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

Within the wide armamentarium of urinary stone treatment modalities extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure. With the Dornier MPL-9000X lithotriptor one has the choice of ultrasound or fluoroscopic localization of calculi throughout the entire urinary tract. Except for the kidney, ultrasound guidance is preferred for calculi in the distal ureter, while fluoroscopy is generally used on the proximal two-thirds of the ureter. Between January and December 1990, 123 ESWL treatments were performed on 83 patients suffering from ureteral calculi with an average stone size of 9.3 x 6 mm. Median treatment parameters were 1,597 shock waves at 19.3 kv. for 43 minutes. For stones in the upper two-thirds of the ureter sedation analgesia was given, while ESWL on the pelvic ureter did not create intolerable pain. Of the treatments 69% were done on an outpatient basis. In situ ESWL treatment of urinary calculi was successful in 72 patients (86.7%), and 20 patients (24.1%) were treated with multiple treatment sessions. ESWL therapy for 47 stones in the distal ureter showed better results than for 33 stones plus 2 steinstrasse in the proximal part (95.5% versus 80% stone-free rate). Of 4 patients with mid ureteral calculi 2 could be rendered stone-free by ESWL alone. Auxiliary procedures, such as percutaneous nephrostomy or ureteral splints, had to be performed in 15.7%. Final endoscopic stone extraction was done in 7 cases and open surgery in 4, constituting a 13.3% failure rate for ESWL therapy. The results prove that the MPL-9000X lithotriptor is effective for primary noninvasive stone treatment.
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PMID:In situ extracorporeal shock wave lithotripsy of ureteral calculi with the MPL-9000X lithotriptor. 150 42

Our initial experience of extracorporeal shock wave lithotripsy (ESWL) with the Storz Modulith SL20 is reported. A total of 500 patients with 551 renal and 120 ureteric stones, mean diameter 11.9 mm, underwent 746 treatments; 68.2% of patients required a single treatment. The mean treatment rate for renal calculi was 1.4 and for ureteric calculi it was 1.5, rising to 4.2 for staghorns; 62.2% of treatments were performed on an out-patient basis. Analgesia (intravenous fentanyl) was required in 60.9% of treatments for renal calculi but in only 38.2% of those for ureteric calculi. The overall stone-free rate at 3 months was 77.6%, with a further 14.7% of patients having fragments less than 3 mm in diameter that required no further treatment. The stone-free rate was dependent on the site of the stone, with the majority of residual fragments lying in a lower pole calix. There were few complications. The Modulith is an efficient and safe lithotripter capable of treating stones in the kidney and throughout the ureter.
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PMID:Extracorporeal shock wave lithotripsy with the Storz Modulith SL20: the first 500 patients. 162 72

The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter.
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PMID:Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor. 178 3

Between March 1988 and March 1990, 751 patients were treated with shock wave lithotripsy using EDAP LT-01. Six hundred and eight patients had renal stones while 143 patients had stones located in the ureter. Because of difficulties in locating ureteric stones with ultrasound 92% of them were pushed back to the kidney before treatment. The mean stone size was 10 mm, range 4-30 mm. Patients with stones bigger than 15 mm had a double J-stent placed before treatment. The mean number of treatments per patient was 1.7 (range 1-8). Sixty-six per cent of the patients with renal stones were completely stone-free after ESWL monotherapy. Another 5% became stone-free after auxiliary procedures in the ureter, because of retained fragments. Fragments equal to or less than 4 mm were retained in 14% of the patients with the renal stones. Of the patients with ureteric stones mobilised back to the kidney 95% were rendered stone-free after ESWL. Most patients experienced no or very little discomfort during the treatment and only 29% of them received analgesics. General of epidural anaesthesia was given to 1% of the patients. Because of the low demand for analgesia or anaesthesia, 99% of the patients with renal stones were treated on an outpatient basis. During the second year, 74% of the patients with ureteric stones were treated on an outpatient basis.
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PMID:Outpatient-based extracorporeal shock wave lithotripsy using EDAP LT-01. 178 16

In June 1988, the new type of the lithotripter MPL 9000 (Dornier), which was the first interdisciplinary lithotripter for treatment of urinary and biliary calculi, was installed at the Shakai Hoken Chukyo Hospital. MPL 9000 has some features which enable one to treat with low range of shock wave energy and without anesthesia due to the enlarged aperture of the ellipsoid (210 mm), and locate the stone by computerized two ultrasound probes (coaxial, lateral). Unlike HM-3, the water bath is not used: shock wave is shot through the water cushion. From June to November 1988, 35 patients suffering from 64 urinary calculi were treated. The majority represented caliceal (75%) and pelvic (17%) stones, whereas 5 calculi were treated in the upper and lower ureter. Twenty-four patients were treated in one session and 11 patients needed additional sessions. The given number of shock waves was between 1337 and 3050 per one session and averaged 2403 with low generator voltage (15-18 kv). Twenty sessions (42%) were given without any medication and other 28 sessions (58%) were under analgesia (Pentazocine, i.v.) for the pain complained during the treatment. The rate of successful disintegration (less than 5 mm) was 88%. After the 1-month followup, 47.1% were free of stone, and 62.1% were free after the 3-month. Four patients had arrhythmia and one patient was with a subcapsular renal hematoma. We have concluded that this lithotripter is useful to treat upper and lower urinary tract calculi, in particular radiolucent ones in high risk patients because it is applicable without anesthesia.
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PMID:[Clinical experience with ESWL with new Dornier lithotripter MPL 9000]. 232 21

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 Piezolith 2200 as an extracorporeal shock wave lithotripter uses piezoelectrically generated, high-energy sonic impulses for treatment of urinary calculi; the shock wave generator is self-focussing. Localization of concrements is performed by means of ultrasound imaging. Treatment with the Piezolith 2200 is painless for the patient and thus possible without anesthesia and analgesia. We report on 806 cases of treatment involving a total of 572 kidneys in 567 patients (561 adults, 6 children) suffering from calculi of various sizes in the renal pelvis (n = 126), calculi in the calyces (n = 384), partial (n = 24) or full (n = 19) staghorn calculi, as well as calculi in the upper part of the ureter (n = 19). In 88% of these cases the concrements could be removed completely. Since cardiac activity is not influenced by piezoelectrically generated high-energy impulses, this procedure is particularly suited to the treatment of patients with heart problems.
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PMID:Results in the use of extracorporeal piezoelectric lithotripsy (EPL) for treatment of urinary calculi. 337 62

The Piezolith 2200 allows not only a qualitatively identical treatment of urolithiasis like the HM-Dornier systems or the Siemens Lithostar, but the application of lithotriptable urinary calculi could be extended to cardiac risk patients, to patients with skeletal deformities and to those with unusual body height and weight. As the piezolithotripsy does not cause pain, treatment is possible without anaesthesia or analgesia. Combined with internal ureteral stenting by self-retaining double-J-ureteral catheter also calculi with larger stone masses can be treated advantageously by exclusive piezolithotripsy as monotherapy. Multiple treatments by the piezolithotriptor are possible because of good focussing of the shock waves and the smaller parenchymal alteration. Lithotripsy of ureteral calculi is performed in the upper and lower part of the ureter. In small calculi the retrograde introduction of an ureteral catheter armed with an "ultrasound mirror" is necessary.
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PMID:[Extracorporeal shockwave lithotripsy in the treatment of urolithiasis--experiences from a center with the Piezolith 2200 and HM3 lithotriptors]. 338 94

Initially, when periaqueductal gray (PAG) is electrically stimulated, analgesia is induced, and this phenomenon is called stimulation-produced analgesia. Nucleus raphe magnus (NRM) as well as PAG are known to be the potent analgesic centers. NRM could modulate the nociceptive response of spinal cord neurons through spinally projecting fibers. However, as well as the above analgesic effects have been confined to the somatic pain, it was variable according to species, and the analgesic effect by NRM stimulation on the visceral pain was not yet clarified. In this study the analgesic effect by NRM stimulation on the visceral pain was examined through recording the activities of the dorsal horn neurons with renal input and renal pain, as a type of visceral pain. The renal pain was induced by ureteral occlusion or renal arterial occlusion, which in turn activated the renal mechanoreceptor or chemoreceptor. These cells had concomitant somatic input. In order to compare the effects of NRM stimulation on the renal pain with somatic pain, the somatic stimulation such as squeezing was conducted on the peripheral receptive field. The main results are summarized as follows: 1) After an electrical stimulation of NRM, spontaneous activities of dorsal horn neurons with renal input were reduced to 73.3 +/- 9.7% of the control value. 2) After an electrical stimulation of NRM, activities of dorsal horn neurons with renal input evoked by a brush, a type of non-noxious stimuli, did not change significantly. But the activities by a squeeze, a type of noxious stimuli, the activities were reduced to 63.2 +/- 7.2% of the control value. 3) After an electrical stimulation of NRM, activities of dorsal horn neurons with renal input evoked by occlusion of ureter or renal artery were reduced to 46.7 +/- 8.8% and 49.0 +/- 8.0% of the control value respectively. 4) The inhibitory effect of NRM on the dorsal horn neurons with renal input did not show any difference between renal A delta fiber and C fiber group. 5) By the electrical stimulation of NRM, the activities evoked by ureteral occlusion showed more reduction in the high threshold cell group than in the wide dynamic range cell group. These results suggest that activation of NRM can alleviate the renal pain as well as the somatic pain by modulating the dorsal horn neurons activities.
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PMID:Mechanism of transmission and modulation of renal pain in cats; effect of nucleus raphe magnus stimulation on renal pain. 748 78


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