Clinical analysis of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis

The objective of the study is to evaluate the clinical value of ureteroscopic holmium laser lithotripsy for the treatment of nephrolithiasis. Clinical data of 44 patients treated for renal stones with polyscope modular flexible ureter- oscopic holmium laser lithotripsy from May 2014 to April 2015 were retrospectively analysed. Following the operation, F4.7 D-J stents were routinely indwelled for 4 weeks and catheterization for 1-3 days. A plain kidney, ureter, and blad- der (KUB) X-ray was performed on postoperative days too. A total of four success cases were determined following the first treatment. The remaining 40 cases were first placed with double-J stent and the surgery was performed one week later. Stone sizes between 0.8-4.0 cm in diameter were defined. The operation time for the treatment was 80-180 minutes. Patients were discharged within 3-5 days, and the double-J stent was removed within 1-3 months. 39 patients were found to be completely stone-free at approximately three months postoperatively. However, five patients were shown to have 11.1% of residual stones after treatment. No blood transfusion, septic shock, ureteral injury, or other complications were reported. Flexible ureteroscopic holmium laser lithotripsy is safe and effective for the treatment of nephrolithiasis. This approach could be a valuable choice for the treatment of patients with renal stones.

Download Full-text

Influence of Pelvicaliceal Anatomy on Stone Clearance After Flexible Ureteroscopy and Holmium Laser Lithotripsy for Large Renal Stones

Journal of Endourology ◽

10.1089/end.2015.0071 ◽

2015 ◽

Vol 29 (9) ◽

pp. 998-1005 ◽

Cited By ~ 17

Author(s):

Takaaki Inoue ◽

Takashi Murota ◽

Shinsuke Okada ◽

Shuzo Hamamoto ◽

Kouei Muguruma ◽

...

Keyword(s):

Renal Stones ◽

Laser Lithotripsy ◽

Holmium Laser ◽

Flexible Ureteroscopy ◽

Stone Clearance ◽

Holmium Laser Lithotripsy

Download Full-text

Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater

International Journal of Urology ◽

10.1111/j.1442-2042.2011.02931.x ◽

2011 ◽

Vol 19 (3) ◽

pp. 264-267 ◽

Cited By ~ 59

Author(s):

Ryoji Takazawa ◽

Sachi Kitayama ◽

Toshihiko Tsujii

Keyword(s):

Renal Stones ◽

Laser Lithotripsy ◽

Holmium Laser ◽

Successful Outcome ◽

Flexible Ureteroscopy ◽

Holmium Laser Lithotripsy

Download Full-text

Efficacy and Safety of Holmium Laser Lithotripsy Under Local Anesthesia in the Treatment of Urethral Stones in Elderly Male Patients

Healthcare ◽

10.3390/healthcare8020150 ◽

2020 ◽

Vol 8 (2) ◽

pp. 150

Author(s):

Dogan Atılgan ◽

Engin Kölükçü ◽

Fatih Fırat ◽

Vildan Kölükçü

Keyword(s):

Local Anesthesia ◽

Demographic Data ◽

Clinical Status ◽

Operation Time ◽

Laser Lithotripsy ◽

Holmium Laser ◽

Complication Rates ◽

Elderly Male ◽

Holmium Laser Lithotripsy ◽

Male Patients

The elderly population has been increasing significantly in our century. In our study, it was aimed to analyze the treatment results of elderly male patients who underwent holmium laser lithotripsy (HLL) for urethral stones under local anesthesia. We evaluated a total of 31 male patients, aged ≥65 years, diagnosed with urethral stones and treated with HLL under local anesthesia. We noted the demographic data and visual pain scores (VAS) of the patients and the duration of the operation and hospital stay. Our analysis involved both the success rates of the surgical procedure and the complication rates according to the modified Clavien classification. In addition. we determined the patients’ preoperative clinical status using the Charlson comorbidity index (CCI). The mean age of the patients was 71.65 ± 8.19 years. Acute urinary retention was the most common complaint (45.2%). Their mean scores were 7.68 ± 2.53 according to CCI. The average operation time was 15.48 ± 5.22 min and the VAS was 2.03 ± 1.08. All patients were stone-free and there was a marked improvement in their symptoms None of them stayed in the hospital for more than one day. We did not observe any Grade 3 or higher complications. In light of the data obtained in our study, we concluded that HLL is an effective and reliable method to treat urethral stones under local anesthesia in elderly male patients.

Download Full-text

Treatment of upper urinary tract stones with flexible ureteroscopy in children

Canadian Urological Association Journal ◽

10.5489/cuaj.5283 ◽

2018 ◽

Vol 13 (3) ◽

Cited By ~ 1

Author(s):

Jing Xiao ◽

Xiangyu Wang ◽

Jun Li ◽

Miaomiao Wang ◽

Tiandong Han ◽

...

Keyword(s):

Urinary Tract ◽

Operation Time ◽

Upper Urinary Tract ◽

Laser Lithotripsy ◽

Holmium Laser ◽

Flexible Ureteroscopy ◽

Holmium Laser Lithotripsy ◽

Stone Free Rate ◽

Urinary Tract Stones ◽

Free Rate

Introduction: This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones. Methods: From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed. Results: A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15–60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate. Conclusions: FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.

Download Full-text

Clinical Analysis on the Safety and Efficacy of 30 cm Short FURS in the Treatment of Multiple Nephrolithiasis in Children

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v3i6.940 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Deqiang Gu ◽

Jingyang Guo ◽

Wenzeng Yang ◽

Feng An ◽

Zhenyu Cui ◽

...

Keyword(s):

Operation Time ◽

Clinical Analysis ◽

Laser Lithotripsy ◽

Renal Scintigraphy ◽

Stress Factors ◽

Urea Nitrogen ◽

Safety And Efficacy ◽

Reactive Protein ◽

Holmium Laser Lithotripsy ◽

Before And After

Objective: To evaluate the safety and efficacy of ultra-percutaneous nephrotic access combined with 30 cm FURS in the treatment of multiple nephrolithiasis in children. Methods: From October 2016 to March 2018, 30 children with multiple nephrolithiasis (age range 2 to 10 years old) were admitted to our hospital with ultra-perc combined with 30 cm FURS holmium laser lithotripsy The patients' operation time, hospitalization time, stone freel rate, blood loss before and after surgery, C-reactive protein, leukocyte, platelet and other stress factors, creatinine, urea nitrogen and other indicators of renal function, Renal scintigraphy was used to evaluation the injury of renal parenchymal. Results: The use of ultra-perc combined with 30 cm FURS, the first lithotomy was 93%, 2 patients were staged surgery, staging clearance rate of 100% (30/30) operation time 20 to 50 minutes, the average 35 minutes, average postoperative hospital stay 2 days, postoperative hemoglobin decreased no significant change. No transfusion in children, before and after surgery creatinine, urea nitrogen and CRP leukocytes, platelet and other grades were no significant differences, in Renal scintigraphy renal parenchymal injury was not obvious. Follow-up from 6 months to 1 year, no long-term complications in all children. Conclusion: Ultra-percutaneous nephrotic access combined with 30 cm FURS in the treatment of multiple nephrolithiasis in children is safe and effective.

Download Full-text