Comparison of Ureteroscopic Laser Lithotripsy with Laparoscopic Ureterolithotomy for Large Proximal and Mid-Ureter Stones

2015 ◽  
Vol 94 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Onur Kaygısız ◽  
Burhan Coşkun ◽  
Hakan Kılıçarslan ◽  
Yakup Kordan ◽  
Hakan Vuruşkan ◽  
...  
Keyword(s):  
Invasive Procedure ◽  
Laser Lithotripsy ◽  
Minimal Invasive ◽  
Ureteral Stones ◽  
Ureter Stone ◽  
Stone Free Rate ◽  
Effective Option ◽  
Stone Treatment ◽  
Ureter Stones ◽  
Free Rate

Objectives: To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones. Material and Methods: We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy (URS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another. Results: Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications. Conclusions: Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.

scholarly journals STONE FREE RATES OF KIDNEY STONE WAS LOWER THAN THE ONE OF URETER STONE PATIENTS MANAGED BY ESWL AND THE ONE OF URETER STONE MANAGED BY URETEROLITHOTRIPSY

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Zuhirman Zamzami
Keyword(s):  
Kidney Stones ◽  
Medical Records ◽  
Kidney Stone ◽  
Shockwave Lithotripsy ◽  
Ureter Stone ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Male Patients ◽  
The One ◽  
Free Rate

Objective: To evaluate the stone free rates of kidney and ureter stone patients managed by Extracorporeal Shockwave Lithotripsy (ESWL), and the ureter stone free rate managed by ureterolithotripsy. Material & method: We reviewed the medical records of kidney and ureter stone patients managed by ESWL and ureter stone patients managed by ureterolithotripsy in Arifin Achmad Regional General Hospital Pekanbaru Riau Province, Indonesia, from January 2010 - December 2016. ESWL and ureterolithotripsy stone free rates were examined by the control of KUB röngents. Results: There were 891 kidney and ureter stone patients consisting of 325 (36.5%) were kidney stone patients and 566 (63.5%) were ureter stone patients. The pyelum stones were the most (78.2%) in kidney stones and the lower ureter stones were the most (57.2%) in ureter stones. There were more male patients than the female ones in which most of the patients were in the group age of 49-59 years. The amount of patients increased each year. The kidney stone free rate managed by ESWL was lower (71.7%) than ureter stone free rate (84.1%) by ESWL, while the stone free rate of ureter stone patients managed by ureterolithotripsy was 100%. Conclusion: The ESWL stone free rate of the kidney stone patients was lower than the one in ureter stone patients while the ureterolithotripsy stone free rate was 100%.

scholarly journals Management of upper ureteral stones exceeding 15 mm in diameter: Shock wave lithotripsy versus semirigid ureteroscopy with holmium:yttrium–aluminum–garnet laser lithotripsy

2016 ◽  
Vol 4 ◽  
pp. 205031211668518 ◽  
Author(s):  
Hamdy Aboutaleb ◽  
Mohamed Omar ◽  
Shady Salem ◽  
Mohamed Elshazly
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
Perioperative Complications ◽  
Operation Time ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Complication Rates ◽  
Stone Free Rate ◽  
Free Rate

Objectives: We conducted a retrospective study to evaluate the efficacy and outcome of shock wave lithotripsy versus semirigid ureteroscopy in the management of the proximal ureteral stones of diameter exceeding 15 mm. Methods: During the 2009−2014 study period, 147 patients presenting with the proximal ureteral stones exceeding 15 mm in diameter were treated. Both shock wave lithotripsy and ureteroscopy with laser lithotripsy were offered for our patients. A 6/8.9 Fr semirigid ureteroscope was used in conjunction with a holmium:yttrium–aluminum–garnet laser. The stone-free rate was assessed at 2 weeks and 3 months post-treatment. All patients were evaluated for stone-free status, operation time, hospital stay, perioperative complications, and auxiliary procedures. Results: Of the 147 patients who took part in this study, 66 (45%) had undergone shock wave lithotripsy and 81 (55%) underwent ureteroscopy. At the 3-month follow-up, the overall stone-free rate in the shock wave lithotripsy group was 39/66 (59%) compared to 70/81 (86.4%) in the ureteroscopic laser lithotripsy group. Ureteroscopic laser lithotripsy achieved a highly significant stone-free rate ( p = 0.0002), and the mean operative time, auxiliary procedures, and postoperative complication rates were comparable between the two groups. Conclusion: In terms of the management of proximal ureteral stones exceeding 15 mm in diameter, ureteroscopy achieved a greater stone-free rate and is considered the first-line of management. Shock wave lithotripsy achieved lower stone-free rate, and it could be used in selected cases.

scholarly journals MANAGEMENT OF URETER STONES USING ESWL COMPARED TO URS

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Muhammad Omar Rusydi ◽  
Djoko Rahardjo
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Laser Lithotripsy ◽  
Therapeutic Modality ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Dj Stent ◽  
Ureter Stones ◽  
Free Rate

Objective: To evaluate the management of ureterolithiasis using Extracorporeal Shock Wave Lithotripsy (ESWL) EDAP Sonolith Technomed compared to ureteroscopy (URS) with holmium:YAG laser lithotripsy. Material & Method: Research was conducted at Central Pertamina Hospital Jakarta by comparative analysis. The data was taken from patients’ medical records diagnosed with ureterolithiasis who had been treated from January to Desember 2009.Results: Central Hospital Pertamina Jakarta had treated 127 patients with urolithiasis from January to December 2009. Most frequent therapeutic modality was URS, which was followed by ESWL.Double J stents were used in 19,8% of the treatmentin combination with URS, more common than ESWL. Stone free rate in urolithiasis was not significantly different between treatment with URS and ESWL, although stone free rate of URS was higher than ESWL.Use of DJ stent didn’t affect stone free rate of urolithiasis from two of these modalities.Conclusion: Stone free rate of these modalities was below of stone free rate at literatures published, because evaluation from stone free rate of this research was taken after the treatment or 1-2 days after the treatment with imaging of KUB and USG.Keywords: Urolithiasis, extracorporeal shock wave lithotripsy, ureteroscopic,DJ stent, stone free rate.

scholarly journals Pneumatic Lithotripsy Versus Laser Lithotripsy for Ureteral Stones

2018 ◽  
Vol 9 (4) ◽  
pp. 233-236 ◽  
Author(s):  
Amir Reza Abedi ◽  
Mohammad Reza Razzaghi ◽  
Farzad Allameh ◽  
Fereshte Aliakbari ◽  
Morteza FallahKarkan ◽  
...  
Keyword(s):  
Yttrium Aluminum Garnet ◽  
Operation Time ◽  
Laser Lithotripsy ◽  
Ureteral Stones ◽  
Pneumatic Lithotripsy ◽  
Stone Free Rate ◽  
Yttrium Aluminum ◽  
Stone Migration ◽  
Mean Size ◽  
Free Rate

Introduction: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. In this study we studied 250 subjects who had ureteroscopic pneumatic lithotripsy (PL) or laser lithotripsy (LL). Methods: Two-hundred fifty patients with ureteral stones underwent ureteroscopic lithotripsy (115 subjects in the PL group, 135 subjects in the LL group) from August 2010 to April 2016. The purpose of this investigation was to evaluate stone-free rate (SFR), mean operation time (MOT), mean hospital stay (MHS), stone migration and complications. Results: Two groups were similar in age, gender, mean size of stones, side of stone, and complications. There was a statistical difference in terms of SFR, stone migration and MHS in favor of the LL group (P ≤ 0.05, P ≤ 0.05 respectively), and MOT in favor of the PL group (P ≤ 0.05). Conclusion: Both the PL and LL techniques were effective and safe for ureteral stones, however a slightly higher SFR was found in the LL group.

scholarly journals Application of a new position in endoscopic combined intrarenal surgery: modified prone split-leg position

2021 ◽  
Author(s):  
Daming Wang ◽  
Hongliang Sun ◽  
Dongdong Xie ◽  
Zhiqi Liu ◽  
Dexin Yu ◽  
...  
Keyword(s):  
Invasive Procedure ◽  
Renal Calculi ◽  
Categorical Variables ◽  
Ureteral Stones ◽  
Continuous Variables ◽  
Advantages And Disadvantages ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate ◽  
Leg Position

Abstract Background: Endoscopic combined intrarenal surgery (ECIRS) well established as a minimally invasive procedure for is treatment of multiple urolithiasis. The position is the key to the perfect combination of Percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). Galdakao-modified supine Valdivia (GMSV) and prone split-leg position are widely used. However, both positions have their own advantages and disadvantages. This study aimed at evaluating the effect of ECIRS in the treatment of multiple urolithiasis in the modified prone split-leg position.Patients and methods: Total 96 patients with multiple urolithiasis underwent ECIRS in modified prone split-leg position from September 2017 and January 2021. Relevant demographic and clinical data were analysed retrospectively. Clinical outcomes such as stone free rate, complications and postoperative hospital stay were evaluated. Factors predicting stone free rate were also evaluated. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups.Results: The mean renal stones size was 32.5 ± 10.7 mm and renal stone surface area was 712.2 ± 264.8 mm2. The mean ureteral stones size was 24.8 ± 12.3 mm. The mean surgical time was 82.2 ± 38.3 min. The incidence of complications was 16.7%, mainly grade 1 and grade 2. No complications occurred above grade 3. The stone was completely removed in 75 (78.1%) patients in a single operation. The risk factors affecting the stone free rate of ECIRS were analyzed, only the number of involved calyces by stone was found to be significant (p=0.01).Conclusion: ECIRS is safe and effective in the treatment of multiple renal calculi or multiple renal calculi with ipsilateral ureteral calculi in the modified prone split-leg position. The modified of prone split-leg position makes the retrograde operation more convenient, which is conducive to the combination of RIRS and PCNL.

scholarly journals Extracorporeal Shock Wave Lithotripsy verus Rigid Ureteroscopy in Treatment of Mid-Ureteric Stones; Randomized Prospective Study

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A S Hegazy ◽  
M I Ahmed ◽  
A F M Abdelgawad
Keyword(s):  
Shock Wave ◽  
Urinary Tract ◽  
Prospective Study ◽  
Hospital Stay ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stones ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Operative Complications ◽  
Free Rate

Abstract Background Urinary stone disease or nephrolithiasis, the third most common disease of the urinary tract is a major health problem due to its high prevalence, incidence and recurrence. The lifetime incidence of kidney stones for men and women is approximately 13% and 7% respectively. Although stones may be asymptomatic, potential consequences include abdominal and flank pain, nausea and vomiting, urinary tract obstruction, infection, and procedure-related morbidity. Ureteral stones frequently cause renal colic and if left untreated can cause obstructive uropathy. Objectives A prospective randomized study to compare between extracorporeal shock-wave lithotripsy and rigid ureteroscopy in mid-ureteric stone treatment regarding efficacy, stone-free rate, retreatment rates, associated complications (intra-operative and post-operative), operative duration, hospital stay. Patients and Methods This study was performed at Ain Shams University (Urology department) and El Doaah hospital (Urology department), From August 2016 to August 2017, a total of 50 patients having solitary radiopaque middle ureteral stone ranges between 0.5 – 1.5 in size were divided into two groups 25 patients each enrolled in our prospective study. Results In this study the overall stone free rate was considered after two sessions of ESWL (in case of ESWL group) or one trial of ureteroscopy (in case of URS group). ESWL group: 14 cases became stone free after the first session, while the remaining 11 out of 25 patients needed second session, 6 cases became stone free after the second session. ESWL failure occurred in 5 cases and they were successfully managed by ureteroscopy. URS group: 23 cases became stone free after first ureteroscopy, while the remaining 2 patients needed second ureteroscopy due to proximal migration of the stone. In ESWL group, patients were already at outpatient clinic so there were no admission or hospital stay, all cases done without anesthesia, just analgesic ± sedation. While in URS group patients admitted and the hospital stay varies from one day to seven days according to the condition of the case, all URS cases had Spinal anesthesia. ESWL was shown to be less time consuming than URS with a mean operative time of 46.84±3.61 minutes versus 56.20±7.11 minutes respectively. In URS group there were 22 patients had ureteric catheter inserted for 24 to 72 hours postoperatively and 3 patients had double (J) stent inserted for 4 weeks postoperatively, while all the patients who underwent ESWL, no auxiliary procedure done as this procedure is completely non-invasive. Among ESWL cases, No case had an intra-operative complication, while URS group had 3 cases of intra-operative complication. There were 4 cases who had post-operative complications among ESWL group, while there were 5 cases who had post-operative complications among URS group. Conclusion In treatment of mid-ureteral stones range 0.5-1.5 in size, both URS and ESWL modalities are comparable but URS is recommended as a first option as it is more effective than ESWL regarding stone free rate and it provides immediate stone clearance with lower re-treatment rates and higher patient satisfaction, but URS requires anesthesia, longer hospitalization, and associated with a higher incidence of complications.

scholarly journals The Role of Antegrade Irrigation via Percutaneous Nephrostomy on Surgical Outcomes in Semirigid Ureteroscopy among Patients with Upper Ureteral Stones

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Wonho Jung ◽  
Hye Jin Byun ◽  
Dong Sup Lee
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Operation Time ◽  
Percutaneous Nephrostomy ◽  
Stone Size ◽  
Stone Free Rate ◽  
Ureter Stones ◽  
Free Rate

Objective. We aimed to investigate the role of antegrade irrigation via percutaneous nephrostomy on surgical outcomes in retrograde ureteroscopy in patients with upper ureter stones. Materials and Methods. In this retrospective study, we analyzed 134 patients who underwent retrograde semirigid ureteroscopy for upper ureter stones between August 2012 and December 2017. Patients were divided into two groups: retrograde irrigation group (conventional URS) and antegrade irrigation group (using percutaneous nephrostomy). Operation time, postoperative hospital stay, complications, and stone-free rate were measured for each patient after ureteroscopy. Results. The mean age in the retrograde irrigation and antegrade irrigation groups was 53.3 and 60.7 years, respectively (p=0.007). The operation time was 60.8 min vs. 43.0 min (p=0.002), and stone-free rate was 82.0 % vs. 95.5 % (p=0.033). Stone size, laterality, the proportion of male patients, and urinary tract infection prevalence were comparable between the groups. In the subgroup analysis of stone size >10 mm, the antegrade irrigation group had a shorter operation time and a higher stone-free rate. For stone size of 5–10 mm, operation time in the antegrade irrigation group was shorter and the stone-free rate between the two groups was comparable. Conclusion. Antegrade irrigation via percutaneous nephrostomy during ureteroscopy has a higher stone-free rate with a shorter operation time without an increased urinary tract infection risk. Therefore, if percutaneous nephrostomy is necessary before ureteroscopy, antegrade irrigation of external fluid via percutaneous nephrostomy is strongly recommended.

scholarly journals Application of Pneumatic Lithotripter and Holmium Laser in the Treatment of Ureteral Stones and Kidney Stones in Children

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Marcin Życzkowski ◽  
Rafał Bogacki ◽  
Krzysztof Nowakowski ◽  
Bartosz Muskała ◽  
Paweł Rajwa ◽  
...  
Keyword(s):  
Operative Time ◽  
Treatment Options ◽  
Population Based ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Stone Free Rate ◽  
Group A ◽  
The Mean ◽  
Laser Group ◽  
Free Rate

Objective.Treatment options for urolithiasis in children include URSL and RIRS. Various types of energy are used in the disintegration of deposits in these procedures. We decided to evaluate the usefulness of URSL and RIRS techniques and compare the effectiveness of pneumatic lithotripters and holmium lasers in the child population based on our experience.Materials and Methods.One hundred eight (108) children who underwent URSL and RIRS procedures were enrolled in the study and divided into two (2) groups according to the type of energy used: pneumatic lithotripter versus holmium laser. We evaluated the procedures’ duration and effectiveness according to the stone-free rate (SFR) directly after the procedure and after fourteen (14) days and the rate of complications.Results.The mean operative time was shorter in the holmium laser group. A higher SFR was observed in the holmium laser but it was not statistically significant in the URSL and RIRS procedures. The rate of complications was similar in both groups.Conclusions.The URSL and RIRS procedures are highly efficient and safe methods. The use of a holmium laser reduces the duration of the procedure and increases its effectiveness in comparison with the use of a pneumatic lithotripter.

scholarly journals Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

2021 ◽  
Vol 8 ◽  
Author(s):  
Longhui Lai ◽  
Wenzhao Zhang ◽  
Fangjian Zheng ◽  
Tao Wang ◽  
Peide Bai ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Operative Time ◽  
Ureteral Calculi ◽  
Flexible Ureteroscopy ◽  
Ureteral Stones ◽  
Ureteral Access Sheath ◽  
Hospitalization Cost ◽  
Access Sheath ◽  
Stone Free Rate ◽  
Free Rate

Background: ShuoTong ureteroscopy (Sotn-ureteroscopy, ST-URS), a new lithotripsy operation method developed on the basis of ureteroscopy, is widely used to treat ureteral stones in China. Its composition includes rigid ureteral access sheath, standard mirror, lithotripsy mirror, and ShuoTong perfusion aspirator (ST-APM). Here, we compared the efficacy and safety of the ST-URS and the flexible ureteroscope (F-URS) holmium laser lithotripsy in the treatment of unilateral upper ureteral calculi.Methods: Retrospective analysis was conducted on the clinical data of 280 patients who met the inclusion 1) urinary tract CT was diagnosed with unilateral single upper ureteral calculi above the L4 lumbar spine; 2) patient age was from 18 to 80 years old; 3) patients were informed and consented to this study; and 4) patients were approved by the hospital ethics committee (proof number: KY-2019-020) and the exclusion criteria for unilateral upper ureteral calculi in the First Affiliated Hospital of Xiamen University from January 2018 to November 2020, and they were divided into the ST-URS group and the flexible ureteroscopy (F-URS) group.Results: The stone-free rate of 1 day after operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P < 0.0001). The operative time (38.45 vs. 46.18 min, P = 0.005) and hospitalization cost (27,203 vs. 33,220 Yuan, P < 0.0001) of the ST-URS group were significantly lower than the F-URS group. There were no significant differences in the success rate of ureteral access sheath placement, operative blood loss, stone-free rate of 1 month after operation, postoperative complications, postoperative hospital stay, and postoperative visual analog scale (VAS) pain score between the two groups (P > 0.05). In subgroups of a diameter of calculi ≥ 1.5 cm, calculi CT numerical value ≥ 1,000 Hounsfield unit and the preoperative hydronephrosis range ≥ 3.0 cm, ST-URS shows more advantages in the operative time, stone-free rate of 1 day after the operation, the hospitalization cost, and the incidence of postoperative complications.Conclusion: In unilateral upper ureteral stones treated with a holmium laser, compared with the simple F-URS, the ST-URS has a shorter operative time, lower hospitalization cost, and a higher stone-free rate of 1 day after the operation, suggesting that the ST-URS could be more widely applied in clinics.

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