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1.
Cureus ; 16(5): e61431, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38947721

RESUMEN

In urological practice, the routine procedure of placing a double J stent aims to facilitate drainage of the upper urinary system. Despite its temporary nature and the necessity for timely removal, approximately 12% of these stents are retained in patients for extended durations due to various reasons. Forgotten ureteral stents can lead to complications that increase the morbidity and mortality of patients. This report discusses a case of the double J stent that became calcified due to prolonged use and needed to be removed in a combined procedure.

2.
Cent European J Urol ; 77(1): 89-110, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38645817

RESUMEN

Introduction: We aim to review the outcomes of shock wave lithotripsy (SWL), ureteroscopy, and percutaneous nephrolithotripsy (PCNL) for renal and ureteral stones in spinal cord neuropathy patients (SNP). Material and methods: A literature search was performed on 8th March 2023 using PubMed, EMBASE, and Google Scholar with no date limit. Preclinical/animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Only English papers were accepted. Results: Thirty-five articles were accepted. Five studies focused on SWL, 17 on PCNL, and 6 on ureteroscopy. The remaining articles employed more than one procedure. Stone composition has shifted from struvite to the more common calcium phosphate. SWL showed a very poor stone-free rate (SFR) likely due to challenges in patient positioning, stone visualization, localization, and inability to pass fragments spontaneously. Flexible ureteroscopy and PCNL were associated with a high incidence of infectious complications, long hospital stays, high blood transfusion rate, and intensive care admissions. There were also cases of death. Both procedures were challenging due to genitourinary reconstruction, scoliosis and kyphosis, rib-cage deformity, lower limb contractures, and severe comorbidity which also affected anesthesia. SFR was lower than in non-neurological patients. Conclusions: SWL, ureterolithotripsy, and PCNL should be considered challenging procedures in SNP due to positioning issues, an increased risk of intra and peri-operative morbidity, and even mortality. Computed tomography should be recommended to assess residual fragments as it becomes imperative to minimize a re-intervention in SNP who should be preferably treated in referral centers.

3.
Urologia ; 91(1): 147-153, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38009295

RESUMEN

BACKGROUND AND OBJECTIVES: There is no recommendation on the timing of ureterolithotripsy after the treatment of obstructive acute pyelonephritis (APN). The effect of early and delayed ureterolithotripsy on postoperative urinary tract infection (UTI) and other complications was investigated. METHODS: Patients who underwent ureterolithotripsy after obstructive APN treatment between February 2017 and August 2021 were divided into two groups, those operated during hospitalization and those operated within 3 months after discharge. Two groups were compared in terms of stone-free status, postoperative complications, postoperative UTI, and urosepsis rates. RESULTS: Of the 91 patients included in the study, 68 were in the early ureterolithotripsy group, while 23 patients were in the delayed ureterolithotripsy group. The postoperative UTI rate was significantly higher in patients who underwent early ureterolithotripsy (29.4% vs 8.7%, p = 0.045). Patients with postoperative UTI had a higher moderate/severe perinephric fat stranding (PFS) on non-contrast CT at hospital admission (52.2% vs 29.4%, p = 0.048). Among the laboratory parameters, white blood cells were significantly higher in the group with postoperative UTI (21604.5 vs 14728.9, p = 0.042). In the multivariate analysis, early ureterolithotripsy and moderate/severe PFS were independent predictors for postoperative UTI. In the created model, the probability of postoperative UTI after ureterolitripsy after obstructive APN treatment was 3.5% in patients without risk factors, while this rate was 51.9% in patients with both risk factors. CONCLUSION: There is no consensus on the timing of stone removal after treatment of obstructive APN. Early ureterolithoripsy and moderate/severe perinephric fat stranding on non-contrast CT are risk factors for postoperative UTI.


Asunto(s)
Pielonefritis , Cálculos Ureterales , Infecciones Urinarias , Humanos , Cálculos Ureterales/terapia , Riñón , Factores de Riesgo
4.
Int J Comput Assist Radiol Surg ; 18(1): 29-43, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36269508

RESUMEN

PURPOSE: The complex and elaborate structure of the urinary system presents surgeons with difficulty in using a ureteroscope with a fixed optical fiber to reach the targeted calculus. To address this challenge, a robotic device is required to control the direction of laser irradiation position independently in ureteroscopes. METHOD: A continuum robotic device was designed and fabricated. The device is constructed with three slackened shape memory alloy (SMA) wires to control the laser irradiation position of the optical fiber combined with the view of the camera on the tip of the ureteroscope. Kinematics analysis and experimental evaluation reveal the capability of the device. RESULTS: The structure of the device is the same as a single-joint continuum robot. This device is unique because of the tiny diameter of 1.1 mm which can be used inside the ureteroscope through a Ø1.2 mm inner channel into the kidney for transurethral ureterolithotripsy. Kinematic analysis revealed the relationship among space coordinates, angles of bending, and direction and SMA wires length. The maximum bending angle was around 25° when the current value was 350 mA on a single SMA wire. The device could achieve multi-directional bending by allocating the values of current on SMA wires, separately. CONCLUSION: This device offers a major advancement in small size and dexterity in medical robotics. Combined with a proper control system, this device could simplify the operation and improve the efficiency of the transurethral ureterolithotripsy.


Asunto(s)
Robótica , Humanos , Aleaciones con Memoria de Forma , Fenómenos Biomecánicos , Diseño de Equipo , Riñón
5.
Urologiia ; (5): 29-33, 2022 Nov.
Artículo en Ruso | MEDLINE | ID: mdl-36382814

RESUMEN

AIM: of the study is to identify risk factors for the development of acute pyelonephritis after contact urethrolithotripsy (URLLT) and to establish the mechanisms for maintaining inflammation after the withdrawal of NSAIDs. MATERIAL AND METHODS: The study included 21 patients who underwent contact ureterolithotripsy (URLT). The severity of leukocyturia was assessed 1 day after URLT, 2 days (the last appointment of NSAIDs, the total duration of the drug was 9 days) and 3 days (24 hours after NSAID discontinuation). The number of circulating platelet-leukocyte aggregates (PLA) was calculated by microscopy of stained blood smears. Analysis of the functional activity of platelet receptors involved in the modulation of the acute inflammatory response was performed by the turbidimetric method on a ChronoLog analyzer (USA).Statistical analysis was performed using the MedCalc package. RESULTS: After URSL, when NSAIDs were prescribed to patients, the level of leukocyturia decreased (p<0.05) compared to that at the time of hospitalization. A similar dynamics was found by analyzing the amount of TLA in the blood. Similar dynamics was found in the analysis of the amount of TLA in the blood. After 24 hours of NSAIDs cancellation, an increase in the severity of leukocyturia was detected (p<0.001). At the same time, normoreactivity of the 2-adrenergic receptor, GPVI receptor, AT1 receptor, PAT receptor, P2X1 receptor and A2A receptor, as well as hyporeactivity of the 2-adrenergic receptor and P2Y receptors, were revealed. An analysis of correlations made it possible to establish that the 2-adrenoreceptor, AT1 receptor, and GPVI receptor play a key role in the formation of TPA. Incubation of blood cells in vitro with agonists made it possible to establish that the maximum effect of TLA formation was reproduced during the interaction of the 2-adrenergic receptor and the AT1 receptor. CONCLUSION: With the abolition of NSAIDs, activation of the sympathetic-adrenal and renin-angiotensin systems, as well as remodeling of the basement membrane of the vascular wall are risk factors for the development of acute pyelonephritis after URLS.


Asunto(s)
Pielonefritis , Receptor de Angiotensina Tipo 1 , Humanos , Pielonefritis/etiología , Factores de Riesgo , Receptores Adrenérgicos , Antiinflamatorios no Esteroideos
6.
Actas urol. esp ; 46(8): 504-512, oct. 2022. ilus, tab
Artículo en Español | IBECS | ID: ibc-211490

RESUMEN

Introducción: Los verdaderos beneficios de la colocación perioperatoria de un catéter doble J (CDJ) están siendo ampliamente estudiados debido a sus conocidos efectos secundarios. Sin embargo, todavía no se ha llegado a un consenso en la literatura sobre el diseño óptimo del catéter. Por este motivo, este estudio prospectivo, aleatorizado y simple ciego, tuvo como objetivo comparar la sintomatología asociada a 2 diseños de catéter: el de superficie lisa y el de diseño acanalado.Materiales y métodosEl estudio recogió prospectivamente los datos de 42 pacientes que se sometieron a la colocación de un CDJ entre julio de 2019 y agosto de 2020. Los pacientes se dividieron aleatoriamente en 2 grupos según el diseño del catéter utilizado: en el primer grupo se utilizó el catéter de superficie lisa (control) y en el segundo, el catéter de diseño acanalado (intervención). Después de la cirugía, todos los pacientes completaron el Cuestionario de Síntomas del Catéter Ureteral validado en portugués en 3 momentos del postoperatorio (días 7 y 30 después del procedimiento quirúrgico, y día 30 después de la retirada del catéter).Resultados: No se encontraron diferencias significativas en cuanto al sexo, la edad, la mediana de índice de masa corporal, la lateralidad, el tipo de procedimiento quirúrgico (ureteroscopia flexible, semirrígida o mixta). Los CDJ de superficie lisa se asociaron a una mayor incidencia de dolor en el flanco (52,38 vs. 10%; p=0,006) y de dolor suprapúbico (57,14 vs. 30%; p=0,04) el día 7 después del procedimiento. La regresión lineal mixta mostró, de forma significativa, menos dolor en el flanco (p<0,001) y suprapúbico (p<0,01), y un rendimiento sexual significativamente mejor en el grupo de intervención (p=0,03).ConclusionesLos CDJ con diseño acanalado se asocian a una menor incidencia de dolor en el flanco y suprapúbico, y tienen un impacto menor en el rendimiento sexual de los pacientes. (AU)


Introduction: The true benefits of perioperative JJ stent placement are being widely studied due to its known side effects. However, no consensus has been reached in the literature regarding the best type of stent. This prospective, randomized, single-blinded study therefore aimed to compare the symptomatology associated with two JJ stent designs: smooth-walled and grooved.Materials and methodsThe study prospectively recruited 42 patients who underwent JJ stent placement between July 2019 and August 2020. The patients were randomly divided into two groups according to the JJ stent design used: the smooth-walled stent (control) and grooved stent (intervention) groups. After surgery, all patients completed the Portuguese-validated Ureteral Stent Symptom Questionnaire at three timepoints (days 7 and 30 post-surgical procedure, and day 30 post-stent removal).Results: No significant differences in gender, age, median body mass index, laterality, type of surgical procedure (flexible, semi-rigid or mixed ureteroscopy) were found. Smooth-walled JJ stents were associated with a higher incidence of flank pain (52.38% vs. 10%, P=.006) and suprapubic pain (57.14% vs. 30%, P=.04) on the 7th. post-procedure day. Linear mixed regression showed significantly lower flank (P<.001) and suprapubic pain (P<.01), and significantly better sexual performance in the intervention group (P=.03).ConclusionsUreteral stent with a grooved format are associated with a lower incidence of flank and suprapubic pain and had less impact on the sexual performance of patients. (AU)


Asunto(s)
Humanos , Dolor , Stents/efectos adversos , Uréter/cirugía , Ureteroscopía/métodos , Método Simple Ciego , Estudios Prospectivos
7.
Actas Urol Esp (Engl Ed) ; 46(8): 504-512, 2022 10.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36109314

RESUMEN

INTRODUCTION: The true benefits of perioperative JJ stent placement are being widely studied due to its known side effects. However, no consensus has been reached in the literature regarding the best type of stent. This prospective, randomized, single-blinded study therefore aimed to compare the symptomatology associated with two JJ stent designs: smooth-walled and grooved. MATERIALS AND METHODS: The study prospectively recruited 42 patients who underwent JJ stent placement between July 2019 and August 2020. The patients were randomly divided into two groups according to the JJ stent design used: the smooth-walled stent (control) and grooved stent (intervention) groups. After surgery, all patients completed the Portuguese-validated Ureteral Stent Symptom Questionnaire at three timepoints (days 7 and 30 post-surgical procedure, and day 30 post-stent removal). RESULTS: No significant differences in gender, age, median body mass index, laterality, type of surgical procedure (flexible, semi-rigid or mixed ureteroscopy) were found. Smooth-walled JJ stents were associated with a higher incidence of flank pain (52.38% vs. 10%, P = .006) and suprapubic pain (57.14% vs. 30%, P = .04) on the 7th post-procedure day. Linear mixed regression showed significantly lower flank (P < .001) and suprapubic pain (P < .01), and significantly better sexual performance in the intervention group (P = .03). CONCLUSIONS: Ureteral stent with a grooved format are associated with a lower incidence of flank and suprapubic pain and had less impact on the sexual performance of patients.


Asunto(s)
Uréter , Humanos , Dolor/etiología , Estudios Prospectivos , Stents/efectos adversos , Uréter/cirugía , Ureteroscopía/métodos
8.
Urol Case Rep ; 39: 101759, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34258229

RESUMEN

Transurethral double J (DJ) stent placement is a standard method for drainage during ureteral obstruction caused by a ureteral stone and for the management of complications after transurethral ureterolithotripsy (TUL). This is a safe and minimally invasive technique; however, severe cases of DJ stent migration have been reported, although rarely. Herein, we report the CASE of a 48-year-old man with DJ stent migration as renal penetration, which arose as a complication after an unsuccessful TUL. As transurethral DJ stent placement is one of the basic techniques performed by urologists, possible rare complications of the placement should be taken into consideration.

9.
Urologiia ; (4): 60-65, 2020 Sep.
Artículo en Ruso | MEDLINE | ID: mdl-32897016

RESUMEN

AIM: to determine main risk factors for complications of ureterolithotripsy. MATERIALS AND METHODS: a retrospective analysis of the results of 545 ureteroscopies performed in 506 patients with ureteral stones over the past 7 years at the urological clinic named after M.F. Vladimirsky was carried out. The relationship between preoperative and intraoperative factors and complications of ureterolithotripsy was analyzed. RESULTS: The overall complication rate was 22.4%. The risk of intraoperative complications was proved to increase (p<0.05) along with the stone size, location in proximal ureter, stone impaction for more than 3 weeks and the degree of hydronephrosis. No preoperative stenting or nephrostomy tube prior to ureteroscopy was associated to an increased risk of intraoperative complications (RR=2.88; p=0.03). Patients with preoperative drainage of upper urinary tract has lower probability of intraoperative complications (OR=0.35; p=0.03). The risk of developing stricture and ureteral obliteration in uncomplicated ureteroscopy was minimal (RR=0.008, p=0.0001). Small ureteral perforation and pronounced mucosal inflammation around the stone have the similar influence on the risk of complications, which was more than 7.5 times (p=0.0001) higher than in uncomplicated ureteroscopy. Large ureteral perforation was associated with the highest risk of stricture formation and ureteral obliteration, which was 64 times (p=0.0001) higher than in uncomplicated ureteroscopy. CONCLUSION: The rate of complications of ureterolithotripsy directly depends on the following factors: size and location of the stone, the stone impaction, pre- and intraoperative (nephrostomy tube) drainage of the upper urinary tract, the degree of hydronephrosis, level of bacteriuria and intraoperative trauma complications.


Asunto(s)
Cálculos Ureterales , Humanos , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Ureteroscopía
10.
J Endourol Case Rep ; 6(1): 26-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32775669

RESUMEN

Background: Renal hematomas, although relatively rare, are potentially life-threatening complications after ureterolithotripsy. Case Presentation: We present four cases of renal hematomas that occurred in our department during the past decade (2008-2018). Unstable vital signs, increased inflammatory markers, fever, and flank pain were the commonest postoperative findings. Two patients were treated conservatively and had an uneventful recovery, whereas one patient underwent selective arterial embolization for bleeding control. The fourth patient was diagnosed with contralateral ureteral urothelial tumor and ultimately underwent contralateral radical nephroureterectomy. Conclusion: Application of safety measures during ureteroscopy may reduce the incidence of perirenal hematomas. Prompt diagnosis is based on a thorough clinical examination in combination with imaging to evaluate the location and extent of the hematoma.

11.
Urologiia ; (3): 87-90, 2020 Jun.
Artículo en Ruso | MEDLINE | ID: mdl-32597592

RESUMEN

Currently, when performing ureterolithotripsy in patients with proximal ureteral stones, urologist should be ready for intraoperative complications and be able to use various methods to diagnose them. Ureteral avulsion is an extremely rare, but the most serious complication of endoscopic procedures. Clinical observation of autologous kidney transplantation performed after ureteral avulsion with good functional and clinical results is presented.


Asunto(s)
Trasplante de Riñón , Uréter , Cálculos Ureterales , Humanos , Complicaciones Intraoperatorias , Riñón
12.
Urologiia ; (2): 51-55, 2020 Apr.
Artículo en Ruso | MEDLINE | ID: mdl-32351064

RESUMEN

AIM: to compare the results of treatment of patients with acute obstructive calculous pyelonephritis, who underwent to retroperitoneoscopic procedure, with patients, who underwent to drainage of the collecting system by means of ureteral stent or nephrostomy tube as the first stage. MATERIALS AND METHODS: A total of 121 patients were treated from 2011 to 2019. Of these, 78 patients were included in the main group. The stones were located in the ureteropelvic junction (n = 20) and the upper and middle ureter (n = 58). The average size of the stone was 12.9 +/- 4.8 mm. Preliminary upper urinary tract drainage was not carried out and the stone was removed completely. The group 2 consisted of 26 people. The stones were located in the upper (n = 18) and the middle ureter (n = 8); the average size was 9 +/- 2.8 mm. Renal drainage was done using ureteral stent and when pyelonephritis resolved, ureterolithotripsy was performed. The group 3 was represented by 17 patients. All stones were located in the ureteropelvic junction. The average size was 20.3 +/- 10.7 mm. Renal drainage was done using percutaneous nephrostomy; when there were no inflammatory changes, percutaneous nephrolithotripsy was performed. RESULTS: In the main group, normalization of body temperature and resolution of inflammatory changes in the blood and urine occurred earlier. The stone was removed completely and there were no residual fragments. Period of rehabilitation was are also significantly shorter than in groups 2 and 3. The retroperitoneoscopic method was more effective and safer for the treatment of patients with acute obstructive pyelonephritis caused by large stones located in the upper or middle ureter and ureteropelvic junction.


Asunto(s)
Cálculos Renales/terapia , Litotricia , Nefrostomía Percutánea , Pielonefritis/terapia , Uréter , Cálculos Ureterales , Humanos , Masculino
13.
Urologiia ; (5): 114-118, 2019 Dec.
Artículo en Ruso | MEDLINE | ID: mdl-31808644

RESUMEN

The problem of urinary stone disease and acute destructive pyelonephritis remains to be relevant in the current urologic practice. The acute pyelonephritis is the most common infectious and inflammatory complication after retrograde ureteroscopy. According to data of leading urologists in Russian Federation and worldwide, the incidence of acute purulent pyelonephritis ranges from 0.1 to 0.2%. Infectious and inflammatory complications of retrograde ureteroscopy often require urgent interventions. Acute pyelonephritis can result in destructive changes in the renal parenchyma. In case of ineffective conservative measures, pyelonephritis can progress into sepsis with the development of multiple organ failure. Therefore, infectious and inflammatory complications require to start combined antibacterial, anti-inflammatory and detoxification therapy, as well as to resolve any upper urinary tract obstruction. If acute pyelonephritis leads to destructive phase with a formation of a carbuncle or an abscess in the kidney, an open surgery is indicated. Despite being minimally-invasive, retrograde ureteroscopy can lead to serious complications requiring an open surgical intervention. In some cases, the severity of the patients condition may require nephrectomy.


Asunto(s)
Absceso/tratamiento farmacológico , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Cálculos Renales/terapia , Litotricia/efectos adversos , Pielonefritis/tratamiento farmacológico , Ureteroscopía/efectos adversos , Humanos , Nefrectomía , Pielonefritis/complicaciones , Pielonefritis/microbiología , Federación de Rusia , Índice de Severidad de la Enfermedad , Cálculos Urinarios
14.
Urologiia ; (3): 84-88, 2019 Jul.
Artículo en Ruso | MEDLINE | ID: mdl-31356018

RESUMEN

AIM: to study an adaptability of the Clavien-Dindo classification of complications for contact ureterolithotripsy. MATERIALS AND METHODS: A total of 506 patients with ureteric stones who were undergone 545 endoscopic interventions in the Urologic Department of "MONIKI" named after M.F. Vladimirsky were included in retrospective analysis. RESULTS: Complications of grade 1, II, IIIa and IIIb were noted in 39 (7.1%), 24 (4.3%), 15 (2.8%) and 14 cases (2,6%), respectively. Among the complications of grade IVa, an acute pyelonephritis was complicated by the septic shock. The complication of grade IVb developed in 1 case (0.2%). There were no complications of Grade V. The Clavien-Dindo classification allows to grade only postoperative complications and attempts to adapt it for the assessment of intraoperative complications can lead to the distortion of study results. CONCLUSION: The uncontrolled use of the Clavien-Dindo classification in all areas of surgery can lead to a decrease in its accuracy, thereby reducing its value as fairly universal tool. In our opinion, a further work aimed to the development of strict criteria for the different grades of complications of the Clavien-Dindo classifications is needed. We believe it is possible and necessary to develop a single tool for the assessment of complications of typical interventions within a single surgical area.


Asunto(s)
Complicaciones Intraoperatorias , Cálculos Renales , Litotricia , Complicaciones Posoperatorias , Humanos , Cálculos Renales/terapia , Litotricia/efectos adversos , Estudios Retrospectivos
15.
Niger J Surg ; 25(1): 26-29, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31007508

RESUMEN

AIMS: The aim of this study is to present our initial experience with intracorporeal pneumatic ureterolithotripsy highlighting the pattern of patients' clinical presentation, techniques, and limitation of the procedure. MATERIALS AND METHODS: This is a retrospective study of cases of ureteric stones managed over a period of 18 months in a private hospital. Data obtained include patients' sociodemography, clinical presentation, stone burden, procedural technique, complication, and need for a secondary procedure. Data were analyzed using the Statistical Package for the Social Sciences version 21. RESULTS: The total number of patients managed was 20 with an age range of 28-75 years and a mean of 48.2 ± 12.4 years. Majority of them, i.e., 11 (55%) were middle aged. Female gender was more predominant, 11 (55%). Flank pain was the most common mode of presentation. Right-sided stone occurred in 9 (45%), left sided in 7 (35%), and bilateral in 4 (20%). Stone location was in the upper ureter in 4 (16.7%), mid-ureter in 7 (29.2%), and lower ureter in 13 (54.2%). The stone size ranged from 6 to 18 mm with a mean of 9.7 ± 2.5 mm. Four patients (20%) required initial bilateral ureteric stenting before definitive procedure to allow for recovery from sepsis and/or nephropathy. All patients had double-J stenting and were discharged 2 days after the procedure. The procedure was successful in 19 (95%) with 100% stone clearance rate and complete resolution of symptom without any complication. One patient (5%) had a very hard upper ureteric stone which retropulsed into the renal pelvis requiring open nephrolithotomy. CONCLUSION: Endoscopic treatment of ureteric stone with intracorporeal pneumatic lithotripsy is a safe and effective treatment modality. It is, however, limited in the management of hard upper ureteric stone, especially those that are close to the pelviureteric junction due to the risk of retropulsion of the stone into the kidney.

16.
Urologiia ; (2): 5-8, 2018 May.
Artículo en Ruso | MEDLINE | ID: mdl-29901287

RESUMEN

RELEVANCE: The prevalence of urolithiasis and osteoporosis (OP) indicates that these diseases may be found concurrently in the same patient. The detection of risk factors for OP and disorders of calcium metabolism in patients with urolithiasis is of interest in the context of primary stone formation and metaphylaxis. AIM: To identify risk factors for osteoporosis and disorders of calcium metabolism in patients with urolithiasis. MATERIALS AND METHODS: Osteoporosis risk factors were studied in 45 urolithiasis patients undergoing surgical treatment. Patients were asked to fill out the osteoporosis risk factor questionnaire, and urinary calcium excretion was measured in 24-h collections. RESULTS: Risk factors for osteoporosis were detected in 20 (44.4%) urolithiasis patients. Patients with osteoporosis risk factors identified by the questionnaire were statistically significantly older (p=0.032). Osteoporosis risk factors were found in 20% of patients with newly diagnosed urolithiasis and 24.4% of patients with recurrent urolithiasis. The study patients showed increased urinary calcium excretion and decreased diuresis. The negative correlation between urinary calcium excretion and 24-h diuresis was greater in patients who had than in those who did not have osteoporosis. CONCLUSION: An increase in urinary calcium excretion and a decrease in diuresis can be a predisposing factor for the recurrence of urolithiasis. In patients with risk factors for osteoporosis, it can provide a rationale for administering drugs aimed at preventing stone formation (thiazide diuretics).


Asunto(s)
Calcio/orina , Osteoporosis/orina , Urolitiasis/orina , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
17.
Nihon Hinyokika Gakkai Zasshi ; 109(2): 74-84, 2018.
Artículo en Japonés | MEDLINE | ID: mdl-31006745

RESUMEN

(Objectives) Transurethral Ureterolithotripsy (TUL) has become an increasingly more common treatment for ureteric stones since the reduction in ureteroscope diameter and other device improvements. At the same time, TUL sometimes shows postoperative febrile urinary tract infection (fUTI) with severe complications. Therefore we investigated the occurrence and risk factors of fUTI in our hospital, and assessed the effect of antibiotic prophylaxis prior to TUL. (Materials and methods) The subjects were 260 patients who underwent TUL in our department during the period from January 2011 to October 2014. We retrospectively reviewed the data of those who developed postoperative fUTI and identified the risk factors of postoperative fUTI. From November 2014 to August 2016, we enrolled 110 patients undergoing TUL with one or more risk factors in a prospective clinical trial of prophylactic oral levofloxacin (500 mg) for 1 week before TUL. The chi-squared test, Mann-Whitney U-test, and logistic regression analysis were used for data analysis (significance level of 0.05). (Results) Postoperative fUTI occurred in 43 (16.5%) of 260 patients. The risk factors of postoperative fUTI included preoperative pyelonephritis (P=0.02), preoperative ureteral stent placement (P=0.017), and operative time >90 min (P=0.005). Operative time was correlated with and could be substituted for pre-TUL stone size (P<0.0001). Chemopreventive therapy before TUL in patients with preoperative pyelonephritis, preoperative ureteral stent placement, or stones of >20 mm significantly reduced their risk of fUTI (P=0.012). (Conclusions) The use of antibiotic prophylaxis significantly reduces the risk of postoperative fUTI in patients with preoperative pyelonephritis, preoperative ureteral stent placement, or stones of >20 mm.


Asunto(s)
Antibacterianos/administración & dosificación , Profilaxis Antibiótica , Fiebre/etiología , Fiebre/prevención & control , Levofloxacino/administración & dosificación , Litotripsia por Láser/efectos adversos , Litotripsia por Láser/métodos , Cálculos Ureterales/terapia , Uretra , Infecciones Urinarias/etiología , Infecciones Urinarias/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Factores de Riesgo , Uréter , Cálculos Ureterales/patología , Adulto Joven
18.
Urologiia ; (4): 49-55, 2018 Oct.
Artículo en Ruso | MEDLINE | ID: mdl-30761790

RESUMEN

INTRODUCTION: Numerous publications on the successful use of NefraDoz (Stada, Germany) in the metaphylaxis of urolithiasis after extracorporeal lithotripsy, and the prevention and treatment of infectious inflammatory diseases of the lower and upper urinary tracts, served as the rationale for a study aimed to evaluate the effectiveness and safety of long-term use of NefraDoz in patients after transurethral and percutaneous interventions performed for urological diseases. PATIENTS AND METHODS: The study analyzed results of 116 transurethral and percutaneous endoscopic operations for urolithiasis performed in 62 men and 54 women aged 21 to 84 years from November to December 2017 at the D.D. Pletnev City Clinical Hospital. Depending on the localization of the stones, all patients were divided into three groups: kidney stones (n=68), ureteral stones (n=28), and bladder stones (n=21). In each group, patients were assigned either to receive (study group, n=50) or not to receive (control group, n=66) postoperative NefraDoz, which was administered at a dose of 1 capsule three times daily for one month. Patients in the control group (n=66) received standard antibacterial therapy for one month. The analysis included leukocyturia, 24-hour diuresis, the severity of the symptoms of the disease and the patients quality of life. RESULTS: The use of NefraDoz after transurethral lower urinary tract procedures, reduced the severity of irritative symptoms, improved the patients quality of life, reduced the number of patients with leukocyturia and increased 24-hour diuresis. The use of NefraDoz after upper urinary tract procedures improved the patients quality of life, reduced the number of patients with leukocyturia and increased 24-hour diuresis, and improved the clearance of residual fragments. There were no adverse events associated with NefraDoz. CONCLUSIONS: We have proved the advantage of using the NefraDoz complex in the rehabilitation of patients after endourologic procedures.


Asunto(s)
Cálculos Renales , Litotricia , Cálculos Ureterales , Urolitiasis , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Urolitiasis/rehabilitación , Adulto Joven
19.
Urologiia ; (6): 136-141, 2016 Dec.
Artículo en Ruso | MEDLINE | ID: mdl-28248059

RESUMEN

Expert panels of AUA and EAU defined highly effective approaches to surgical treatment of ureterolithiasis and recommended extracorporeal and contact lithotripsy as the main options. Therapeutic strategy for ureteral stones measuring less than 10 mm is clearly defined and supported by the Russian Society of Urology. At the same time, the views of researchers on the management of large ureteral stones vary. This literature review provides information on the results of extracorporeal shock-wave lithotripsy and contact ureterolithotripsy of large stones located in various parts of the ureter. Besides, the article outlines the results of treating ureterolithiasis using the second line surgical modalities.


Asunto(s)
Litotricia/métodos , Cálculos Ureterales/cirugía , Humanos , Resultado del Tratamiento
20.
Int J Urol ; 22(1): 128-30, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25252092

RESUMEN

The prevalence of urinary tract stones in the pediatric population is lower than that in adults. Although methods of surgery and medical equipment have developed, medical treatments for urinary tract stones are limited for pediatric cases. We report the case of a 10-month-old male infant with urinary stones in the left kidney and ureter who underwent percutaneous nephrolithotripsy and ureterolithotripsy using antegrade insertion of a ureteroscope through the same nephrostomy tract.


Asunto(s)
Riñón/diagnóstico por imagen , Litotricia/métodos , Uréter/diagnóstico por imagen , Cálculos Urinarios/terapia , Humanos , Lactante , Masculino , Tomografía Computarizada por Rayos X , Ureteroscopios , Urografía
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