Document Detail

Ureteroscopic management of sepsis associated with ureteral stone impaction: is it still contraindicated?
MedLine Citation:
PMID:  15897696     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Retrograde decompression is generally not advocated for patients with sepsis owing to ureteral obstruction by stone impaction, and the initial treatment of choice is percutaneous nephrostomy (PCN). We report our experience with the treatment of urosepsis with retrograde ureteroscopy (URS) instead of PCN drainage. PATIENTS AND METHODS: Fifty-six consecutive patients diagnosed with ureteral stone-related sepsis received URS as primary treatment at our institution. Patients with uncontrollable sepsis underwent emergent URS and hemodynamically stable patients underwent elective URS within two days of diagnosis. RESULTS: URS was successful in 53 (94.6%) of the 56 patients. PCN was performed in the 3 cases of URS failure. Internal ureteral stenting was performed in 48 patients. Secondary procedures were performed in 10 (18.9%) patients. Twenty-six patients suffered from postoperative fever for an average of 1.6 days (range 1-4 days). There were no anesthesia-related morbidities, postoperative exacerbations of the clinical condition, or postoperative deaths. The median length of hospital stay was 7 days (range 3-94 days). CONCLUSION: PCN drainage is the standard treatment of sepsis associated with ureteral stone obstruction. However, our results show that URS can be safely and successfully performed by skilled endourologists in select clinical situations.
Jong-Ming Hsu; Marcelo Chen; Wen-Chou Lin; Huang-Kuang Chang; Stone Yang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urologia internationalis     Volume:  74     ISSN:  0042-1138     ISO Abbreviation:  Urol. Int.     Publication Date:  2005  
Date Detail:
Created Date:  2005-05-17     Completed Date:  2005-09-20     Revised Date:  2006-10-30    
Medline Journal Info:
Nlm Unique ID:  0417373     Medline TA:  Urol Int     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  319-22     Citation Subset:  IM    
Copyright Information:
Copyright 2005 S. Karger AG, Basel
Department of Urology, Mackay Memorial Hospital, and Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
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MeSH Terms
Aged, 80 and over
Middle Aged
Retrospective Studies
Sepsis / drug therapy,  etiology,  surgery*
Treatment Outcome
Ureteral Calculi / complications,  surgery*
Ureteral Obstruction / etiology,  surgery*

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