urinary tract calculi
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2022 ◽  
Vol 55 (1) ◽  
Author(s):  
Jaimie Greasley ◽  
Shivan Goolcharan ◽  
Roger Andrews

In the twin-island state of Trinidad and Tobago, urinary stone analysis is not routinely performed. This study investigates, via powder X-ray diffraction, 52 urinary tract calculi collected from hospitals in Trinidad. Of these, 46 stones were analysed with Rietveld refinement for quantitative analysis and materials characterization. Refined unit-cell, microstructural and weight fraction parameters were obtained, with the last being used for stone classification. The results revealed seven distinct mineralogical phases of varying frequency: calcium oxalate monohydrate (COM, 58%), calcium oxalate dihydrate (COD, 23%), carbonated apatite (APA, 48%), brushite (BRU, 6%), struvite (STR, 42%), uric acid (UA, 23%) and ammonium acid urate (AAU, 19%). The average refined crystallite sizes were 1352 ± 90 Å (COM), 1921 ± 285 Å (COD), 83 ± 5 Å (APA), 1172 ± 9 Å (BRU), 1843 ± 138 Å (STR), 981 ± 87 Å (UA) and 292 ± 83 Å (AAU). Subsequently, 36.5% of stones were categorized as phosphates, 34.6% as oxalates, 13.5% as uric acid/urates and 15.4% as mixed compositions. The study findings highlight the importance of stone analysis as a necessary step towards disease management of local patients, and endorse the application of Rietveld refinement as a natural extension to diffraction-based kidney stone investigations.


2021 ◽  
Vol 1 (2) ◽  
pp. 38-41
Author(s):  
Dipak Kumar Thakur

Introduction: Due to its non-invasive nature, extracorporeal shockwave lithotripsy (ESWL) is the preferred treatment modality for uncomplicated renal and ureteral stone < 20 mm in diameter. The success rate of it ranges from 46% to 91% depending on various factors. Objective: To assess the outcome of ESWL as monotherapy in uncomplicated solitary renal and upper ureteric calculus ranging from 10mm to 20mm. Methods: In this retrospective study, the records of 34 patients who underwent Extracorporeal shockwave lithotripsy ESWL inBirat Medical College – Teaching Hospital over a period of one and a half years were reviewed to assess the outcome in terms of stone free rate and complication rate. Results: Mean age of the patients was 30.57±8.44 years and mean calculus size was 14.47±2.68 mm (range 10-20mm). The male and female ratio was 2:1. The success rate was higher for pelvic (83.33%) and upper calyceal (75%) and upper ureteric calculi (75%) compared to other calyces. Clinically significant residual fragment (CSRF) was the most common problem after ESWL (23.33%) at three months after the procedure. Conclusions: The outcome of ESWL as monotherapy for upper urinary tract calculi is acceptable in selected cases three months after the procedure. Keywords: Extracorporeal shockwave lithotripsy; outcome; upper urinary tract calculi.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zachary Kranz ◽  
Greggory Peifer ◽  
Matthew Rohloff ◽  
Thomas Maatman ◽  
Kenneth Shockley

2021 ◽  
Vol 6 (5) ◽  
pp. 25-37
Author(s):  
Mahnoor Pracha ◽  
Amtullah Fatima ◽  
Najeebullah Alakozai ◽  
Azizullah Alakozai ◽  
Taiba Aslam ◽  
...  

Background: Ultrasound is a non-invasive imaging modality, and it is cost effective while CT in invasive that uses ionizing radiations, yet it is difficult on ultrasound to diagnose calculi in ureter hence for evaluation of ureteric calculi CT scan is gold standard modality. Objective: To compare the detection of renal& urinary tract calculi (nephrolithiasis & urolithiasis) on ultrasound and CT. Material and methods: The data bases PubMed, ProQuest, and Google scholar and research gate were searched with the key words: nephrolithiasis on ultrasound and CT, sensitivity, specificity, from 2010 to 2021. For inclusion and exclusion of studies independently screened the titles and abstracts of full and related articles. Articles that had information about nephrolithiasis, urolithiasis at ultrasound and CT and its sensitivity and specificity were included. Results:  In total, 28 studies were found on renal & urinary tract calculi at ultrasound and computed tomography. This literature review demonstrates that computed tomography is characterized by high sensitivity and specificity in diagnosing renal, ureteric calculi while ultrasound has low sensitivity and specificity. Conclusions: Ultrasound is the best modality for imaging calculi within the kidney, a well hyper echoic mass with posterior acoustic shadow is identified as stone on gray scale, color Doppler can be used for demarcation of stone. At Color Doppler twinkling artifact appears around the calculi hence it can be differentiated by hyper echoic renal sinuses but this is crucially dependant on the size and anatomical position of the stone. The ultrasonic evaluation either overestimates or misinterprets the calculi size while CT gives an exact measurement, position with authentic sensitivity and specificity. Hence, CT is the gold standard for detection of renal calculi. Recommendation: Ultrasound is a non-invasive imaging modality and it is cost effective while CT in invasive that uses ionizing radiations, yet it is difficult on ultrasound to diagnose calculi in ureter hence for evaluation of ureteric calculi CT scan is gold standard modality.


2021 ◽  
Author(s):  
Shun Wang ◽  
Kehua Jiang ◽  
Xiaolong Chen ◽  
Qing Wang ◽  
Xiangyi Liang ◽  
...  

Abstract Purpose To evaluate the clinical efficacy and safety of a Chinese single-use flexible ureteroscope (ZebraScopeTM) for the treatment of upper urinary tract calculi ≤2 cm based on a retrospective database. Methods Overall, 84 patients with upper urinary tract calculi who underwent FURS at our hospital from July, 2020 to January, 2021 were enrolled and reviewed. Demographic characteristics and perioperative data were evaluated and analyzed. Results We identified 84 patients: 51 male and 33 female. The mean age of the patients was(49.63±12.23)years, and the mean body mass index was༈24.44±3.62༉Kg/m2. The degree of hydronephrosis was absent, mild, moderate and severe in 24, 35, 21 and 4 patients, respectively. The average operation time was༈74.57±42.51༉min, and the average blood loss was༈5.28±4.99༉ml. The catheter retention time was༈1.71±0.99༉day and the double-J tube retention time was༈32.89±13.23༉day. The length of hospital stay was༈4.29±3.28༉day. The stone-free rate was 77.78% after 1-month, and the cost of hospitalization was ¥༈34619±8719.16༉. The overall complication rate was 4.76%. There were significant increase in leukocyte, neutrophils, and decrease in urea nitrogen, albumin and globulin after surgery (P༜0.05), while no significant difference were observed in hemoglobin and creatinine (P༞0.05). Conclusion The Chinese single-use ureteral flexible ureteroscope (ZebraScopeTM)can be considered effective and safe for the treatment of upper urinary tract calculi ≤ 2 cm.


Author(s):  
Annu Singhal ◽  
Vivek C. Kottiyath ◽  
Tej Prakash Gupta ◽  
Prachi Arora

Ovarian ectopic pregnancy (OEP) is a rare form of ectopic pregnancy (EP) and constitutes approximately 0.5-3% of all ectopic cases. Its presentation mimics the symptoms of tubal ectopic pregnancy, hemorrhagic ovarian cyst/follicle, tubo-ovarian abscess, urinary tract calculi, appendicitis or ovarian torsion. Occasionally determining the anatomic location of an extra-tubal ectopic pregnancy based on ultrasound imaging and presentation alone can be challenging, particularly when it is adherent to the fallopian tube. Although transvaginal ultrasound (TVS) is the primary modality used in the diagnosis, various forms of OEP and its complications may be incidentally detected and further evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) when an alternative diagnosis is suspected. We reported a case of a second gravid para zero, 25 years old lady, who came with pain in the left lower abdomen. Her urine pregnancy test was positive. TVS showed empty uterine cavity, an extremely tender, heterogenous hyperechoic right adnexal mass, but no obvious gestation sac (GS). A large hematoma was detected adjacent to it in the pouch of Douglas (POD). Keeping a high suspicion of ectopic pregnancy, MRI was performed to evaluate the lesion better which revealed a natural, non-assisted, ruptured right ovarian ectopic pregnancy and was subsequently confirmed at laparotomy and proven on histopathology. Patient underwent left oophorectomy and discharged on 4th day with uneventful follow up. 


2021 ◽  
pp. 1-11
Author(s):  
Wei Tao ◽  
Xu Ming ◽  
Yachen Zang ◽  
Jin Zhu ◽  
Yuanyuan Zhang ◽  
...  

PURPOSE: To evaluate efficacy and safety of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi. METHODS: We retrospectively analyzed 784 patients who underwent FURSL between January 2015 and October 2020 in our unit. All patients were preoperatively evaluated with urine analysis, serum biochemistry, urinary ultrasonography, non-contrast computed tomography and intravenous urography. The procedure was considered as successful in patients with complete stone disappearance or fragments <  4 mm on B ultrasound or computed tomography. The operative parameters, postoperative outcomes and complications were recorded and analyzed respectively. RESULTS: The average operative time and postoperative hospital stay were 46.9±15.8 min and 1.2±1.1 days, respectively, among 784 patients. In addition, 746 patients were followed up and 38 patients were lost. In these patients, 700 (93.8%) cases met the stone removal criteria and 46 cases (6.2%) did not meet the stone removal criteria who need further treatment. The stone free rate (SFR) is 92.5%after 1–3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever (58/784, 7.4%), gross hematuria (540/784, 68.9%) and lpsilateral low back pain (47/784, 6.0%). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. CONCLUSION: FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear. The complications are few and the safety is high. However, there are certain limitations to the efficacy in treating larger stone and lower calyceal calculi.


2021 ◽  
pp. 139-152
Author(s):  
Alexander Cho ◽  
Patrick G Duffy ◽  
Naima Smeulders

Author(s):  
Samjhana Thapaliya ◽  
Samuel L. Brady ◽  
Elanchezhian Somasundaram ◽  
Christopher G. Anton ◽  
Brian D. Coley ◽  
...  

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