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

During the 39 months since the introduction of transurethral lithotripsy (TUL) for the treatment of ureteral stones at our hospital in August 1985, TUL was performed a total of 200 times in 178 patients with ureteral stones. Among them, 111 patients had left ureteral stones and 65 had right ureteral stones, while 2 patients had ureteral stones in both sides. The stones were divided into upper ureteral stone (84 patients) and lower ureteral stone (94 patients) at above and below the iliac brim. 89% of the stones were less than 2 cm in diameter. Most of the patients were given lumbar anesthesia, and a guide wire was inserted into the ureter. The ureter was dilated with a ureteral bougie, and a 13F or 14F Storz ureteroscope was inserted. The stones were disintegrated by an ultrasound lithotripto and removed using forceps and a basket catheter. After the TUL procedure, a double J catheter was indwelled and removed within 5 days. The results were evaluated by DIP which was done 2 to 3 months after TUL. The success rate included residual stones less than 4 mm in diameter, as they could be spontaneously discharged. As a result, the success rate for upper ureteral stones was 53%, and it was higher for smaller stones. On the other hand, the success rate for lower ureteral stones was 85% and significantly higher. The main reasons for failure were the upper migration of the stones (60%) and inability to insert the ureteroscope up to the stone due to ureterostenosis and ureteral perforation (39%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transurethral uretero-lithotripsy of ureteral stones in Osaka City University]. 262 24

From March 1988 until May 1989, 361 patients with 438 stones were treated with the Dornier multipurpose lithotripter MPL 9000. 64.8% of the stones were situated in the calyx, 32.6% in the renal pelvis, 1.1% in the upper and 1.4% in the distal ureter. 19.6% of the stones were radiolucent. Multiple MPL treatments were performed in 10.2%. In 4.3% fragments post-ESWL treatment were larger than 5 mm. In 95.7% of the cases complete disintegration was achieved. 63.5% of the treatments were performed without using analgesia or anesthesia. Intravenous anesthesia was used in 20.5%. Analgesia and sedation in 13.6%, general anesthesia in 1.7% and epidural anesthesia in 1.1%. After 3 months' follow up 74.3% were stone-free. Residual fragments were found in the upper calyx in 1%, in the middle calyx in 5%, in the lower calyx in 13%, in the renal pelvis in 5.6% and in the ureter in 1%. The MPL 9000 has been proven to be similarly effective for the treatment of renal stones, while difficulties in localizing ureteral stones, while difficulties in localizing ureteral stones were noted. The major number of treatment was performed without any analgesia or anesthesia. No major complications were encountered. Due to the small focal area and the ultrasound location system. Special advantages were found for the therapy of children.
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PMID:[1 year's experience with the multifunctional lithotriptor Dornier MPL 9000]. 263 42

Concrement lithotripsy in the kidney and ureter using extracorporeal shock waves (ESWL) was performed with the aid of a 2nd-generation lithotriptor--Lithostar Siemens. Over a period of 11 months ESWL was applied in 526 patients aged 7 to 80 years, 10 of these were children. 19 patients had bilateral lithiasis so that the treatment was applied to a total of 545 renoureteral units and 698 concrements were disintegrated. In the ureter 34 concrements were disintegrated, the remainder being in the kidney. 12 patients had solitary kidney lithiasis; 62 subjects prior to ESWL, had been operated on the same kidney for lithiasis or on the ipsilateral ureter. Most patients had only local infiltration anaesthesia of the relevant intercostal nerves sometimes supplemented with mild opioid analgesia. Children were operated on in general anaesthesia. More than one ESWL application was needed in 33% cases, 54 disintegrated concrements measured more than 30 mm. Cystine concrements in 2 patients remained unaffected, in 1 woman with apatite lithiasis the disintegration was unsatisfactory. Auxiliary interventions had to be performed in 22% cases, prior to ESWL, and in 13% patients after ESWL, in 1 case following ESWL, open ureteromy was performed. The patient's exposure to radiation is negligibly low, the paramedical personnel is exposed to none. The noise level both for the patient and personnel is within the hygienic limits and is lower than in the case of 1st--generation lithotriptors. The average hospitalization period in patients with unilateral lithiasis lasted 7 days, 8 patients were treated in out-patient departments. When released from the clinic, 39.5% patients had no concrements, the remainder had only minute residual concrements. Three months upon the release, 77.6% patients were found with no demonstrable signs of concrements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracorporeal shock-wave lithotripsy]. 274 89

The main indication for renoscopy is percutaneous removal of concrements from the pyelocaliceal system (percutaneous nephrolithotripsy, PNL). Today, following the introduction of extra-corporeal shockwave lithotripsy (ESWL), PNL is still used for the treatment of staghorn stones. During ureteroscopy (URS), which is more frequently used, the ureter is examined retrogradely by a rigid instrument. Previously untreated ureteral stones and "steinstrasse" following ESWL can be successfully removed in one session. Since these techniques are invasive and require at least regional anesthesia, they are rarely used for diagnostic purposes only (e.g. ureteral stenosis of unknown origin, tumor biopsy).
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PMID:[Renoscopy and ureteroscopy]. 274 18

We treated successfully 16 patients with stones in the mid ureter, that is overlying the pelvic bone, in the prone position with a Dornier HM3 lithotriptor. The lithotriptor was equipped with the original reflector and generator system, and all treatments were performed with only surface anesthesia of the skin and premedication with pethidine chloride and diazepam. Between 1 and 3 sessions were necessary with up to 2,000 shock waves at each session. The generator voltage was varied between 14 and 18 kv. After completion of extracorporeal shock wave lithotripsy all patients became free of stones without ureteroscopy or transureteral manipulation except for a ureteral catheter and fluid irrigation during treatment.
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PMID:Extracorporeal shock wave lithotripsy of stones in the mid ureter. 291 44

Ureteral stones can now be removed endoscopically, using a ureteroscope. This instrument, provided with a direct optic system and an operating tube, is introduced under general anaesthesia after the ureteral opening has been dilated and is pushed up until it reaches the stone which is then removed by means of a basket catheter or a forceps. Voluminous stones can be shattered in situ by ultrasounds or hydroelectric shock waves. Forty-three stones, representing 72% of all attempts, were removed by this method from 30 patients. There were 6 failures due to impassable vesico-ureteral opening, ureteral flexure and wedged in or ascended stone, and 4 complications including 2 cases where the basket catheter went under the mucosa and 1 case each of secondary urinoma and ureteral clotting. There was no perforation nor overt septic complication. Most stones were larger than 10 X 4.5 mm and were located in the pelvic or iliac part of the ureter. Infected stones can be removed endoscopically under antibiotic treatment and provided a draining catheter is left in place. Ureteroscopy notably reduces the need for ureteral lithotomy.
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PMID:[Removal of ureteral calculi by uteroscopy]. 315 24

Percutaneous nephrostomy (PCN) was used to treat 16 ureteral fistulas, two ileal fistulas following ileo-cystoplasty, and one pelvic fistula. Discharge resolved in all cases. PCN alone achieved complete recovery of the ileal and pelvic fistulas. Insertion of a wire-guide through the fistula into the bladder and stenting of the ureter for 5 to 20 days with a 8 to 10 F multi-side-hole catheter was possible in 12 of the ureteral fistulas and ensured complete recovery in every case. Because of complete stenosis, this procedure failed in the four other cases of ureteral fistula, and surgery was therefore required. Transrenal percutaneous treatment of urinary fistulas is a simple, effective procedure requiring only local anesthesia, and can be recommended in recently operated patients, and when retrograde catheterization is inadvisable (ileo-cystoplasty).
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PMID:[Transrenal percutaneous treatment of urinary fistula. Apropos of 19 cases]. 319 Jan 69

A total of 433 extracorporeal lithotripsy procedures was performed for renal, ureteral and bladder stones by means of a system of ultrasonographic detection and piezoelectric destruction in 386 patients. The stones were detected easily in 87 per cent of the patients, difficult to detect in 10 per cent and impossible to detect in 3 per cent. Mean duration of treatment was 35 minutes. Mean number of piezoelectric waves was 2,700 at 1.25 per second. With a frequency of 1.25 to 5 per second, extracorporeal lithotripsy was performed without any local, regional or general anesthesia, and without premedication in 210 patients. Of the 217 patients with a renal stone reviewed at 3 months 161 (74 per cent) had successful results and 56 (26 per cent) failed therapy. Thirty patients (14 per cent) underwent 2 or 3 sessions. The morbidity was low: 2 per cent of the patients suffered ureteral obstruction, 1.5 per cent had subcapsular hematoma and 4 per cent had fever. No significant modifications of laboratory tests were necessary and no patient suffered renal failure. Of the stones 31 in the lumbar ureter, 15 in the pelvic ureter and 8 in the bladder were treated, with success rates of 87, 46 and 50 per cent, respectively. A total of 103 patients was treated on an outpatient basis. This outpatient treatment, together with the low cost and minimal maintenance of the apparatus, and the absence of anesthesia constitute a new progress in the treatment of renal stones.
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PMID:Piezoelectric extracorporeal lithotripsy by ultrashort waves with the EDAP LT 01 device. 328 Aug 30

Three hundred and sixty one extracorporeal lithotripsies for renal, ureteric and bladder stones have been performed by means of a system of ultrasonographic detection and piezoelectric destruction (EDAP LT01). The localisation of the stone is achieved by a 5 MHz real time sectorial transducer situated in the centre of a small dish containing 320 piezoelectric elements concentrated in a source 5 mm wide by 15 mm high. The pressure recorded in vitro is 900 bars. The stone is easily detected in 87.2% of cases, difficult to detect in 10% of cases and impossible to detect in 28% of cases. By using a frequency of 1.25 to 5 per second, extracorporeal lithotripsy can be performed without any local, regional or general anaesthesia and without premedication in the 120 patients with a renal stone, reviewed between 1 and 3 months, 88 (73%) were considered to be complete successes. Ten (8%) were considered to be failures and 19 (21%) were considered to be partial successes. The best results were obtained in stones of the renal pelvis less than 20 mm in diameter. These results relate to a mean series which must take into account the successive improvements made to the lithotripter. Today, stone fragmentation is obtained in 93% of cases. Thirty six stones of the lumber and pelvic ureter were treated with success rates of 93% and 50%, respectively. Six bladder calculi were treated with a 50% success rate. Forty two patients were treated without being admitted to hospital.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Extracorporeal piezoelectric lithotripsy by ultra-short waves using the EDAP LT01 device]. 330 28

The established treatment for ureterointestinal anastomotic strictures is open surgical revision. In an effort to evaluate the efficacy of endourological surgery for this problem, we compared 7 patients (9 strictures) who underwent open revision to 6 patients (7 strictures) who underwent endoscopic incision and balloon dilation of the stricture. The success rate (that is patent ureter and no stent) was 89 per cent for the open revision group and 71 per cent (5 of 7) for the endoscopic group. All open revisions required use of general anesthesia, while 3 of the endoscopic procedures were performed with the patient under assisted local anesthesia. The endoscopic group had markedly shorter hospitalization, decreased blood loss, diminished patient discomfort and no postoperative complications. While the endoscopic procedure for ureteroileal anastomotic strictures is less successful than open revision, the lower morbidity, decreased cost and shorter hospital stay associated with the endourological approach favor its use over open revision. For elderly patients who fail initial endoscopic revision and for patients with metastatic transitional cell cancer, placement of an indwelling stent is a reasonable alternative. Given these guidelines, less than 30 per cent of the patients who suffer a ureteroileal anastomotic stricture will require open surgical revision.
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PMID:Management of ureterointestinal anastomotic strictures: comparison of open surgical and endourological repair. 337 85


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