Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on the results of shock wave extracorporeal lithotripsy in a series of 13 patients with urinary lithiasis and neurologic disease (5 tetraplegics, 6 paraplegics and 2 hemiplegics). Anesthesia, positioning and complementary endourologic procedures in a group of patients in whom many factors contribute to lithogenesis are discussed. Sixteen renal units were treated with good stone fragmentation in all cases. Seventy-five percent of the patients remained stone-free three months later. Complications were few (15%) and minor (mainly post-operative fever) and the hospital stay was short (average 5 days). We advocate this technique as the treatment of choice of urolithiasis in patients with neurologic sequelae because of its safety, relative noninvasiveness and good results, especially in calculi smaller than 2 cm.
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PMID:[Extracorporeal lithotripsy in sequelae of neurologic lesions]. 263 43

Localization, stone-size as well as type of lithotriptors influence the extent of disintegration of stones and the individual rate free of stones after treatment with extracorporeal shock wave lithotripsy. The piezoelectric lithotriptors do not require anaesthesia, but perform insufficient stone disintegration requiring no repeated treatments. Another draw-back is stone localization by ultrasound, which prevents treatment of some ureteral stones. Used voltage and rate of shock waves per treatment affect the extent of damage no the renal parenchyma. Risk of hypertension, residual disintegrated stones, which don't clear the renal pelvis, the higher recurrency rate and injury to the urothelium of the renal pelvis demand a concomitant meta- and prophylaxis of urolithiasis.
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PMID:[Prevention of urinary calculi in spite of painless lithotripsy?]. 268 19

In 210 patients with urolithiasis extracorporeal shock wave lithotripsy was performed without regional, general or infiltration anesthesia by means of a technically unmodified Dornier HM3 lithotriptor. The stone burden varied from small ureteral stones to complete staghorn stones. All patients were given premedication with pethidine and diazepam, and a lidocaine-prilocaine-containing cream was applied on the skin at the entry site of the shock wave. Energy usually varied between 14 and 16 kv. More than 90% of the patients reported the pain to be at most of moderate intensity and acceptable. Less than 3% found the treatment unpleasant. The results were compared to those obtained in 250 patients treated with anesthesia according to the original procedure, with a generator voltage of 18 to 23 kv. The number of extracorporeal shock wave lithotripsy sessions for ureteral and large stones was somewhat higher with the low energy method than with the original procedure. However, the therapeutic result in terms of renal units without stones after 4 weeks was similar to that recorded for patients treated with the anesthesia method. According to these promising results we believe that extracorporeal shock wave lithotripsy without anesthesia in an unmodified Dornier HM3 lithotriptor can be performed successfully in a majority of patients and is an attractive alternative to other technical modifications of the equipment.
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PMID:Evaluation of extracorporeal shock wave lithotripsy without anesthesia using a Dornier HM3 lithotriptor without technical modifications. 281 Apr 89

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

The introduction of percutaneous nephrolithotomy and ureterolithotomy has greatly widened the therapeutical spectrum of urolithiasis. In this paper indications and contraindications of percutaneous stone removal will be discussed as well as techniques of this procedure. 210 percutaneous stone operations were performed after an initial training period primarily using local anesthesia (neuroleptanalgesia). This operative procedure allowed stone removal in patients otherwise inoperable because of increased operation risk or of advanced age. With increasing experience the success rate has been improved, though the stage of difficulties in nephrolithotomy and ureterolithotomy has increased too. Percutaneous operation primarily in connection with extracorporal shock wave lithotripsy is the first treatment modality for patients with staghorn stones. Possible complications (bleeding, perforation, injury to neighbouring organs) and their treatment are discussed.
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PMID:[Clinical experiences in 210 percutaneous removal of kidney and ureteral calculi]. 340 36

The report concerns initial experience with local anesthesia in the treatment of urolithiasis by extracorporeal shock wave lithotripsy. This form of anesthesia is well tolerated for stones of limited size and hardness, though the patients must be carefully selected.
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PMID:Initial experience with local anesthesia in extracorporeal shock wave lithotripsy. 378 44

To evaluate the impact of the percutaneous removal of renal calculi we compared 41 patients who had undergone open renal surgery to 88 patients who had a one- or two-stage percutaneous nephrostolithotomy for symptomatic urolithiasis. The two groups were similar with regard to stone size, stone location, treatment success, and complication rates. However, for patients with calculi 2.5 cm or smaller in diameter, the percutaneous procedure resulted in lower postoperative morbidity, more rapid convalescence, less hospital cost, and greater patient satisfaction. For patients with calculi larger than 2.5 cm in diameter, the percutaneous approach was slightly more expensive than open surgery but resulted in a markedly shortened convalescent period. In our experience, percutaneous nephrostolithotomy performed in a single stage under assisted local anesthesia was the most efficacious and least expensive of the percutaneous approaches.
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PMID:Percutaneous nephrostolithotomy vs open surgery for renal calculi. A comparative study. 402 Oct 44

Although the morbidity of porphyria is rare, the surgical and anesthetic managements of patients with porphyria should be prudent, for various stresses including surgery and anesthesia may cause occurrence or exacerbation of this disease, occasionally resulting in the mortal course. Several drugs such as barbiturate, diazepam, pentazocine, and pancuronium, which can be used during anesthesia or after operation, reportedly exacerbate the disease. Furthermore, the acute exacerbation of porphyria may be misdiagnosed as acute abdomen, ileus, acute appendicitis, cholelithiasis, urolithiasis, or ectopic pregnancy. The managements of patients with acute porphyria during anesthesia and after surgery are discussed along with the introduction of our case report. Since there is no definitive treatment of porphyria, the most important thing is to understand the disease and to prevent the acute exacerbation of the disease. When patients are suspected of porphyria or possible porphyria, careful management is required during anesthesia and after operation with selecting secure drugs against the disease.
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PMID:[Surgical and anesthetic managements of patients with porphyria]. 761 68

ESWL of urinary stones is a well-established treatment in adult patients. The treatment of urinary stones in children has gained increasing importance in recent years. From 1987 to 1993, a series of 27 children with urolithiasis in all parts of the urinary tract were treated by ESWL. Treatment was performed with general anaesthesia or analgosedation. During the treatment no complications occurred. On average, 34 sessions of ESWL, with 2165 shockwaves and 22.3 kV energy, were performed. Minor early complications, such as fever, pain and hydronephrosis, were observed in 7 patients. The overall stone clearance rate was 92%. Stone recurrence occurred in only 1 patient. There were no late complications, such as malfunction of the kidney, skeletal deformation or hypertension after 38 months of follow up. In conclusion, ESWL is the treatment of first choice in paediatric urolithiasis.
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PMID:[Extracorporeal shockwave lithotripsy in children. Complications and long-term results]. 767 42

We performed treatment of urolithiasis on 7 patients with spinal cord injury (6 males and one female, with a mean age of 41 years old) by extracorporeal shock wave lithotripsy (ESWL) using a Lithostar (Siemens). The level of injury was cervical in 3 patients and lower thoracic in 4. The treated stones were renal in 6 patients, including one staghorn caliculus, ureteral in 2, and bladder stones in 2 patients. ESWL was performed under general anesthesia in 2 patients, and in another patient, epidural anaesthesia was employed in the first several sessions, but thereafter treatment was safely continued with no anesthesia. The other 4 patients were treated without anesthesia. In most patients, the stones (9 stones in 6 cases) were easily disintegrated after treatment of from one to 14 sessions, except one case of staghorn caliculus, and the clearance of fragments was also satisfactory. In one patient, hypertension and bradycardia due to autonomic hyperreflexia were observed during ESWL, and the treatment was discontinued, but the stone was successfully disintegrated and the fragments were voided. In another patient, autonomic hyperreflexia was observed while the fragments passed through the ureter, although no signs of this reflexia were seen during the ESWL procedure.
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PMID:[Extracorporeal shock wave lithotripsy on patients with spinal cord injury with special reference to autonomic hyperreflexia]. 770 1


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