scholarly journals Effectiveness of the self-retrieval basketing technique for stone extraction during flexible ureteroscopy for urolithiasis

2020 ◽  
Author(s):  
Go Anan ◽  
Kenji Komatsu ◽  
Shingo Hatakeyama ◽  
Hiromichi Iwamura ◽  
Yuki Kohada ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
The Self ◽  
Flexible Ureteroscopy ◽  
Dominant Hand ◽  
Stone Extraction ◽  
Ureter Injury ◽  
Stone Free Rate ◽  
Basket Catheter ◽  
Clavien Grade ◽  
Study Population

Abstract Background To assess the safety and effectiveness of using the self-retrieval basketing technique by solo surgeon as a method for stone extraction during flexible ureteroscopy (f-URS) for urolithiasis. Methods This retrospective study enrolled patients with urinary calculus who underwent f-URS at two institutions in Japan between September 2014 and November 2019. A total of 100 cases were performed by one experienced surgeon using the self-retrieval basketing technique. With this approach, the f-URS apparatus was manipulated with the nondominant hand and the basket catheter was manipulated with the dominant hand. The self-retrieval basketing technique employed two parts—specifically, a “front catch” and “side catch” to gather fragmented stones visible in the front and side of the ureteroscopic view, respectively. We retrospectively examined perioperative results, complications, and the stone free rate (with “stone-free” defined as ≤ 2 mm with kidney ureter bladder (KUB) 1 month after f-URS) to estimate the safety and effectiveness for comparison with results of the conventional retrieval basketing technique. Results Among our study population, the median stone size was 14 mm and the median operative time was 80 minutes. A stone free status was achieved in 87 patients (87%). The median stone fragmentation time was 16 minutes and the stone retrieval time was 32 minutes. All included cases were completed with the self-retrieval basketing technique. Complications related to stone retrieval were identified in two cases (2%); the degree of ureter injury being Clavien grade IIIa. There were no intraoperative complications such as heavy hematuria not to detect ureteral mucosa. Conclusions The self-retrieval basketing technique is safe and effective for the extraction of stone fragments during f-URS for urolithiasis. The self-retrieval basketing technique does not require assistance for basketing; therefore, f-URS with active retrieval basketing could be completed by solo surgeon.

scholarly journals Long-term outcome after flexible ureteroscopy with holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones

2019 ◽  
Vol 47 (8) ◽  
pp. 3601-3612 ◽  
Author(s):  
Zhu Zewu ◽  
Chen Hequn ◽  
Cui Yu ◽  
Li Yang ◽  
Yang Zhongqing ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Intraoperative Complications ◽  
Renal Cysts ◽  
Holmium Laser ◽  
Flexible Ureteroscopy ◽  
Simultaneous Treatment ◽  
Period Range ◽  
Term Outcome ◽  
Long Term Outcome

Objective To assess the long-term outcome of simultaneous treatment of a single renal cyst and ipsilateral stones with transurethral flexible ureteroscopy (FURS) lithotripsy and internal cyst drainage. Methods Patients who underwent simultaneous treatment with FURS lithotripsy and internal cyst drainage in our institution between July 2014 and September 2017 were enrolled. The cyst wall was identified endoscopically and a 1–3-cm window was created in the wall using a holmium laser. The proximal end of a double-J stent was placed in the cystic cavity to facilitate internal drainage. Results Thirteen patients underwent simultaneous treatment. No intraoperative complications with Clavien grading score >2 were noted in any patients. Mean stone burden and cyst diameter were 1.6 (range: 0.9–2.5) cm and 5.8 (range: 3.0–7.1) cm, respectively. Stone-free rates after single and complementary procedures were 84.6% and 92.3%, respectively. During the mean 33.1-month follow-up period (range: 17–54 months), seven patients (53.8%) achieved full resolution of renal cysts, five patients (38.5%) maintained >50% size reduction, and one patient (7.6%) experienced recurrence at 18 months postoperatively. Conclusions FURS with a holmium laser may constitute a safe and effective alternative procedure for simultaneous treatment of a single renal cyst and ipsilateral stones.

Factors that affect Stone Free Rate in flexible ureteroscopy in large renal calculi lithotripsy

2018 ◽  
Vol 17 (4) ◽  
pp. e2016
Author(s):  
G. Dellis ◽  
E. Patili ◽  
J. Varkarakis ◽  
A. Papatsoris ◽  
M. Berdebes ◽  
...  
Keyword(s):  
Renal Calculi ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Free Rate

Modified supine percutaneous nephrolithotomy with combined fluoroscopy and ultrasound-guided renal puncture: Initial single-surgeon experience at a UK teaching hospital

2017 ◽  
Vol 10 (6) ◽  
pp. 535-540
Author(s):  
N Nkwam ◽  
MA Khan
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Ultrasound Guidance ◽  
Plain Film ◽  
Ultrasound Guided ◽  
Visceral Injury ◽  
Stone Free Rate ◽  
Surgeon Experience ◽  
Clavien Grade ◽  
Low Incidence ◽  
Free Rate

Objective: The purpose of this article is to report the outcomes of our initial experience of performing percutaneous nephrolithotomy in the supine position using ultrasound guidance in addition to fluoroscopy for renal access. Patients and methods: The first 34 consecutive modified supine percutaneous nephrolithotomy cases performed by a single consultant urologist inserting their own percutaneous tracts using ultrasound-guidance and fluoroscopy were evaluated. Operative data was collected prospectively over a 10-month period including any complications. The stone-free rate was evaluated three months post-operatively with a plain film or non-contrast computed tomography of the kidneys, ureters and bladder. Results: Renal access was achieved in all 34 cases. Mean age was 57 years (19–82) with 14 males and 20 females. Mean stone size 37.2 mm (20–72 mm). Overall stone-free rate was 85.3% at a mean follow up of 11.2 months. There was one Clavien Grade I, and three Clavien Grade II complications of post-operative fever requiring treatment with intravenous antibiotics. No patients developed urosepsis, required blood transfusion or sustained any visceral injury. Median in-patient stay was one night (1–4). Conclusion: Modified supine percutaneous nephrolithotomy with combined fluoroscopy and ultrasound-guided renal access has a low incidence of complications allowing for short hospital stay.

scholarly journals Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2728 ◽  
Author(s):  
Jiaqiao Zhang ◽  
Chuou Xu ◽  
Deng He ◽  
Yuchao Lu ◽  
Henglong Hu ◽  
...  
Keyword(s):  
Renal Stone ◽  
Operation Time ◽  
Renal Stones ◽  
Renal Calculi ◽  
Good Prognosis ◽  
Flexible Ureteroscopy ◽  
Stone Free Rate ◽  
Ureteral Stenting ◽  
Free Rate

Purpose To clarify the outcome of flexible ureteroscopy (fURS) for management of renal calculi without preoperative stenting. Methods A total of 171 patients who received 176 fURS procedures for unilateral renal stones were reviewed. All procedures were divided into two groups depending on whether they received ureteral stenting preoperatively. Baseline characteristics of patients, stone burden, operation time, stone-free rates, and complications were compared between both groups. Results Successful primary access to the renal pelvis was achieved in 104 of 114 (91.2%) patients without preoperative stenting, while all procedures with preoperative stenting (n = 62) were successfully performed. A total of 156 procedures were included for further data analysis (56 procedures in stenting group and 100 in non-stenting group). No significant differences was found regardless of a preoperative stent placement in terms of stone-free rate (73.2% with stenting vs. 71.0% without, P = 0.854), operative time (70.4 ± 32.8 with stenting vs. 70.2 ± 32.1 without, P = 0.969). Conclusions fURS for management of renal stone without preoperative ureteral stenting are associated with well outcome in short term follow-up. Our study may help patients and doctors to decide if an optional stent is placed or not.

scholarly journals Foreign bodies of the urinary tract in children: Multicenter study

2021 ◽  
Vol 14 (3) ◽  
pp. 175-180
Author(s):  
I.M. Kagantsov ◽  
◽  
V.V. Sizonov ◽  
D.N. Shchedrov ◽  
V.I. Dubrov ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Medical Care ◽  
Help Seeking ◽  
Foreign Bodies ◽  
Urine Analysis ◽  
Favourable Outcome ◽  
Flexible Ureteroscopy ◽  
Group I ◽  
Study Population ◽  
Group Ii

Introduction. Urinary obstructions caused by foreign bodies (FB) represent quite a rare clinical case in practicе of pediatric urologists. However, some recent publications note a tendency towards higher occurrence of FB in urinary tracts in children. Most publications on FB urinary obstructions in children are devoted to the descriptions of individual medical cases. Considering the lack of multicenter research works on the problem, a study based on generalized clinical experience of several hospitals appears relevant. Materials and methods. The study is based on retrospective analysis of treatment results of 44 pediatric cases from 10 clinics of Russia and Belarus during the period from 2000 through 2020. The study population comprised 28 (63.3%) boys and 16 (36.4%) girls. Mean age of the patients was 10.9±3.7 years. The children were subdivided into two groups: group I included 28 (63.3%) cases where FB had been introduced in the urethra or bladder by the child; group II included 16 (36.4%) cases where foreign bodies ended up in urinary tracts as a result of instrumental or surgical procedures. Results. Clinical manifestation of FB was typical among the patients in the group I while in group II the condition more often occurred inapparently. Children often concealed FB introduction in the urinary tracts, and so contacts with a healthcare institution were ordinarily triggered by changes in urine analysis findings. Concealment of FB introduction in the urinary tracts determined help seeking start later than 7 days following the incident in 64.2% cases of group I. More than a half of the FB in children of group I were revealed within the first month after the incident. In group II, FB were revealed accidentally during follow-up examinations in 75% of the children. Transurethral FB extraction succeeded in 50% of the patients in group I. In group II, transurethral FB extraction was performed in 5 (31.3%) children. In 2 cases (12.5%), FB were extracted using flexible ureteroscopy. Percutaneous nephroscopy was used in 2 (12.5%) patients. 5 (31.3%) cases required pyelotomy with laparoscopic access, and in 2 (12.5%) patients a lumbotomy had to be carried out. Discussion. The rarity of FB of the urinary tract in the practice of a pediatric urologist is the reason for the combination ofthe existing experience in providing medical care to children from 11 centers. Delayed demand for medical care was noted if FB were introduced by the child independently. The generalized material shows that in childhood, the same approaches to FB extraction are applicable as in adult patients; endoscopic FB removal is optimal. Conclusions. In most cases of children suffering from foreign bodies in urinary tracts, the FB can be extracted using endoscopy without complications and with favourable outcome.

scholarly journals The Effect of Self-Financing on Learning Motivation with Mediation of Training Quality

2021 ◽  
Vol 5 (1) ◽  
pp. 79-88
Author(s):  
Endang Setyowati ◽  
Dyah Sawitri
Keyword(s):  
Regression Analysis ◽  
Data Collection ◽  
The Self ◽  
Learning Motivation ◽  
Questionnaire Data ◽  
Sampled Data ◽  
Training Quality ◽  
Study Population ◽  
The Impact ◽  
And Training

This study aims to examine the effect of Self-financing on Training quality and the impact on learning motivation of trainees at UPT BLK Singosari-Malang. This research is important because in the researchers knowledge it has never been studied before and can contribute to Singosari BLK UPT to determine appropriate Self-financing and training. The study population was 60 participants who had attended training at UPT BLK Singosari during 2019 using Self-financing. Because the samples are small, this study uses a census sample, where a total of 60 people are sampled. Data collection uses a questionnaire. Data was obtained by distributing a list of questions about the Self-financing variable and Training quality in relation to learning motivation to respondents. The data obtained were analyzed by multiple regression analysis and path analysis. The results showed that Self-financing directly has a significant effect on Training quality variable. Self-financing directly has a significant effect on variable Learning motivation. The Training quality directly has a significant effect on Learning motivation variable. Self-financing indirectly has a significant effect on Learning motivation mediated by Training quality.

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