Retrograde Intrarenal Lithotripsy Outcome After Failure of Shock Wave Lithotripsy

Stav, Kobi; Cooper, Amir; Zisman, Amnon; Leibovici, Dan; Lindner, Arie; Siegel, Yoram I.

doi:10.1097/01.ju.0000096421.56225.79

Cited by 50 publications

(35 citation statements)

References 18 publications

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“…The other patient with a single kidney developed obstructive anuria 1 month after the last procedure due to earlier disintegrated fragments and was managed successfully with ureteroscopy and a DJ stent. The overall complication rate (20.7%), which is reported in our study, is comparable to similar published series [11,12,[20][21][22][23].…”

Section: Discussionsupporting

confidence: 94%

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Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience

et al. 2011

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The management of renal calculi following previous open surgery represents a challenge for urologists. The aim of this study is to evaluate the outcomes and safety of ureteroscopic laser retrograde intrarenal surgery (RIRS) for renal calculi following prior open renal surgery. The charts of 53 patients who underwent RIRS for renal calculi following prior open surgery for urolithiasis were reviewed. Both flexible and semi-rigid ureteroscopes were utilized together with holmium: YAG laser for stone disintegration. Intravenous urography, computed tomography (CT) and ultrasound were used to evaluate the patient, perioperatively. Stone size ranged from 5 to 32 mm (mean 14.3 mm). The mean operative time was 86 min (20-130). The overall stone-free rate was 92.4%. The overall stone-free rates after one and two-procedures were 79.2% (42 cases) and 92.4% (49 cases), respectively. Four patients (7.5%) had larger residual fragments, 2 (3.8%) of them underwent SWL, and 2 (3.8%) cases were followed up conservatively. Major complications were reported in two patients (3.8%). Stone analysis revealed calcium oxalate in 39 patients, uric acid in 5, calcium phosphate in 4, struvite in 3, and cystine in 2 cases. Ureteroscopic retrograde intrarenal surgery for renal calculi following prior open renal surgery was a minimally invasive, safe procedure with a high success rate. It is a viable alternative for PNL in managing recurrent renal calculi efficiently.

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Section: Discussionsupporting

confidence: 94%

“…The overall complication rate of ureteroscopy, which is reported in recent literature lies between 6 and 23% [9,11,12,[17][18][19][20][21][22][23][24]. In our study, the overall complication rate was 20.7%.…”

Section: Discussioncontrasting

confidence: 38%

Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience

et al. 2011

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“…Stav et al [51] reported a SFR of 67% in 81 patients with a history of unsuccessful SWL. Holland et al [52] compared 93 patients, whom were divided into two groups of 42 patients with primary treatment and 51 patients with secondary treatment (92% after SWL, 8% after PCNL).…”

Section: Rirs As a Second-line Therapymentioning

confidence: 99%

Retrograde intrarenal surgery for renal stones - Part 2

Kılıç

Akand

2017

Turkish Journal of Urology

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Retrograde intrarenal surgery (RIRS) has become an effective and safe treatment modality in the management of urinary system stone disease. Recent developments and innovations in the flexible ureterorenoscope and auxiliary equipment have made this procedure easier and more effective with increased success rates. RIRS can be used as a primary treatment in patients with renal stones smaller than 2 cm, prior unsuccessful shock wave lithotripsy, infundibular stenosis, renoureteral malformation, skeletal-muscular deformity, bleeding diathesis and obese patients. In the second part of this detailed review for RIRS, effect of stone composition on success rate, preoperative assessment of stone-free rate, the cost of this modality, education for RIRS, fluoroscopy use, the current role of RIRS in the treatment of various urolithiasis types and special conditions, and combined treatment methods are discussed with up-to-date literature.

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“…[20] ESWL başarısızlığı sonrası böbrek taşlarında retrograd intrarenal cerrahi uygulamasının yüksek başarı ve ESWL'den daha iyi taşsızlık oranlarına sahip olduğu da bilinmektedir. [21,22] Çalışmamızda ESWL sonrası ÜRS yapılan hastalarda başarı oranı ESWL öyküsü olmayanlardan anlamlı derecede düşük bulundu. ESWL öyküsünün artmış reoperasyon, double J stent ve/veya üreteral stent gereksinimi ile ilişkili olmadığı ancak ek alet kullanımını %56 oranında arttırdığı tespit edildi.…”

Section: Discussionunclassified

The need for additional equipment after ESWL in ureteroscopic lithotripsy

Guner¹,

Çaşkurlu²,

Karakose³

et al. 2011

Turkish Journal of Urology

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Objective: This study evaluated our results with ureteroscopic lithotripsy (URS) in patients with failed extracorporeal shock wave lithotripsy therapy (ESWL) and examined the effect of previous ESWL on the use of tools during URS, operating time, and outcome. Materials and methods:URS performed in two centers between 2008 and 2011 was reviewed retrospectively. The patients were divided into two groups according to the history of previous ESWL: 1) patients who underwent ESWL previously (n=39) and 2) no previous ESWL (n=116). Results:The demographic data were similar in both groups. The use of accessory tools and treatment failure was statistically higher in Group 1. The operating time was longer in Group 1. The need for re-operation, balloon dilatation, and ureteral catheter was similar in the two groups. However, the use of accessory equipment was increased by 56% in those with a previous ESWL. Balloon dilatation was required in 17.9% of the patients in Group 1. Conclusion:URS is the main treatment modality after the failure of ESWL. In patients with a history of ESWL, the need for accessory equipment is increased.Key words: Equipment; lithotripsy; treatment failure; ureteroscopy. ÖZETAmaç: Çalışmanın amacı vücut dışı şok dalga tedavisi (ESWL) başarısız olmuş hastalarda üreteroskopik litotripsi (ÜRS) sonuçlarımızı incelemek ve geçirilmiş ESWL öyküsünün ÜRS esnasında alet kullanımı, operasyon süresi ve başarı üzerine olan etkisini değerlendirmektir. Gereç ve yöntem:2008-2011 yılları arasında iki merkezde yapılan ÜRS vakaları retrospektif olarak değer-lendirildi ve geçirilmiş ESWL öyküsüne göre hastalar iki gruba ayrıldı. ESWL öyküsü olan 39 hasta Grup 1, ESWL öyküsü olmayan 116 hasta Grup 2 olarak tanımlandı. Bulgular:Her iki grubun demografik verileri benzerdi. Grup 1'de başarısızlık ve aksesuar alet kullanımı istatistiksel olarak daha yüksekti. Operasyon süresi Grup 1'de daha uzun olarak tespit edildi. Geçirilmiş ESWL öyküsü olanlarda yeniden operasyon, balon dilatasyon gereksinimi ve üreter kateteri gereksinimi ESWL öyküsü olmayan hastalarla benzerdi. Ancak geçirilmiş ESWL öyküsü olanlarda aksesuar alet kullanımı %56 oranında artmakta idi. Stone cone, en sık kullanılan aksesuar alet idi. Grup 1'deki hastaların %17.9'unda balon dilatasyon gereksinimi oldu.Sonuç: ESWL başarısızlığı sonrası ÜRS esas tedavi yöntemidir. Geçirilmiş ESWL öyküsü olanlarda aksesuar alet kullanım gereksinimi artmaktadır. Son üç dekatda üreteroskopi (ÜRS) ve dışa-rıdan şok dalga tedavisi (ESWL) cihazlarının gelişimiyle üreter ve böbrek taşı tedavisinde yeni bir çığır açılmıştır. Avrupa ve Amerika rehberlerinde yer alan bir tedavi seçeneği olarak ESWL, son yıllarda düşük morbidite ve yüksek başarı oranları ile üriner sistem taşları-nın tedavisinde yaygın olarak kullanılmaktadır.ESWL için kullanılan cihazlardaki teknolojik gelişime rağmen, halen hem taşların tamamı bu yöntemle kırılmadığı için hem de sistemin taşlardan tamamen temizlenebilmesi için ek cihaz ve girişimlere ihtiyaç duyulabilmektedır. Daha küçük çaplı ve daha geniş ça...

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Retrograde Intrarenal Lithotripsy Outcome After Failure of Shock Wave Lithotripsy

Cited by 50 publications

References 18 publications

Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience

Ureteroscopic retrograde intrarenal surgery after previous open renal stone surgery: initial experience

Retrograde intrarenal surgery for renal stones - Part 2

The need for additional equipment after ESWL in ureteroscopic lithotripsy

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