Document Detail

Efficacy of flexible ureterorenoscopy with holmium laser in the management of stone-bearing caliceal diverticula.
MedLine Citation:
PMID:  20491573     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We aim to evaluate the outcome of flexible ureterorenoscopy (F-URS) with a holmium laser in managing stone-bearing caliceal diverticula as a minimally invasive option. PATIENTS AND METHODS: We retrospectively reviewed the records of 38 patients who underwent F-URS using a holmium laser from 2003 to 2009 for symptomatic stone-bearing caliceal diverticula. The presenting symptoms were renal colic, urinary tract infection, or hematuria. F-URS was used in 30 (78.9%) patients as an alternative after the failure of shockwave lithotropsy (SWL). F-URS was repeated twice for two patients. In the first patient, the indication was uncompleted fragmentation of the stone. In the second patient, it was because of failure to identify the diverticulum. The follow-up visit ranged from 4 to 6 weeks with plain radiography of the kidneys, ureters, and bladder and either renal ultrasonography or noncontrast CT. RESULTS: Patients who were included in the study were 38: 22 women and 16 men (mean age 45.7 years; range 18-72 years). Post-F-URS, 21 (55.3%) patients were rendered stone free (SF), 10 (26.3%) patients had clinically insignificant residual fragments (less than 4 mm) (CIRF), and a residual fragment (RF) was found in seven (18.4%) patients. The success rate was considered as SF or CIRF, which was obtained in 31 (81.6%) patients. In total, 34 (90%) patients were symptom free after the procedure. CONCLUSION: F-URS using a holmium laser is a very effective, minimally invasive technique. It could be the best option in managing stone-bearing caliceal diverticula, especially for those patients in whom there was SWL failure. The development of the actively deflectable ureteroscope with miniaturization allowed us to obtain a high success rate, low morbidity, and a brief hospital stay.
Majed Sejiny; Saeed Al-Qahtani; Abdel Elhaous; Benoit Molimard; Olivier Traxer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  24     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-09-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  961-7     Citation Subset:  IM    
Urology Department, Tenon Hospital, Pierre & Marie Curie University, Paris, France.
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MeSH Terms
Diverticulum / radiography,  surgery*
Kidney Calculi / radiography,  surgery*
Kidney Calices / radiography,  surgery*
Lasers, Solid-State / therapeutic use*
Middle Aged
Treatment Failure
Treatment Outcome
Ureter / radiography
Ureteroscopy / methods*
Urinary Bladder / radiography
Young Adult

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