Ureterorenoscopic Approach to the Symptomatic Caliceal Diverticulum

Batter, Stephen J.; Dretler, Stephen P.

doi:10.1097/00005392-199709000-00006

Cited by 11 publications

(13 citation statements)

References 7 publications

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“…[67] There are numerous disadvantages with ureteroscopic treatment including longer operative time compared to percutaneous technique and difficulty in managing lower pole CD. [67]…”

Section: Discussionmentioning

confidence: 99%

“…[2] Management options for caliceal diverticular calculus include extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopy, laparoscopy, or percutaneous nephrolithotomy (PCNL). [56789] PCNL achieves high stone-free rates and in many cases causes resolution of CD. [510] In the past, staged PCNL (access by interventional radiologist followed by stone removal in the operating room) along with dilation of infundibular neck or creation of a neoinfundibulum was performed.…”

Section: Introductionmentioning

confidence: 99%

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Management of renal caliceal diverticular stones: A decade of experience

et al. 2017

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Objective:The objective of this study is to evaluate our methods for management of renal caliceal diverticular stones (CDS).Materials and Methods:We conducted a retrospective study from January 2005 to July 2015 and included patients who were treated for renal CDS. Patients were evaluated for treatment modality, puncture site (in case percutaneous nephrolithotomy [PCNL] attempted), operative time, stone clearance rate, and complications. During PCNL, if the infundibulum was found to connect the diverticulum to the calyx, then a double J stent was placed. No attempt was made to dilate the diverticular neck or to create a neoinfundibulum.Results:Twenty-four patients were treated for CDS during the study period. Two patients underwent shockwave lithotripsy, and 22 were managed by PCNL. Mean stone size was 16.37 mm (range: 6–35 mm) and mean diverticulum size was 20.62 mm (range: 12–37 mm). No fulguration was done in initial 17 patients, while fulguration by Holmium Laser was performed in the last five cases treated with PCNL. Mean operative time was 70.31 min (range: 47–90 min). Mean follow-up was 34 months, diverticulum resolved in 14 patients and reduced in size in 7 patients.Conclusion:Caliceal diverticular calculi can be treated most efficiently by PCNL. Stone-guided puncture and no attempt to dilate or create neoinfundibulum reduces operative time and morbidity while yielding high stone-free rate.

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“…[67] There are numerous disadvantages with ureteroscopic treatment including longer operative time compared to percutaneous technique and difficulty in managing lower pole CD. [67]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of renal caliceal diverticular stones: A decade of experience

et al. 2017

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“…56 The factors influencing the success rate of retrograde interventions depend on the diverticulum position and the ureteroscope used (semirigid or flexible), and is associated with the operatory skills (being a technically demanding intervention). 57 Other recent studies reported a stone-free rate between 19-61% in cases of intrarenal stenosis associated with pyelocaliceal diverticulum treated by retrograde intrarenal surgery. 7,57,58 By comparison with SWL, retrograde intrarenal surgery as the primary technique is more efficient while also avoiding the PCNL specific morbidity.…”

Section: Pyelocaliceal Diverticulum and Calyceal Infundibular Stenosismentioning

confidence: 94%

“…57 Other recent studies reported a stone-free rate between 19-61% in cases of intrarenal stenosis associated with pyelocaliceal diverticulum treated by retrograde intrarenal surgery. 7,57,58 By comparison with SWL, retrograde intrarenal surgery as the primary technique is more efficient while also avoiding the PCNL specific morbidity. 7 Regarding the calyceal infundibular stenosis, there are few studies analyzing this subject, as it is a rather rare pathology.…”

Section: Pyelocaliceal Diverticulum and Calyceal Infundibular Stenosismentioning

confidence: 94%

Retrograde flexible ureteroscopic approach of upper urinary tract pathology: What is the status in 2014?

2014

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Abbreviations & AcronymsAbstract: Flexible uretero-renoscopy witnessed dramatic technological improvements, ultimately translating in more diverse indications, better instrument durability, procedural efficacy and safety. Diagnostic exploration of the upper urinary tract, treatment of selected cases of ureteral and especially pyelocaliceal stones, caliceal diverticulum and infundibular stenosis, treatment, and follow-up of upper urinary tract tumors are the main indications for this approach. We review the technique, results and complications of retrograde flexible ureteroscopy, with an emphasis on the latest developments of the method.

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“…It has been recommended to minimize high-pressure irrigation during these procedures, due to concerns that high intrarenal pressures may promote pyelovenous or pyelolymphatic migration of malignant cells. [20] However, to date, ureteroscopy and ureteroscopic resection have not been associated with a higher risk of development of metastatic disease. [21]…”

Section: Transitional Cell Carcinomamentioning

confidence: 99%

Ureteroscopic management of upper tract transitional cell carcinoma and ureteropelvic obstruction

Crouzet¹,

Berger²,

Monga³

et al. 2008

Indian J Urol

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Introduction:Technological advances have increased the application of the endoscopic management of upper tract transitional cell carcinoma (TCC) and ureteropelvic junction obstruction (UPJO).Materials and Methods:Published, peer-reviewed articles on endoscopic treatment of upper tract TCC and UPJO were identified using the MEDLINE database.Results:Although nephroureterectomy remains the gold standard for upper tract TCC treatment, low-grade, low-stage and small tumors, especially in patients with solitary kidneys or poor renal function can be managed with encouraging success rates, despite the considerable recurrence rate. Endoscopic alternatives to pyeloplasty for UPJO can be used especially in cases with absence of crossing vessels, stricture length less than 1.5 cm, severe hydronephrosis and renal function less than 30%.Conclusion:Proper patient selection is critical for the successful endoscopic management of treatment of upper tract TCC and UPJO.

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Ureterorenoscopic Approach to the Symptomatic Caliceal Diverticulum

Abstract: Ureterorenoscopy produces minimal morbidity and is an effective treatment of upper and middle caliceal diverticula.

Cited by 11 publications

References 7 publications

Management of renal caliceal diverticular stones: A decade of experience

Management of renal caliceal diverticular stones: A decade of experience

Retrograde flexible ureteroscopic approach of upper urinary tract pathology: What is the status in 2014?

Ureteroscopic management of upper tract transitional cell carcinoma and ureteropelvic obstruction

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