Disparities in care among patients presenting to the emergency department for urinary stone disease
AbstractTo determine whether patients with ureteral stones received different standard of care in the emergency department (ED) according to various sociodemographic factors. We conducted a retrospective study of patients presenting to EDs in a large tertiary-care hospital in the Bronx, New York with a diagnosis of ureteral stones. Electronic chart review was used to assess each patient ’s ED course and to gather socio-demographic information. The primary outcomes of interest were administration of pain medication, prescription of alpha-1 antagonists to facilitate stone passage, and whether or not patients received CT scan or ultrasound. Associations of these outcomes with age ca tegories, sex, race/ethnicity, BMI category, socioeconomic status and insurance status were examined using multivariate logistic regression models. 1200 patients were included in this analysis of which 616 (51%) were women. A large proportion of patients were minorities: 40% Hispanic, 15% non-Hispan ic Black, and 20% other/multiracial. Patients aged 55–64 years and those 65 or older were less likely to receive pain medication compared to patients
In this report, we discuss the identification and management of this rare condition.
Conclusion: In the treatment of 2-4 cm renal stone, using V-UAS in RIRS can improve surgical efficiency with lower postoperative early pain scores. Comparing with MPCNL, its initial SFR was more depressed, and there is still a trend towards requiring more auxiliary procedures to achieve comparable final SFR. PMID: 32509870 [PubMed - in process]
DiscussionThe PUrE trial aims to provide robust evidence on health status, quality of life, clinical outcomes and resource use to directly inform choice and National Health Service provision of the three treatment options.Trial registrationISRCTN:ISRCTN98970319. Registered on 11 November 2015.
Conclusion: Tamsulosin plus Tadalafil is more effective than tamsulosin with early passage of stone and decreased number of colic episodes and emergency visits without significant side effects for lower ureteric calculi of 5 mm to 10 mm. PMID: 32411212 [PubMed]
We report on two cases treated with our standardized laparoscopic technique using only three 5-mm trocars. The proposed approach could be considered as the first-line treatment for RCU. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | open access Full text
AbstractBackgroundWe sought to determine the rate of emergency department (ED) attendance for complications after ureterorenoscopy (URS) for stone disease and to identify risk factors for ED attendance after URS.MethodsAn analysis of all patients undergoing URS over 12 months at a single institution was performed. Patient demographics, preoperative and intraoperative variables associated with postoperative complications and subsequent ED attendance were collected. Logistic regression analyses were performed to determine predictors of URS complications presenting to ED.ResultsIn total, 202 ureteroscopies were performe...
Conclusion: Pain was the commonest indication for intra-corporeal lithotripsy (92.8%) and also the commonest post-operative complication (9.30%). Funding: None declared. PMID: 32116343 [PubMed - in process]
Condition: Nephrolithiasis Interventions: Drug: Mirabegron 50 MG; Drug: Placebo oral tablet Sponsors: St. Michael's Hospital, Toronto; Canadian Urological Association Recruiting
We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the ...
If you’ve been diagnosed with kidney stones (urolithiasis), you may have several options for treatment. These include medical therapy, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotripsy (PCNL), and ureteroscopy. A brief anatomy of the urinary tract The urinary tract includes kidneys (two organs that filter waste and extra water from the blood) ureters (two tubes bringing urine from each kidney to the bladder) bladder (organ that collects urine) urethra (a single tube through which urine in the bladder passes out of the body). The evaluation for kidney stones If your symptoms suggest kidney...