Imaging for Stones

Bradley, Andrew J.; Rao, P. N.

doi:10.1007/978-1-84800-362-0_28

Cited by 1 publication

(2 citation statements)

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“…Facilitated by the high contrast between the stone and the adjacent soft tissue, these new methods avoid excessive irradiation of the patient, having the sensitivity and specificity comparable with the standard CT and the radiation exposure comparable with KUB. Acknowledging the limitations of KUB in evaluation of stone density, it should be mentioned that there are published data which support its role as surrogate for CT (Lim et al 2015 ; Bon et al 1996 ; Dretler 1988 ; Bradley and Rao 2011 ).…”

Section: Discussionmentioning

confidence: 99%

“…In this last situation, the SWL is prohibited until the urinary tract infection is treated (Türk et al 2014 ). Retrograde mobilization of the ureteric stone into the renal pelvis barely improves SWL efficiency (Bradley and Rao 2011 ). Thus, an endoscopic approach aiming to mobilize the stone, besides insertion of the JJ stent to relief an obstructed kidney is widely abandoned (Shen et al 2011 ; Musa 2008 ).…”

Section: Discussionmentioning

confidence: 99%

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Has the pelvic renal stone position inside the upper loop of JJ stent any influence on the extracorporeal shock wave lithotripsy results?

et al. 2016

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Background JJ stents are often encountered in patients with pelvic renal stones referred for shock wave lithotripsy, most of them being placed either for obstructive renal pelvic stones or for ureteric stones mobilized retrograde during the JJ stent insertion. The aim of the study was to determine whether the relative stone position in the upper loop of the JJ stent during extracorporeal shock wave lithotripsy (SWL) influences the efficiency of the procedure. The study was designed as a prospective cohort study on 162 patients addressing the same urological department, with single renal pelvic stone (primary or mobilized to the renal pelvis during the insertion of JJ stent), smaller than 15 mm, with JJ stent, treated by SWL using a second generation spark gap lithotripter, 18 kV, 3000 waves/session. Patients were divided in three groups according to the relative position of the stone to the upper loop of the JJ stent as appears on plain X-ray: stone-inside-loop, loop-crossing-stone and stone-outside the loop. The SWL success rate was the primary outcome of the study. p Value, Chi square and Kruskal–Wallis tests were used for statistical analysis.ResultsFor stone-inside-loop cases, SWL efficiency was 22.7 versus 42 % for all the other cases (p = 0.002). Other factors for decreased SWL success rate were: higher stone radio-opacity, larger JJ of stent and obese patients. Study limitation is represented by the relative small study group and by the evaluation of stone density using plain X-ray instead of computer tomography.ConclusionsFor pelvic renal stones having the same density characteristics studied by plain X-ray, the SWL efficiency is lower in stone-inside-loop cases comparing with the other positions. The overall stone free rate for renal pelvic stones could be explained by the second generation lithotripter used for all procedures.

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