Efficacy analysis of self-help position therapy after holmium laser lithotripsy via flexible ureteroscopy

Jie Yang,Pei Lu,Li-Di Wan,Wei Zhang,Xin-Kun Huang,Xiao-Rong He,Jing Wang,Ying-Heng Huang,Ke-Liang Chen,Xin Tang,Meng-Xing Chen,Rong-Zhen Tao

doi:10.1186/s12894-018-0348-1

Jie Yang, Pei Lu + Show 10 more

Open Access

https://doi.org/10.1186/s12894-018-0348-1

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Abstract

BackgroundTo observe the efficacy of self-help position therapy (SHPT) after holmium laser lithotripsy via flexible ureteroscopy (FURS).MethodsFrom January 2010 to November 2015, 736 nephrolithiasis patients who had received FURS lithotripsy were analyzed retrospectively. In position group, 220 cases accepted SHPT after lithotripsies, and 428 cases as control, coming from another independent inpatient area in the same center. The stone-free status (SFS) between two groups were compared at the 2nd, 4th and 12th week ends by X-ray examinations.ResultsThe preoperative incidence of hydronephrosis (25.9% vs. 18.0%, p = 0.018) or lower calyceal seeper (33.6% vs. 24.3%, p = 0.012) and the proportion of patients with > 2.0 cm stones (33.6% vs. 24.3%, p = 0.003) were all significantly higher in position group than in control group. There were no substantial difference between two groups in age, BMI, gender and medical histories. In postoperative followup, the incidence of hydronephrosis in position group was significantly lower than in control group (9.5% vs. 15.7%, p = 0.032) after removing double-J stents. In position group, the SFS of the 2nd week end (60.9% vs. 47.2%, p = 0.001), the 4th week end (74.1% vs. 62.8%, p = 0.004) and the 12th week end (86.9% vs. 79.4%, p = 0.021) were all significantly higher than those in control group.ConclusionsSHPT after holmium laser lithotripsy via FURS may increase postoperative SFS, accelerate stone fragment clearance, and decrease the incidence of hydronephrosis after removal of double-J stents. The therapy does not require professional assistance and is economical, simple, and effective.

Highlights

To observe the efficacy of self-help position therapy (SHPT) after holmium laser lithotripsy via flexible ureteroscopy (FURS)
Information was collected in telephone or faceto-face interviews using a uniform questionnaire that consisted of general characteristics including population and practices between institutions, personal medical history including lithotripsy and double-J stent placement, lifestyle, occupational history, dietary habits, and family history
The incidence of preoperative hydronephrosis (25.9% vs. 18.0%, p = 0.018) and lower calyceal seeper (33.6% vs. 24.3%, p = 0.012), and the proportion of patients with stones > 2.0 cm in size (33. 6% vs. 24.3%, p = 0.003) were significantly higher in the position group than in the control group

Summary

Introduction

To observe the efficacy of self-help position therapy (SHPT) after holmium laser lithotripsy via flexible ureteroscopy (FURS). Nephrolithiasis is one of the most frequently encountered diseases in urology practice. It varies in occurrence globally [1]. Flexible ureteroscopy (FURS) with holmium laser lithotripsy is the most popular and mature technology for small- and mid-size renal stones (≤2.5 cm). Postoperative stone residue and fusion of drainable fragments (≤4 mm) are still intractable problems in clinical practice [8, 9]. Hyams et al reported 120 cases undergoing FURS with holmium laser lithotripsy for renal stones 2–3 cm in size Residual lower pole fragments < 2 mm in diameter can still be difficult to clear from the renal collecting system due to gravity and anatomy

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