Combined Removal of Stones with Resection of Concurrent Pathologic Ureter May Be a Preferred Treatment for Impacted Ureteral Stones with Stricture Lesions

Xi, Qilin; Wang, Shaogang; Ye, Zhangqun; Liu, Jihong

doi:10.1089/end.2008.0507

Cited by 12 publications

(10 citation statements)

References 14 publications

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“…After the procedure, an indwelling 5‐F JJ stent was placed in each patient and remained in situ for 3–6 weeks after surgery, until patients were stone‐free on follow‐up radiography. Image protocols were plain abdominal film of kidney, ureter and bladder and US, which was performed to confirm SRH formation and to verify stone passage [6].…”

Section: Methodsmentioning

confidence: 99%

Subcapsular renal haematoma after holmium:yttrium‐aluminum‐garnet laser ureterolithotripsy

Bai¹,

Liu

Wang

et al. 2011

BJU International

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Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The literature scarcely reports subcapsular renal haematoma (SRH) after lithotripsy techniques. We reported the incidence, associated risk factors, possible pathogenesis, precautions, and outcomes of SRH after ureteroscopic lithotripsy (URSL). OBJECTIVE To report the incidence, risk factors, and outcomes of subcapsular renal haematoma (SRH) after ureteroscopic lithotripsy (URSL) using holmium:yttrium‐aluminum‐garnet (Ho:YAG) laser to treat ureteric stones. PATIENTS AND METHODS Prospective data from 2848 URSLs performed between January 2003 and September 2010 were retrospectively analysed. In all 11 patients were identified as having a SRH after URSL if they had persistent severe ipsilateral flank pain or a palpable mass within a day of surgery, or presented with radiographic evidence of a SRH. Risk factors for the development and course of the SRH were reported. RESULTS Of the 2848 consecutive patients treated with URSL using Ho:YAG laser, 11 (0.4%) developed a SRH after surgery. Patients who developed a SRH had larger stones (1.4 vs 0.9 cm, P < 0.001), more severe ipsilateral hydronephrosis (P < 0.001), longer operation duration (41 vs 33 min, P < 0.001), and higher perfusion pressure of hydraulic irrigation (176.8 vs 170.2 mmHg, P < 0.001) than patients who did not develop a SRH. Patient age, sex, body mass index, presence of diabetes mellitus, history of urolithiasis and hypertension, presence of multiple stones, stone location and flow rate of hydraulic irrigation were not statistically different in patients who did or did not develop a SRH. Most patients were managed conservatively, with no further intervention or with a flank drain, until the SRH resolved. Overall, in three patients the SRH resolved with no further intervention, six patients were treated with a drain only, and two patients had open surgery within a day of presenting with SRH. CONCLUSIONS The rate of development of SRH after URSL is very low. Most patients who present with a SRH after URSL, can be treated conservatively with no intervention or with a drain only.

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Section: Methodsmentioning

confidence: 99%

Subcapsular renal haematoma after holmium:yttrium‐aluminum‐garnet laser ureterolithotripsy

Bai¹,

Liu

Wang

et al. 2011

BJU International

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“…Studies have demonstrated that concurrent ureteral lesion is related to a significant longer impaction, which makes a spontaneous passage difficult. 3,12,19 Based on the results of this study, secondary signs on UHCT were able to predict the presence of concurrent ureteral lesion. Therefore, even in small distal ureteral stones <5 mm, if secondary signs such as high degree of the tissue rim sign and hydronephrosis are identified on UHCT, early intervention seems to be better than prolonged conservative management to avoid the potential risk of urinary tract infection or deterioration of renal function.…”

Section: Discussionmentioning

confidence: 74%

Factors That Predict Spontaneous Passage of a Small Distal Ureteral Stone <5 mm

Hwang

Kim²,

Yuk³

et al. 2010

Journal of Endourology

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“…Compared with the ureteroureterostomy group, a higher incidence of ureteral stricture was observed in the URL group (26.2% vs. 4.0%; p = 0.019). This result showed that the removal of the pathologic ureter with a polyp or stricture lesion might reduce the long-term risk of ureteral stricture for patients with impacted stones [15] .…”

Section: Risk Factorsmentioning

confidence: 80%

“…Xi et al. [15] compared the outcomes of URL and ureteroureterostomy for patients with impacted ureteral stones. Compared with the ureteroureterostomy group, a higher incidence of ureteral stricture was observed in the URL group (26.2% vs. 4.0%; p = 0.019).…”

Section: Risk Factorsmentioning

confidence: 99%

Prevention strategies for ureteral stricture following ureteroscopic lithotripsy

Dong

Peng

et al. 2018

Asian Journal of Urology

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Ureteral stricture formation after ureteroscopic lithotripsy is a late complication that can lead to hydronephrosis and a subsequent risk of renal deterioration. The specific incidence is unknown, and the mechanism of stricture formation has not been completely explained. In this review, we summarize the current evidence regarding the incidence of this condition and discuss its pathogenesis. We then list preventive strategies to reduce the morbidity of ureteral strictures.

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Combined Removal of Stones with Resection of Concurrent Pathologic Ureter May Be a Preferred Treatment for Impacted Ureteral Stones with Stricture Lesions

Abstract: Chronically impacted stones are frequently associated with ureteral polyp or stricture lesions. Our results reveal that combined removal of stones with resection of the pathologic ureter may achieve better long-term outcomes for patients with impacted stones with stricture lesions.

Cited by 12 publications

References 14 publications

Subcapsular renal haematoma after holmium:yttrium‐aluminum‐garnet laser ureterolithotripsy

Subcapsular renal haematoma after holmium:yttrium‐aluminum‐garnet laser ureterolithotripsy

Factors That Predict Spontaneous Passage of a Small Distal Ureteral Stone <5 mm

Prevention strategies for ureteral stricture following ureteroscopic lithotripsy

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