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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From September 1988 to April 1989, 400 patients with stones in the calix (40%), in the renal pelvis (45%), in the ureter (15%) and with staghorn calculi (5%), underwent shock wave treatment. In the majority of patients therapy was carried out with general anesthesia. Disintegration was achieved in 95% of stones in the kidney and 44% of stones localized in the ureter following in situ ESWL. The ureteronephroscopy and stone push-up with replacement into the renal pelvis was performed in 56% of ureteral calculi. The average number of impulses to achieve disintegration was 1,850. In 20 patients 4,000 shock waves were necessary. We studied these patients with echotomography, CT scan and magnetic resonance imaging 48 hours after the treatment. The aim of this trial was to assess the efficacy and cost benefit ratio of the Tripter X1 lithotripter.
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PMID:Experience with our first 400 treatments with ESWL and URS. 233 Nov 72

The results obtained in 143 cases or ureteral stones treated by EDAP LT-01 were analysed concerning stone location, ureteral manipulation, and treatment position. The ureter was divided into six segments: ureteropelvic junction (UPJ), proximal ureter higher than the lower pole of the kidney (PU1), proximal ureter between the lower pole and the iliac crest (PU2), mid-ureter between the iliac crest and the lower end of the sacroiliac joint (MU), distal ureter between the lower end of the sacroiliac joint and the ischial spine (DU1), and the distal ureter below the ischial spine to the meatus (DU2). The overall fragmentation rate (FR) was 72%, as detailed below: (table; see text) Anesthesia or iv sedation was never used for EPL. 28% of the patients underwent retrograde ureteral manipulation (29/103). For PU1, the FR was twice as high after retrograde manipulation (push back/in situ = 5/8). For UPJ, the supine position was most common. For PU1 and PU2, it was often better to have the patient lie on his side. For DU1 and DU2, a prone position was necessary. For all stones in DU1, the bladder had to be well filled and the FR was higher in DU2 than in DU1. DU2 stones appeared to adhere to the bladder wall or were intravesical (stone in the meatus). The stone-free rate for successfully manipulated ureteral calculi (3 month follow-up) is 93% (27/29). The stone-free rate for in situ stones at 3 months is 94% (70/74). Extracorporeal piezoelectric lithotripsy combined with stone manipulation is highly efficient in the management of UPJ, PU1 and DU2 stones.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracorporeal piezoelectric lithotripsy in the treatment of calculi of the ureter. Apropos of a series of 143 cases]. 235 Jan 64

We reviewed our experience with in situ extracorporeal shock wave lithotripsy for ureteral stones in 30 patients. The Siemens Lithostar unit was used for stone disintegration and no attempts were made to manipulate the calculi back into the kidney. During the study period 15 patients presented with upper, 9 with mid and 6 with lower ureteral calculi. The mean stone size was 5 x 12 mm. The success rates in stone removal, hospitalization, anesthesia, average number of shocks and kilovolts used were analyzed. Complete removal of all calculous material was obtained in 86.6% of the patients after 3 months. Followup consisted of a plain film of the kidneys, ureters and bladder, and eventually renal ultrasound 1 day and 1 to 3 months postoperatively. Routinely, patients were treated without hospitalization, while 3 had persistent stone fragments and required hospitalization for auxiliary endourological procedures. The average hospital stay for these patients was 1.6 days. Of the 30 patients 13 (43.4%) were treated without anesthesia, 9 (30.0%) received intravenous sedation and 8 (26.6%) had epidural anesthesia. Patients received 3,000 to 6,000 shock waves per session (median 4,000) at 14.0 to 19.0 kv. (median 18.1 kv.), and in 76.9% the treatment was completed after 1 session. Patients who needed more than 1 session received 3,000 to 4,000 shock waves (median 3,000) at 15.0 to 19.0 kv. (median 17.8 kv.) per additional session. Minor complications, such as hematuria, were observed in 33.3% of the patients for less than 24 hours. A small erythematous area usually was present on the abdominal wall at the shock wave entrance site and temporary ileus was noted in 2 patients. In situ extracorporeal shock wave lithotripsy with the Siemens Lithostar device is an effective method for treatment of ureteral stones in all parts of the ureter due to the ease of patient positioning.
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PMID:In situ extracorporeal shock wave lithotripsy for ureteral calculi. 237 88

The Siemens Lithostar lithotriptor was used to treat 20 children (4 to 17 years old) with renal or ureteral calculi. Two patients had bilateral renal and 2 had ureteral calculi. Of 34 calculi treated 47% were in the renal pelvis, 29% in the lower calix, 12% in the upper calix, 3% in the middle calix and 9% in the upper ureter. Stone size ranged from 2 X 2 to 40 X 20 mm. and averaged 10 X 7 mm. Of the children 60% were treated while they were under neuroleptic anesthesia. No major complications were encountered. The 3-month rate free of stones after 1 treatment was 60% and increased to 80% with multiple treatments. The success rate, defined as being either free of stones or with residual fragments equal to or less than 4 mm. in diameter, was 95%. We conclude that lithotripsy with the Lithostar device in children, at least for the short term, is safe and effective.
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PMID:Lithostar extracorporeal shock wave lithotripsy in children. 237 27

Records were reviewed of 100 patients who underwent an operation for ureteropelvic junction obstruction from 1978 to 1989: 14 cases were bilateral and 17 were antenatally diagnosed. The ureter was opacified preoperatively in all but 1 patient: in 65 by retrograde pyelography, in 18 by antegrade pyelography, either through a nephrostomy tube with which the patient was referred or during a Whitaker test, in 9 by vesicoureteral reflux seen on voiding cystourethrography performed before an operation for ureteropelvic junction obstruction and in 7 by an excretory urogram. Of the 65 patients who underwent retrograde pyelography 29 had a discrete area of narrowing. However, 36 patients had something more, including a longer segment of narrowing (13), tortuosity of the upper ureter (8), more than 1 area of narrowing (11), high insertion of the ureter on the renal pelvis (3) and compression of the ureter by the lower pole of the kidney (1). In 10 patients referred for reoperation after failed pyeloplasty there was narrowing of the ureter below the level of the prior pyeloplasty. Although indications for retrograde pyelography are fewer today with the various modern imaging modalities in current use, we believe a retrograde examination should be performed before pyeloplasty if the ureter has not been well shown by other means. The retrograde catheter should be small and soft, so as to create no edema or other injury to the lower ureter. The study is done with the patient under the same anesthesia as the pyeloplasty and not at a previous time. All 114 pyeloplasties in these 100 patients were successful.
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PMID:The importance of visualizing the ureter before performing a pyeloplasty. 237 43

In a one year period from July 1985 to July 1986, 224 upper and 62 distal ureteric calculi were treated. In situ ESWL represents the therapy of first choice for upper and distal ureteric calculi with a success rate of 81% and 76%, respectively. Retrograde mobilization of the calculus was used only in cases where in situ ESWL was impossible because of localization difficulties (obesity, stone close to the spine, skeleton deformation). Although ESWL after successful mobilization succeeded in 95%, retrograde mobilization was possible only in 80%. Antegrade ureterorenoscopy via percutaneous nephrostomy was performed to avoid open surgery after impossible retrograde mobilization and succeeded in 90%. Two second generation lithotripters suitable for treatments without invasive forms of anesthesia, the modified Dornier HM3+ and the Wolf Piezolith 2200, were compared in terms of efficacy for ureteric calculi. In situ ESWL was successful for upper ureter calculi in 70.7% with the HM3+ and 37.9% with the Piezolith 2200. In situ ESWL of middle ureteric calculi was successful in 81.8% with the modified HM3+, while in situ treatment of middle ureteric calculi was impossible with the piezolith 2200 due to insufficient localization of middle ureteric calculi with ultrasound. Distal ureteric calculi were treated successfully in 71.4% with the modified Dornier HM3+ and in 64% with the Piezolith 2200. Our initial clinical experience with ESWL in the prone position for iliac ureteric calculi is reported. Eight of 10 cases were treated successfully in situ.
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PMID:Minimal invasive therapy of ureteral calculi using modern techniques. 238 85

Endogenous glycosaminoglycans probably have a protective effect in the urinary tract, e.g. against stone formation. The synthetic sulphated polysaccharide pentosanpolysulphate (PPS) has been suggested to exert a similar protective effect e.g. by inhibition of crystallization and bacterial anti-adhesion. We have studied the distribution in rats of tritium-labelled PPS. Chromatography showed this material to contain two distinct peaks with approximate molecular weight around 2.700 (60-70%) and 1.000 (30-40%) daltons. PPS was administered orally and intravenously (5 mg/kg b.wt.) to Sprague-Dawley rats, which were killed 1 and 4 hours later, respectively, and subjected to whole-body autoradiography. Autoradiograms of sections from intravenously injected rats showed an extensive distribution of radioactivity in the whole animal, with a notable labelling of connective tissues, while bone and cartilage had low activity. There was upper intestine activity, suggesting some hepatic excretion. The most conspicuous finding, however, was the high concentration in urine and a preferential localization of activity corresponding to the lining of the urinary tract (pelvis, ureter, and bladder). The distribution was similar, but the activity lower after oral administration. In one experiment, PPS was applied intravesically under anaesthesia, with and without epithelial destruction caused by instillation of 0.4 M HCl. After vigorous rinsing, with saline, the radioactivity was still retained in the bladder wall. In other intravenous experiments, the bladder was extirpated, everted and rinsed in saline or urea of increased osmolality. High amount of radioactivity could be rinsed off by 0.5 M saline. Chromatography of the rinsing solution showed presence of both fractions of PPS previously found in the injection solution.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Preferential localization of 3H-pentosanpolysulphate to the urinary tract in rats. 244 5

Several kinds of nonvascular interventional radiology of the urinary tract are reviewed. Transurethral balloon dilation of the prostate (TU-DP) is a newly developed nonsurgical treatment for benign prostate hyperplasia, which is performed under local anesthesia with minimal morbidity and requires no hospitalization. The TUDP technique involves dilating the prostatic urethra and bladder neck to 75 F for 10 minutes under fluoroscopic control using a high-pressure dilating balloon. Long-term follow-up studies are required. Percutaneous nephrolithotomy (PNL) and transurethral ureterolithotomy (TUL) have signified a revolution in stone surgery of upper urinary tract. Indications for these treatments, endoscopic manipulation, complications and their clinical features are presented. The procedure of PNL consists of 3 steps, puncture for nephrostomy tract, tract dilation and stone removal. Among these steps the most important is the puncture and it should be effected through the calyx. During the operation, if there is too much bleeding, it can be discontinued at any time while keeping the track open. It is no longer necessary for the kidney to be free of stones at the end of the operation. TUL is performed with a rigid or flexible ureterorenoscope. Dilation of the ureteral orifice and the intramural ureter is necessary for passing the scopes. When they have been sufficiently dilated, the ureterorenoscope can be passed to the level of the renal pelvis through the urethra. Calculi have been removed successfully at a higher rate in lower ureter. Endopyelotomy may be performed safely as an initial procedure to correct congenital obstruction of the ureteropelvic junction. Recent advancements have permitted an approach to percutaneous resection for renal pelvic tumor in a solitary kidney or bilateral synchronous disease. There are great expectations for continuing important innovations in the field of interventional radiology.
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PMID:[Non-vascular interventional radiology nonvascular interventional radiology of the urinary tract]. 247 77

From September 1988 to April 1989, 400 patients with stones in the calyx (40%), in the renal pelvis (45%), in the ureter (15%) and with staghorn calculi (5%) underwent shock wave treatment. In the majority of patients therapy was carried out with general anesthesia. Disintegration was achieves in 95% of stones in the kidney and 44% of stones localized in the ureter following "in situ" ESWL. The ureteroscopy and stone push-up with replacement into the renal ampulla was performed in 56% of ureteral calculi. The average number of impulses to achieve disintegration was 1850. In 20 patients were necessary 4000 SW; we studied this patients with echography, TAC and RMN 48 hours after the treatment. The objective of this trial is the assessment of the efficacy and cost benefit relation of lithotripter TRIPTER X1.
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PMID:[The lithotripsy therapy center "Citta di Brescia". Our experiences with the first 400 treatments]. 253 6

This report describes the results of clinical trials of the second generation extracorporeal shock wave lithotriptor (Sonolith 2000 Type B) in patients with upper urinary tract stones. The studies were carried out on 101 cases at the Departments of Urology, Juntendo University School of Medicine, Kanto Teishin Hospital and General Daiyukai Hospital from Nov. 1987 to Jun. 1988. The location of stones were renal calyx and pelvis in 84 cases, ureteropelvic junction in 7 cases and upper ureter in 12 cases (2 of them had multiple stones at different levels). The average number of treatment per a patient was 1.25, and that of shock waves delivered per treatment was 1798. Ultrasound localization has been effective in all cases. The rate of destruction of the stones was 100% in the kidney, 66.7% in the upper ureter, with an overall average of 95.0%. On the X-ray film obtained six weeks after ESWL treatment, the stone free rate was 53.5%, and the effectiveness rate was 89.1%, including the cases of stone free and cases with fragments smaller than 5 mm. No serious adverse effect was observed, although there were mild transient hematuria in all cases and pyrexia (more than 38.0 degrees C) in 7 cases (6.9%). The procedure was performed safely in the majority of patients without anesthesia. In 10 cases, we applied anesthesia (epidural anesthesia in 3 cases, and local anesthesia in 7 cases) for the prevention of pain. It is concluded that ESWL treatment using Sonolith 2000 Type B is as effective as other types of shock wave lithotriptor previously applied to urolithiasis without serious clinical complication.
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PMID:[Clinical application of Sonolith 2000 type B on extracorporeal shock wave lithotripsy for upper urinary tract calculi]. 259 42


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