scholarly journals Comparison of Fragmentation and Dusting Laser Modes for Laser Ureteroscopy Lithotripsy of Ureteral Stones at a Single Center

2021 ◽  
Author(s):  
Bo-Han Chen ◽  
Tsu-Feng Lin ◽  
Marcelo Chen ◽  
Allen W. Chiu
Keyword(s):  
Multivariate Analysis ◽  
Ureteral Stone ◽  
Medical Center ◽  
Demographic Data ◽  
Ureteral Stones ◽  
Single Center ◽  
Laser Mode ◽  
Stone Free Rate ◽  
Laser Modes ◽  
Free Rate

Abstract Background Laser ureteroscopic lithotripsy (URSL) is an efficacious treatment for ureteral stones. There have been few previous studies compared the different energy and frequency settings for URSL in a single center. The fragmentation and dusting laser mode were simultaneously used in our medical center. We compared the efficacy and outcomes of these two laser modalities for the treatment of ureteral stones.Methods Patients who underwent fragmentation or dusting laser URSL for ureteral stones were retrospectively reviewed. The demographic data, stone parameters, perioperative data and stone-free rates were analyzed between the two groups.Results There were a total of 421 patients with ureteral stones who met the study criteria. More patients in the dusting group had multiple ureteral stones and pyuria than in the fragmentation group. The fragmentation group had a better stone free rate and a lower push back rate compared with the dusting group. (82% vs. 71%; 10% vs. 20% respectively, both p<0.05). Multivariate analysis revealed that stone basket use (odds ratio [OR] = 3.026; p<0.001) significantly improved the stone free rate, whereas multiple stones (OR=0.322; p <0.001), upper ureteral stone location (OR=0.098; p=0.002) and pyuria (OR=0.428; p=0.001) significantly decreased the stone free rate. The laser mode used was not significantly related to the stone free rate in the multivariate analysis.Conclusions Both laser modes were effective and safe for ureteral lithotripsy. Risk factors associated with a lower stone free rate were multiple stones, pyuria, upper ureteral stone location and an operation without the use of a stone basket.

scholarly journals External validation of the R.I.R.S. scoring system to predict stone-free rate after retrograde intrarenal surgery

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cong Wang ◽  
ShouTong Wang ◽  
Xuemei Wang ◽  
Jun Lu
Keyword(s):  
Scoring System ◽  
Kidney Stone ◽  
Medical Center ◽  
External Validation ◽  
Retrograde Intrarenal Surgery ◽  
Stone Burden ◽  
Stone Free Rate ◽  
Stone Density ◽  
Free Rate ◽  
Free Status

Abstract Background The R.I.R.S. scoring system is defined as a novel and straightforward scoring system that uses the main parameters (kidney stone density, inferior pole stones, stone burden, and renal infundibular length) to identify most appropriate patients for retrograde intrarenal surgery (RIRS). We strived to evaluate the accuracy of the R.I.R.S. scoring system in predicting the stone-free rate (SFR) after RIRS. Methods In our medical center, we retrospectively analyzed charts of patients who had, between September 2018 and December 2019, been treated by RIRS for kidney stones. A total of 147 patients were enrolled in the study. Parameters were measured for each of the four specified variables. Results Stone-free status was achieved in 105 patients (71.43%), and 42 patients had one or more residual fragments (28.57%). Differences in stone characteristics, including renal infundibulopelvic angle, renal infundibular length, lower pole stone, kidney stone density, and stone burden were statistically significant in patients whether RIRS achieved stone-free status or not (P < 0.001, P: 0.005, P < 0.001, P < 0.001, P: 0.003, respectively). R.I.R.S. scores were significantly lower in patients treated successfully with RIRS than patients in which RIRS failed (P < 0.001). Binary logistic regression analyses revealed that R.I.R.S. scores were independent factors affecting RIRS success (P = 0.033). The area under the curve of the R.I.R.S. scoring system was 0.737. Conclusions Our study retrospectively validates that the R.I.R.S. scoring system is associated with SFR after RIRS in the treatment of renal stones, and can predict accurately.

Guy’s Stone Score as a Predictor for Stone-Free Rate and Complications in Percutaneous Nephrolithotomy: A Single-Center Report from a Stone Belt Country

2020 ◽  
Vol 104 (9-10) ◽  
pp. 746-751
Author(s):  
Aso Omer Rashid ◽  
Huthiem Khalid ◽  
Goran Friad ◽  
Reebeen Yosif Hamed ◽  
Noor Buchholz
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Single Center ◽  
Center Report ◽  
Stone Free Rate ◽  
Free Rate

scholarly journals Extracorporeal Shock Wave Lithotripsy verus Rigid Ureteroscopy in Treatment of Mid-Ureteric Stones; Randomized Prospective Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S Hegazy ◽  
M I Ahmed ◽  
A F M Abdelgawad
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Prospective Study ◽  
Hospital Stay ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stones ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Operative Complications ◽  
Free Rate

Abstract Background Urinary stone disease or nephrolithiasis, the third most common disease of the urinary tract is a major health problem due to its high prevalence, incidence and recurrence. The lifetime incidence of kidney stones for men and women is approximately 13% and 7% respectively. Although stones may be asymptomatic, potential consequences include abdominal and flank pain, nausea and vomiting, urinary tract obstruction, infection, and procedure-related morbidity. Ureteral stones frequently cause renal colic and if left untreated can cause obstructive uropathy. Objectives A prospective randomized study to compare between extracorporeal shock-wave lithotripsy and rigid ureteroscopy in mid-ureteric stone treatment regarding efficacy, stone-free rate, retreatment rates, associated complications (intra-operative and post-operative), operative duration, hospital stay. Patients and Methods This study was performed at Ain Shams University (Urology department) and El Doaah hospital (Urology department), From August 2016 to August 2017, a total of 50 patients having solitary radiopaque middle ureteral stone ranges between 0.5 – 1.5 in size were divided into two groups 25 patients each enrolled in our prospective study. Results In this study the overall stone free rate was considered after two sessions of ESWL (in case of ESWL group) or one trial of ureteroscopy (in case of URS group). ESWL group: 14 cases became stone free after the first session, while the remaining 11 out of 25 patients needed second session, 6 cases became stone free after the second session. ESWL failure occurred in 5 cases and they were successfully managed by ureteroscopy. URS group: 23 cases became stone free after first ureteroscopy, while the remaining 2 patients needed second ureteroscopy due to proximal migration of the stone. In ESWL group, patients were already at outpatient clinic so there were no admission or hospital stay, all cases done without anesthesia, just analgesic ± sedation. While in URS group patients admitted and the hospital stay varies from one day to seven days according to the condition of the case, all URS cases had Spinal anesthesia. ESWL was shown to be less time consuming than URS with a mean operative time of 46.84±3.61 minutes versus 56.20±7.11 minutes respectively. In URS group there were 22 patients had ureteric catheter inserted for 24 to 72 hours postoperatively and 3 patients had double (J) stent inserted for 4 weeks postoperatively, while all the patients who underwent ESWL, no auxiliary procedure done as this procedure is completely non-invasive. Among ESWL cases, No case had an intra-operative complication, while URS group had 3 cases of intra-operative complication. There were 4 cases who had post-operative complications among ESWL group, while there were 5 cases who had post-operative complications among URS group. Conclusion In treatment of mid-ureteral stones range 0.5-1.5 in size, both URS and ESWL modalities are comparable but URS is recommended as a first option as it is more effective than ESWL regarding stone free rate and it provides immediate stone clearance with lower re-treatment rates and higher patient satisfaction, but URS requires anesthesia, longer hospitalization, and associated with a higher incidence of complications.

Flexible Ureterorenoscopy for Renal and Proximal Ureteral Stone in Patients with Previous Ureteral Stenting: Impact on Stone-Free Rate and Morbidity

2016 ◽  
Vol 30 (10) ◽  
pp. 1084-1088 ◽  
Author(s):  
Jean-François Dessyn ◽  
Loïc Balssa ◽  
Eric Chabannes ◽  
Baptiste Jacquemet ◽  
Stéphane Bernardini ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Flexible Ureterorenoscopy ◽  
Stone Free Rate ◽  
Ureteral Stenting ◽  
Proximal Ureteral Stone ◽  
Free Rate

scholarly journals Application of Pneumatic Lithotripter and Holmium Laser in the Treatment of Ureteral Stones and Kidney Stones in Children

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Marcin Życzkowski ◽  
Rafał Bogacki ◽  
Krzysztof Nowakowski ◽  
Bartosz Muskała ◽  
Paweł Rajwa ◽  
...  
Keyword(s):  
Operative Time ◽  
Treatment Options ◽  
Population Based ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Stone Free Rate ◽  
Group A ◽  
The Mean ◽  
Laser Group ◽  
Free Rate

Objective.Treatment options for urolithiasis in children include URSL and RIRS. Various types of energy are used in the disintegration of deposits in these procedures. We decided to evaluate the usefulness of URSL and RIRS techniques and compare the effectiveness of pneumatic lithotripters and holmium lasers in the child population based on our experience.Materials and Methods.One hundred eight (108) children who underwent URSL and RIRS procedures were enrolled in the study and divided into two (2) groups according to the type of energy used: pneumatic lithotripter versus holmium laser. We evaluated the procedures’ duration and effectiveness according to the stone-free rate (SFR) directly after the procedure and after fourteen (14) days and the rate of complications.Results.The mean operative time was shorter in the holmium laser group. A higher SFR was observed in the holmium laser but it was not statistically significant in the URSL and RIRS procedures. The rate of complications was similar in both groups.Conclusions.The URSL and RIRS procedures are highly efficient and safe methods. The use of a holmium laser reduces the duration of the procedure and increases its effectiveness in comparison with the use of a pneumatic lithotripter.

scholarly journals Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

2021 ◽  
Vol 8 ◽  
Author(s):  
Longhui Lai ◽  
Wenzhao Zhang ◽  
Fangjian Zheng ◽  
Tao Wang ◽  
Peide Bai ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Ureteral Calculi ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteral Access Sheath ◽  
Hospitalization Cost ◽  
Access Sheath ◽  
Stone Free Rate ◽  
Free Rate

Background: ShuoTong ureteroscopy (Sotn-ureteroscopy, ST-URS), a new lithotripsy operation method developed on the basis of ureteroscopy, is widely used to treat ureteral stones in China. Its composition includes rigid ureteral access sheath, standard mirror, lithotripsy mirror, and ShuoTong perfusion aspirator (ST-APM). Here, we compared the efficacy and safety of the ST-URS and the flexible ureteroscope (F-URS) holmium laser lithotripsy in the treatment of unilateral upper ureteral calculi.Methods: Retrospective analysis was conducted on the clinical data of 280 patients who met the inclusion 1) urinary tract CT was diagnosed with unilateral single upper ureteral calculi above the L4 lumbar spine; 2) patient age was from 18 to 80 years old; 3) patients were informed and consented to this study; and 4) patients were approved by the hospital ethics committee (proof number: KY-2019-020) and the exclusion criteria for unilateral upper ureteral calculi in the First Affiliated Hospital of Xiamen University from January 2018 to November 2020, and they were divided into the ST-URS group and the flexible ureteroscopy (F-URS) group.Results: The stone-free rate of 1 day after operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P &lt; 0.0001). The operative time (38.45 vs. 46.18 min, P = 0.005) and hospitalization cost (27,203 vs. 33,220 Yuan, P &lt; 0.0001) of the ST-URS group were significantly lower than the F-URS group. There were no significant differences in the success rate of ureteral access sheath placement, operative blood loss, stone-free rate of 1 month after operation, postoperative complications, postoperative hospital stay, and postoperative visual analog scale (VAS) pain score between the two groups (P &gt; 0.05). In subgroups of a diameter of calculi ≥ 1.5 cm, calculi CT numerical value ≥ 1,000 Hounsfield unit and the preoperative hydronephrosis range ≥ 3.0 cm, ST-URS shows more advantages in the operative time, stone-free rate of 1 day after the operation, the hospitalization cost, and the incidence of postoperative complications.Conclusion: In unilateral upper ureteral stones treated with a holmium laser, compared with the simple F-URS, the ST-URS has a shorter operative time, lower hospitalization cost, and a higher stone-free rate of 1 day after the operation, suggesting that the ST-URS could be more widely applied in clinics.

MP63-19 DEVELOPMENT OF A NOMOGRAM PREDICTING THE PROBABILITY OF STONE FREE RATE IN PATIENTS WITH URETERAL STONES ELIGIBLE FOR LASER URETEROLITOTHRIPSY

2020 ◽  
Vol 203 ◽  
pp. e962
Author(s):  
Cosimo De Nunzio* ◽  
Riccardo Lombardo ◽  
Giorgio Russo ◽  
Ana Albano ◽  
Mariangela Bellangino ◽  
...  
Keyword(s):  
Ureteral Stones ◽  
Stone Free Rate ◽  
Free Rate
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