scholarly journals Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique

2015 ◽  
Vol 9 (7-8) ◽  
pp. 494 ◽  
Author(s):  
Giovanni Scala Marchini ◽  
Fábio Cesar Miranda Torricelli ◽  
Eduardo Mazzucchi ◽  
Miguel Srougi ◽  
Manoj Monga
Keyword(s):  
Shock Wave ◽  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Treatment Modalities ◽  
Flexible Ureteroscopy ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Intracorporeal Lithotripsy ◽  
Leg Position

The management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy, cystolithopaxy, rigid or flexible ureteroscopy with intracorporeal lithotripsy, percutaneous nephrolithotomy, open surgery, and a combination of those methods. In this study we describe the management of severe forgotten encrusted ureteral stents in 3 female patients using a prone splitleg position. This position allows us to effectively treat any site and degree of stent encrustation in a single-session approach with the patient in the same position during the whole procedure. All patients were rendered stent and stone free. No complications occurred.

Extracorporeal shock-wave lithotripsy to remove calcified ureteral stents

Urology ◽  
1990 ◽  
Vol 36 (2) ◽  
pp. 164-165 ◽  
Author(s):  
Thierry A. Flam ◽  
Michel Brochard ◽  
Marc Zerbib ◽  
Bernard Debre ◽  
Adolphe Steg
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stents ◽  
Extracorporeal Shock Wave

scholarly journals Preoperative use of alpha-1 receptor blockers in male patients undergoing extracorporeal shock wave lithotripsy for a ureteral calculus: a retrospective cohort study

2019 ◽  
Author(s):  
Takashi Yoshioka ◽  
Kenji Omae ◽  
Tatsushi Kawada ◽  
Yosuke Inoue ◽  
Morito Sugimoto ◽  
...  
Keyword(s):  
Shock Wave ◽  
Cohort Study ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Treatment Success ◽  
Ureteral Calculus ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Male Patients ◽  
Negative Predictor

Abstract Purpose To characterize the preoperative use of alpha-1 adrenergic receptor (AR) blockers and investigate its impact on the outcome of single-session extracorporeal shock wave lithotripsy (SWL) for a ureteral calculus in male patients. Methods We conducted a retrospective single-center cohort study involving 193 patients who underwent SWL for a single ureteral calculus between 2006 and 2016. We reviewed their medical records to obtain the data on the preoperative use of alpha-1 AR blocker and, if any, the reason for the prescription. The primary outcome was treatment success after single-session SWL, defined as complete stone clearance or residual fragments <4 mm in size by X-ray imaging. We performed a multivariable logistic regression analysis adjusting for clinically important confounders to examine the association between preoperative use of alpha-1 AR blockers and the treatment success of SWL. We further analyzed this association according to the reason for the prescription. Results Among the 193 patients, 15 (7.8%) were taking an alpha-1 AR blocker preoperatively with 8 (4.1%) for medical expulsive therapy (MET) and 7 (3.7%) for the treatment of benign prostatic hypertrophy (BPH). A multivariate analysis showed that the preoperative use of alpha-1 AR blocker was a significant negative predictor for treatment success of SWL (adjusted odds ratio [aOR] 0.17; 95% confidence intervals [CI], 0.04–0.74). Moreover, the use of alpha-1 AR blocker for MET, but not for BPH, was associated with lower rate of successful treatment (aOR 0.14 and 0.23; 95% CI, 0.02-0.90 and 0.03-1.97, respectively). Conclusions Our findings suggest that the preoperative use of alpha-1 AR blocker, especially for MET, was a negative predictor for treatment success of SWL in male patients with a single ureteral calculus. Clinicians should pay more attention to the preoperative drug use in determining an appropriate stone therapy modality.

Innovative Piezoelectric Extracorporeal Lithotripter

2008 ◽  
pp. 745-753
Author(s):  
Achim M. Loske ◽  
Francisco Fernández ◽  
Gilberto Fernández
Keyword(s):  
Shock Wave ◽  
Shock Waves ◽  
Kidney Stones ◽  
Open Surgery ◽  
Shock Wave Lithotripsy ◽  
Renal Tissue ◽  
The Body ◽  
Extracorporeal Shock Wave ◽  
Tissue Trauma ◽  
Salivary Gland Stones

Before 1980, the majority of patients with urolithiasis and nephrolithiasis needed surgery (Kerbl, Rehman, Landman, Lee, Sundaram, & Clayman, 2002; Soucie et al., 1994). Fortunately, percutaneous nephrolithotomy, ureteroscopic intrarenal surgery, laparoscopic surgery, and extracorporeal shock wave lithotripsy (SWL) now allow almost any calculus to be removed without open surgery. SWL refers to the use of high intensity pressure pulses, generated outside the body, to break up kidney stones (Chaussy, Brendel, & Schmiedt, 1980; Loske, 2007). It has become the standard treatment for the majority of patients and an alternative in the management of gallbladder stones, pancreatic concrements, and salivary gland stones. Even though initial studies concluded that shock waves had no damaging effect on renal tissue, later several authors reported that shock waves may cause tissue trauma (Evan, Willis, Connors, McAteer, & Lingeman, 1991; Evan, Willis, & Lingeman, 2003 Willis et al., 1999). Fortunately, techniques and devices are still evolving and improvements to increase stone fragmentation efficiency and reduce tissue trauma are being constantly sought.

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