scholarly journals Optimization of laparoscopic ureteral repair with a buccal graft in case of its extended strictures and obliterations

2021 ◽  
Vol 8 (3) ◽  
pp. 52-61
Author(s):  
A. A. Volkov ◽  
N. V. Budnik ◽  
O. N. Zuban
Keyword(s):  
Chronic Pancreatitis ◽  
Urinary Tract ◽  
Postoperative Period ◽  
Average Length ◽  
Stent Migration ◽  
Upper Urinary Tract ◽  
Ureteral Stent ◽  
Laparoscopic Technique ◽  
Ureteral Stenting ◽  
The Moment

Purpose of the study. Currently, laparoscopic technique has become widely used in the treatment of extended strictures and obliterations of the ureter. The use of minimally invasive approaches will also be relevant for such a relatively new operation as buccal ureteroplasty. In the literature, there are isolated publications devoted to this technique. The aim of this study was to study the results of our own experience of laparoscopic ureteral reconstruction using a buccal graft.Patients and methods. We observed 5 patients – 2 men and 3 women, at the age of 30–62 years. All patients have already been operated on the urinary tract, of these, in four patients, the urinary tract was drained with a nephrostomy or internal ureteral stent. Two patients underwent replacement ureteroplasty with tubularized buccal graft, and three patients underwent augmentation ureteroplasty with buccal graft using the onlay method.Results. All operations in this group were carried out without conversions. The average length of the ureteral defect was 4.9 cm (4.0–6.0 cm). The patients did not have severe complications in the postoperative period according to the ClavienDindo classification. One patient underwent treatment for exacerbation of chronic pancreatitis; one man experienced ureteral stent migration, which required restentation. The follow-up period was 1–15 months; one woman developed unextended ureteral restenosis, which was eliminated by endoureterotomy and ureteral stenting. At the moment, all patients are spared from permanent urinary drains, they do not have upper urinary tract obstruction. Conclusion. All operations in this group were carried out without conversions. The average length of the ureteral defect was 4.9 cm (4.0–6.0 cm). The patients did not have severe complications in the postoperative period according to the Clavien-Dindo classification. One patient underwent treatment for exacerbation of chronic pancreatitis; one man experienced ureteral stent migration, which required restentation. The observation period for the patients was 1–15 months, one woman developed short ureteral restenosis, which was eliminated by endoureterotomy and ureteral stenting. At the moment, all patients do not have permanent urinary drains, violations of the urodynamics of the upper urinary tract were not revealed in them.

scholarly journals Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Kohei Kakimoto ◽  
Mayu Hikone ◽  
Ko Nagai ◽  
Jun Yamakawa ◽  
Kazuhiro Sugiyama ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Stent Placement ◽  
Treatment Options ◽  
Ureteral Stent ◽  
Rare Type ◽  
Ureteral Catheter ◽  
Ureteral Stenting

Abstract Background Ureterosciatic hernia is a rare type of pelvic floor herniation that occurs through the sciatic foramen. The resulting ureteral obstruction may lead to hydronephrosis and to further complications including urinary tract infection and urosepsis. There have been 30 reported cases of ureterosciatic hernia. Ureteral stenting and surgical repair have been used as treatment options. Case presentation We report the case of an 86-year-old woman who was transferred to Tokyo Metropolitan Bokutoh Hospital with symptoms of fever and septic shock. Her computed tomography scan revealed left hydronephrosis and deviation of the left ureter into the sciatic foramen; she was therefore diagnosed with a left ureteral sciatic hernia and admitted in our intensive care unit for further treatment with resuscitative fluids, vasopressors, and antibiotics. Following a retrograde insertion ureteral catheter insertion, ureteral incarceration was relieved, and a double-J ureteral stent was placed in situ. Antibiotic treatment was initiated, and the patient’s hemodynamic status gradually improved. Conclusions Although ureterosciatic hernia is a rare disorder, it is associated with serious complications including urinary tract infection with sepsis, which may warrant urgent corrective procedure to relieve the structural obstruction. Treatment may be conservative or surgical, though treatment with ureteral stent placement may be a favorable approach in elderly patients with multiple comorbidities presenting with urosepsis.

scholarly journals URODYNAMIC STUDY OF THE UPPER URINARY TRACT IN THE STATE OF URETERAL STENTING

1990 ◽  
Vol 81 (11) ◽  
pp. 1720-1724
Author(s):  
Masayuki Takeda ◽  
Yasushi Katayama ◽  
Hitoshi Takahashi ◽  
Yoshiaki Kawakami ◽  
Hiroshi Suzuki ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
The State ◽  
Urodynamic Study ◽  
Ureteral Stenting

scholarly journals Optimizing the lithotripsy timing after drainage of the upper urinary tract in patients with urolithiasis and obstructive uropathy

2021 ◽  
Vol 9 (3) ◽  
pp. 62-69
Author(s):  
A. I. Khotko ◽  
D. N. Khotko ◽  
V. M. Popkov ◽  
A. I. Tarasenk
Keyword(s):  
Urinary Tract ◽  
Postoperative Period ◽  
Obstructive Uropathy ◽  
Antibiotic Sensitivity ◽  
Percutaneous Nephrostomy ◽  
Upper Urinary Tract ◽  
Urine Sampling ◽  
Surgery Timing ◽  
Remodeling Index ◽  
The Subject

Introduction. Timely unresolved upper urinary tract (UUT) obstruction in patients with infection can cause severe complications, such as sepsis, pyonephrosis and even death. There are no clear recommendations regarding the methods and timing of drainage. At the same time, this issue is still the subject of discussion in publications of recent years.Purpose of the study. To optimize the timing of lithotripsy after drainage of the UUT in patients with urolithiasis and obstructive uropathy (OU).Materials and methods. At the first stage, 90 patients with OU caused by the stone of the ureteropelvic junction underwent drainage of the UUT using a percutaneous nephrostomy. Subsequently, percutaneous nephrolithotripsy (PNLT) was performed at various times after drainage. The level of inflammatory markers (IL-8) and profibrotic factor (MCP-1) in the urine was determined. The calculated concentrations of urinary biomarkers were normalized by the level of urinary creatinine. Urine sampling for the analysis was carried out during and after the PCN placement (nephrostomy urine) 7 days later, and then once weekly before surgery. The coefficient K was calculated using a patented formula to evaluate the process of kidney remodeling. Urine sampling was performed for culture to determine the bacterial spectrum and antibiotic sensitivity.Results. The values of K ≤ 1.85 were observed in 11 patients of the group with OU (12.2%), K > 1.85 in 79 (87.8%) by day 21. The values of K ≤ 1.85 were achieved in 70 patients (88.6%) by day 28 and 4 patients (80.0%) by day 35. PNLT was performed on 21 days in patients with K ≤ 1.85 (11 patients), no complications were noted in the postoperative period., PNLT was performed in patients with K ≤ 1.85 (70 patients) by day 28, exacerbation of pyelonephritis and the development of chronic kidney disease were not noted. Six patients with values of K ˃ 1.85 underwent PNLT by day 28. In the postoperative period, all patients had an exacerbation of calculous pyelonephritis, 50% had a decrease in glomerular filtration rate within 3 months after surgery. The bacteria in urine were detected in 55 (61.0%) patients. Escherichia coli (63.0%), Proteus mirabilis (18.0%), Enterococcus faecalis (14.5%), Streptococcus haemolyticus (2.5%) were identified most often.Conclusion. The use of the developed remodeling index allows optimizing the surgery timing and minimizing the development of complications during the postoperative period. The presence of bacteria is associated with a long process of renal parenchymal remodeling.

Drug-eluting biodegradable ureteral stent: New approach for urothelial tumors of upper urinary tract cancer

2016 ◽  
Vol 513 (1-2) ◽  
pp. 227-237 ◽  
Author(s):  
Alexandre A. Barros ◽  
Shane Browne ◽  
Carlos Oliveira ◽  
Estevão Lima ◽  
Ana Rita C. Duarte ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Ureteral Stent ◽  
New Approach ◽  
Tract Cancer ◽  
Urinary Tract Cancer ◽  
Upper Urinary Tract Cancer ◽  
Drug Eluting ◽  
Urothelial Tumors

scholarly journals Pyelolithotomy in a Patient with Complete Coraliform Calcification Induced by a Double-J Ureteral Stent

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Miguel Bonfitto ◽  
Analaura de Oliveira Cury ◽  
Victoria Caroline Pagelkopf ◽  
Vinicius Ramos Bezerra de Morais ◽  
Carlos Abib Cury
Keyword(s):  
Urinary Tract ◽  
Healthcare System ◽  
Urinary Tract Obstruction ◽  
Financial Burden ◽  
Upper Urinary Tract ◽  
Ureteral Stent ◽  
Upper Urinary Tract Obstruction

The placement of a double-J ureteral stent enables the treatment of upper urinary tract obstruction. Despite advances, forgetting the stent favors the occurrence of calcification, leading to increased morbidity rates, lawsuits, and a financial burden on the healthcare system. This paper describes a successful pyelolithotomy for the removal of a calcified double-J ureteral stent.

When is Prior Ureteral Stent Placement Necessary to Access the Upper Urinary Tract in Prepubertal Children?

2008 ◽  
Vol 180 (4S) ◽  
pp. 1861-1864 ◽  
Author(s):  
Anthony T. Corcoran ◽  
Marc C. Smaldone ◽  
Dev Mally ◽  
Michael C. Ost ◽  
Mark F. Bellinger ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Stent Placement ◽  
Upper Urinary Tract ◽  
Ureteral Stent ◽  
Prepubertal Children

scholarly journals Opportunities for Unsalted Management of the Postoperative Period in Patients with Uncomplicated Ureterolithiasis

Health of Man ◽  
2021 ◽  
pp. 32-38
Author(s):  
Oleh Nikitin ◽  
Yurii Roshchyn ◽  
Ihor Komisarenko ◽  
Oleksandr Fukszon ◽  
Sviatoslav Smikhun
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Upper Urinary Tract ◽  
Ureteral Stones ◽  
Cost Of Treatment ◽  
Results Of Treatment ◽  
Technical Advances ◽  
Ureteral Stenting ◽  
Stent Complications

When performing surgeries for ureteral stones, ureteral stenting is traditionally performed to avoid obstruction of the ureter in the postoperative period due to edema or stone fragments. Modern technical advances allow ureteroscopy to be performed relatively atraumatically and to avoid routine ureteral stenting, which makes it possible to exclude exacerbations of pyelonephritis caused by reflux, reduce stent costs, improve the quality of life in the postoperative period, and avoid cystoscopy for dentition. The objective: studying the possibility of non-drainage management of the postoperative period, identifying risk factors for postoperative complications in patients with uncomplicated ureteral stones. Materials and methods. The analysis of the results of treatment of 198 patients with uncomplicated ureterolithiasis, in whom it was decided to refuse stenting after ureteroscopy, was carried out. Results. The analysis of the condition of patients in the postoperative period was carried out. To identify the factors influencing the decision on non-drainage management of the patient in the postoperative period, as well as factors that could be predictors of postoperative complications, we analyzed various indicators. Conclusions. In the case of uncomplicated ureterolithiasis, in most cases (in 68.2 % of patients) in the postoperative period, there is no need to drain the upper urinary tract using a stent. At the same time, in a number of cases – namely in 31.8 % of patients – upon refusal to install a stent, complications arose that significantly influenced the duration and cost of treatment, in some cases requiring an increase in the volume of therapy, additional procedures – installation stent and puncture nephrostomy.

scholarly journals Is ureteral stent an effective way to deliver drugs such as bacillus Calmette-Guérin to the upper urinary tract? An experimental study

2019 ◽  
Vol 11 ◽  
pp. 175628721983689
Author(s):  
Fernando Korkes ◽  
Willy Baccaglini ◽  
Marcel Aranha Silveira
Keyword(s):  
Urinary Tract ◽  
Stent Placement ◽  
Upper Urinary Tract ◽  
Ureteral Stent ◽  
Bladder Volume ◽  
Bacillus Calmette Guerin ◽  
Double J Stent ◽  
Group 2 ◽  
Visual Confirmation ◽  
Group 1

Background: We aim to evaluate the distribution in the upper urinary tract of intravesical-delivered fluids, after inducing vesicoureteral reflux (VUR) with a double J stent. Methods: In group 1 ( n = 35) patients were maintained in a 20° Trendelenburg position and were evaluated after immediate insertion of ureteral stent, while in group 2 ( n = 16) patients were evaluated after several days with ureteral stent placement. Patients in both groups were submitted to a cystogram with progressive volumes of iodine contrast and were evaluated according to VUR of contrast medium to the renal pelvis. Additionally, in group 2 visual confirmation was performed by endoscopic inspection of upper tract mucosal impregnation with methylene blue. Results: In group 1, after immediate insertion of ureteral stent reflux occurred in 51.4% ( n = 18/35), and after several days with ureteral stent placement reflux was observed in 87.5% ( n = 14/16) of patients. Reflux was progressively more frequent according to increasing bladder volume ( p < 0.001). At 60 ml bladder volume no reflux was observed, while at 120 ml, 180 ml, 240 ml, 300 ml and 360 ml bladder volume reflux was observed in 14%, 25%, 41%, 55% and 63% of patients, respectively. Conclusion: Retrograde delivery of fluids such as bacillus Calmette-Guérin to the upper urinary tract through double J stents can be effective; however, it is mainly effective after several days with ureteral stent and relatively large volumes might be instilled into the bladder.

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