectiveness analysis to examine the relative efficacy and costs of percutaneous ultrasonic lithotripsy (PUL), extracorporeal shock-wave lithotripsy (ESWL), and surgery for the treatment of upper urinary tract stones. We developed a Markov model with 35 states, cycles of 3 months, and a time frame of 5 years. Probability estimates were derived from a meta-analysis of the published literature. For stones less than or equal to 2 cm, ESWL is preferred to PUL, since it prevents 2 additional days of morbidity and saves $440. For larger stones, PUL is preferable to ESWL, avoiding 4 more days of morbidity, and saving $722. Both ESWL and PUL were superior to surgery. Sensitivity analysis showed that the results are sensitive to ESWL efficacy rates, the stone recurrence rate, and the hospital component of the ESWL cost. Our analysis suggests that although ESWL is preferable, relatively small changes in the efficacy and cost can shift the preferred strategy; in addition, these findings underscore the need for more reliable data.

CT-Guided Pericardiocentesis

1996 ◽  
Vol 37 (3P2) ◽  
pp. 775-778 ◽  
Author(s):  
O. Duvernoy ◽  
A. Magnusson
Keyword(s):  
Cardiac Surgery ◽  
Pericardial Effusion ◽  
Guide Wire ◽  
Pericardial Fluid ◽  
Good Information ◽  
Indwelling Catheter ◽  
Ct Guided ◽  
Cardiac Apex ◽  
The Right ◽  
Stereotactic Device

Purpose: Pericardial effusion in patients who have recently undergone cardiac surgery is often trapped in compartments. CT of the pericardium provides good information about the distribution of pericardial fluid in the postoperative period after cardiac surgery. Contrary to echocardiography, CT imaging is not affected by postoperative mediastinal emphysema and pain from the wound. A method for CT-guided pericardiocentesis was developed. Material and Methods: CT-guided pericardiocentesis was carried out with a stereotactic device in 10 patients. The pericardium was punctured with a 0.9-mm needle and a 0.46-mm guide wire was introduced through the needle. An indwelling catheter was introduced over the guide wire and was left in the pericardium. Both the subxiphoid and parasternal approaches were used. Results: CT guidance facilitated placement of an indwelling catheter into the pericardial space in positions difficult to reach in patients with postoperative pericardial compartments, i.e. near the right atrium and adjacent to the cardiac apex/left ventricle. Conclusion: CT-guided pericardiocentesis offers a new possibility in patients where fluoroscopically or echocardiographically guided pericardiocentesis is difficult.

Flexible ureterorenoscopy to treat upper urinary tract stones in children

Urolithiasis ◽  
2018 ◽  
Vol 48 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Ahmed Suliman ◽  
Tariq Burki ◽  
Massimo Garriboli ◽  
Jonathan Glass ◽  
Arash Taghizadeh
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Flexible Ureterorenoscopy ◽  
Urinary Tract Stones

Retrieval of a Catheter Foreign Body from the Right Heart Using a Guide Wire Deflector System

Radiology ◽  
1971 ◽  
Vol 100 (1) ◽  
pp. 61-62 ◽  
Author(s):  
William J. McSweeney ◽  
David C. Schwartz
Keyword(s):  
Foreign Body ◽  
Guide Wire ◽  
Right Heart ◽  
The Right

scholarly journals The effect of urinary tract calculosis to levels of low molecular inhibitors of crystallization in the urine

2006 ◽  
Vol 134 (1-2) ◽  
pp. 40-43
Author(s):  
Dragica Milenkovic ◽  
Natasa Lalic
Keyword(s):  
Urinary Tract ◽  
Shock Waves ◽  
Stone Formation ◽  
Upper Urinary Tract ◽  
Therapeutic Procedure ◽  
Residual Stone ◽  
Extracorporeal Shock Waves ◽  
Urinary Levels ◽  
Urinary Tract Stones ◽  
Pre Treatment

The incidence of urinary tract calculosis continuously progresses. The triggering event in the process of stone formation is decreased urinary level of crystallizing inhibitors. The aim of our study was to investigate whether the existing stone or applied therapeutic procedure - extracorporeal shock waves lithotripsy (ESWL) - has effect to urinary levels of Mg, citrate and pyrophosphate. Study included 128 patients with the upper urinary tract stones. ESWL using the Lithostar (Siemens) device was used as a mode of treatment. Out of all patients, 76 (59%) were free of stone particles before 1 month, while 52 (41%) had residual stone fragments even 3 months after ESWL. Mg, citrate and pyrophosphate were measured in 24hurine specimens: before, between days 2 and 3, as well as 1 and 3 months after ESWL. The analysis of the results revealed that stone itself had no effect on urinary crystallizing inhibitors. Detected increased urinary levels of Mg, citrate and pyrophosphate after ESWL, compared with pre-treatment values, could be attributed to applied therapeutic procedure.

scholarly journals Uretero-transappendix-cystoneostomy as a technique for the reconstruction of the lower part of the ureter

2005 ◽  
Vol 62 (12) ◽  
pp. 931-933
Author(s):  
Novak Milovic ◽  
Pero Janjic ◽  
Vladimir Bancevic ◽  
Srdjan Kupresanin
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Surgical Techniques ◽  
Large Defect ◽  
Boari Flap ◽  
Gun Shot ◽  
Psoas Hitch ◽  
The Right

Background. Any large missing part of the ureter may be replaced by transureteroureterostomy, psoas hitch, Boari flap, nephrectomy, renal autotransplanation or by the implementation of an intestinal graft. Case report. A patient with a defect of the lumbal- pelvic portion of the right ureter, after the management of a penetrating and perforating gun shot wound was presented. The missing part of the ureter was successfully replaced with an appendix. The technique of uretero-transappendixcystoneostomy complete with a Boari flap and a psoas hitch was used. Conclusion. By the use of an original combination of surgical techniques, a large defect of the ureter and the defect of the bladder, as well as the preservation of the renal function was achieved in a more successful manner.

scholarly journals A Child with Right Complete Ureteral Duplication Revealed by Sepsis in Northern Benin: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 71-74
Author(s):  
Agbeille Mohamed F ◽  
Agossou J ◽  
Gandaho I ◽  
Kpanidja MG ◽  
Noudamadjo A ◽  
...  
Keyword(s):  
Case Report ◽  
Urinary Tract ◽  
Lumbar Spine ◽  
Early Diagnosis ◽  
Upper Urinary Tract ◽  
Urinary Tract Abnormalities ◽  
Ureteral Duplication ◽  
The Right ◽  
Upper Urinary Tract Abnormalities ◽  
Complete Duplication

Upper urinary tract abnormalities are relatively common and may be diagnosed before or at birth. Some cases will be seen during complications that most often are obstructive. We herein report one case of complete right ureter duplication revealed by sepsis. The case involved one little girl aged 3 years, referred from a peripheral health center for prolonged fever. Physical examination found out a right flank mass connecting with the lumbar spine, renal ballottement, and pain due to a blow to the right flank. Further explorations helped establish the diagnosis of complete duplication of the right ureter with the destruction of the upper renal pelvis. Little girl benefitted from a dual antibiotic therapy combined with partial nephrectomy of the right kidney upper pole. Infectious are serious complications in upper urinary tract obstructions resulting in kidney destruction; therefore, early diagnosis is required.

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