Does the presence or degree of hydronephrosis affect the stone disintegration efficacy of extracorporeal shock wave lithotripsy? A systematic review and meta-analysis
AbstractThe aim of this study was to determine whether the presence or degree of hydronephrosis (HN) affects the stone disintegration efficacy of shock wave lithotripsy (SWL). A comprehensive literature search using PubMed, Embase, Cochrane Library, and Web of Science was conducted to retrieve relevant studies. Risk ratios (RRs) and mean differences (MDs) with corresponding 95% confidence intervals (CIs) were calculated for comparisons of outcomes of interest. In total, seven comparative studies with 2033 patients were included. Overall results indicated no significant difference in stone-free rate (SFR) and retreatment rate between two groups. Subgroup analysis further revealed: (1) compared with moderate or severe HN, non-HN SWL brought significantly lower retreatment rate (RR 0.67, 95%CI 0.52 –0.87,P = 0.002 and RR 0.55, 95%CI: 0.40–0.76,P = 0.0003, respectively) and shorter clearance time (MD − 3.80, 95%CI − 5.81 to − 1.79,P = 0.0002 and MD – 5.93, 95%CI − 10.29 to − 1.57,P = 0.008, respectively); (2) SWLs performed without stone-induced HN or with artificial HN were associated with significantly higher SFR (RR 1.11, 95%CI 1.04−1.18,P = 0.001 and RR 0.93, 95%CI 0.87−0.99,P = 0.02, respectively); (3) non-HN SWL brought significantly higher SFR than HN group when treating proximal ureteral stones (RR 1....
CONCLUSIONS: The vmPCNL seems to be sustainable, safe and feasible for kidney stones treatment in the pediatric population. PMID: 33016029 [PubMed - as supplied by publisher]
AbstractTo investigate the reliability of newly defined CT-related parameters and cardiovascular risk factors in groups adjusted for stone size and location to predict spontaneous stone passage (SP) of uncomplicated ureteral stones ≤ 10 mm. The data of 280 adult patients with solitary unilateral ureteral stones ≤ 10 mm in diameter in non-contrast computed tomography were prospectively recorded. All patients undergoing a four-week observation protocol with medical expulsive therapy using tamsulosin were divided i nto two groups according to SP or no SP. Demographic, clinical and ...
CONCLUSIONS: Diabetic patients are under greater risk to develop postoperative UTI following URS. Those patients with UTI history and HbA1c level higher than 6.9% must be followed carefully. PMID: 32886078 [PubMed - as supplied by publisher]
CONCLUSION: Utilizing direct visual semi-rigid ureteroscopic dilation with a semi-ridged ureteroscope prior to flexible ureteroscopy leads to successful primary ureteroscopy for renal stone treatment in most patients. This technique is an effective, safe and possibly cost-effective method of obtaining ureteral access to facilitate primary URS for renal stone treatment. PMID: 32861259 [PubMed - in process]
A large left renal calculus in the renal pelvis. Significant obstruction looking to the severe hydronephrosis. see more:https://www.ultrasound-images.com/renal-calculi/
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]
Conclusions: US-guided MPCNL showed an excellent SFR and low complication rate in the management of pediatric patients with upper ureteral and renal stones. PMID: 32401098 [PubMed - as supplied by publisher]
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
CONCLUSION: PI-DJS during PCNL allowed for a reliable and stable reflux from the bladder into the renal pelvis to produce an artificial hydronephrosis without the formation of microbubbles, unlike conventional ureteral catheters. PMID: 32309876 [PubMed - as supplied by publisher]
AbstractThe aim of the study was to analyze the factors predicting success for the treatment of proximal ureteral stones larger than 1 cm with extracorporeal shockwave lithotripsy (SWL) in adult patients. Between January 2014 and December 2018, 480 adult patients in total underwent SWL and data were retrospectively evaluated. Patients with multiple ureteral stones, solitary kidney, congenital abnormality, skeletal system abnormal ity, history of previous urinary system surgery and SWL, renal insufficiency, patients who could not tolerate SWL and pediatric patients were excluded from the study. The remaining 415 patie...