Medical and surgical interventions for the treatment of urinary stones in children.

CONCLUSIONS: Based on mostly very low-quality evidence for most comparisons and outcomes, we are uncertain about the effect of nearly all medical and surgical interventions to treat stone disease in children.Common reasons why we downgraded our assessments of the quality of evidence were: study limitations (risk of bias), indirectness, and imprecision. These issues make it difficult to draw clinical inferences. It is important that affected individuals, clinicians, and policy-makers are aware of these limitations of the evidence. There is a critical need for better quality trials assessing patient-important outcomes in children with stone disease to inform future guidelines on the management of this condition. PMID: 31596944 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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AbstractTo perform a systematic review and meta-analysis for the evaluation of 22 drug interventions in the management of ureteral stones, MEDLINE, Web of Science, EMBASE, and Cochrane central databases were searched to identify RCTs focusing on the evaluation of the efficacy of multiple drug interventions in medical expulsive therapy (MET) for ureteral stones, with no restrictions on year or language. Study quality assessment and data extraction were performed by independent reviewers. Major outcome measures were the stone expulsion rate, stone expulsion time, and pain episodes during treatment. A total of 78 RCTs with 14...
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research
Clinical Features: Renal colic is defined as a flank pain radiating to the groin caused by kidney stones in the ureter (urolithiasis). Renal colic is a frequent cause of Emergency Department visits. Most renal colic cases present as acute distress and severe back and/or abdominal pain that require prompt treatment with analgesics. Therapeutic Challenge: Nonsteroidal anti-inflammatory drugs and opioids are traditionally used for renal colic in the Emergency Department. This trend of practice is based on clinical experience and expert opinion. Consensus guidelines that provide evidence-based approach for the management ...
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Therapeutic Challenges Source Type: research
ConclusionOur study demonstrates that in appropriate setting a high stone-free rate can be achieved with minimal morbidity for paediatric patients. There is potentially a need to factor the increasing role of URS in future paediatric urolithiasis guidelines.
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
We present a review of recent literature to summarize the most recent evidence on the use of ureteral stents, including the use of different materials and treatment of stent-related symptoms. Recent findings Metal stents are able to resist lumen occlusion from extrinsic compression allowing longer indwelling time and making them an option for long-term use. Biodegradable stents have the advantage not to require secondary procedures; however, they have not proven their safety in the clinical setting yet. Coated and drug-eluting stents seem to be promising concepts to prevent stent-related symptoms, but still have to be c...
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Arkadiusz Miernik Source Type: research
CONCLUSIONS: Subcapsular renal hematoma represents a rare but potentially serious complication after ureterorenoscopic lithotripsy. Its real incidence and aetiology still need to be clarified. The elevated intrarenal pressures play an important role. Persistent hematuria, flank pain and haemoglobin drop should guide prompt investigation to reach an early diagnosis. In most cases a conservative management is sufficient. PMID: 30037212 [PubMed - as supplied by publisher]
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
CONCLUSIONS: Based on mostly very low-quality evidence for most comparisons and outcomes, we are uncertain about the effect of nearly all medical and surgical interventions to treat stone disease in children.Common reasons why we downgraded our assessments of the quality of evidence were: study limitations (risk of bias), indirectness, and imprecision. These issues make it difficult to draw clinical inferences. It is important that affected individuals, clinicians, and policy-makers are aware of these limitations of the evidence. There is a critical need for better quality trials assessing patient-important outcomes in chi...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
AbstractObjectiveTo evaluate the clinical outcomes with a Chinese single-use fiberoptic flexible ureteroscope (YouCare Tech) from a prospective database.Materials and methodsA prospective study was conducted in a single center in China between January 2016 and October 2017. All consecutive patients who underwent flexible ureteroscopy performed by YouCare flexible ureteroscope were analyzed. Patients ’ demographics, clinical characteristics, intraoperative parameters, postoperative complications, and stone-free rate were evaluated and recorded. Stone-free status was defined as no visible stones or clinically insignifi...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Conclusion Our study indicated that renal stone contributed to a significantly higher risk of ER-visiting rate to patients than did ureteral stone, following outpatient ESWL within 48 h. This study confirmed that Outpatient ESWL is a safe treatment for renal or ureteral stones, while inpatient ESWL is not absolutely necessary.
Source: Journal of the Chinese Medical Association - Category: General Medicine Source Type: research
ConclusionsPrimary obstructive megaureter should be a differential diagnosis in an adult with hydroureteronephrosis associated with urolithiasis especially when there is kidney impairment. Through this case report we will discuss the diagnosis and management of primary obstructive megaureter associated with urolithiasis in adults.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
We report our experience in managing a case of ectopic pelvic kidney with a pelvic stone by robotic pyelolithotomy after failure of flexible ureteroscopy. Materials and Methods A 46-year old male with 2 months history of vague lower abdominal pain was found to have on Computed Tomography scan a left ectopic pelvic kidney with a 12mm stone in an anomalous renal pelvis. Flexible ureteroscopy failed to reach the stone twice and a 4.7 French ureteric stent was placed. Results Side docking was utilized with the patient in supine Trendelenburg position. Port placements were similar to robotic assisted laparoscopic prostatectomy....
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
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