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Management of calcular anuria in adults caused by ureteric stones: By using of ureteroscopy and holmium laser.

Abdel-Kader MS - Arab J Urol (2011)

Bottom Line: The successful fragmentation rate was (100%).The stone-free rate was 90.9%.Urine output gradually reached normal level within a week.

View Article: PubMed Central - PubMed

Affiliation: Urology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

ABSTRACT

Purpose: To present our clinical outcomes in the management of anuria in adult patients caused by ureteral calculi by using of ureteroscopy and holmium laser.

Materials and methods: Nineteen patients presented with calcular anuria with ages between 19 and 48 years. The presentation was anuria with serum creatinine levels of 2-5.5 mg% (mean 3.5) and hyperkalemia in nine patients (5.2-6.1 mmol/L). There were bilateral ureteric stones in 14 (73.7%) and unilateral in five (26.3%) with single functioning kidney. Thirty-three ureteroscopic procedures were performed for 19 patients including bilateral ureteroscopy in 14. Laser lithotripsy was delivered using holmium laser via 356 μm laser fibre, with energy (1-1.2 J) and pulse rate (10 Hz). Post-operatively, monitoring of urine output, serum creatinine and K levels was done until normal values were obtained.

Results: Ureteroscopy was performed for all 19 patients (33 procedures), but laser lithotripsy was done successfully in 30 procedures. The operative time was 46 min (25-70). The successful fragmentation rate was (100%). The stone-free rate was 90.9%. There were mucosal abrasions in 6 (31.5%), and mild to moderate haematuria in 9 (47.4%), and high fever in two patients (10.5%). Serum creatinine and potassium levels returned to normal within 7-10 days. Urine output gradually reached normal level within a week.

Conclusions: Ureteroscopy and holmium laser lithotripsy represent an effective and safe modality for the treatment of anuria caused by ureteral calculi.

No MeSH data available.


Related in: MedlinePlus

(a) Preoperative KUB of a patient with bilateral lower ureteric stones. (b) Post operative KUB after bilateral same-session ureteroscopy and laser treatment and bilateral DJ insersion.
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f0010: (a) Preoperative KUB of a patient with bilateral lower ureteric stones. (b) Post operative KUB after bilateral same-session ureteroscopy and laser treatment and bilateral DJ insersion.

Mentions: Ureteroscopy was performed for all 19 patients (33 procedures), but laser lithotripsy was done successfully in 30 procedures (Fig. 1a, b) where stone migration to the kidney occurred in three events during upper ureteric stone manipulation, and DJ stents were left in these ureters and the migrated stones were subjected to ESWL after normalisation of serum creatinine. Bilateral same-session ureteroscopy and laser lithotripsy (Fig. 2a, b) were done successfully in 14 patients (73.7%).


Management of calcular anuria in adults caused by ureteric stones: By using of ureteroscopy and holmium laser.

Abdel-Kader MS - Arab J Urol (2011)

(a) Preoperative KUB of a patient with bilateral lower ureteric stones. (b) Post operative KUB after bilateral same-session ureteroscopy and laser treatment and bilateral DJ insersion.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150568&req=5

f0010: (a) Preoperative KUB of a patient with bilateral lower ureteric stones. (b) Post operative KUB after bilateral same-session ureteroscopy and laser treatment and bilateral DJ insersion.
Mentions: Ureteroscopy was performed for all 19 patients (33 procedures), but laser lithotripsy was done successfully in 30 procedures (Fig. 1a, b) where stone migration to the kidney occurred in three events during upper ureteric stone manipulation, and DJ stents were left in these ureters and the migrated stones were subjected to ESWL after normalisation of serum creatinine. Bilateral same-session ureteroscopy and laser lithotripsy (Fig. 2a, b) were done successfully in 14 patients (73.7%).

Bottom Line: The successful fragmentation rate was (100%).The stone-free rate was 90.9%.Urine output gradually reached normal level within a week.

View Article: PubMed Central - PubMed

Affiliation: Urology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

ABSTRACT

Purpose: To present our clinical outcomes in the management of anuria in adult patients caused by ureteral calculi by using of ureteroscopy and holmium laser.

Materials and methods: Nineteen patients presented with calcular anuria with ages between 19 and 48 years. The presentation was anuria with serum creatinine levels of 2-5.5 mg% (mean 3.5) and hyperkalemia in nine patients (5.2-6.1 mmol/L). There were bilateral ureteric stones in 14 (73.7%) and unilateral in five (26.3%) with single functioning kidney. Thirty-three ureteroscopic procedures were performed for 19 patients including bilateral ureteroscopy in 14. Laser lithotripsy was delivered using holmium laser via 356 μm laser fibre, with energy (1-1.2 J) and pulse rate (10 Hz). Post-operatively, monitoring of urine output, serum creatinine and K levels was done until normal values were obtained.

Results: Ureteroscopy was performed for all 19 patients (33 procedures), but laser lithotripsy was done successfully in 30 procedures. The operative time was 46 min (25-70). The successful fragmentation rate was (100%). The stone-free rate was 90.9%. There were mucosal abrasions in 6 (31.5%), and mild to moderate haematuria in 9 (47.4%), and high fever in two patients (10.5%). Serum creatinine and potassium levels returned to normal within 7-10 days. Urine output gradually reached normal level within a week.

Conclusions: Ureteroscopy and holmium laser lithotripsy represent an effective and safe modality for the treatment of anuria caused by ureteral calculi.

No MeSH data available.


Related in: MedlinePlus