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

Healthcare ◽  
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.

scholarly journals Treatment of upper urinary tract stones with flexible ureteroscopy in children

2018 ◽  
Vol 13 (3) ◽  
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.

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

2018 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Yansi Xue ◽  
Lei Xu ◽  
Xiaojun Xu ◽  
Dukun Wang ◽  
Guocheng Wang ◽  
...  
Keyword(s):  
Operation Time ◽  
Renal Stones ◽  
Ureteral Injury ◽  
Clinical Analysis ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Clinical Value ◽  
X Ray ◽  
Holmium Laser Lithotripsy ◽  
Double J Stent

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.

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

2018 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Yansi Xue ◽  
Lei Xu ◽  
Xiaojun Xu ◽  
Dukun Wang ◽  
Guocheng Wang ◽  
...  
Keyword(s):  
Operation Time ◽  
Renal Stones ◽  
Ureteral Injury ◽  
Clinical Analysis ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Clinical Value ◽  
X Ray ◽  
Holmium Laser Lithotripsy ◽  
Double J Stent

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.

scholarly journals Effects of irrigation fluid temperature during flexible ureteroscopic holmium laser lithotripsy on postoperative fever and shivering: a randomized controlled trial

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue He ◽  
You-Gang Feng ◽  
Jun He ◽  
Bo Liang ◽  
Ming-Dong Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Fluid Temperature ◽  
Postoperative Fever ◽  
Irrigation Fluid ◽  
Suspected Infection ◽  
Randomized Controlled ◽  
Holmium Laser Lithotripsy

Abstract Background Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L). Results There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group. Conclusion Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.

Size Distribution of Fragments by High-power Holmium Laser Lithotripsy in MiniPCNL with Suction

2021 ◽  
Vol 22 (12) ◽  
Author(s):  
Naveen K. Reddy ◽  
Abhijit P. Patil ◽  
Gopal R. Tak ◽  
Darshit Shah ◽  
Abhishek G. Singh ◽  
...  
Keyword(s):  
Size Distribution ◽  
High Power ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Holmium Laser Lithotripsy

scholarly journals Treatment of Complex Whole Liver Intrahepatic Ductal Stones Using a Patented Stone-Clearance Sheath Combined with Nephroscopic Holmium Laser Lithotripsy

2021 ◽  
pp. 1-4
Author(s):  
Yuancai Xie ◽  
Dingwen Zhong ◽  
Yanda LU ◽  
Donghua Xie ◽  
Xianjin Cheng ◽  
...  
Keyword(s):  
Operative Time ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Control Group ◽  
Observation Group ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Second Stage ◽  
Holmium Laser Lithotripsy ◽  
One Year

Purpose: To investigate the clinical efficacy of nephroscopic laser lithotripsy with the aid of a patented suctioning sheath in treating complicated whole-liver dispersed intrahepatic ductal stones. Methods: From September 2013 to September 2017, 150 patients who were diagnosed with whole-liver dispersed intrahepatic ductal stones were included in this study and were divided into two groups randomly. The control group consists of 75 patients who were treated by traditional surgery combined with choledochoscopic laser lithotripsy. The observation group consists of the other 75 patients who were treated by traditional surgery combined with nephroscopic laser lithotripsy with the aid of the patented sheath. Related treatment outcome parameters were compared. Results: There were no significant differences in first surgery operative time, first surgery bleeding amount, complication and stone clearance rates (P>0.05). However, the second surgery operative time was (63.58±9.84) min while the complication rate was 7.5% in the observation group, significantly less than that of control group (P<0.05). There were significantly higher first-stage and second stage sinus ductal stone clearance rates and final stone clearance rate in the observation group compared to that of control group (P<0.05), while operative times, hospitalization duration and cost, and one year stone recurrent rate were significantly lower (P<0.05). Conclusion: The efficacy of using the patented stone-clearance sheath combined with nephroscopic holmium laser lithotripsy was significant, warrants more extensive clinical adoption.

Sign in / Sign up

Export Citation Format

Share Document