Cystine Stones: The Efficacy of Percutaneous and Shock Wave Lithotripsy

Cranidis, Angelos; Karayannis, A.; Delakas, Dimitrios; Livadas, C E; Anezinis, Ploutarchos

doi:10.1159/000282836

Cited by 26 publications

(13 citation statements)

References 16 publications

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“…For the existing urinary stones in cystinuria patients, interventional treatments such as irrigation, endoscopic removal, extracorporeal shock-wave lithotripsy and open surgery may be performed successfully [7,8]. However, recurrence or growth or urinary stone is frequently observed during the clinical course of cystinuria patients [9,10].…”

Section: Discussionmentioning

confidence: 99%

The Long-Term Outcome of Cystinuria in Japan

et al. 1998

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Recurrence of growth of urinary stone is frequently observed during the clinical course of cystinuria patients. The aim of the present study is to examine the long-term outcome of cystinuria in Japan and clarify the effects of medical treatment on urinary stone. Thirty-one patients with cystinuria who had been followed up longer than 6 months were included. The follow-up period was 6–264 months with a mean of 89.5 months. Stone event was defined as appearance of new stone or radiological evidence of stone growth. All patients were managed with forced hydration and urine alkalization. Twenty-eight patients were treated with administration of thiol such as D-penicillamine or α-mercaptopropionylglycine. Stone events per year ranged from 0 to 1.09 with a median of 0.09. Stone events per patient-year was 0.19 for all patients. The average urinary cystine concentration during treatment in the favorable outcome group (stone events per year < 0.3) was lower that that in the unfavorable outcome group (stone events per year ≥0.3); 221.2 ± 75.2 vs. 303.3 ± 93.5 mg/l, although the difference was not statistically significant. Prognosis of urinary stone in Japanese patients with cystinuria was relatively good with large variation. The medical treatment to reduce urinary cystine concentration would be useful for the management of cystinuria.

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Section: Discussionmentioning

confidence: 99%

The Long-Term Outcome of Cystinuria in Japan

et al. 1998

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“…They are strongly associated with urinary tract infections from urea splitting organisms and can grow rapidly over weeks to months to fill the entire renal pelvis. This can lead to renal failure and/or sepsis (51,52). One study found a mortality risk of 27% and renal failure risk of 28% over an 8-year period for untreated struvite calculi (53).…”

Section: Upper Urinary Tract Infectionsmentioning

confidence: 99%

Surgical management of recurrent urinary tract infections: a review

Bergamin

Kiosoglous

2017

Transl. Androl. Urol.

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There are many causes of recurrent urinary tract infections (rUTI) which are amenable to surgical management. This usually follows a lengthy trial of conservative management. Aetiological classification of rUTI requiring surgical management may be divided into congenital or acquired. Predisposing factors are classified into two groups; those providing a source for organisms, or by maintaining favourable conditions for the proliferation of organisms. Sources of infections include calculi, fistulae or abscesses. Conditions which predispose to bacterial proliferation include malignancies, foreign bodies, high post void residuals, and neuropathic bladders. Removal of identified sources, treating the obstruction, and improving urinary drainage, are all goals of surgical management. Surgical options for rUTI management can range from minimally invasive procedures such as endoscopic or percutaneous, through to more invasive requiring laparoscopic or an open approach. Surgery remains a very important and viable solution.

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“…[11,12] Ayrıca SWL tedavisinde sistin taşlarının kırılamaması, taşların küçük fragmantasyondan ziyade daha büyük parçalara ayrılması, birden çok tekrarlayıcı tedavi gereksinimi ve tekrarlayan tedavilerin uzun süreli toplam takip sürelerinin hasta başı maliyeti artırması gibi kısıtlamalar vardır. [13] Park ve ark. [14] çalışmalarında >10 mm üreter taşlarında SWL ile %42.1 taşsızlık sağlamış ve başarıda en önemli faktörün taş boyutu olduğunu belirtmişlerdir.…”

Section: şEkilunclassified

The effectiveness of antegrade percutaneous approach on impacted proximal ureteral stones

Gücük¹,

Burgu²,

Tuygun³

et al. 2010

Turkish Journal of Urology

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Objective:To evaluate the efficacy of anterograde percutaneous nephrolithotomy (PNL) for impacted proximal ureteral stones larger than 15 mm. Materials and methods:We retrospectively evaluated the data of the patients who underwent PNL for impacted proximal ureteral stones between February 2007 and April 2009. Patients, who underwent PNL for a radiopaque stone larger than 15 mm localized between the upper border of the 4th lumbar vertebra and ureteropelvic junction on intravenous pyelography were included. Patients with associated renal stones and a history of previous retroperitoneal surgery were excluded. The demographics, stone-free rates, hospitalization duration, bleeding and complication rates were evaluated.Results: Totally 39 patients underwent PNL for impacted proximal ureteral stones. Eleven patients were excluded due to previous PNL or retroperitonoscopic surgery for renal or ureteral stones. The mean age of the patients was 43.07±15.9 years and stone size was 271±85.43 mm², the male to female ratio was 16:12. Access was achieved to the upper or middle calix through an supracosal entry in 18 (%64) and subcostal entry in 10 (%36) patients. Residual-free treatment was obtained in 27 (%96.4) patients, 2 (%7.1) patients required double J stents due to ureteral perforations, and 2 (%7.1) required post-operative blood transfusion. The mean hemoglobin decrease was 1.92±1.04, hospitalisation time was 48.4±14.6 hours, the need for of analgesic use was 172.4±54.3 mg, and operation time was 78.4±19.3 min.Conclusion: PNL is technique with high success rate in the presence of surgical experience and appropriate equipment for the management of impacted proximal ureteral stones.

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Cystine Stones: The Efficacy of Percutaneous and Shock Wave Lithotripsy

Cited by 26 publications

References 16 publications

The Long-Term Outcome of Cystinuria in Japan

The Long-Term Outcome of Cystinuria in Japan

Surgical management of recurrent urinary tract infections: a review

The effectiveness of antegrade percutaneous approach on impacted proximal ureteral stones

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