Post ureteroscopic stone surgery ureteral strictures management: a retrospective study

Mao, Xiong; Zhu, Xin; Chen, Daihui; Hossain, Mohammad Arman; Xie, Yongpeng; Gou, Xin; Yuanzhong, Deng

doi:10.1007/s11255-020-02375-4

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…Xiong et al [4] reported the results of 83 patients who were diagnosed with a ureteral stricture after ureteroscopic lithotripsy and showed a 60.9% success rate when patients were treated with ureteral dilatation or endoureterotomy. A literature review made by Hafez et al [5] reported success rates of endoureterotomy from 55% to 85% for benign ureteral strictures and balloon dilatation success rates from 48% to 88%, with an overall mean of 55%.…”

Section: Discussionmentioning

confidence: 99%

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Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns

et al. 2022

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Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. A treatment with an Allium ureteral stent (URS), a self-expanding, large-caliber URS, was implemented in our department for ureteral stricture. Our study aim was to report the long-term results, including success rate, complications, and adverse effects. Methods: We retrospectively collected data on all patients who were treated with an Allium URS in our department between January 2017 and January 2021. Demographic, clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. Results: Our cohort included 17 patients, 9 men and 8 women. The etiology of ureteral strictures was urolithiasis in 76.5% and pelvic procedure injury in 17.6%. The overall success rate was 35.29% in an average follow-up of 10.42 ± 2.39 months after stent removal. A higher failure rate was observed in the urolithiasis etiology group (90% vs. 66.7%, p = 0.38). The mean indwelling time of the Allium stent was 14.29 ± 1.29 months. Conclusions: Although an Allium URS could be considered as a feasible and attractive treatment of ureteral strictures, due to its minimal invasiveness, the success rate of this treatment is relatively low. Therefore, this option should be carefully considered and should be discouraged in young and fit patients and reserved for older unfit patients who are unwilling to undergo surgical repair of ureteral strictures.

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Section: Discussionmentioning

confidence: 99%

“…The success rate of surgical ureteral repair, regardless of the approach (open, laparoscopic, or robot-assisted), are 90% and above [4]. Seideman et al [6] reported their results of 45 patients who underwent laparoscopic ureteral reimplantation due to distal ureteral stricture with an overall success rate of 96%.…”

Section: Discussionmentioning

confidence: 99%

Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns

et al. 2022

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“…Findings of a study conducted between 2013 and 2018 in an experienced center on 95 patients who developed ureteral strictures after per primam URS showed that reconstruction performs more favorably than endourological procedures. There are no clear data regarding the stricture rate after URS following ESWL and the best-correcting procedure indicated; consequently, further studies are necessary (36).…”

Section: Resultsmentioning

confidence: 99%

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

et al. 2021

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“…Previous research has highlighted the risk of ureteral stricture post-ureteroscopic lithotripsy [15], attributing it to laser-induced thermal effects on the ureteral mucosa [2,16]. Although the threshold for thermal damage in the urothelium remains unclear, existing literature suggests tissue injury typically begins at 43°C [17], with complete necrosis observed at 54°C [14].…”

Section: Discussionmentioning

confidence: 99%

Exploring Thermal Dynamics of Thulium Super-Pulsed Lasers in Lithotripsy Procedures

Hu,

hilowle,

Shen

et al. 2024

Preprint

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Purpose Optimizing lithotripsy protocols for clinical practice by studying the thermal effects of laser technologies across different parameters and perfusion rates. Methods This study highlights Thulium Super-Pulsed Lasers from Lakh Medical Equipment (Beijing) Co., Ltd. Both operate at 1940nm peak wavelength and 500W power output. An in vitro model used detached pig kidney ureters in a constant-temperature water bath 37°C. A disposable ureteroscope with domestically produced pulsed thulium fiber laser stimulated the ex vivo simulated ureteral model. Laser parameters included 15ml/min, 25ml/min, and 35ml/min perfusion rates with physiological saline at 25℃±1℃. Artificial stones were inserted using ureteroscopy. Results At 15 ml/min infusion rate and 6W stone fragmentation power, ureter temperature rises positively with excitation time, reaching 37.4°C within 30 seconds. Increasing to 12W, the thulium laser surpassed 43.4°C within 30 seconds. At 18W, consistent temperature elevation regardless of mode, reaching 43°C in 5 seconds at >400Hz. For 6W, 12W, and 18W, excitation time remains under 30 seconds, ensuring ureter stays <43°C. Except for specific parameters, ureteral temperature exceeds the safety threshold at 24W and 30W. At 35 ml/min infusion rate and 30W, intrapelvic temperature remains safe within 30 seconds except for one mode. Conclusion This investigation demonstrates that Thulium laser therapy can safely raise ureter temperature within controlled limits, aiding urological disease treatment. Urologists gain a scientific footing for laser parameter selection. Thulium laser's power, energy, frequency, and pulse width dictate temperature changes, demanding careful consideration for effective treatment planning.

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Post ureteroscopic stone surgery ureteral strictures management: a retrospective study

Cited by 9 publications

References 26 publications

Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns

Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study

Exploring Thermal Dynamics of Thulium Super-Pulsed Lasers in Lithotripsy Procedures

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