scholarly journals NEEDLE RENAL LIFTING TECHNIQUE IN MANAGEMENT OF COMPLICATED PROXIMAL URETERAL LITHOTRIPSY: A CASE REPORT

2021 ◽  
Vol 28 (2) ◽  
pp. 215-219
Author(s):  
Muhammad Risan ◽  
Indrawarman Soeroharjo ◽  
Raden Danarto ◽  
Prahara Yuri
Keyword(s):  
Case Report ◽  
Success Rate ◽  
Ureteral Stone ◽  
Flank Pain ◽  
Ureteral Stones ◽  
Proximal Side ◽  
Lifting Technique ◽  
Caudal Direction ◽  
Proximal Ureter

Objective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter.   

scholarly journals Extra-Corporeal Shock Wave Lithotriposy ( ESWL ) for Lower Ureteral Stone

2020 ◽  
Vol 19 (2) ◽  
pp. 174-179
Author(s):  
Othman Jasim Mohammed Alzaidy ◽  
◽  
Reyad Ahmed Farhood
Keyword(s):  
Shock Wave ◽  
Success Rate ◽  
Ureteral Stone ◽  
Ureteral Stones ◽  
Ureteric Stone ◽  
Residual Stone ◽  
Extracorporeal Shock Wave ◽  
Double J Stent ◽  
Two Parameters ◽  
The Right

Background: The optimal treatment of ureteral stones, particularly the lower ureteral stone, still controversial[5,13,15,18]. Objective: To assess the success rate of ESWL and tamsulosin in lower ureteral stone. Also to identify the parameters that affects the success rate of ESWL in the lower ureteral stone. Patients and Methods: Prospective study has been done on thirty-six patients sequentially selected from referred cases to the ESWL department in Sulaimania Teaching Hospital in the period from June, 2010 to January, 2011). All had radioopaque lower ureteric stone (from the lower border of sacroiliac joint to uretero-vesical junction). Stones ranging from (5.8 to14mm), twenty in the left side and sixteen in the right side , age ranging from (10 to 78 years), and only four of them had double J-stent (within 1 week before ESWL). Weekly follow up of all patients were done by U/S and twice-weekly by KUB for 6 weeks. Results: Twenty four cases (66.7%) were free of stone, five cases (13.9%) had residual stone and seven cases (19.4%) failed to respond, the most important two parameters that affect the result are the size of stone and number of sessions. Conclusion: ESWL is safe and useful, and it is considered to be the first favorable line of intervention for lower ureteric stones after failure of watchful waiting and medical expulsion therapy especially those without complications like obstruction. Keywords: Lower ureteric stone, extracorporeal shock wave lithotripsy

scholarly journals Tadalafil versus alpha blockers (alfuzosin, doxazosin, tamsulosin and silodosin) as medical expulsive therapy for < 10 mm distal and proximal ureteral stones

2018 ◽  
Vol 90 (2) ◽  
pp. 117 ◽  
Author(s):  
Serdar Çelik ◽  
Firat Akdeniz ◽  
Muge Afsar Yildirim ◽  
Ozan Bozkurt ◽  
Merve Gursoy Bulut ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Statistical Significance ◽  
Flank Pain ◽  
Ureteral Stones ◽  
Hounsfield Units ◽  
Ureteric Stone ◽  
Expulsion Rate ◽  
Alpha Blockers ◽  
The Difference ◽  
Urology Clinic

Objectives: To evaluate the effect of tadalafil compared with four alpha blockers (alfuzosin, doxazosin, tamsulosin and silodosin) as medical expulsive treatment for ureteral stones in male adults. Materials and methods: Male adults who were admitted to urology clinic with flank pain and diagnosed with non complicated < 10 mm ureteral stone on non-contrast computed tomography (NCCT) between June 2014-September 2015 were retrospectively evaluated. A total of 273 patients with ureteral stone were divided into five groups. Alfuzosin 10 mg/daily, doxazosin 8 mg/daily, tamsulosin 0.4 mg/daily, silodosin 8 mg/daily and tadalafil 5 mg/daily for 6 weeks were prescribed respectively. Stone localization, diameter, volume and Hounsfield units were noted as NCCT findings. The patients were divided into the two groups based on their stone localization as distal and mid-proximal stones. These two groups were evaluated separately. Expulsion rate were noted at the end of 6 weeks. NCCT and treatment findings were compared between five drug groups in distal and mid-proximal stones separately. Results: Age was higher in tadalafil group in distal stones (p = 0.032). Expulsion rate was found 78.1% for alfuzosin, 75.7% for doxazosin, 76.5% for tamsulosin, 88.6% for silodosin and 90% for tadalafil in distal (p = 0.44) and 21.7%, 30%, 30%, 30% and 54.5% in mid-proximal stones (p = 0.034) respectively.Conclusions: Expulsion rate was higher in silodosin and tadalafil for distal ureteral stones but the difference didn’t meet statistical significance. However the expulsion rate was significantly higher in tadalafil than in the other groups for mid-proximal ureteral stones. The result of this study showed that tadalafil may increases ureteric stone expulsion.

Managament of Bhagandara (Fistula-in-Ano) by Palasha Ksharasutra prepared with Arkaksheera - A Case Report.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Success Rate ◽  
Spinal Anesthesia ◽  
Curcuma Longa ◽  
Weekly Interval ◽  
Butea Monosperma ◽  
Fistula In Ano

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.

scholarly journals Role of the gonadal vessels on the stone lodgment in the proximal ureter: Direct observation during laparoscopic ureterolithotomy

2018 ◽  
Vol 90 (3) ◽  
pp. 163-165
Author(s):  
Mohammad Hadi Radfar ◽  
Reza Valipour ◽  
Behzad Narouie ◽  
Mehdi Sotoudeh ◽  
Hamid Pakmanesh
Keyword(s):  
Direct Observation ◽  
Ureteral Stone ◽  
Ureteral Stenosis ◽  
Ureterovesical Junction ◽  
Gonadal Vein ◽  
Close Proximity ◽  
Proximal Ureter ◽  
Radiological Studies ◽  
Stone Passage

Introduction: Previous radiological studies revealed that stones lodge more frequently in the ureterovesical junction (UVJ) as well as the proximal ureter. Factors that prevent stone passage from the proximal ureter are not well studied. Aim: To explore the site of the lodged stones in the proximal ureter with direct observation during laparoscopic ureterolithotomy. Materials and methods: Between November 2014 and February 2015, we included 26 patients including 18 men and 8 women with stones larger than 10 millimeters in the proximal ureter who were candidate for laparoscopic ureterolithotomy. We prospectively recorded the site of the lodged stones in the ureter during laparoscopic ureterolithotomy in relation with the sites of ureteral stenosis as well as the gonadal vessels. Results: Among 26 patients with ureteral stone, in 19 cases stone was found close to the gonadal vein compared with seven cases that stone was in other locations of the ureter (p = 0.02). The characteristics of patients and stones were not different in cases that the stone was close to gonadal vessels compared with other locations. Conclusions: This study showed that most of the stones lodged in the proximal ureter were in close proximity with gonadal vessels. Gonadal vessels may be an extrinsic cause of ureteral narrowing.

scholarly journals Low-cost semirigid ureteroscopy is effective for ureteral stones: Experience of a single high volume center

2014 ◽  
Vol 86 (2) ◽  
pp. 118
Author(s):  
Roberto Giulianelli ◽  
Barbara Cristina Gentile ◽  
Giorgio Vincenti ◽  
Luca Mavilla ◽  
Luca Albanesi ◽  
...  
Keyword(s):  
Ureteral Stone ◽  
Effective Means ◽  
Holmium Laser ◽  
Ureteral Stones ◽  
Success Rates ◽  
Renal Surgery ◽  
Absolute Minimum ◽  
Distal Ureter ◽  
Holmium Laser Lithotripsy ◽  
Number Of Patients

Aim of the study: To demonstrate how, in a center with a large number of patients, as our center is, it is possible to perform ureterolithotripsy using a limited set of instruments. Methods: We evaluated medical charts of our center related to semirigid ureteral ureteroscopy (URS) with ureterolithotripsy using Holmium laser performed from July 2004 to July 2011. Overall, 658 URS for ureteral stones were performed in 601 patients, of which 204 in proximal ureter (31%), 86 in the mid (13.06%) and 368 (57.76%) in the distal ureter. In 504 patients (76.5%) ureterohydronephrosis (Grade II-III) was observed. In 57 patients (8.6%), we performed a bilateral approach at the same time, but most patients had a solitary distal ureteral stone. 106 patients (16.1%) had more than one stone in their distal ureter and 96 (14.8%) had a proximal ureteral stone treated in the same surgery as well. Results: The overall stone-free rate for ureteral stones was 86.1% (567/658). Success rates for proximal, medial and distal ureteral stones were 68.13% (139/204 patients), 84.8% (73/86 patients) and 96.4% (355/368 patients), respectively. One hundred and twenty patients (18.3%) required additional surgical treatment for their stones beyond the initial URS, including a second URS in 97 patients (14.74%) and URS plus Retrograde Intra-Renal Surgery (RIRS) in 23 patients (3.54%). The overall stonefree rate after the second treatment was 99.3%. Intra-operative complications accounted for 5.92% and consisted of ureteral perforations in 16 pts (2.4%), erosions of urothelium leading to significant bleeding in 15 pts (2.27%), severe pain in 4 pts (0.6%), fever in 3 pts (0.45%) and one case of ureteral avulsion (0.15%). Conclusions: This study demonstrates that the use of Holmium laser lithotripsy is a safe and effective means of treating ureteral stones regardless of sex, age, stone location, or stone size. The instrumentation we used was extremely limited, in order to reduce costs related to the procedure to an absolute minimum whilst maintaining the two quality indicators for the procedure, namely success rate and length of hospitalisation (86.1% and 34 hours).

scholarly journals The impact of ureteral Double-J stent insertion following ureterorenoscopy in patients with ureteral stones accompanied by perirenal fat stranding

2018 ◽  
Vol 90 (1) ◽  
pp. 15
Author(s):  
Ercan Ogreden ◽  
Ural Oguz ◽  
Erhan Demirelli ◽  
Erdal Benli ◽  
Özkan Özen
Keyword(s):  
Ureteral Stone ◽  
Ureteral Stones ◽  
Stent Insertion ◽  
Female Ratio ◽  
Group I ◽  
Dj Stent ◽  
Group Ii ◽  
Fat Stranding ◽  
The Impact ◽  
Perirenal Fat

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

scholarly journals Do stone size and impaction influence therapeutic approach to proximal ureteral stones?

2009 ◽  
Vol 66 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Radulovic ◽  
Aleksandra Vuksanovic ◽  
Dragica Milenkovic-Petronic ◽  
Bozo Vavic
Keyword(s):  
Therapeutic Approach ◽  
Ureteral Stone ◽  
Treatment Success ◽  
Ureteral Stones ◽  
Stone Size ◽  
Extracorporeal Shock Wave ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Proximal Ureteral Stone

Background/Aim. Primary therapeutic approach to lumbar ureteral stones is still contraversial. The aim of the study was to investigate the influence of stone impaction and size on the effectiveness of proximal ureteral stone lithotripsy. Methods. A total of 123 patients with proximal ureteral stones were investigated in this prospective study performed in a 10- month period. The patients were divided into the group I - 86 patients treated with extracorporeal shock wave lithotripsy (ESWL) and the group II - 37 patients treated with 'Swiss' Lithoclast. In the group I, 49 stones (57%) were classified as impacted, while 20 stones (23.3%) were larger than 100 mm2. In the group II, 26 stones (70.3%) were impacted, and 11 stones (29.7%) were larger than 100 mm2. Stones were defined as impacted by the radiographic, echosonographic as well as endoscopic findings in the group II of patients. Stone size was presented in mm2. Chemical composition of stones were almost the same in both groups of the patients. Results. Generally, there was no statistically significant difference in the treatment success between the groups. However, stones larger than 100 mm2 were statistically more successfully treated endoscopically, while there was no statistical difference in the treatment success of impacted stones between these two groups. Conclusion. ESWL can by considered as primary first therapeutic approach in treatment of all proximal ureteral stones except for stones larger than 100 mm2 that should primarily be treated endoscopically.

scholarly journals Bilateral Ureteral Stones Causing Anuria: A Case Report

2015 ◽  
Vol 6 (4) ◽  
pp. 72-74
Author(s):  
Ali Gur ◽  
Muhammet Gokhan Turtay ◽  
Sukru Gurbuz ◽  
Hakan Oguzturk ◽  
M. Ediz Sarihan ◽  
...  
Keyword(s):  
Case Report ◽  
Ureteral Stones

scholarly journals Spontaneous Rupture of Proximal Ureter: A Case Report

2019 ◽  
Vol 6 (1) ◽  
pp. 74-75
Author(s):  
İlke Onur Kazaz ◽  
Ahmet Serdar Teoman ◽  
Fatih Çolak ◽  
Rasin Özyavuz
Keyword(s):  
Case Report ◽  
Spontaneous Rupture ◽  
Proximal Ureter

scholarly journals Unilateral complete ureteral duplication with distal ureteral stone: A rare entity

2013 ◽  
Vol 7 (7-8) ◽  
pp. 511 ◽  
Author(s):  
Ayhan Karakose ◽  
Ozgu Aydogdu ◽  
Yusuf Ziya Atesci
Keyword(s):  
Urinary Bladder ◽  
Ureteral Stone ◽  
Flank Pain ◽  
Rare Entity ◽  
Ureteral Duplication ◽  
Mesonephric Duct ◽  
Distal Ureteral Stone

Complete duplex ureters opening separately into the urinary bladder is extremely rare; they can be embryologically explained as a development of two ureteral buds separately from a single mesonephric duct. We describe a case of unilateral complete ureteral duplication with distally localized ureteral stone in a 49-year-old male who presented with right flank pain.

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