Treatment Of Upper Urinary Stones Research Articles

Application of flexible ureteroscopy combined with holmium laser lithotripsy and their therapeutic efficacy in the treatment of upper urinary stones in children and infants.

To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) for the treatment of pediatric patients. A total of 45 patients with upper urinary stones treated using flexible ureteroscopy combined with holmium laser lithotripsy at our department between June 2015 and January 2017 were examined in this study. The operative success rate of treatment using holmium laser lithotripsy via flexible ureteroscopy was 97.8% (44/45); one patient (1/45, 2.2%) was converted to laparoscopic pyelolithotomy, and the calculus was successfully removed. Lithotripsy via flexible ureteroscopy was successful during the first phase in 38 patients (38/45, 84.4%), and second or third phase lithotripsy was needed for six patients (6/45, 13.3%). Intraoperative ureteral fracture in the middle and lower sections occurred in one pediatric patient who was converted to laparoscopic pyelolithotomy and ureter bladder reimplantation. This patient was discharged after recovery at 2 weeks postoperative and showed no significant renal dysfunction over the 12-month follow-up period. Severe postoperative gross hematuria occurred in one patient, who improved after hemostasis and other symptomatic treatments. High fever occurred in two patients (body temperature >39°C), who later improved. These pediatric patients were discharged after active anti-infection and other conservative treatments for 4 days. All of the included patients were followed up for 2-15 months, with an average follow-up period of 8 months. The total calculus clearance rate was 100% (45/45), with no recurrence of the calculus. In this study, most upper urinary stones in children and infants were treated successfully with holmium laser lithotripsy applied via flexible ureteroscopy.

Comparison efficacy and side effects of combined cystone and hydrochlorothiazide with cystone monotherapy in treatment and passage of upper urinary stones; a randomized clinical trial

Introduction: Urinary stones are one of the most common and painful diseases of humans after urinary tract infections and prostate diseases. Objectives: The aim of this study was comparing the efficacy and complications of combined cystone and hydrochlorothiazide with cystone monotherapy in the treatment of upper urinary stones. Patients and Methods: In this randomized clinical trial 80 patients older than 15 years old with renal and ureteral stones less than 10 mm after taking informed consent form were allocated randomly in one of two groups. Patients with azotemia, hydronephrosis, bothersome pain and pregnant women were excluded. In the first group, combinations of cystone and hydrochlorothiazide tablets (every 12 hours, two 100 mg cystone and 25 mg hydrochlorothiazide) were prescribed. In the second group, cystone were prescribed as the first group. One month later, patients were followed by kidney, ureter, and bladder x-ray (KUB) and ultrasonography and the success of treatment was determined by changing the size of stones and report of stone passage by the patients. All data were collected and analyzed by SPSS software version 23 and statistical tests. Results: The mean age of the patients in combined and single groups were 48.02±13.72 and 44.15 ± 14.86(P = 0.24) years respectively. The mean size of stone after treatment in two groups was 1.72±0.98 and 1.85±0.78 mm respectively (P=0.53). Regarding efficacy of combined and single group, more than 90% of the patients reported stones passage after the intervention (P=0.06). There were no significant differences in mean blood urea (P=0.38) and serum creatinine (P=0.53) after treatment in two groups. Conclusion: The results of this study showed that combination of cystone and hydrochlorothiazide do not increase the efficacy of cystone in treatment and passage of urinary stones, although in both groups stone passage significantly increased.

Laser in Urology – State of the Art

Abstract A review of the papers presented at the 16th Annual Meeting of Deutsche Gesellschaft fur Lasermedizin (June 17 and 18, 2007 in Munich) and the last two years’ publications show the still raising interest in urological laser applications. Lasers are used for the treatment of various benign and malignant urological disorders such as benign prostatic hyperplasia, stone disease, strictures and tumors of the urinary tract, and intravesical foreign bodies. Laser prostatectomy has successfully entered the era of prospective randomized studies. Ureteroscopic Holmium:YAG Laser lithotripsy has been generally accepted first choice for treatment of upper urinary stones. Regarding the large number and high quality of publications in the field of urological laser application, we are looking forward to an exciting session during our 16th Annual Meeting of DGLM.

Stepwise shock wave lithotripsy: Results of initial study for the treatment of urinary stones in childhood

To assess the effectiveness of stepwise extracorporeal shock wave lithotripsy in the treatment of upper urinary stones in childhood. Between August 1998 and August 2003, 31 patients were treated for renal or ureteric stones. All treatments were performed with Dornier Compact Delta lithotripter. The number of shock wave was limited to maximum 3000 shock waves/session. The voltage was started at 10 kV and increased stepwise to 12.75 kV. Stone clearance was assessed at 3 months. The stone free state was defined as the absence of stone fragments. Total 31 stones (24 renal and 7 ureteral stones) were treated. The age of the patients was median 8 (min-max: 0.8-12) years. The length of the stones was median 1 (min-max: 0.5-1.5) cm for renal stones and median 0.5 (min-max: 0.5-1) cm for ureteral stones. As an auxiliary procedure, open pyelolithotomy was required for 1 patient. The overall stone free rates for renal and ureter stones were 79% and 100%, respectively. Post-treatment insignificant hematuria was observed in all cases. Stepwise shock wave lithotripsy was an effective procedure for the treatment of urinary calculi in childhood.