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Objective: In this study, our clinical results of extracorporeal shock wave lithotripsy (ESWL) in the treatment of upper ureteral stones were analyzed, and discussed under the literature knowledgment. Material and Method: The data of 64 patients over 18 years old and who were treated with ESWL between March 2017 and August 2018, were evaluated retrospectively. The sexes, stone dimensions, hydronephrosis grades and treatment results were evaluated. Results: The mean age, stone size and number of the ESWL session of the patients were 50.02±18.03 years, 13.36±3.24 mm and 1.85±0.99, respectively. A total of 52 (81.25%) patient's upper ureteral stones were completely eliminated. Five patients had stone street in the distal ureter, 3 patients did not tolerate ESWL and 4 patients had insufficient stone fragmentation. Ureterorenoscopy was used for the treatment of these patients. None of the patients had major life-threatening complication. Conclusion: We think that, with low complication and high success rates in the treatment of upper ureteral stones, ESWL should be preferred primarily.
Objective: In this study, our clinical results of extracorporeal shock wave lithotripsy (ESWL) in the treatment of upper ureteral stones were analyzed, and discussed under the literature knowledgment. Material and Method: The data of 64 patients over 18 years old and who were treated with ESWL between March 2017 and August 2018, were evaluated retrospectively. The sexes, stone dimensions, hydronephrosis grades and treatment results were evaluated. Results: The mean age, stone size and number of the ESWL session of the patients were 50.02±18.03 years, 13.36±3.24 mm and 1.85±0.99, respectively. A total of 52 (81.25%) patient's upper ureteral stones were completely eliminated. Five patients had stone street in the distal ureter, 3 patients did not tolerate ESWL and 4 patients had insufficient stone fragmentation. Ureterorenoscopy was used for the treatment of these patients. None of the patients had major life-threatening complication. Conclusion: We think that, with low complication and high success rates in the treatment of upper ureteral stones, ESWL should be preferred primarily.
A atividade sexual satisfatória é um dos pilares da qualidade de vida, envolvendo das preliminares ao intercurso sexual, mecanismos neurológicos, vasculares, endocrinológicos, musculoesqueléticos, psicossociais, culturais, além do parceiro sexual e fatores individuais (autoestima, imagem corporal e habilidade pessoal). A disfunção sexual consiste na incapacidade para participar do ato sexual com satisfação, comprometendo desejo e/ou excitação e/ou orgasmo. Pode também se apresentar como dor que antecede, ocorre durante ou após o ato. Os numerosos fatores de risco para a disfunção sexual explicam sua alta prevalência nas diferentes fases da vida, podendo apresentar etiologia orgânica, psicossocial e/ou sociodemográfica. Entre estes últimos citam-se idade avançada, renda familiar baixa e educação precária. Quanto aos fatores orgânicos, encontram-se: deficiência hormonal, hipertensão arterial, diabetes, cardiopatias, neuropatias, alcoolismo, tabagismo, uso de drogas ilícitas, bem como uso de alguns medicamentos. Depressão e ansiedade respondem pelas causas psiquiátricas mais comuns de disfunção sexual. A prevalência é alta em homens, especialmente nos casos de disfunção erétil (DE) e de ejaculação precoce (EP). O mesmo se observa nas mulheres, quanto à diminuição do desejo, falta de lubrificação vaginal, transtornos do orgasmo e dor ao intercurso sexual. Por comprometer a satisfação sexual e a satisfação com a vida, a disfunção sexual resulta em menor qualidade de vida, baixa autoestima, depressão, ansiedade e prejuízo na relação interpessoal e dos parceiros. Doenças crônicas podem conduzir ao desinteresse sexual e à falta dessa atividade, por baixa autoestima e preocupação quanto à imagem corporal, por exemplo. A depressão também reduz a libido, deteriorando a qualidade do relacionamento sexual. Os pacientes, ansiosos sobre sua habilidade em satisfazer o parceiro, com o tempo desenvolvem ansiedade antecipatória e, pelo receio de falhar, acabam evitando o intercurso. Fadiga e estresse também acompanham as doenças crônicas, podendo contribuir para a disfunção sexual.
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