Novel Use of a Modified Triangular Prismatic Double-J Stent for 2- to 3-cm Renal Stones after One-Stage Retrograde Intrarenal Surgery

2021 ◽  
pp. 1-6
Author(s):  
Rui Wang ◽  
Yude Hu ◽  
Haijie Xie ◽  
Linguo Xie ◽  
Yu Yang ◽  
...  
Keyword(s):  
Renal Stones ◽  
Treatment Method ◽  
Standard Group ◽  
Retrograde Intrarenal Surgery ◽  
Efficient Treatment ◽  
Stent Removal ◽  
One Stage ◽  
Significant Difference ◽  
Dj Stent ◽  
Residual Fragments

Objectives: To initially evaluate the outcomes of the modified triangular prismatic double-J (DJ) stent in the management of 2- to 3-cm renal stones after one-stage retrograde intrarenal surgery (RIRS). Methods: Patients with 2- to 3-cm renal stones who underwent one-stage RIRS with indwelling DJ stents were retrospectively evaluated. Eighty-eight patients who were placed the triangular prismatic DJ stents and 64 patients who received standard DJ stents were randomly included. The clinical characteristics and intraoperative and postoperative outcomes of the 2 groups were compared and analyzed. Results: The 2 groups had similar baseline characteristics. The urinary symptom score and pain score did not differ between groups (p > 0.05). The residual fragments of the 2 groups were similar 1 day after operation (p = 0.134). There was no significant difference in residual fragments in the lower calyx between groups at the time of stent removal (p = 0.834). The patients in the modified group had better spontaneous passage of residual fragments in the nonlower calyx than those in the standard group during the 2 weeks with the stents (p = 0.005). Fewer patients in the modified group had residual fragments (>4 mm) in the nonlower calyx (p = 0.026) and ureter (p = 0.010) than the patients with standard stents at the time of stent removal. Conclusion: The indwelling triangular prismatic DJ stent is a safe and efficient treatment method. Patients with these stents had better spontaneous residual fragment passage than those with the standard DJ stents.

Percutaneous nephrolithotomy versus flexible ureteroscopy in terms of cost-effectiveness in patients with 10–30 mm renal stones

2019 ◽  
Vol 87 (1) ◽  
pp. 41-46
Author(s):  
Abdullah Erdoğan ◽  
Ercüment Keskin ◽  
Abdulsemet Altun
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Flexible Ureteroscopy ◽  
Common Disease ◽  
Retrograde Intrarenal Surgery ◽  
Total Cost ◽  
Extracorporeal Shock Wave ◽  
Significant Difference ◽  
The Cost ◽  
Mean Cost

Purpose: Kidney stones are one of the most common urological problems. When deciding on the method of treatment for this common disease, the cost of the procedure should also be taken into consideration. Materials and methods: We performed a retrospective analysis of 55 patients who underwent percutaneous nephrolithotomy and 75 patients who underwent retrograde intrarenal surgery between January 2016 and November 2018. Until operative success was achieved, all additional surgical procedures, extracorporeal shock wave lithotripsy procedures, and interventional procedures required to resolve complications were recorded. Total cost was compared between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups. Results: No significant difference was found between the percutaneous nephrolithotomy and retrograde intrarenal surgery groups in terms of gender, mean age, stone side, stone localization and stone surface area. The total cost of 55 patients that underwent percutaneous nephrolithotomy was calculated as US$14.766 after the first operation, and the total cost of 75 patients that underwent retrograde intrarenal surgery was determined to be US$46.627. The mean cost per patient was calculated US$320 ± US$186 for percutaneous nephrolithotomy and US$749 ± US$242 for retrograde intrarenal surgery (p < 0.001). Conclusions: Percutaneous nephrolithotomy is a lower-cost and successful method in the surgical treatment of 1–3 cm stones, but the serious complications involved in this operation should be kept in mind.

scholarly journals Efficacy of Tamsulosin in Relieving Double-J Stentrelated Symptoms: a Randomized Controlled Study

2016 ◽  
Vol 19 (2) ◽  
pp. 3-6
Author(s):  
Deepak K Thakur ◽  
Suman Chapagain ◽  
Bhojraj Luitel ◽  
Pawan Raj Chalise ◽  
Uttam Kumar Sharma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stent Placement ◽  
Ureteral Stent ◽  
Controlled Study ◽  
Control Group ◽  
Stent Removal ◽  
Significant Difference ◽  
Dj Stent ◽  
And Control

Introduction: Ureteral stent placement is an increasingly common procedure in urological practice. They are used for both prevention and treatment of ureteral obstruction. Despite improved design and materials, many patients still develop stent-related symptoms which commonly affect quality of life and sometimes necessitate early removal. Tamsulosin improves stent-related symptoms and quality of life. But such study has not been conducted in Nepalese context. In the present study, the effect of Tamsulosin in improving double-J stent-related symptoms and quality of life following ureteral stent placement was studied. Methods: This study was carried out in the Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from February 2015 to January 2016. Forty six patients were included in the study and randomized into Tamsulosin (T) group and Control (C) group each having 23 patients. In addition to standard postoperative care, Tamsulosin group received 0.4 mg Tamsulosin daily for 2 weeks and Paracetamol on demand and control group received only Paracetamol (1gram/dose). Stent related symptoms and quality of life was assessed by International prostate symptom score (IPSS) at discharge (day2) and at the time of DJ stent removal (2 weeks). Pain was evaluated by visual analog scale (VAS) and analgesic requirement was documented. Data were analysed using Statistical Package for the Social Sciences (SPSS) 20, chisquare test and Student’s t- test was used. A p-value of <0.05 was considered significant. Results: Mean age in Tamsulosin group was 37.96±12.98 years and Control group 36.43± 10.99 years (p=0.67).There was no significant difference in IPSS (p=0.141), QoL index (p=0.089) and VAS (p=0.59) in the two groups at the time of discharge. At the time of DJ stent removal, IPSS (p<0.001), QoL index(p<0.001), VAS(p=0.004) and analgesic needed(p<0.001) was significantly lower in T group than in C group. Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patients with indwelling DJ stent though the effect is not immediate.  

scholarly journals Forgotten double J stent in crossed renal fused ectopia: a rare case report

2020 ◽  
Vol 7 (10) ◽  
pp. 3497
Author(s):  
Prashant Kumar ◽  
Sachin Joseph ◽  
Pabitra Kumar Misra ◽  
Kiran S. Nair
Keyword(s):  
Case Report ◽  
Diabetic Patient ◽  
Renal Dysfunction ◽  
Rare Case ◽  
First Trimester ◽  
Retrograde Intrarenal Surgery ◽  
Stent Removal ◽  
Double J Stent ◽  
Rare Case Report ◽  
Dj Stent

Ureteral double J (DJ) sent has now become one of the most commonly used tools in endourology. Complications are bound to occur if forgotten to remove, such as encrustations, infection, migration, renal dysfunction, hydronephrosis. Crossed renal fused ectopia is a very rare congenital malformation due to abnormal kidney ascent with fusion during embryogenesis in the first trimester. we report a very rare case of forgotten DJ stent in crossed fused ectopia, in 66 years old diabetic patient post left ureterorenoscopy (URS) done 3 years back. Retrograde intrarenal surgery (RIRS) was done for DJ stent removal right.

scholarly journals Factors for predicting early infection after retrograde intrarenal surgery (RIRS) in 1-2 cm renal stones

2021 ◽  
Author(s):  
Huseyin Kazan ◽  
Mehmet Caglar Cakici ◽  
Ferhat Keser ◽  
Meftun Culpan ◽  
Ozgur Efiloglu ◽  
...  
Keyword(s):  
Urine Analysis ◽  
Demographic Data ◽  
Operation Time ◽  
Renal Stones ◽  
Early Infection ◽  
Retrograde Intrarenal Surgery ◽  
Patient Demographics ◽  
Significant Difference ◽  
Median Diameter ◽  
History Of

Objective: To investigate the factors, especially preoperative urinalysis, predicting postoperative early infection after retrograde intrarenal surgery (RIRS) in 1-2 cm renal stones. Methods: Of the 642 patients who underwent RIRS between September 2013 and July 2019, 289 patients with a total stone size of 1-2 cm were included in the study. Patients were divided into two groups as with and without postoperative urinary tract infection. The demographic data and perioperative findings of all patients were retrospectively reviewed. Sterile urine cultures were obtained in all patients during the preoperative 30-day period and urine analysis values were included in the data. Results: Urinary system infection (UTI) was seen in 20 (6.9%) of 289 patients. Patient demographics were similar between groups. There was no statistically significant difference between the two groups in terms of stone diameter and stone localization (median diameter 13.5 vs 15, p=0.285). Patients with postoperative UTI had a higher rate of UTI history (55% vs 20.5%, p=0.000) and longer operative times (62.5 vs 60 min., p=0.008). Rate of pyuria, leukocyte esterase and nitrite positivity were observed more frequently in patients with postoperative UTI. In multivariate analysis, UTI history, prolonged operative time, and nitrite positivity were found to be independent risk factors for postoperative UTI. Conclusion: Nitrite positivity in preoperative urinanalysis, history of UTI and prolonged operation time are the factors that predict the postoperative infection in RIRS for stones between 1-2 cm.

scholarly journals Effectiveness of Percutaneous Nephrolithotomy, Retrograde Intrarenal Surgery, and Extracorporeal Shock Wave Lithotripsy for Treatment of Renal Stones: A Systematic Review and Meta-Analysis

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 26
Author(s):  
Chan Hee Kim ◽  
Doo Yong Chung ◽  
Koon Ho Rha ◽  
Joo Yong Lee ◽  
Seon Heui Lee
Keyword(s):  
Systematic Review ◽  
Shock Wave ◽  
Percutaneous Nephrolithotomy ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Meta Analysis ◽  
Renal Stones ◽  
Retrograde Intrarenal Surgery ◽  
Extracorporeal Shock Wave ◽  
Significant Difference

Background and objectives: To perform a updated systematic review and meta-analysis comparing effectiveness of percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), and extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stones (RS). Materials and Methods: A total of 37 studies were included in this systematic review and meta-analysis about effectiveness to treat RS. Endpoints were stone-free rates (SFR), incidence of auxiliary procedure, retreatment, and complications. We also conducted a sub-analysis of ≥2 cm stones. Results: First, PCNL had the highest SFR than others regardless of stone sizes and RIRS showed a higher SFR than ESWL in <2 cm stones. Second, auxiliary procedures were higher in ESWL than others, and it did not differ between PCNL and RIRS. Finally, in <2 cm stones, the retreatment rate of ESWL was higher than others. RIRS required significantly more retreatment procedures than PCNL in ≥2 cm stones. Complication was higher in PCNL than others, but there was no statistically significant difference in complications between RIRS and PCNL in ≥2 cm stones. For ≥2 cm stones, PCNL had the highest SFR, and auxiliary procedures and retreatment rates were significantly lower than others. Conclusions: We suggest that PCNL is a safe and effective treatment, especially for large RS.

Joint Treatment of Industrial and Municipal Wastewater – Case Project: City of Kotka, Finland

1992 ◽  
Vol 25 (1) ◽  
pp. 83-92
Author(s):  
Pentti Väänänen ◽  
Pekka Pouttu ◽  
Timo Kulmala
Keyword(s):  
Food Industry ◽  
Municipal Wastewater ◽  
Forest Products ◽  
Treatment Method ◽  
Municipal Sewage ◽  
Forest Products Industry ◽  
Efficient Treatment ◽  
National Board ◽  
The City ◽  
Joint Treatment

The National Board of Waters in Finland has proposed a study on the joint treatment of industrial and municipal wastewaters of the City of Kotka. This study is of great interest due to the large forest products industry and food industry in Kotka. All of the wastewaters from the forest products and the food industry and the municipal sewage have been found to be suitable for biological treatment, which makes the joint treatment applicable. An activated sludge process is selected because it takes advantage of the large amount of nutrients in the municipal sewage and it has proved to be the most efficient treatment method for forest industry wastewaters. However, municipal wastewater contains more nutrients than needed for the biological process, which can cause eutrophication problems in the watercourse. To reduce the pollution caused by the nutrients, chemical treatment of the wastewater is also proposed in the joint treatment. It was concluded that the joint treatment of wastewater is economically, technically and environmentally the best way to arrange wastewater treatment for the industry and the city.

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