A randomised comparison was made between high and normal diuresis during the primary session of extracorporeal shock wave lithotripsy (SWL) for removal of ureteral stones. High diuresis was accomplished by pressure infusion of approximately 1 L of Ringer acetate solution together with 20 mg of furosemide during the 30-40 min ...

OBJECTIVES: Prolonged urine leakage (PUL) from the percutaneous tract after percutaneous nephrolithotomy is a major complication that necessitates the placement of a urethral Double-J stent. We analyzed the characteristics of patients who had this complication to find out its risk factors. PATIENTS AND METHODS: During a 6-year period, 1407 standard ...

OBJECTIVE: To review 17 years experience of the stone clinic with incorporating the changes in practice over the years and to report the benefits of stone clinic in a developing country. METHODS: The SIUT Stone clinic was established in 1990 with installation of HM4 Lithotriptor. This clinic is run jointly ...

We tested the hypotheses that chronic human urinary obstruction impairs the renal regulation of the red blood cell (RBC) production and compared the chronic outcome of relief of obstruction between parenchyma-saving surgery and extracorporeal lithotripsy (SWL). We measured RBC count and serum erythropoietin (Epo) concentration before and 3 months after ...

Study Type - Therapy (case series) Level of Evidence 4 To investigate the effect of renal function on the stone-free rate (SFR) of proximal ureteric stones (PUS) after extracorporeal shock wave lithotripsy (ESWL), as urinary obstruction caused by PUS can impair renal function, and elevated serum creatinine levels are associated with ...

BACKGROUND: Little is known about whether a routinely inserted endoscopic nasobiliary drainage (ENBD) tube improves the clinical course in patients with choledocholithiasis-induced acute cholangitis after clearance of choledocholithiasis. OBJECTIVE: The aim of this study was to investigate the need for ENBD on the clinical outcomes of patients with acute cholangitis ...

OBJECTIVES: To find appropriate ureteric substitute in the pediatric age group. METHODS: Retrospective analysis was done from 2003 to 2008 of all patients operated in our hospital who had undergone ureteric replacement. All cases were followed up to find conduit patency, renal function, and any related complication. RESULTS: Ureteric replacement ...

OBJECTIVES: To present a randomized trial investigating immediate vs delayed voltage escalation during shock wave lithotripsy (SWL). SWL efficiency is affected by the energy setting of the lithotripter, the consumption level of the electrode, and the rate of shock wave administration. Preliminary data have suggested that delaying voltage escalation for ...

PURPOSE: An ultrasound-based real-time tracking system has been shown to improve the efficacy of lithotripsy in animal studies. This system has been implemented into an electromagnetic shockwave lithotripter (LM-9200 ELMA), and the treatment outcomes were prospectively evaluated. MATERIALS AND METHODS: A total of 1332 patients with one renal stone were ...

The authors of several studies have recommended extracorporeal shock-wave therapy as an alternative to surgical treatment for long-bone nonunions. This study was performed to compare the results of extracorporeal shock-wave therapy produced by two different devices with those of surgical treatment in the management of long-bone nonunions. One hundred and ...

PURPOSE: We analyzed the results of patients who underwent percutaneous nephrolithotomy (PCNL) for management of kidney stone disease under combined spinal-epidural anesthesia and compared surgical parameters and outcomes with a matched control group who underwent PCNL under general anesthesia. PATIENTS AND METHODS: A total of 82 patients were studied in ...

OBJECTIVES: To investigate the role of tamsulosin as an adjunct to management of upper ureteric stones (UUS) with extracorporeal shock wave lithotripsy (SWL). METHODS: In this prospective, randomized, open label study, patients with single UUS (for SWL) were randomly assigned into 2 groups based on whether they received 0.4 mg ...

PURPOSE: We evaluated the effectiveness of doxazosin in children with distal ureteral stones in terms of stone expulsion rates and time to expulsion. MATERIALS AND METHODS: A total of 39 patients 2 to 14 years old with lower ureteral stones smaller than 10 mm were enrolled and randomly divided into ...

OBJECTIVES: To compare the feasibility and morbidity of tubeless, totally tubeless, and standard percutaneous nephrolithotomy (PNL) with nephrostomy tube in a single center with selected patient population. METHODS: Between July 2006 and February 2008, PNL was performed in 176 patients in this retrospective study. Patients with no serious bleeding or ...

A total of 25 Chinese patients aged 6 to 36 months hospitalised at Beijing Children's Hospital due to melamine-induced kidney stones complicated by acute obstructive renal failure in 2008 were included in a study in order to diagnose and treat these special cases more effectively. Feeding history, clinical presentation, ultrasound ...

We have been using a risk index calculation for urolithiasis, which included most of the identifiable factors promoting calculogenesis. However, it was observed that the frequency of a patient getting stone problem was not uniform in spite of similarity of the risk index in the permanent setting. Also, many of ...

OBJECTIVES: To prospectively evaluate the role of tamsulosin on the stone free rate and the rate of colic episodes after ureteroscopic laser lithotripsy. The presence of alpha-1A adrenoceptor in the distal ureteral smooth muscle prompted the use of tamsulosin, a selective alpha-1 blocker, to promote spontaneous passage of distal ureteral ...

To analyze etiology, clinical features, effective diagnostic methods and therapeutic efficacy of infant urolithiasis related to melamine. A total of 2,235 children fed with milk products were screened at the Second Hospital of Shandong University between 1st September and 31st December 2008. Of the children screened, 1,242 were male and ...

OBJECTIVE: To assess the short-term efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) with the standard Dornier Lithotripter S 220 F EMSE in the treatment of a large population of 736 patients with renal and ureteral stones. This is the only report with more than 1000 treatments performed with ...

OBJECTIVES: To conduct a prospective randomized study comparing both techniques for the management of solitary radio-opaque upper ureteral stones < 2 cm in diameter. The ideal treatment for upper ureteral stones > 1 cm size remains to be determined with shock wave lithotripsy (SWL) and ureteroscopy (URS) being acceptable options. ...

OBJECTIVES: To assess the need for pre-extracorporeal shock wave lithotripsy (pre-ESWL) stenting in management of impacted upper ureteral stones of size < or = 2 cm and to verify whether stenting would influence the success of therapy. METHODS: Between 2007 and 2008, a total of 60 patients with solitary, radio-opaque ...

OBJECTIVES: To determine whether percutaneous nephrolithotomy (PCNL) can be safely performed in the high-risk patient. METHODS: The records of 84 patients undergoing 98 consecutive PCNL procedures from January 2005 to January 2007 at a single institution were examined. Patients were divided into a high-risk preoperative group, which comprised patients having ...

Medial tibial stress syndrome (MTSS) is a pain syndrome along the tibial origin of the tibialis posterior or soleus muscle. Extracorporeal shock wave therapy (SWT) is effective in numerous types of insertional pain syndromes. Shock wave therapy is an effective treatment for chronic MTSS. Cohort study; Level of evidence, 3. ...

AIM: To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS: We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile ...

AIM: Uric acid stone disease is dependent on three pathogenetic factors: acid urine pH, low urine volume, and hyperuricosuria. However, the most important factor for uric acid stone formation is persistently acidic urine that represents a prerequisite for uric acid stone formation and growth. Urinary alkalization with alkali administration has ...

Two positions have been reported for ureteroscopy (URS): dorsal lithotomy (DL) position and dorsal lithotomy position with same side leg slightly extended (DLEL). The aim of the present study was to compare the outcomes associated with URS performed with patients in DL vs. DLEL position. A total of 98 patients ...

PURPOSE: Recent evidence demonstrates that decreasing shock wave frequency from the previous standard of 120 to 60 shocks per minute results in improved fragmentation of stones located within the renal collecting system. We report the first randomized trial to our knowledge to examine the effect of a slower shock wave ...

Percutaneous nephrolithotomy (PCNL) is the first-line treatment for large and complex renal calculi. Accepted UK practice is to insert a nephrostomy tube at the end of the procedure to drain the kidney and reduce potential complications. 'Tubeless' or 'nephrostomy-free' PCNL has been advocated in selected patients as it is thought ...

INTRODUCTION/OBJECTIVE: We examined the potential correlation between Charlson comorbidity index (CCI) and stone free rate after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Two hundred twenty-six adult patients were treated with 241 ESWL procedures for a renal or ureteral stone(s) over a 3 year period. Age, race, comorbidities, CCI, ...

PURPOSE: To evaluate the feasibility and safety of bilateral simultaneous tubeless percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: From August 2007 to January 2008, six patients underwent bilateral simultaneous totally tubeless PCNL. Patients who needed more than one access, who had significant intraoperative bleeding, and who had pelvicaliceal system perforations or ...

Ureteroscopic lithotripsy using Swiss Lithoclast was performed in 411 cases from January 1996 to September 2007 in a single hospital. Medical records of 341 cases, in which Swiss Lithoclast was successfully applied, were available for this retrospective study. We used 9.5Fr and 10Fr Storz rigid ureteroscopes. A success was defined ...

Various risk indices have been propounded by various authors to assess the severity of stone formation in the human urinary tract. However, most of these indices are laboratory oriented and not feasible to be performed in a hospital setting. Most of these also do not take into consideration all the ...

OBJECTIVES: For frail, elderly patients with large impacted common bile duct (CBD) stones, long-term treatment with biliary stenting provides palliation. Biliary stenting with choleretic agents such as ursodeoxycholic acid (UDCA) and terpene preparations may promote CBD stone size reduction. We studied the effectiveness of biliary stenting combined with UDCA and ...

Endoscopic ultrasonography (EUS) is a minimally invasive diagnostic tool for common bile duct stones (CBDS) and may be used to select patients for therapeutic endoscopic retrograde cholangiography (ERC). The aim of this trial is to compare, in patients with non-high-risk for CDBS, the clinical and economic impact of EUS plus ...

PURPOSE: To report our experience of percutaneous nephrolithotomy (PCNL) in patients who were treated previously with open stone surgery. PATIENTS and METHODS: Sixty-six patients with a history of open stone surgery (group 1) were compared with 90 patients without previous surgical intervention (group 2). Both groups were almost similar in ...

Plantar fasciitis is a common problem without known etiology. It responds well to multiple conservative modalities and no particular modality has been demonstrated to be clearly superior in the treatment of this condition. Over 90% of patients will be cured by non-operative treatment but this may require 6 to 12 ...

OBJECTIVE: To evaluate the role of mannitol infusion in preventing or ameliorating renal injury that accompanies shock wave lithotripsy as measured by changes in resistive index (RI). METHODS: Between February and September 2006, 38 patients (28 men and 10 women) underwent extracorporeal shock wave lithotripsy (ESWL) for radiologically documented renal ...

PURPOSE: We describe an objective method to evaluate kidney stone radiopacity for use in selection of cases suitable for ESWL. MATERIALS AND METHODS: We recruited 76 adult patients with a solitary 1 to 2 cm renal pelvic stone. All patients underwent routine plain x-ray of the urinary tract but an ...

OBJECTIVES: To use a matched-pair analysis design to compare the safety and efficacy of shock wave lithotripsy (SWL) and ureteroscopy (URS). Controversy still exists regarding whether SWL or URS is the best management of upper ureteral calculi. METHODS: We reviewed the records of patients with a single radiopaque upper ureteral ...

BACKGROUND: Tamsulosin, an alpha-1 receptor antagonist, has been demonstrated effective in promoting distal ureteral stone passage and in reducing pain associated with stone expulsion. This study aimed to evaluate the effect of tamsulosin in comparison with nifedipine and extracorporeal shock wave lithotripsy (ESWL) on the expulsion rate of distal ureteral ...

PURPOSE: To determine the efficacy of a gated and slower shockwave lithotripsy (SWL) vs a nongated and faster SWL delivery with regard to stone fragmentation and clearance using the Medstone STS lithotriptor. PATIENTS AND METHODS: We performed a retrospective chart review of 300 consecutive patients who underwent SWL for renal ...

PURPOSE: To evaluate the safety and efficacy of ultrasound-guided percutaneous nephrolithotomy (PCNL). PATIENTS AND METHODS: Between August 2003 and December 2007, 47 patients were treated, 29 men and 18 women, with a mean age of 33.4 years (range 21-67 yrs) and a mean stone size of 31.5 mm (range 24-46 ...

BACKGROUND: Extracorporeal Shock Wave Lithotripsy (ESWL) is a simple and non-invasive technique in which renal and ureteric calculi are pulverised into small fragments by shockwaves and then allowed to pass spontaneously in small fragments along with urine. Effective ESWL requires a co-operative patient who will remain immobilize on the lithotripsy ...

The objective of this study is to evaluate the safety and outcomes of tubeless PCNL in comparison with standard PCNL. Since June 2002, we have performed 99 tubeless PCNL. Tubeless technique involves antegrade placement of a 6Fr double-J stent without nephrostomy tube at the end of the procedure. This series ...

OBJECTIVE: To compare the efficiency of pneumatic lithotripsy with and without the Accordion antiretropulsion device (PercSys, Palo Alto, CA, USA). MATERIALS AND METHODS: The study comprised two in vitro experiments: in experiment 1, 10 trials were conducted using stone phantoms (6 x 6 x 10 mm), placed in a horizontal ...

AIM: To investigate the issue of shockwave lithotripsy failure by studying the effect of machine crossover to the Technomed Sonolith Vision (TSV) lithotriptor in patients with previously unsuccessfully treated renal stones with the Dornier Compact Delta (DCD). Records were examined for the period between 1998 and 2006. Parameters analysed were: ...

OBJECTIVE: To analyse the efficiency of extracorporeal shockwave lithotripsy (ESWL) vs retrograde ureteroscopy and holmium:YAG laser lithotripsy, as ESWL is successful in 67-90% of cases but endoscopic lithotripsy with pneumatic lithotrites or lasers is successful in 90-96% of distal ureteric calculi, and holmium:YAG lithotripsy is effective in proximal ureteric calculi. ...

OBJECTIVE: To present our experience with 454 patients who had tubeless percutaneous nephrolithotomy (TPCNL) over last 3 years. PATIENTS AND METHODS: From September 2004 to August 2007, all patients aged >14 years and undergoing PCNL were considered for TPCNL. Exclusion criteria were the presence of pyonephrosis, matrix calculi, significant bleeding ...

In this study, we aimed to compare the treatment results of two different shock wave lithotripsy (SWL) machines used in the management of pediatric urolithiasis. Between January 1993 and October 2004, Dornier MPL 9000 (electrohydraulic) had been used, and since then Siemens Lithostar Modularis (electromagnetic) has been used. The last ...

OBJECTIVE: To review the development of the technique of percutaneous nephrolithotomy (PCNL), for ease of learning and development of instrumentation for staghorn calculi at our centre since 1991, and to assess the results and outcomes. PATIENTS AND METHODS: We retrospectively analysed the hospital records of 773 patients (632 males and ...