Cases Of Renal Calculi Research Articles

Assessing the role of upside-down (inverted) renal allografts in pediatric kidney transplantation: a propensity-score matched analysis.

To evaluate the implications of inverted (upside-down) kidney configuration in pediatric renal transplantation employing a comparative analysis with at least 1-year follow-up. Patients who underwent kidney transplantation at our institution between January 2011 and June 2021 were reviewed. Patients who had an inverted renal transplant were propensity-score matched (PSM) in 1:2 ratio with those who had traditional orientation transplant. The outcomes assessed included delayed graft function (DGF), urine leak, lymphocele, rejection, allograft calculus, ureteric stricture, and nadir creatinine. A total of 24 patients with inverted orientation were identified. Following PSM, 41 patients were matched, with exclusions due to incompatible propensity scores. Baseline characteristics were appropriately matched, and no significant differences were noted between the two groups. There were no differences in: delayed graft function (0/24 vs. 3/41, p = 0.290), urine leak (3/24 vs. 2/41, p = 0.350), lymphocele (2/24 vs. 4/41, p = 1.000), rejection (3/24 vs. 5/41, p = 1.000), graft calculus (2/24 vs. 0/41, p = 0.133), and ureteric stricture (0/24 vs. 2/41, p = 0.527). The two cases of renal calculus seen in the inverted transplant group occurred on post-operative day 13 and 1584, both were managed without complications. There was no difference in nadir creatinine (median 34umol/L IQR23-57 vs. 35 umol/L IQR 20-50, p = 0.624) or time to nadir creatinine (8days IQR 6-12 vs. 8days IQR 7-28, p = 0.315). Inverting a renal allograft does not appear to significantly contribute to increased risk of post-operative adverse outcomes. When aiming to achieve the best anatomical placement to secure a comfortable vascular anastomosis, inverting the allograft should be considered.

Comparative study of balloon dilatation and ureteral guide sheath dilation in the treatment of renal calculi with flexible ureteroscopy

Objective To explore the balloon dilatation and ureteral guide sheath expansion in the treatment of renal calculi with flexible ureteroscopy. Methods From July 2017 to December 2017, 35 cases of renal calculi were treated by phase I ureteroscopy in our hospital. All patients were randomly divided into the observation group (using balloon dilatation) and the control group (using the ureteral guiding sheath dilatation). Two groups of patients were observed in the first phase of treatment success, complications and hospitalization time and hospitalization expenses and other social indicators. Results The results showed that there was no significant difference between the two indexes of the operation time and the time of hospitalization in the two groups. It showed that the two expansion methods did not increase the recovery time of the patients, but the hospitalization cost of the observation group was significantly higher than the control group (P 0.05). The incidence of complications in the two groups was analyzed, and the incidence of complications in the observation group was significantly lower than the control group (P 0.05). Conclusions From the point of view of complications, the two types of dilatation are all safe, but the incidence of complications in the balloon dilatation group is lower, but the cost of balloon dilatation in hospitalization is significantly higher than ureteral guidance sheath expansion because of the balloon as a disposable medical consumable. The two methods have their own advantages. It is suggested that suitable methods should be chosen when clinical application. Key words: Kidney Calculi; Dilatation; Ureteroscopy

Safety and efficacy of flexible ureteroscopy lithotripsy for the treatment of renal stone in solitary kidney patients

Objective To evaluate the safety and efficacy of flexible ureteroscopy lithotripsy (FURL) for the treatment of renal stone in solitary kidney patients. Methods The clinical data of 46 patients of solitary kidney , who were treated with FURL from March 2015 to May 2018 in our hospital, were analyzed retrospectively. There were 34 males and 12 females, aged (48.6±9.6) years. Maximum diameter of stone was (15.3±4.8) mm, and 29 cases in left kidney and 17 cases in right. 34 cases were non-renal calcaneal calculi, 12 cases were subrenal calyceal stones.There were 3 cases of congenital solitary kidney, 31 cases of functional solitary kidney (contralateral kidney GFR<10 ml/min) and 12 cases of acquired solitary kidney (7 cases of renal calculi, 4 cases of tumor, 1 case of tuberculosis). The mean reoperative serum creatinine was (116.38±25.77)μmol/L. All patients were treated with general anesthesia, lithotomy, soft ureteroscopy combined with holmium laser lithotripsy, and assisted lithotripsy. All operations were performed by the same surgeon. The data of operation time, hospital stay, blood loss, renal function before and after operation, postoperative complications and stone clearance rate were recorded. Results In this study, 46 cases of the operation were successfully completed. The mean operation time was (58.6±16.4) min, the average hospitalization time was (5.6±1.4) days. The mean hemoglobin was decreased (1.4±0.9)g/L. The mean operative time was (58.6±16.4)min. The average postoperative hospitalization time was (5.6±1.4) days. The Postoperative hematuria occurred in 32 cases, low back pain in 3 cases and fever in 1 case. Stone-free reached in 39 of 46 patients, the stone-free rate(SFR)of primary operation was 84.8%(39/46). There were 7 cases of residual calculi, five patients were treated with secondary FURL, 2 patients were required conservative treatment. The SFR was 95.7%(44/46) after the second stage operation. The mean serum creatinine was (112.29±20.62)μ mol/L on the first day after operation, which was not different statistically with that before operation(P=0.177). The mean serum creatinine was (81.54±10.75)μmol/L one month after operation, which was significantly lower than preoperative and 1 day postoperative (P<0.05). Conclusions FURL could be a safe and effective treatment for renal stone in solitary kidney patients. It has a definite stone-free effect, low incidence of complications. Key words: Flexible ureteroscope; Solitary kidney; Kidney calculi; Renal function; Efficacy

The analysis of the application of holmium laser in the treatment of renal calculi

Objective To explore the clinical application of flexible ureteroscopy combined with holmium laser in the treatment of renal calculi. Methods From April 2013 to June 2014, 100 cases of renal calculi were treated in our hospital . According to the distribution of stone position, 55 cases of renal pelvis and renal upper calculi and 45 cases of lower renal calculi were treated with ureteroscopy combined with holmium laser. Evaluation of ureteroscope combined with holmium laser in double kidney CT plain scan was performed after 30 days. Results The success rate of the primary mirror was 96.00%, the proportion of the stones found in the operation was 95.00%, the rate of searching for the upper calculi in the renal pelvis and kidney was 96.36% (53/55), and the rate of searching for the lower renal calyx stones was 93.33% (42/45). The total successful lithotripsy rate was 86.32% (82/95). The successful lithotripsy rate of the renal pelvis and kidney stones was 92.45% (49/53), and the success rate of the lower renal calyx lithotripsy was 78.57% (33/42). The difference between the two groups was statistically significant (P<0.05). A few patients developed minor complications such as fever, lumbago and gross hematuria. No serious complications occurred. After the operation, the results of the patients were good after 30 days, the total stone exclusion rate was 82.92% (68/82) after the operation, and the clearance rate of the upper pyelolithiasis in the renal pelvis and kidney was 93.87% (46/49), and the rate of drainage of the lower renal calyx after operation was 66.67% (22/33). The difference between the two groups was statistically significant (P<0.05). Conclusions Ureteroscopy combined with holmium laser has a comprehensive, safe and effective treatment for renal calculi, and can reduce the incidence of complications. It is worthy of clinical promotion. Key words: Kidney Calculi; Holmium; Lasers, Solid-State; Ureteroscopes; Lithotripsy, Laser

Sun′s tip-flexible ureterorenoscopy combined with holmium laser lithotripsy in treatment of renal and upper ureteral calculi

Objective To evaluate the efficacy and safety of Sun′s tip-flexible ureterorenoscopy (tf-URS) combined with holmium laser lithotripsy in treatment of renal and upper ureteral calculi. Methods Clinical data of 48 patients (29 males and 19 females) with renal and upper ureteral calculi treated by tf-URS with holmium laser lithotripsy in our hospital from November 2015 to May 2016 were retrospectively analyzed. Among 48 patients there were 29 males and 19 females with a mean age of (37.8±12.5) years (21-67), including 31 cases of upper ureteral calculi and 17 cases of renal calculi with a mean stone size of (1.4±0.6) cm (0.8-2.1). The tf-URS was advanced through the ureter under visual direction with rigid mode . When the endoscope reached the ueteropelvic junction, the inner flexible part was extended out to explore the pelvicaliceal stones and then the holmium laser lithotripsy was performed. The therapeutic results were evaluated by KUB 2 days after operation and color ultrasonography or CT 4 weeks after operation. Results The success rate of insertion of tf-URS was 94% (45/48). The calculi were detected in 45 cases, and laser lithotripsy succeeded in 43 cases (96%). The rate of total stone clearance was 87% (39/45). The procedure was transformed to laparoscopic or percutaneous nephrolithotomy (PCNL) in 3 patients with ureterostenosis or ureteral distortion. No serious complications occurred. Conclusion The tf-URS with holmium laser in the treatment of renal and upper ureteral calculi is safe, reliable and effective. Key words: Ureteroscopy; Ureteral calculi; Lithotripsy, laser; Laser, holmium

Comparison of Guy’s vs S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNL

Introduction and objective: The aim of the present study was to compare the accuracy of the Guy’s and S.T.O.N.E. scoring systems in predicting percutaneous nephrolithotomy (PCNL) outcomes. Methods: This prospective study was carried out in the Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between August 2013 and September 2015 in collaboration with the Department of Radiodiagnosis and Imaging. A total of 100 cases of renal calculi operated on with PCNL were considered in the study on the basis of CT morphodensitometry. The study was approved by the institute’s ethical committee. Guy’s and S.T.O.N.E. scoring systems were calculated. Regression analysis and ROC curves were performed. Results: A total of 100 PCNLs were operated on. The overall stone-free rate was 90% with a complication rate of 17%. When compared to patients with residual fragments, stone-free patients had significantly lower Guy’s grade (3.5 vs 2; p &lt; 0.001) and S.T.O.N.E. score (9.1 vs 7.5; p = 0.023). Logistic regression analysis showed that both Guy’s and S.T.O.N.E. systems were significantly associated with stone-free status, OR 0.96 ( p &lt; 0.001) and OR 0.94 ( p &lt; 0.001), respectively. Furthermore, both scoring systems were significantly associated with estimated blood loss ( p = 0.02 and p = 0.004). There was good correlation between both scoring systems and operative time ( r = 0.2, p &lt; 0.002 and r = 0.3, p &lt; 0.002) and length of hospital stay ( r = 0.1, p = 0.002 and r = 0.2, p &lt; 0.002). There were significant associations between both scoring systems and complications ( p &lt; 0.001 and p = 0.004). There was no significant difference in the areas under the curves for the Guy’s and S.T.O.N.E. scoring systems (0.96 (95% CI 0.92–0.99) vs 0.94 (95% CI 0.89–1.001); p &lt; 0.001). Conclusion: Both Guy’s and S.T.O.N.E scoring systems have comparable accuracies in predicting post-PCNL stone-free status. Other factors not included in either scoring system may need to be incorporated in the future to increase their accuracy.

Clinical efficacy of percutaneous renal biopsy under the guide of B-ultrasound in treatment of children with upper urinary tract calculi

Objectives To investigate the clinical efficacy and safety of percutaneous renal biopsy under the guide of B-ultrasound in treatment of children with upper urinary tract calculi. Methods The clinical data of 80 patients with upper urinary tract calculi in 82 cases were retrospectively analyzed. The average age was (33.1±17.3) months, the average size was (1.47±0.43)cm. Left side(34 cases), right side(43 cases), bilateral(2 cases) (no urine, renal dysfunction), 46 cases of single stone, 34 cases of multiple stones, 64 cases of renal pelvis, 5 cases of ureteral calculi, 6 cases of renal calculi combined with ureteral calculi, 4 cases with renal calculi, 1 cases of patients with renal pelvis were found. First, children with upper urinary tract calculi, prone position, B-ultrasound guided puncture target calyx, were indwelled 4-5F ureteral catheter with ureteroscope .During the operation, WOLF 8/9.8F ureteroscope and 16F peel-away were used in ballast lithotripsy. Results 82 cases were treated with operation, 78 cases with stone free at first time, 4 cases of stone free at second time, 4 cases of residual stones were found. Stone-free rate at third day after operation was 95.2%. Operation time was 15 ~ 90 min, average time was (33±21.7)min. HGB decreased (9.8 ± 7.8) g/L, and the change of HCT was (0.0375 ± 0.0367)%. The average hospitalization time was (6±1.6)d, 1 cases with pleural effusion, 15 cases with fever, no serious complications occurred. There was no recurrence of st- ones within 1 month after operation. Conclusions Percutaneous renal biopsy under the guide of B-ultrasound is safe and effective in the treatment of pediatric renal and ureteral calculi. Key words: Urinary Calculi; Ureteroscopes; Punctures

The role of laparoscopic surgery for renal calculi management

To date, most cases of renal calculi have been managed with extracorporeal shockwave lithotripsy and endoscopic procedures. However, for complex renal stone conditions, these minimally invasive procedures may require multiple operative sessions. Open surgery is usually reserved as a salvage procedure, although it is invasive in nature. Laparoscopic treatment is well accepted in renal surgery. For stone disease, it can duplicate open surgical techniques such as pyelolithotomy, pyeloplasty, anatrophic nephrolithotomy, caliceal diverticulectomy and nephrectomy. Although the laparoscopic techniques for stone treatment are quite challenging, it is both feasible and safe. Laparoscopic treatment is a viable option for large renal stone treatment with an excellent stone-free rate, especially when patients require their stones to be treated within a single session. However, it is more invasive in nature than endourology procedures and so should be reserved as the last resort option for renal stone management in the modern endourology era.

USE OF COMPUTERIZED TOMOGRAPHY IN THE EVALUATION OF FILLING DEFECTS OF THE RENAL PELVIS

AbstractComputerized tomography has been used in the evaluation of 5 patients with radiolucent masses of the collecting system. There were 3 cases of renal calculi, 1 peripelvic cyst and 1 squamous cell carcinoma of the renal pelvis. The results of computerized tomography scanning are correlated with the results of excretory urography and ultrasonographic scanning. The diagnostic advantage of computerized tomography scanning for evaluation of radiolucent masses of the upper collecting system is elucidated.

Clinical experiences with the application of "Urocalun" for upper urinary lithiasis

Investigation is carried out in order to evaluate the effectiveness of “UROCALUN” in 42 cases of upper urinary lithiasis.The results obtained are as follows;1. In 25 of 37 cases of ureteral calculi, spontaneous passage of the calculi has been resulted. The maximal size of passed stone are 0.7×1.5cm.2. Five cases of renal calculi has not passed spontaneously.3. No appreciable side effects are noticed.4. Administration of “UROCALUN”, the chief components of which is aqueous extract of “Quercus Stenophylla Makino”, is indicated in case where the short diameter of the stone are less than 1.0cm and when the calculi locate in the ueteral area.

THE PRESENT-DAY MANAGEMENT OF STONE IN THE KIDNEY

Stone has received more attention than any other lesion of the kidney; however, certain conservative methods are retained which often result in the destruction of the kidney harboring the stone, and certain benign operations are continued which, in spite of being popularized for their simplicity and safety, favor the recurrence of stone. This paper reviews seventy-four cases of renal calculi removed by surgical intervention or cystoscopic maneuvers. Silent, quiescent, nonobstructing calculi unaccompanied by infection were untreated and are not included. The etiologic role of congenital deformity, stasis and infection is carefully studied and correction emphasized. The pathologic effects of stone, pyelonephritis, ulcerative necrosis, renal abscess, perinephric abscess and hydronephrosis are thoughtfully considered. These pathologic processes progressively destroy the kidney and emphasize the necessity of early recognition and removal of stone. Several cases presenting the so-called nonsurgical coralform type of stone are reported in which fragments broke off and passed into

KIDNEY STONE AS A DIAGNOSTIC PROBLEM

No consideration of kidney stones as a diagnostic problem is complete without a review of the clinical and urologic symptoms presented by this type of disease of the kidney. If we are to study only the cases in which the suspicion that a stone may be present is aroused by pain of the renal colic type, then many cases of renal calculus will remain undiagnosed. There are many cases in which pain in the genito-urinary tract is a minor complaint or is entirely absent, and I feel that in such cases, which present an atypical symptomatologic syndrome, the liability of an error in diagnosis is most apt to occur. In order to obviate this, a wholesome respect must be paid to all the symptoms that may be present in a patient suffering with a calculus of the kidney. I am prompted to prepare this paper by the frequency with which

A Case of Renal Calculus with Complications

A Case of Renal Calculus with Complications

A Case of Renal Calculi in a Horse

A Case of Renal Calculi in a Horse

A CASE OF RENAL CALCULI, PYONEPHROSIS, AND NEPHRO-LITHOTOMY

A CASE OF RENAL CALCULI, PYONEPHROSIS, AND NEPHRO-LITHOTOMY