Anesthesia for extracorporeal shockwave lithotripsy: Teikyo University Hospital experience using the third generation lithotripter. (1/5)
A single-board certified urologist with training and experience in anesthesiology was assigned to treat 502 patients (185 with renal stones, 317 with ureteral stones) using the Dornier Compact Delta lithotripter under general or epidural anesthesia. Data were obtained regarding stone location, stone size, shockwave use, stone-free rate, and complications. In all, 502 stones were treated with the Dornier Compact Delta lithotripter. Among renal stones, 73% were in the renal pelvis. Among ureteral stones, 60% were in the upper, 10% in the middle, and 30% in the lower ureter. Diameters of 61.8% of stones were less than 1 cm. The mean number of shocks was 3,471 at a mean power setting of 5. The stone-free rate for renal stones was 71.5%, while for ureteral stones this reached 99%. The efficiency quotient was calculated as 0.65. One patient with a renal stone developed perinephric hematoma requiring 3 units of transfusion. With a success rate higher than that reported for other lithotripters, the Dornier Compact Delta lithotripter represents a feasible treatment for urolithiasis. We stress that even in the third generation machines the lithotripsy under anesthesia can improve the treatment efficacy. (+info)Less-invasive ways to remove stones from the kidneys and ureters. (2/5)
(+info)The utility of renal ultrasonography in the diagnosis of renal colic in emergency department patients. (3/5)
OBJECTIVE: Computed tomography (CT) is an imaging modality used to detect renal stones. However, there is concern about the lifetime cumulative radiation exposure attributed to CT. Ultrasonography (US) has been used to diagnose urolithiasis, thereby avoiding radiation exposure. The objective of this study was to determine the ability of US to identify renal colic patients with a low risk of requiring urologic intervention within 90 days of their initial emergency department (ED) visit. METHODS: We completed a retrospective medical record review for all adult patients who underwent ED-ordered renal US for suspected urolithiasis over a 1-year period. Independent, double data extraction was performed for all imaging reports and US results were categorized as "normal," "suggestive of ureterolithiasis," "ureteric stone seen" or "disease unrelated to urolithiasis." Charts were reviewed to determine how many patients underwent subsequent CT and urologic intervention. RESULTS: Of the 817 renal US procedures ordered for suspected urolithiasis during the study period, the results of 352 (43.2%) were classified as normal, and only 2 (0.6%) of these patients required urologic intervention. The results of 177 (21.7%) renal US procedures were suggestive of ureterolithiasis. Of these, 12 (6.8%) patients required urologic intervention. Of the 241 (29.5%) patients who had a ureteric stone seen on US, 15 (6.2%) required urologic intervention. The rate of urologic intervention was significantly lower in those with normal results on US (p < 0.001) than in those with abnormal results on US. CONCLUSION: A normal result on renal US predicts a low likelihood for urologic intervention within 90 days for adult ED patients with suspected urolithiasis. (+info)Extracorporeal shockwave lithotripsy for ureteral stones: twelve years of experience with 2836 patients at a single center. (4/5)
PURPOSE: To retrospectively analyze the efficacy of extracorporeal shockwave lithotripsy (SWL) for managing ureteral stones in patients who were treated during a 12-year period at a single center in Turkey. MATERIALS AND METHODS: The study involved 3300 patients who had single ureteral stone and underwent SWL between January 1999 and March 2011. Medical records from 2836 (85%) patients were available for evaluation. Only patients with radiopaque stones of 5- to 15-mm diameter were included. All procedures were carried out by an experienced urologist (ACK). Patients with proximal ureteral calculi were treated in supine position. Those with mid or distal ureteral stones were treated in modified prone position. Persistence of radiologic image of the stone after three SWL sessions or no spontaneous passage of stone fragments after one month of follow-up was defined as treatment failure. Treatment success was defined as radiologically confirmed fragmentation and spontaneous passage of the stone. RESULTS: The success rates for the subgroups with stones located in the proximal, mid, and distal ureter were 85.1%, 83.9%, and 88.4%, respectively (P = .257). The success rates for individuals with smaller stones ( 10 mm) were 75.3%, 81.3%, and 81.6%, respectively (P = .09). CONCLUSION: Our retrospective evaluation of this large patient series reveals that SWL is effective for treating stones in the proximal, mid, and distal ureter. (+info)Recent finding and new technologies in nephrolitiasis: a review of the recent literature. (5/5)
(+info)Ureterolithiasis is the medical condition characterized by the presence and formation of stones (calculi) within the ureter, which can obstruct urine flow and potentially cause severe pain, hematuria, or infection if not properly treated.
Ureterolithiasis is a medical condition characterized by the presence or formation of a stone (calculus) in the ureter, which is the tube that carries urine from the kidney to the bladder. The stone can cause obstruction and/or irritation leading to symptoms such as severe pain, hematuria (blood in the urine), nausea, vomiting, and changes in urinary frequency or urgency. Ureterolithiasis is also known as ureteral stones or ureteric colic.
'Ureteral calculi' are defined as the presence of stones or solidified mineral deposits within the ureters, typically capable of causing varying degrees of obstruction and associated pain, often resulting from their formation in the upper urinary tract, such as the kidneys.
Ureteral calculi, also known as ureteric stones or ureteral stones, refer to the presence of solid mineral deposits (calculi) within the ureters, the tubes that transport urine from the kidneys to the bladder. These calculi can vary in size and composition, and their formation is often associated with conditions such as dehydration, urinary tract infections, or metabolic disorders. Ureteral calculi may cause symptoms like severe pain, hematuria (blood in the urine), and obstruction of urine flow, potentially leading to serious complications if left untreated.