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

The authors submit evaluation of 188 patients operated on during five years (1989-1993). Using the ureterorenoscopic technique (URS), 207 operations have been performed. The average age in the group of patients was 56.1 years. In general anesthesia 151 operations were completed, in spinal anesthesia 54, in neuroleptanalgesia 1 and without any anesthesia 1. The postoperative ureteric intubation was accomplished 128 times (61.8%). The moderate dilatation of the hollow system of the kidney was proved ultrasonographically in only 7 cases. The average postoperative hospitalization reached 5.8 days. Out of 207 operations, we have reached successful result 177 times (85.5%) and 30 times (14.5%) we were not able to accomplish the operation only by means of the URS. 184 operations were performed because of urolithiasis (88.9%) and 23 (11.1%) for other reasons. Out of 184 URS for urolithiasis, 156 (84.8%) were successful and there was no difference found between pelvic (85.4%) and lumbal (83.6%) localization of urolithiasis in the view of success rate. The authors summarize the causes of mishaps and following solutions. The biochemical analyses of 153 concrements are added.
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PMID:[Personal experience with uretero-renoscopy]. 771 55

Extracorporeal shock wave lithotripsy became a main treatment method for the upper urinary tract calculi. About 500 ESWL machines of 28 types are currently used in Japan and ESWL therapy occupies more than 90% of the surgical intervention for upper tract stones. The doctors who are engaging in the ESWL therapy are strongly advised to know the features of their own ESWL machines, since the treatment strategy may differ considerably depending on the type of machines. The strategy has changed from the in-patient ESWL under anesthesia by original Dornier HM-3 to out-patient anesthesia-free treatment by machines of second or third generations. At present, it is reasonable to treat the easy stones by initial out-patient ESWL without anesthesia. When the initial ESWL fails, the second ESWL may be performed under anesthesia with the help of various auxiliary procedures. If one use the machines requiring anesthesia, one should employ every possible ancillary procedures, e.g. ureteral catheterization, stenting, push-up etc. at the time of first session to achieve the highest pulverization rate and the highest stone free rate. The treatment strategy should be assessed individually in every case of problem stone. Simple repetition of ESWL at out-patient clinic should be avoided in these cases. In the case of staghorn calculi, especially of a large stone burden with calyceal dilatation, ESWL is not advised to be an initial treatment. In the review article, the author surveyed recent clinical reports on ESWL therapy and tried to convey their treatment strategies. The article may hopefully helps the readers to establish their own policy in the ESWL treatment for urolithiasis.
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PMID:[Current status of extracorporeal shock wave lithotripsy in the treatment of urolithiasis]. 786 43

In November 1991, a third generation extracorporeal shock wave lithotriptor (Piezolith 2500) was installed in our clinic. We examined the effective and safe aspect of this machine for urolithiasis. From November 1991 to October 1993, we experienced 530 sessions of ESWL treatment on 235 patients (270 cases). All patients except two underwent ESWL treatment without anesthesia, and in situ ESWL treatment was possible on 247 cases. The mean number of shock waves and sessions per patient of renal stone were 3369 and 2.1, respectively. Those of ureteral stone were 3970 and 1.9, respectively. The complete removal rate of renal and ureteral stone 3 months after the last session were 86% and 92%, respectively. This outcome was very satisfactory. On the other hand, endoscopic procedure was needed on 13 patients. In almost all cases hematuria was noted after ESWL, but major complications such as subcapsular hematoma or gastrointestinal hemorrhage were not experienced at all. It was concluded that Piezolith 2500 was very effective and safe in the treatment of urolithiasis.
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PMID:[Anesthesia-free extracorporeal piezoelectric shock wave lithotripsy for urolithiasis]. 786 50

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.
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PMID:[The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis]. 801 1

Extracorporeal shock wave lithotripsy (ESWL) has dramatically changed the current therapeutic spectrum for urolithiasis and is currently the frontline modality for most upper tract calculi. We report our experiences of treating 3000 patients of urinary calculus disease with shock wave therapy on the Siemens Lithostar at our institution. There were 1350 patients with ureteric stones and 73 had vesical calculi. 20.2% patients had recurrent stones and 25.6% had associated medical disorders. The calculus size varied from 4-115 mm. 81 patients had coexisting congenital upper tract anomalies and 84 had a solitary kidney. General anesthesia was required in 4.1%. Pre ESWL auxiliary procedures were necessary in 96.4% with JJ stenting in 2852 patients. The overall 6-month stone free rate was 86.8% with major complication rate of 0.8%.
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PMID:Extracorporeal shock wave lithotripsy for urolithiasis. Experience with 3000 patients. 806 62

Extracorporeal shock-wave lithotripsy (ESWL) is now applied as the treatment of choice in most cases of urinary stones. Its acceptance in pediatry, however has been only gradual despite numerous positive studies. We report on fourteen young patients (mean age: 9.7 years) who were all treated by ESWL with the MPL9000 lithotriptor for renal stones. Each patient received an average of 1440 shocks with generator energy set at 14.4 Kv. Six of these patients required either analgosedation or anesthesia. No observable complications of treatment occurred. At one-month follow up, the kidneys of twelve patients were found to be stone-free, while two still presented fragments that could pass spontaneously. At three-month follow-up, thirteen patients were stone-free and a single patient retained some fragments. From this data we infer that ESWL with the MPL9000 lithotriptor may be used safety and efficiently to treat urolithiasis in younger patients.
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PMID:Extracorporeal shock-wave lithotripsy with MPL9000 for the treatment of urinary stones in pediatric patients. 831 50

We report 8 patients with urolithiasis in a duplex system. These patients (7 males and 1 female) underwent 16 extracorporeal shock wave lithotripsy (ESWL) treatments. Five had renal and 3 had ureteral stones. The mean stone size was 21 mm (12-54 mm). Five patients had incomplete and 3 had complete duplication, of which one had an associated horseshoe kidney. Retrograde ureteropyelography was done in all the patients and in 7 a JJ stent was inserted. The JJ stent could not be inserted in 1 patient with incomplete duplication and retrograde catheterization with saline infusion was used as an auxiliary procedure. One patient with complete duplication had stones in both the ipsilateral ureters with a stone bulk of 54 mm and required two JJ stents. Only 1 paediatric patient required general anaesthesia. The 3-month stone-free rate was 100%.
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PMID:Calculus disease in duplex system--role of extracorporeal shockwave lithotripsy. 846 84

Extracorporeal shock wave lithotripsy (ESWL) using Sonolith 3000 was performed on 153 patients with urolithiasis form October, 1990 to April, 1992. The location of the stone was as follows; kidney in 70 cases, ureter in 82 cases and a Kock reservoir in one case. A double J catheter was installed in 6 cases before ESWL. Epidural anesthesia was required in 4 cases because of severe pain. Among 149 cases available for follow up one month after ESWL, 119 cases (79.9%) became stone free and 19 cases (12.8%) retained stone fragments less than 4 mm in diameter. The effectiveness rate, calculated as the sum of the cases stated above, was 92.7%. A side effect was observed in one case which was perirenal hematoma but required no therapy.
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PMID:[Clinical experience in extracorporeal shock wave lithotripsy with Sonolith 3000 for urinary stones]. 846 98

Spinal cord injury patients are at increased risk for urolithiasis and many will require treatment, most commonly with extracorporeal shock wave lithotripsy. New, second generation lithotripsy devices allow treatment without tub immersion, and without general or regional anesthesia for most patients. Spinal cord injury patients, with loss of sensation below the level of injury, would seem to be ideal candidates for such treatment. We present our experience with 20 consecutive spinal cord injury patients treated without anesthesia on the Medstone STS second generation lithotriptor. All patients were awake and experienced no direct sensation from the shock waves. All but 1 patient (T12 level), however, experienced autonomic dysreflexia, with significant elevations in systolic blood pressure (mean increase 44 mm. Hg, maximum 74) and diastolic blood pressure (mean increase 24 mm. Hg, maximum 61), with reflex bradycardia (mean decrease -22 beats per minute). Autonomic dysreflexia was successfully treated in this setting with short-acting sublingual nifedipine. Associated bradycardia was treated with atropine in 6 patients. Preoperative bowel preparation proved to be useful in spinal cord injury patients to maximize stone imaging and may decrease autonomic dysreflexia if this is caused by shock waves impacting on the distended bowel. Other problems included uncontrolled skeletal muscle spasms elicited by shock waves, which proved to be troublesome in maintaining patient position and stone localization. Muscle spasms were decreased with benzodiazepines. Care was also observed in spinal cord injury patients to pad all pressure points on the hard, dry treatment surfaces associated with second generation lithotriptors and, thus, prevent skin breakdown.
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PMID:Incidence and management of autonomic dysreflexia and other intraoperative problems encountered in spinal cord injury patients undergoing extracorporeal shock wave lithotripsy without anesthesia on a second generation lithotriptor. 848 11

A prospective study was undertaken to assess the feasibility and safety of bilateral simultaneous percutaneous nephrolithotomy (BPNL) under single anesthesia. BPNL was attempted in 16 consecutive patients with upper tract urolithiasis suitable for percutaneous treatment bilaterally. Bilateral simultaneous PNL could be accomplished in 14 of 16 cases; the opposite side was abandoned in 2 due to technical reasons. The operating sides could be switched within a short period (15 min) by rotating the patient table by 180 degrees. The average total operating time and irrigation time was 83 and 43 min, respectively. A total of 29 tracts and 18 sessions were required for endourologic treatment of 28 units in 14 patients. There was no significant morbidity. Complete clearance was achieved in 11 of 14 patients; there was insignificant residue in 1, while 2 with major residue required adjunct JJ stenting and extra-corporeal shockwave lithotripsy. The average hospital stay was 5.4 days. After initial proficiency with endourology, preparedness for BPNL is advisable in all such cases.
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PMID:Bilateral simultaneous percutaneous nephrolithotomy. A prospective feasibility study. 852 34


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