Update of the ICUD-SIU consultation on stone technology behind ureteroscopy (original) (raw)
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Ureterorenoscopy, a review of first three years of experience for ureteric stone disease
The Professional Medical Journal, 2019
Objectives: Ureterorenoscopy is a diagnostic and therapeutic modality, used for different ureteral and renal pathologies. It has virtually replaced open surgery for ureteric calculi. Study Design: Observational. Setting: Urology Department of Sargodha Medical College, Sargodha. Period: 2011-2015. Material and Methods: All cases who underwent URS for stone disease during the study period were included in the study. The initial criterion was a bit strict, due to minimum experience, which limited only clinically fit patients with no co-morbid illnesses, with stone size of 1 cm or less, located in middle or preferable in distal ureter, single stone was also preferred, but later the criterion was relaxed with gain confidence. The procedures were performed under general anesthesia using R Wolf Ureterorenoscope. Results: The total number of cases included in the study were 332 of which 189 were males and 143 were females. Average age being 42.82 years. The total number of stones managed we...
Ureteroscopy and stones: Current status and future expectations
World journal of nephrology, 2014
Urolithaisis is becoming an ever increasing urological, nephrological and primary care problem. With a lifetime prevalence approaching 10% and increasing morbidity due to stone disease, the role of ureteroscopy and stone removal is becoming more important. We discuss the current status of stone disease and review the ever increasing role that ureteroscopy has to play in its management. We discuss technological advances that have been made in stone management and give you an overview of when, how and why ureteroscopy is the most common treatment option for stone management. We touch on the role of robotic ureteroscopy and the future of ureteroscopy in the next 10 years.
Central European Journal of Urology
10 years has been reported to be 26% in first-time stone formers [3]. The prevalence of urolithiasis in Western countries range from 8-19% in males and from 3-5% in females [4] and the prevalence of urolithiasis is increasing [5]. Studies suggest that ureteroscopy (URS) is as effective as extracorporeal shockwave lithotripsy (ESWL) for treating stones also in proximal parts of the urinary tract [6, 7]. The guidelines of the European Association of Urology (EAU) [8] recommend using
Renal Ureteroscopy Treatment of Kidney and Bladder Stones
— The high incidence of urinary stones ranges from 20-40 years with a M / F ratio of 3: 1 The advent of extracorporeal shock wave lithotripsy associated with improved optical endoscopic have significantly reduced morbidity representing the gold standard for the treatment of urinary stones purpose of the study is to detect, by implementing an analysis of the physical and clinical parameters, the technique and complications of the procedure, the factors that can predict what the potential cases of high morbidity. Materials and methods From January 2000 to December 2014 were performed at the Surgical Clinic III of the University of Catania Policlnico 134 ureterorenoscopy procedures (URS) .the review covered the medical records considering the age, BMI, medical history, treatments and the stone free rate of URS the indication for therapeutic purposes has been carried out in the ureter and kidney stones of size handling <15mm, placement of ureteral catheter, ureteral stenosis, treatment of high urinary tract neoplasms. (Figure 9) .the procedure took an anesthesia care to spontaneous breathing, with cardiac monitoring. Discussion The development of complications in an investigation conducted is slightly higher than the detected case studies, (14%) in the absence of ureteral injury. the survey carried out has a therapeutic success in the first two years stood at 70% reaching the 90% at the end of the period observed, then the use of both general and spinal anesthesia promotes muscle paralysis avoiding potential injuries. With fast deployment anesthetics. Conclusion :The URS is a safe and reliable reality in the treatment of ureteral pathology. the analysis of clinical cases allows to state as the stretch pelvic ureter is easier to deal with both flexible semirigid uretroscopi that becomes essential when a complication arises stop take the appropriate therapeutic options in order to avoid the transformation into major complications.
Translational Andrology and Urology
With an increase in the number of ureteroscopy (URS) procedures, URS is now performed more widely and is becoming a standard procedure for all urologists. There is also a rise in the complexity of these procedures and URS is now offered for treatment of stones as well as for diagnosis and treatment of urothelial tumours. We wanted to provide a 'pictorial review' of the 'tips and tricks' of URS, as the finer and technical details are often easier to understand and remember with images rather than through textual explanations.
European Urology, 2014
Background: Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones. Objective: To describe the differences in the treatment and outcomes of ureteroscopic stones in different locations. Design, setting, and participants: Prospective data were collected by the Clinical Research Office of the Endourological Society on consecutive patients treated with ureteroscopy at centres around the world over a 1-yr period. Intervention: Ureteroscopy was performed according to study protocol and local clinical practice guidelines. Outcome measurements and statistical analysis: Stone location, treatment details, postoperative outcomes, and complications were recorded. Pearson's chi-square analysis and analysis of variance were used to compare outcomes among the different stone locations. Results and limitations: Between January 2010 and October 2012, 9681 patients received ureteroscopy treatment for stones located in the proximal ureter (n = 2656), midureter (n = 1980), distal ureter (n = 4479), or multiple locations (n = 440); location in 126 patients was not specified. Semirigid ureteroscopy was predominantly used for all stone locations. Laser and pneumatic lithotripsy were used in the majority of cases. Stone-free rates were 94.2% for distal ureter locations, 89.4% for midureter locations, 84.5% for proximal ureter locations, and 76.6% for multiple locations. For the proximal ureter, failure and retreatment rates were significantly higher for semirigid ureteroscopy than for flexible ureteroscopy. A low incidence of intraoperative complications was reported (3.8-7.7%). Postoperative complications occurred in 2.5-4.6% of patients and varied according to location, with the highest incidence reported for multiple stone locations. Limitations include shortterm follow-up and a nonuniform treatment approach. Conclusions: Ureteroscopy for ureteral stones resulted in good stone-free rates with low morbidity. Patient summary: This study shows that patients who have ureteral stones can be treated successfully with ureteroscopy with a low rate of complications for the patient.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2017
OBJECTIVE To compare the effectiveness of laser lithotripsy (LL) and pneumatic lithotripters (PL) in calcium oxalate (CaOx) and calcium phosphate (CaP) stones and assess whether these stone compositions affect the outcomes of LL and PL. STUDY DESIGN Comparative, descriptive study. PLACE AND DURATION OF STUDY Istanbul Training and Research Hospital, Turkey, from August 2010 to August 2015. METHODOLOGY A total of 114 patients underwent ureteroscopy using LL and PL. Fifty-eight (50.9%) had CaOx stones and 56 (49.1%) had CaP stones. The lithotripters were compared in stone composition groups, and stone compositions were compared in lithotripter groups. Patient characteristics, perioperative parameters, and postoperative complications were compared. RESULTS The baseline patient and stone characteristics were similar in all groups. The operation time of the PL and LL for the patients with CaP stones (68.75 ±32.88 and 44.48 ±34.37 minutes, respectively) was significantly shorter than the o...
The Medical Journal of Cairo University, 2018
Background: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5). Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complication outcomes for the treatment of renal and ureteral calculi during the learning curve. Patients and Methods: This study was conducted prospectively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV). Results: The mean patient age in the total procedures was 45.63 ± 10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36 ±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ≥ 1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ≥ 1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ≥ 1.5cm. Group II: The mean stone size 1.46 ±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ≥ 1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ≥ 1.5cm. The overall post-operative
Urologia Internationalis, 2020
Background: Primary ureteroscopy (P-URS) has been shown to be as safe and as efficacious as preoperative stent insertion followed by a delayed ureteroscopy (D-URS). However, studies are of limited patient cohort. Methods: A prospective study comparing P-URS and laser fragmentation for ureteric stones to those who received a stent insertion followed by D-URS and stone fragmentation. Results: A total of 367 consecutive patients were included. P-URS was conducted on 235 patients and D-URS on 132 patients. There was no overall difference between patient or stone demographics between the 2 groups, although there were more proximal ureteric and pelvi-ureteric junction stones in the preoperative stent group. The mean operative times were comparable with a stone free rate of 97 and 94% in the preoperative stent and no-stent groups, respectively. The overall complication rates were comparable. Conclusion: The current study provides evidence for the feasibility, safety, and efficacy of P-URS for ureteric calculi in a publicly funded healthcare setting with results comparable to those patients with a preoperative stent and delayed procedure. Therefore, cumulatively, P-URS could lead to less hospitalization, length of stay, stent-related morbidity, and ultimately will be more cost-effective.