scholarly journals Low-cost semirigid ureteroscopy is effective for ureteral stones: Experience of a single high volume center

2014 ◽  
Vol 86 (2) ◽  
pp. 118
Author(s):  
Roberto Giulianelli ◽  
Barbara Cristina Gentile ◽  
Giorgio Vincenti ◽  
Luca Mavilla ◽  
Luca Albanesi ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Effective Means ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Success Rates ◽  
Renal Surgery ◽  
Absolute Minimum ◽  
Distal Ureter ◽  
Holmium Laser Lithotripsy ◽  
Number Of Patients

Aim of the study: To demonstrate how, in a center with a large number of patients, as our center is, it is possible to perform ureterolithotripsy using a limited set of instruments. Methods: We evaluated medical charts of our center related to semirigid ureteral ureteroscopy (URS) with ureterolithotripsy using Holmium laser performed from July 2004 to July 2011. Overall, 658 URS for ureteral stones were performed in 601 patients, of which 204 in proximal ureter (31%), 86 in the mid (13.06%) and 368 (57.76%) in the distal ureter. In 504 patients (76.5%) ureterohydronephrosis (Grade II-III) was observed. In 57 patients (8.6%), we performed a bilateral approach at the same time, but most patients had a solitary distal ureteral stone. 106 patients (16.1%) had more than one stone in their distal ureter and 96 (14.8%) had a proximal ureteral stone treated in the same surgery as well. Results: The overall stone-free rate for ureteral stones was 86.1% (567/658). Success rates for proximal, medial and distal ureteral stones were 68.13% (139/204 patients), 84.8% (73/86 patients) and 96.4% (355/368 patients), respectively. One hundred and twenty patients (18.3%) required additional surgical treatment for their stones beyond the initial URS, including a second URS in 97 patients (14.74%) and URS plus Retrograde Intra-Renal Surgery (RIRS) in 23 patients (3.54%). The overall stonefree rate after the second treatment was 99.3%. Intra-operative complications accounted for 5.92% and consisted of ureteral perforations in 16 pts (2.4%), erosions of urothelium leading to significant bleeding in 15 pts (2.27%), severe pain in 4 pts (0.6%), fever in 3 pts (0.45%) and one case of ureteral avulsion (0.15%). Conclusions: This study demonstrates that the use of Holmium laser lithotripsy is a safe and effective means of treating ureteral stones regardless of sex, age, stone location, or stone size. The instrumentation we used was extremely limited, in order to reduce costs related to the procedure to an absolute minimum whilst maintaining the two quality indicators for the procedure, namely success rate and length of hospitalisation (86.1% and 34 hours).

Design of Holmium Laser Treatment Instrument Control System

2011 ◽  
Vol 311-313 ◽  
pp. 1417-1420
Author(s):  
You Jie Zhou ◽  
Chun Hua Xiong ◽  
Chang Bo Lu
Keyword(s):  
Image Recognition ◽  
Kidney Stone ◽  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Manual Control ◽  
Ureteral Stones ◽  
The Core ◽  
Holmium Laser Lithotripsy ◽  
Instrument Control ◽  
Design Ideas

Based on current market of the holmium laser lithotripsy device power by manual control, the image recognition technology are presented by which are used in the stone therapy. ,in this paper，the core circuit, the external circuit and image recognition part of the circuit and software are discussed, and the corresponding Design ideas and programs is given. The system which can not only generate reliably, practically, high intelligently, but also can be widely applied to the treatment of ureteral stones, bladder stones and kidney stone.

Comparative Study between Pneumatic and Holmium Laser Lithotripsy in Treatment of Ureteric Stones

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Esmat ◽  
Karim Omar Elsaeed ◽  
Moataz Bellah Mohamed Adel
Keyword(s):  
Operating Time ◽  
Laser Lithotripsy ◽  
Early Postoperative Period ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Pneumatic Lithotripsy ◽  
Randomized Clinical Study ◽  
Holmium Laser Lithotripsy ◽  
Group 2 ◽  
Group 1

Abstract Objective The aim of this study was to compare the efficacy & safety of holmium laser and pneumatic lithotripsy used in the ureteroscopic treatment of ureteral stones. Materials and Methods A prospective randomized clinical study was done using the data of patients to whom ureteroscopic lithotripsy (URL) was applied for ureter stones in our clinic. Then these patients were separated into 2 groups according to the type of lithotriptor used in stone fragmentation as laser lithotripsy (Group 1) and pneumatic lithotripsy (Group 2). Results Statistically, the two groups were similar in respect of the number of stones, stone burden and the number of double J stents applied intra-operatively. Mean operating time was calculated as 62.9 (±7.69) minutes in Group 1 and 50.98 (±6.63) minutes in Group 2. The mean operating time was found to be higher in group 1 than group 2 (P = 0.000). On postoperative day 1 after the URL, the SFR of Group 1 79.0% found to be significantly high compared to the SFR of Group 2 (64.0%) (P = 0.019), while at postoperative month 1, the SFR of both groups (Group 1 84%, Group 2 80%) was found to be similar (P = 0.462). Conclusions Compared to the pneumatic lithotripter, the Ho: YAG laser seems to have a statistically significant higher SFR in the early postoperative period (1 day), even though there are statistically insignificant success rate (after 1 month) and complications (hematuria, mucosa injury, stone migration, stricture and perforation avulsion).

scholarly journals Comparison of ESWL and Ureteroscopic Holmium Laser lithotripsy in Management of Ureteral Stones

PLoS ONE ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. e87634 ◽  
Author(s):  
Yon Cui ◽  
Wenzhou Cao ◽  
Hua Shen ◽  
Jianjun Xie ◽  
Tamara S. Adams ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Holmium Laser Lithotripsy

scholarly journals Spontaneous Renal Pelvis Rupture: Unexpected Complication of Urolithiasis Expected to Passage with Observation Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Tuncay Tas ◽  
Basri Cakıroglu ◽  
Süleyman Hilmi Aksoy
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Renal Pelvis ◽  
Ureteral Stone ◽  
Rare Condition ◽  
Ureteral Stones ◽  
Spontaneous Perforation ◽  
Analgesic Treatment ◽  
Distal Ureter ◽  
Ureter Stones

Seventy percent of ureteral stones are located at distal ureter. Effective and safe passage of distal ureter stones is mediated by observation or medical expulsive treatment. Most of stones located at distal ureter pass spontaneously under observation; however, some are complicated with urinary tract infection, hydronephrosis, and renal function disturbances. Spontaneous perforation of the upper ureter is a rare condition that poses diagnostic and therapeutic problems. This case is reported, because the patient developed an unexpected spontaneous renal pelvis rupture (SRPR), while she was under observation and expected to pass her right ureteral stone spontaneously through hydration and analgesic treatment.

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