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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 30 patients with urolithiasis underwent 35 sessions of fiberoptic transurethral lithotripsy (f-TUL) involving electrohydraulic lithotripsy. There were 11 patients with nephrolithiasis including 4 with staghorn calculi and 19 patients with ureterolithiasis which were all located above the pelvic brim. A fiberoptic nephroureteroscope (URF-P) was successfully introduced up to the stone in all but 2 cases (93.3%). Of the 28 patients with successful introduction, 21 received a single session of f-TUL for complete fragmentation of their stones, which measured less than 16 x 9 mm by radiography. Three patients with larger renal stones (greater than or equal to 17 x 9 mm) underwent 2 sessions of f-TUL for complete fragmentation. The remaining 4 patients who had staghorn calculi (greater than or equal to 38 x 33 mm) received 1 session of f-TUL with partial fragmentation; then 3 were sent to an ESWL clinic with good results, while the other patient received 2 more sessions of f-TUL and formed a stone street. Attempts were subsequently made to destroy the latter by ESWL but were unsuccessful. In conclusion, f-TUL appears to be most suitable for smaller impacted ureteral calculi above the pelvic brim.
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PMID:Fiberoptic transurethral lithotripsy prefers smaller impacted ureteral calculi rather than large renal stones. 225 Apr 9

The incidence and prevalence of urolithiasis in the Czechoslovak Socialist Republic is as high as in other countries of Central and Western Europe, and lower than in the Scandinavian countries. Apart from its high incidence, urolithiasis is characterized by its high tendency to recurrence. New knowledge of its pathogenesis helps to diagnose metabolic disorders responsible for increased excretion of concretion-producing substances and/or for deficiency in protective factors. In case of calcium oxalate lithiasis, with the highest incidence, attention is to be paid to its various forms of hypercalciuria, and, more recently, to moderate hyperoxaluria, and as regards protective factors, to magnesium, citrates, pyrophosphates and mucopolysaccharides. The determination of the type of metabolical disorder in patients with lithiasis enables to modify the diet and/or medication leading to causal prophylaxis against recurrence, i.e. metaphylaxis. At our Prague urological clinic, a consultation centre for lithiatic patients has been in operation since 1977. Long-term experience has shown that it has been successful especially in preventing recurrence or a in a substantial reduction in recurrence in 94% of the followed-up patients. Although the centre's activity is demanding both on the personnel and laboratory, even first sufferers from ilthiatic attacks should take advantage of it. At this early stage, such patients were found to have a metabolic disorders in 60%. In the past 7 years of treating nephrolithiasis and ureterolithiasis, new methods have been introduced which substantially improve the results and are less invasive than a classical operation. Among others, they comprise percutaneous endoscopic methods of disintegration and concrement extraction from the kidney and ureter, uteroscopy and extracorporeal shock-wave lithotripsy. It is to be expected that these methods will replace classical operations at a rate of 90%.
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PMID:[Urolithiasis. Review of present knowledge of epidemiology, pathogenesis, metaphylaxis and treatment]. 266 71

The relationships between urolithiasis, ureterolithiasis and blood groups have been analysed. The examinations of 1451 women and 1611 men confirmed the occurrence of statistical relationships of blood groups A, AB and 0 and those diseases. They did not occur in blood group B. Urolithiasis incidence rate was similar in men and women. The highest morbidity rate fell on the fourth decade of life in women and on the fifth decade in men.
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PMID:Distribution of blood groups of the ABO system in patients with urolithiasis. 666 48

Urolithiasis is a common medical problem. The diagnosis of this entity in the setting of acute flank pain presents an interesting challenge to the radiologist. Unenhanced helical CT has recently entered the fray and has quickly become the imaging study of choice when evaluating patients with acute flank pain and suspected ureterolithiasis. The nature and origin of ureteral stones and the pathophysiology of ureteral obstruction provide a basis for understanding the imaging findings in these patients.
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PMID:Helical CT of urinary tract stones. Epidemiology, origin, pathophysiology, diagnosis, and management. 1049 78

Actually extracorporeal shock wave lithotripsy (ESWL) is the most frequent method in the treatment of urolithiasis in children. The aim of the study was to estimate the results of ESWL in children with urolithiasis. Between 1991 and 1999 y, in our Department 260 "reno-ureteral units" in 203 children were treated by lithotripsy. Totally of 518 ESWL procedures were performed. In general efficacy of ESWL was 88.08%, in children with single stone in kidney--97.80%., with multiple stones in kidneys--78.65%, in ureterolithiasis--71.88%. For complete recovery in patients mean 1.99 ESWL procedures were performed on 1 "reno-ureteral unit" on the average diameter of the stone/stones 13.3 mm.
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PMID:[Results of ESWL treatment in children with urolithiasis: own experience]. 1089 8

Unenhanced helical computed tomography (UHCT) has evolved into a well-accepted alternative to intravenous urography (IVU) in patients with acute flank pain and suspected ureterolithiasis. The purpose of our randomized prospective study was to analyse the diagnostic accuracy of UHCT vs IVU in the normal clinical setting with special interest on economic impact, applied radiation dose and time savings in patient management. A total of 122 consecutive patients with acute flank pain suggestive of urolithiasis were randomized for UHCT ( n=59) or IVU ( n=63). Patient management (time, contrast media), costs and radiation dose were analysed. The films were independently interpreted by four radiologists, unaware of previous findings, clinical history and clinical outcome. Alternative diagnoses if present were assessed. Direct costs of UHCT and IVU are nearly identical (310/309 Euro). Indirect costs are much lower for UHCT because it saves examination time and when performed immediately initial abdominal plain film (KUB) and sonography are not necessary. Time delay between access to the emergency room and start of the imaging procedure was 32 h 7 min for UHCT and 36 h 55 min for IVU. The UHCT took an average in-room time of 23 min vs 1 h 21 min for IVU. Mild to moderate adverse reactions for contrast material were seen in 3 (5%) patients. The UHCT was safe, as no contrast material was needed. The mean applied radiation dose was 3.3 mSv for IVU and 6.5 mSv for UHCT. Alternative diagnoses were identified in 4 (7%) UHCT patients and 3 (5%) IVU patients. Sensitivity and specificity of UHCT and IVU was 94.1 and 94.2%, and 85.2 and 90.4%, respectively. In patients with suspected renal colic KUB and US may be the least expensive and most easily accessable modalities; however, if needed and available, UHCT can be considered a better alternative than IVU because it has a higher diagnostic accuracy and a better economic impact since it is more effective, faster, less expensive and less risky than IVU. In addition, it also has the capability of detecting various additional renal and extrarenal pathologies.
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PMID:Unenhanced helical computed tomography vs intravenous urography in patients with acute flank pain: accuracy and economic impact in a randomized prospective trial. 1289 74

The purpose of this study is to present our experience with ureteral lithotripsy in ureteroscopy in children. Between 1996-2004, 105 patients aged 1,5-13 years with urolithiasis were treated in our department. Eight (8) of them with ureterolithiasis (5 in the lower ureter and 3 in the middle ureter) were treated with ureteroscopy (URS). The procedure was possible in all patients. The ureteroscopical approach of the stone and subsequent lithotripsy took place without major complications. There was a small difficulty to enter the ureteral orifice but it was overcome using dilations. On the other hand, there was no problem with the ureteral width. No stent was placed and all patients were stone free after 3 months. Ureteroscopy (URS) constitutes the golden standard for the treatment of ureteral lithiasis in children as well as in adults, as long as the narrow ureteral orifice is dilated with a guide wire. Pediatric ureter has good compliance and does not cause any problems to the whole procedure. The percentage of lithiasic children treated with open surgical procedures is less than 10% with a prospect for further reduction.
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PMID:Ureteroscopical treatment of ureterolithiasis in childhood. Our experience. 1675 83

The aim of the study was to establish the usefulness of ultrasound examination for imaging of stones dislocation in urinary tract after lithotripsy treatment. The study group included 335 children with urolithiasis treated in our Clinic since 1994 until 2005y. In the group were 295 (88%) children with nephrolithiasis and 40 (12%) children with ureterolithiasis. In the whole group 335 children there were performed 619 lithotripsy procedures--545 kidney and 74 ureter units. The ultrasound examinations were performed in each patient before, on the first and second day of the treatment and two months after using the Hitachi EUB 315 with 5Mhz transducer. In the ultrasound examinations after lithotripsy treatment: in 596/619 (96,3%) cases imaging of stones dislocation in urinary tract and urinary retention was possible.
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PMID:[Ultrasound imaging of stones dislocation in urinary tract after lithotripsy treatment in children with urolithiasis]. 1689 10

In 2002, speedy elimination of ureterolithiasis in the lower part of ureter was first reported with the alpha 1 blocker. Thereafter, there are a lot of reports including meta-analysis about tamsulosin. In 2011 EAU Guidelines on Urolithiasis, it is the most important to establish effective MET (medical expulsive therapy) to facilitate spontaneous stone passage. Alpha 1 blockers are the preferred agents for MET. As a basic evidence for MET, we reported that alpha 1a and 1d AR subtype mRNA was highly expressed in the human ureter and that alpha 1A AR is the main participant in the human ureteral contraction. It is published newly in Japanese Guidelines on Urolithiasis revised edition to schedule to be published soon.
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PMID:[Medical expulsive therapy facilitated by alpha 1 adrenoceptor antagonist]. 2196 Feb 38

Retrocaval ureter is a rare cause of hydronephrosis. Its rarity and non-specific presentation pose a challenge to surgeons and radiologists in making the correct diagnosis. Differentiation from other causes of urinary tract obstruction, especially the more common urolithiasis, is important for successful surgical management. Current practice has seen multislice computed tomography (MSCT) rapidly replaces intravenous urography (IVU) in the assessment of patients with hydronephrosis due to suspected urolithiasis, especially ureterolithiasis. However, MSCT, without adequate opacification of the entire ureter, may allow the physician to overlook a retrocaval ureter as the cause of hydronephrosis. High-resolution IVU images can demonstrate the typical appearance that leads to the accurate diagnosis of a retrocaval ureter. We reported a case that illustrates this scenario and highlights the importance of IVU in the assessment of a complex congenital disorder involving the urinary tract.
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PMID:Retrocaval ureter: the importance of intravenous urography. 2258 77


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