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1

PATTERN OF URINARY CALCULI IN FAISALABAD  

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Full Text Available OBJECTIVES: To find out the pattern of constituents of urinary calculi in Faisalabad. DESIGN:Consecutive case study. SETTING: Urinary stones received from government and private hospitals bypathology department of Punjab Medical College, Faisalabad. PERIOD: January, 1992 to December, 1994.SUBJECT: One hundred and eighty three patients (n=183) with urinary stones disease (no%=146), (n&=37)females. Age range between 1.5 year to 70 years). RESULTS: Maximum number of calculi (n=84) were ofmixed type having calcium oxalate and uric acid as main constituents. Pure calcium oxalate stones were(n=55) in number. CONCLUSIONS: The pattern of constituents of urinary calculi in Faisalabad zone issimilar to Multan, Bahawalpur and Dera Ghazi Khan zones.

Iqbal Hussain Malik

1997-01-01

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Management of urinary calculi in pregnant women.  

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The incidence and predisposing factors of urinary calculi are generally the same in both pregnant and non pregnant women, but anatomic changes during pregnancy make diagnosis and treatment a more challenging issue. We reviewed 16 patients (22 stones) of urinary stone during pregnancy between 1986 an...

Lee, S. J.; Rho, S. K.; Lee, C. H.; Chang, S. G.; Kim, J. I.

3

Computed tomographic analysis of urinary calculi  

International Nuclear Information System (INIS)

Excised urinary calculi were subjected to computed tomographic (CT) scanning in an attempt to determine whether CT attenuation values would allow accurate analysis of stone composition. The mean, maximum, and modal pixel densities of the calculi were recorded and compared; the resulting values reflected considerable heterogeneity in stone density. Although uric acid and cystine calculi could be identified by their discrete ranges on one or more of these criteria, calcium-containing stones of various compositions, including struvite, could not be distinguished reliably. CT analysis of stone density is not likely to be more accurate than standard radiography in characterizing stone composition in vivo

1984-01-01

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Computed tomographic analysis of urinary calculi  

Energy Technology Data Exchange (ETDEWEB)

Excised urinary calculi were subjected to computed tomographic (CT) scanning in an attempt to determine whether CT attenuation values would allow accurate analysis of stone composition. The mean, maximum, and modal pixel densities of the calculi were recorded and compared; the resulting values reflected considerable heterogeneity in stone density. Although uric acid and cystine calculi could be identified by their discrete ranges on one or more of these criteria, calcium-containing stones of various compositions, including struvite, could not be distinguished reliably. CT analysis of stone density is not likely to be more accurate than standard radiography in characterizing stone composition in vivo.

Newhouse, J.H.; Prien, E.L.; Amis, E.S. Jr.; Dretler, S.P.; Pfister, R.C.

1984-03-01

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Computed tomographic analysis of urinary calculi  

International Nuclear Information System (INIS)

Computed tomography (CT) was employed in an effort to analyze the chemical composition of urinary calculi. Twenty-three surgically removed calculi were scanned in a water bath (in vitro study). Forteen of them in the body were scanned (in vivo study). The calculi consisted of four types: mixed calcium oxalate and phosphate, mixed calcium carbonate and phosphate, magnesium ammonium phosphate, and uric acid. The in vitro study showed that the mean and maximum CT values of uric acid stones were significantly lower than those of the other three types of stones. This indicated that stones with less than 450 HU are composed of uric acid. In an in vivo study, CT did not help to differentiate the three types of urinary calculi, except for uric acid stones. Regarding the mean CT values, there was no correlation between in vitro and in vivo studies. An experiment with commercially available drugs showed that CT values of urinary calculi were not dependent upon the composition, but dependent upon the density of the calculi. (Namekawa, K.).

1986-01-01

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Evaluation of Urinary Calculi by Infrared Spectroscopy  

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Full Text Available Purpose: To analyze urinary calculi composition and its relationship with gender, age, calculus weight, color, and location.Materials and Methods: Two hundred and forty one patients with urinary calculus, who had undergone open lithotomy from June 1999 to April 2001, were enrolled in this prospective study which was performed by Tehran and Oroomieh Medical Sciences Universities. The calculi compositions were analyzed by infrared spectroscopy in Bonn University. Statistical analyses were made by paired t testResults: One hundred and forty five males with a mean age of 40.4 years and 96 females with a mean age of 42.5 years were enrolled in this study. Mean calculus weight was 4.28 gr. Mean calculus number was 4.33. Thirty four (14.1%) calculi were pure (carbonate apatite: 2, brushite: 1, uric acid: 19, cystine: 3, weddellite: 6, mono-NH4-urate: 2, struvite: 1), 207(85.6%) were mixed and none of them contained octa-ca-phosphate, apatite, newberyte, 2,8-dihydroxyadenine, mono-Na-urate, or xanthine. Weddellite was found in 77% of calculi. It comprised more than 50% of them in 26% of cases. Whewellite crystals were found in 78% of calculi. It comprised more than 50% of them in 46% of cases. The most common pure calculus was uric acid and the most common component of calculi was whewellite followed by weddellite.Conclusion: Although there is no comprehensive study on urolithiasis incidence and prevalence in Iran, it can be concluded that whewellite and weddellite may be the most common components of urolithiasis in Iran and uric acid calculi are the most common pure calculi. There was no significant difference in calculi composition in our study.

Abdolrasool Mehrsai; Ali Taghizadeh Afshari; R Zohrevand; Hooman Djaladat; H J Steffes; A Hesse; Gholamreza Pourmand

2004-01-01

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OBSERVATIONS THE CHEMICAL PROFILE OF URINARY CALCULI  

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Full Text Available Renal stone disease is an etiologically heterogenous problem associated with a high rate of recurrence. Thebiochemical profile of urinary calculi removed form the urinary tract of 48 patients in urology ward, MayoHospital Lahore was determined. The distribution of stone analysis was calcium oxalate with uric acid 46%calcium oxalate with phosphate 27%, pure calcium oxalate 19%. Magnesium ammonium phosphate withthe calcium oxalate 6%, and pure uric acid 2%. The incidence of urolithiasis in upper urinary tract washigher than lower urinary tact in adults. This study suggests calcium oxalate stones to be the most commontype.

Shahnaz Javed Khan

1997-01-01

8

Computer tomography and urinary calculi, 2  

International Nuclear Information System (INIS)

To find whether computer tomography (CT) can determine the composition of urinary calculi, we measured the CT values of 47 calculi in vitro and 26 calculi in situ. The results are as follows; 1) CT values (Hounsfield Unit) of various stones which were measured in vitro (mean ± s.d.) were as follows; mixed calcium oxalate and calcium phosphate (the mixed stone) 1555 ± 193 H, magnecium ammonium phosphate (MAP) 1285 ± 248 H, cystine 757 ± 114 H, uric acid 480 H. 2) In situ the peak CT values of various calculi were almost the same as those in vitro, but the mean CT values were slightly less. 3) From these results we concluded that cystine and uric acid stones can be identified by the CT value. With regard to the mixed stone and MAP, it is almost impossible to identify these stones especially when they reveal the CT values of 1100 - 1500 H. However, stones with the peak CT values of more than 1500 H were rarely MAP and often the mixed stone, and those with the mean CT values of 1000 - 1100 H were rarely the mixed stone and often MAP. (author).

1986-01-01

9

Haematuria in the diagnosis of urinary calculi.  

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The aims of this study were to compare the sensitivity of urine dipstix (Combur 9 test) versus urine microscopy in detecting haematuria and to determine the proportion of patients with renal or ureteric colic due to urinary calculi who have haematuria. This is a prospective study of 122 patients presenting to an emergency department in a tertiary teaching hospital with symptoms suggestive of renal or ureteric colic. The same urine specimen tested using dipstix was sent for urine microscopic examination for haematuria, after which a plain radiograph of the kidneys, ureter and bladder was done. An early intravenous urogram was done (delay of an average of 4 days). Telephone interviews were done to determine whether any calculi had been passed. Urine dipstix detected haematuria in 95.4% [95% confidence intervals (CI) 87.1% to 100.0%] of patients with urinary calculi, whilst urine microscopy detected haematuria in 70.8% (95% CI 58.2% to 92.6%). This study showed that urine Combur 9 is more sensitive than urine microscopy in detecting haematuria. The combined use of urine Combur 9 and microscopy does not increase the sensitivity of detecting haematuria. In the absence of haematuria on urine Combur 9 for suspected ureteric colic, alternative diagnoses should be considered. PMID:9663312

Ooi, S B; Kour, N W; Mahadev, A

1998-03-01

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Haematuria in the diagnosis of urinary calculi.  

UK PubMed Central (United Kingdom)

The aims of this study were to compare the sensitivity of urine dipstix (Combur 9 test) versus urine microscopy in detecting haematuria and to determine the proportion of patients with renal or ureteric colic due to urinary calculi who have haematuria. This is a prospective study of 122 patients presenting to an emergency department in a tertiary teaching hospital with symptoms suggestive of renal or ureteric colic. The same urine specimen tested using dipstix was sent for urine microscopic examination for haematuria, after which a plain radiograph of the kidneys, ureter and bladder was done. An early intravenous urogram was done (delay of an average of 4 days). Telephone interviews were done to determine whether any calculi had been passed. Urine dipstix detected haematuria in 95.4% [95% confidence intervals (CI) 87.1% to 100.0%] of patients with urinary calculi, whilst urine microscopy detected haematuria in 70.8% (95% CI 58.2% to 92.6%). This study showed that urine Combur 9 is more sensitive than urine microscopy in detecting haematuria. The combined use of urine Combur 9 and microscopy does not increase the sensitivity of detecting haematuria. In the absence of haematuria on urine Combur 9 for suspected ureteric colic, alternative diagnoses should be considered.

Ooi SB; Kour NW; Mahadev A

1998-03-01

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Percutaneous retrieval of upper urinary tract foreign bodies and calculi  

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To determine, when extracorporeal shockwave lithotripsy is contraindicated, the usefulness and safety of percutaneous management in the removal from the upper urinary tract of foreign bodies and calculi, or small remnants of these, retained after percutaneous nephrolithotomy. Between January 1996 and May 2001, We attempted to retrieve foreign bodies or calculi from the upper urinary tract of 20 patients, using various percutaneous technique. There were eleven foreign bodies, namely fragmented nephrostomy catheters (n=2), migrated ureteric stents inaccessible to retrograde ureteroscopic management (n=8), and one metallic radiopaque marker which was separated from the pusher of the internal ureteral stent. Nine urinary tract calculi were present. These ranged in radiographically measured size from 4 to 8 mm in their largest diameter, and were found in the renal pelvis or calyx (n=5) and ureter (n=4). After percutaneous nephrostomy, all procedures involved the use of a 7-F to 14-F sheath, inserted under fluoroscopic guidance. Devices used for the retrieval of these objects include a stone basket retriever, loop snare, grasping forceps, and balloon catheter. In all cases except one, it was possible to retrieve calculi or other items from the upper urinary tract. No surgical procedure was required and no significant complications were encountered in any of the cases during or after the procedures. The percutaneous technique can be useful and safe in the management of foreign bodies or calculi present in the upper urinary tract.

Shin, Tae Beom; Seong, Chang Kyu; Kim, Yong Joo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

2002-07-01

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Chemometric examination of trace elements analysis in urinary calculi  

International Nuclear Information System (INIS)

The content of Pb, Cd, Ni, Fe, Na and K was determined in sixteen samples of urinary calculi taken from patients in Macedonia. The trace elements were determined by atomic absorption spectrophotometry and by flame emission spectrometry. The chemometric examination of the calculi was done by factor analysis. This chemometric method has been extensively used for classification purposes while solving different multidimensional problems. The results obtained from the analysis revealed that the highest correlation exists between the concentrations of lead and potassium. No significant correlation among other analyzed elements was found. The examination of the first two principal components (with 67 % variance captured) calculated from the auto scaled data matrix showed a clear separation between the composition of the calculi taken from male and from female patients, especially in the case of the calculi consisting of the two oxalates (whewellite and weddelite) and those composed of carbonate apatite in mixture with oxalates.

2006-01-01

13

Medical management of common urinary calculi.  

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Nephrolithiasis is a common condition affecting nearly 5 percent of U.S. men and women during their lifetimes. Recurrent calculi can be prevented in most patients by the use of a simplified evaluation, reasonable dietary and fluid recommendations, and directed pharmacologic intervention. Serum studies and 24-hour urine collections are the mainstays of metabolic investigation and usually are warranted in patients with recurrent calculi. Although some stones are the result of inherited conditions, most result from a complex interaction between diet, fluid habits, and genetic predisposition. Calcium-sparing diuretics such as thiazides often are used to treat hypercalciuria. Citrate medications increase levels of this naturally occurring stone inhibitor. Allopurinol can be helpful in patients with hyperuricosuria, and urease inhibitors can help break the cycle of infectious calculi. Aggressive fluid intake and moderated intake of salt, calcium, and meat are recommended for most patients. PMID:16848382

Pietrow, Paul K; Karellas, Michael E

2006-07-01

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Metabolic factors associated with urinary calculi in children.  

UK PubMed Central (United Kingdom)

INTRODUCTION: We aimed to identify metabolic and anatomical abnormalities present in children with urinary calculi. MATERIALS AND METHODS: Metabolic evaluation was done in 142 pediatric calculus formers. Evaluation included serum biochemistry; measurement of daily excretion of urinary calcium, uric acid, oxalate, citrate, and magnesium (in older children); and measurement of calcium, uric acid, oxalate, and creatinine in random urine samples in nontoilet-trained patients. Urinary tests for cystinuria were also performed. All of the patients underwent renal ultrasonography. RESULTS: Sixty-one patients (42.7%) had metabolic abnormalities. Anatomical abnormalities were found in 12 patients (8.4%). Three children (2.1%) had infectious calculi, and 3(2.1%) had a combination of metabolic and anatomic abnormalities. In 66 children (46.2 %) we did not find any reasons for calculus formation (idiopathic). Urinalysis revealed hypercalciuria in 25 (17.6%), hyperuricosuria in 23 (16.1%), hyperoxaluria in 17 (11.9%), cystinuria in 9 (6.3%), hypocitraturia in 3 (2.1%), and low urinary magnesium level in 1 (0.7%) patients. Sixteen patients (11.2%) had mixed metabolic abnormalities. CONCLUSIONS: Metabolic abnormalities are common in pediatric patients with urinary calculi. In our study, calcium and uric acid abnormalities were the most common, and vesicoureteral reflux seemed to be the most common urological abnormality which led to urinary stasis and calculus formation.

Naseri M; Varasteh AR; Alamdaran SA

2010-01-01

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Metabolic Factors Associated With Urinary Calculi in Children  

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Full Text Available Introduction. We aimed to identify metabolic and anatomical abnormalities present in children with urinary calculi. Materials and Methods. Metabolic evaluation was done in 142 pediatric calculus formers. Evaluation included serum biochemistry; measurement of daily excretion of urinary calcium, uric acid, oxalate, citrate, and magnesium (in older children); and measurement of calcium, uric acid, oxalate, and creatinine in random urine samples in nontoilet-trained patients. Urinary tests for cystinuria were also performed. All of the patients underwent renal ultrasonography. Results. Sixty-one patients (42.7%) had metabolic abnormalities. Anatomical abnormalities were found in 12 patients (8.4%). Three children (2.1%) had infectious calculi, and 3(2.1%) had a combination of metabolic and anatomic abnormalities. In 66 children (46.2 %) we did not find any reasons for calculus formation (idiopathic). Urinalysis revealed hypercalciuria in 25 (17.6%), hyperuricosuria in 23 (16.1%), hyperoxaluria in 17 (11.9%), cystinuria in 9 (6.3%), hypocitraturia in 3 (2.1%), and low urinary magnesium level in 1 (0.7%) patients. Sixteen patients (11.2%) had mixed metabolic abnormalities. Conclusions. Metabolic abnormalities are common in pediatric patients with urinary calculi. In our study, calcium and uric acid abnormalities were the most common, and vesicoureteral reflux seemed to be the most common urological abnormality which led to urinary stasis and calculus formation.

Mitra Naseri; Abdol Reza Varasteh; Seied Ali Alamdaran

2010-01-01

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Composition of urinary calculi of the inhabitants of Rawalpindi/Islamabad area  

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One hundred and twenty eight urinary calculi of the inhabitants of Rawalpindi / Islamabad are were analysed employing infrared spectrophotometric method using the potassium bromide pellet technique. Calcium oxalate was the most frequently occurring component of adult upper urinary tract as well as of lower urinary tract calculi. In children ammonium hydrogen urate was the commonest component of upper urinary tract calculi, whereas the maximum frequency of occurrence of calcium oxalate was observed in the lower urinary tract calculi of children. The frequency of occurrence of different components was discussed and compared with the reported values for other countries. (author)

1991-01-01

17

In vitro characterization of urinary calculi: Dual-energy technique  

International Nuclear Information System (INIS)

Using a dual-energy program implemented on a Siemens Somatom DR3 CT unit, the authors attempted to discriminate between urinary calculi of different chemical compositions by means of selective image reconstruction based on their high kVp(125 keV), low kVp (85 keV), 65 keV, and electron density values. Simultaneous dual-energy images were obtained using a technique of rapid kVp switching (85 and 125 keV) and advanced evaluation algorithms. Representative stones of pure and mixed composition were scanned in a water bath. Computer printouts of electron density and CT attenuation values at each kVp setting were obtained. Preliminary observations indicate readily feasible discrimination between uric acid and all other calculi and between struvite stones and brushite or calcium oxalate stones.

1986-12-05

18

Medicinal health agent for preventing and treating canine urinary calculi  

UK PubMed Central (United Kingdom)

The invention relates to a medicinal health agent for preventing and treating canine urinary calculi, which is characterized in that the agent is obtained by evenly mixing the following effective components in ratio by weight or unit: 10 to 40 mg of organic germanium, 1,000 to 6,000 mg of potassium citrate, 20,000 mg of lysimachia nummularia particles, 5,000 IU of vitamin A and 10 mg of vitamin B6, wherein the vitamin A maintains the integrity of urinary tract epithelium to realize the activity of crystallization inhibitor so as to inhibit crystallization the organic germanium enhances the process of crystallization inhibition lysimachia nummularia promotes urination, treats stranguria and plays a significant role in promoting urination and removing stones meanwhile, the lysimachia nummularia has the function of resisting inflammation and bacteria, reduces urinary tract injury, inhibits urease-producing bacteria, and turns urine to be acidic after the lysimachia nummularia is metabolized in human bodies so as to inhibit the formation of magnesium ammonium phosphate stones citric acid competes with oxalic acid for calcium in urine and the vitamin B6 promotes the combination ofthe citric acid with urine calcium so as to reduce the chance of forming calcium oxalate stones. The health agent is reasonable in compatibility, and jointly uses medicaments from different angles toeliminate the inducing factors of magnesium ammonium phosphate and calcium oxalate urinary calculi which are the most common among dogs.

JINYONG WANG; LIANMIN WANG

19

[Treatment of pyonephrosis with upper urinary tract calculi].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To improve the treatment of pyonephrosis with upper urinary tract calculi (UTC). METHODS: A total of 49 UTC patients with pyonephrosis were selected at our hospital during May 2004 to February 2010. Among them, 22 cases were treated with transurethral ureteroscope lithotripsy followed by tube internal drainage while another 27 cases underwent percutaneous nephrolithotomy. RESULTS: No such complications as septicemia and septic shock occurred during the first stage of external and internal drainage. The bacteremic symptoms of chill or fever occurred in 3 cases during the second stage of percutaneous nephrolithotomy and pyelolithotomy/ureterolithotomy (11.1%). There were 3 cases of nephrectomy. A follow-up period of 3 months to 5.5 years showed that all 33 cases had a varying degree of recovered renal functions. And there was no nephrectomy. CONCLUSION: The keys to a successful surgical treatment of pyonephrosis with upper urinary tract calculi are early diagnosis, timely drainage and relief of obstruction. Ureteroscopic lithotripsy, double-J placement and percutaneous nephrostomy drainage are excellent for relieving obstruction. As a safe procedure with minor complications, it creates proper conditions for a second stage operation.

Tu MQ; Shi GW; He JY

2011-04-01

20

Nondestructive analysis of urinary calculi using micro computed tomography  

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Full Text Available Abstract Background Micro computed tomography (micro CT) has been shown to provide exceptionally high quality imaging of the fine structural detail within urinary calculi. We tested the idea that micro CT might also be used to identify the mineral composition of urinary stones non-destructively. Methods Micro CT x-ray attenuation values were measured for mineral that was positively identified by infrared microspectroscopy (FT-IR). To do this, human urinary stones were sectioned with a diamond wire saw. The cut surface was explored by FT-IR and regions of pure mineral were evaluated by micro CT to correlate x-ray attenuation values with mineral content. Additionally, intact stones were imaged with micro CT to visualize internal morphology and map the distribution of specific mineral components in 3-D. Results Micro CT images taken just beneath the cut surface of urinary stones showed excellent resolution of structural detail that could be correlated with structure visible in the optical image mode of FT-IR. Regions of pure mineral were not difficult to find by FT-IR for most stones and such regions could be localized on micro CT images of the cut surface. This was not true, however, for two brushite stones tested; in these, brushite was closely intermixed with calcium oxalate. Micro CT x-ray attenuation values were collected for six minerals that could be found in regions that appeared to be pure, including uric acid (3515 – 4995 micro CT attenuation units, AU), struvite (7242 – 7969 AU), cystine (8619 – 9921 AU), calcium oxalate dihydrate (13815 – 15797 AU), calcium oxalate monohydrate (16297 – 18449 AU), and hydroxyapatite (21144 – 23121 AU). These AU values did not overlap. Analysis of intact stones showed excellent resolution of structural detail and could discriminate multiple mineral types within heterogeneous stones. Conclusions Micro CT gives excellent structural detail of urinary stones, and these results demonstrate the feasibility of identifying and localizing most of the common mineral types found in urinary calculi using laboratory CT.

Zarse Chad A; McAteer James A; Sommer Andre J; Kim Samuel C; Hatt Erin K; Lingeman James E; Evan Andrew P; Williams James C

2004-01-01

 
 
 
 
21

Use of laparoscopic-assisted cystoscopy for removal of urinary calculi in dogs.  

UK PubMed Central (United Kingdom)

Urinary calculi were removed by means of laparoscopic-assisted cystoscopy in 3 dogs. Two small abdominal incisions were made--1 for a laparoscope and 1 for placement of a Babcock forceps to aid in grasping and lifting the urinary bladder to the abdominal wall. A cystoscope and instruments for calculi removal were passed through a small cystotomy. Biopsy of the urinary bladder or other abdominal organs could also be performed by use of this technique. Laparoscopic-assisted cystoscopy was minimally invasive and provided clear images of the mucosal surface of the urinary bladder and proximal portion of the urethra for easy retrieval of urinary calculi. An imaging procedure should be performed to ensure complete removal of calculi.

Rawlings CA; Mahaffey MB; Barsanti JA; Canalis C

2003-03-01

22

Results of urinary dissolution therapy for radiolucent calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Purpose In this paper we present our experience with dissolution therapy of radiolucent calculi. Materials and Methods This was a retrospective analysis of patients who were offered urinary dissolution therapy between January 2010 and June 2011. Patients were treated with tablets containing potassium citrate and magnesium oxide. Partial dissolution was defined as at least a 50% reduction in stone size. Patients with complete or partial dissolution (more) were classified in the successful dissolution group. Patients with no change, inadequate reduction, increase in stone size and those unable to tolerate alkali therapy were classified as failures. Patient sex, stenting before alkalinization, stone size, urine pH at presentation and serum uric acid levels were analyzed using Fisher t-test for an association with successful dissolution. Results Out of 67, 48 patients reported for follow up. 10 (15%) had complete dissolution and 13 (19%) had partial dissolution. Alkalinization was unsuccessful in achieving dissolution in 25 (37%). Stenting before alkalinization, patient weight (< 60 vs. > 75kg) and serum uric acid levels (? 6 vs. > 6) were the only factors to significantly affected dissolution rates (p = 0.039, p 0.035, p 0.01 respectively). CONCLUSIONS A policy of offering dissolution therapy to patients with radiolucent calculi had a successful outcome in 34% of patients.

Maneesh, Sinha; Kumar, Prabhu; Prasanna, Venkatesh; Venkatesh, Krishnamoorthy

2013-01-01

23

Results of urinary dissolution therapy for radiolucent calculi.  

UK PubMed Central (United Kingdom)

PURPOSE: In this paper we present our experience with dissolution therapy of radiolucent calculi. MATERIALS AND METHODS: This was a retrospective analysis of patients who were offered urinary dissolution therapy between January 2010 and June 2011. Patients were treated with tablets containing potassium citrate and magnesium oxide. Partial dissolution was defined as at least a 50% reduction in stone size. Patients with complete or partial dissolution were classified in the successful dissolution group. Patients with no change, inadequate reduction, increase in stone size and those unable to tolerate alkali therapy were classified as failures. Patient sex, stenting before alkalinization, stone size, urine pH at presentation and serum uric acid levels were analyzed using Fisher t-test for an association with successful dissolution. RESULTS: Out of 67, 48 patients reported for follow up. 10 (15%) had complete dissolution and 13 (19%) had partial dissolution. Alkalinization was unsuccessful in achieving dissolution in 25 (37%). Stenting before alkalinization, patient weight (< 60 vs. > 75kg) and serum uric acid levels (? 6 vs. > 6) were the only factors to significantly affected dissolution rates (p = 0.039, p 0.035, p 0.01 respectively). CONCLUSIONS: A policy of offering dissolution therapy to patients with radiolucent calculi had a successful outcome in 34% of patients.

Sinha M; Prabhu K; Venkatesh P; Krishnamoorthy V

2013-01-01

24

Mineral composition of urinary calculi from potbellied pigs with urolithiasis: 50 cases (1982-2012).  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the mineral composition and anatomic location of urinary calculi and to investigate sex and reproductive status as predisposing factors for development of urolithiasis in potbellied pigs. DESIGN: Retrospective case series SAMPLES: Urinary calculi from 50 purebred and crossbred potbellied pigs. PROCEDURES: Laboratory records for urinary calculi of potbellied pigs submitted to the University of California-Davis Stone Laboratory from 1982 through 2012 were reviewed. Mineral composition of calculi was determined by polarized light microscopy, infrared spectroscopy, and, in some cases, x-ray diffractometry. RESULTS: Of the 48 urinary calculi analyzed by infrared spectroscopy, 21 (44%) were composed primarily of amorphous magnesium calcium phosphate; another 9 (19%) were primarily composed of calcium phosphate in the form of apatite. Of 50 urinary calculi, 22 (44%), 14 (28%), 10 (20%), 3 (6%), and 1 (2%) were removed from the urinary bladder only, urethra, both urinary bladder and urethra, urine, and renal pelvis, respectively. Sex of 6 potbellied pigs was not recorded. For 44 urinary calculi, 41 (93%) were from males (11 sexually intact males and 30 castrated) and 3 (7%) were from females (2 sexually intact females and 1 spayed). Among males, 73% (30/41) of submissions were from castrated males. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to results from studies in commercial pigs, the most common composition of urinary calculi identified in purebred and crossbred potbellied pigs was amorphous magnesium calcium phosphate. Potential predisposing factors for urolithiasis in potbellied pigs may be similar to those for urolithiasis in commercial pigs. These include diet, urinary tract infections, and sex. Thus, prevention of urolithiasis should target these potential predisposing factors.

Chigerwe M; Shiraki R; Olstad EC; Angelos JA; Ruby AL; Westropp JL

2013-08-01

25

Urinary calculi and urinary tract infection. A clinical and microbiological study.  

Science.gov (United States)

The problem of urinary calculi in association with urinary tract infection (UTI) was investigated. Fifty-two (7%) of 796 patients attending our outpatient stone clinic had UTI which was considered of pathogenic importance for their stone formation. Proteus was the most common microorganism. Metabolic disorders were found in one third and anatomical and functional abnormalities in two thirds of the patients. The infected patients had lower urinary calcium excretion and higher serum creatinine than idiopathic stone formers and had a higher frequency of stone operations. The prevalence of staghorn calculi as a cause of urimia was low (1.5% of 481 dialysis patients). Eight such patients were studied and six of them had metabolic and anatomical disorders. The time taken for the uremia to develop was 7.4 +/- 2.0 (SD) years. In 535 patients treated surgically for renal calculi, about one third had positive urine culture at the time of operation and E. coli was the most common bacterial strain (35%). Proteus was found in 28% and these patients had the highest frequency of UTI episodes, most of which occurred before hospitalization. Patients infected with E. coli had a higher frequency of phosphate-containing calculi than non-infected patients, in whom the highest frequency of calcium oxalate calculi was found. A new broad-spectrum cephalosporin, ceftazidime, was used as perioperative prophylaxis in 15 patients operated upon for renal calculi and UTI. Ten had bacterial growth in the renal pelvis and all strains were eradicated. Bacterial growth was found in two out of six cultured stones from patients with bacterial growth in the pelvis. The pharmacokinetics of the drug was studied and the decreases in the ceftazidime levels in serum and renal tissue seemed to be parallel. Bacterial binding of urinary isolates to hydroxyapatite (HAP) particles was studied. Two E. coli strains (A5089 and E7704) and one Proteus mirabilis strain (A5076), all obtained from stone patients, were compared with two E. coli strains (2683 and M7810) with well defined cell-surface properties. Hemagglutination tests were performed and the cell-surface hydrophobicity was determined by a salt-aggregating test. When the strains were cultured at 37 degrees C to promote fimbriae formation they hemagglutinated erythrocytes and displayed hydrophobic cell-surface properties, and showed higher capacity for binding to HAP than when cultured at 18 degrees C to suppress fimbriae formation, when they showed almost complete absence of hemagglutination and low cell-surface hydrophobicity. Bacterial cell-surface properties seem to influence the binding of uropathogens to HAP particles. PMID:3026032

Holmgren, K

1986-01-01

26

Association between schizophrenia and urinary calculi: a population-based case-control study.  

UK PubMed Central (United Kingdom)

BACKGROUND: People with schizophrenia have been demonstrated to have higher overall morbidity and all-cause mortality rates from general medical conditions. However, little attention has been given to the urinary system of people with schizophrenia. As no direct evidence has been reported demonstrating a link between schizophrenia and urinary calculi, this study utilized a population-based case-control study design to investigate the possibility of an association between schizophrenia and the occurrence of urinary calculi. METHOD: This study used data from the Taiwan Longitudinal Health Insurance Database. Cases consisted of 53,965 urinary calculi patients newly diagnosed between 2002 and 2008. In total, 269,825 controls were randomly selected and matched with the cases in terms of age and sex. Each person was traced to discern whether he had previously received a diagnosis of schizophrenia. Conditional logistic regression models were performed for the analysis. RESULTS: A total of 3,119 (1.0%) subjects had been diagnosed with schizophrenia prior to the index date. This included 0.7% of the patients with urinary calculi, and 1.0% of the controls. A prior diagnosis of schizophrenia was independently associated with a 30% decrease (95% CI?=?0.62-0.76) in the occurrence of urinary calculi. The reduction was even more remarkable in males (38%, 95% CI?=?0.55-0.71) and in elder individuals independent of gender (48% in those aged >69, 95% CI?=?0.36-0.77). CONCLUSION: Our findings suggest that there is an inverse association between schizophrenia and urinary calculi. Future studies are needed to elucidate the mechanisms by which schizophrenia negatively associates with urinary calculi.

Liu SP; Lin CC; Lin HC; Chen YH; Yu HJ

2013-01-01

27

[Experimental study of urinary calculi fragmentation with pulsed laser shockwave, based on their chemical composition  

UK PubMed Central (United Kingdom)

OBJECTIVES: To attempt to classify the resistance of urinary calculi to shock waves according to the chemical composition of the calculi most frequently treated in clinical practice. METHOD: Seventy four urinary calculi obtained after surgery were submitted to shock waves produced by an experimental neodyme glass phosphate pulsed laser, at a frequency of 532 nanometres, delivering impulses of 4.8 Joules lasting 25 nanoseconds with a recurrence of 1 second. The calculi (25 homogeneous: 90% of one constituent, 49 heterogeneous: > 45% < 90% of one constituent) had to be fragmented down to 2 mm fragments. The total fragmentation energy (TFE) required was the parameter adopted to classify calculi and to compare the fragmentation of various chemical compositions studied by infrared spectrophotometry. The TFE of 25 homogeneous calculi were compared to a microhardness study performed on calculi with the same chemical composition. The fragmentation thresholds energy (TFE) was used to compare the fragmentation thresholds of each type of calculi. Statistical analysis by ascending multiple regression was performed to classify the various factors likely to influence fragmentation. RESULTS: Two groups were able to be significantly distinguished according to whether the TFE required to obtain 2 mm fragments was greater than 200 Joules (cystine, weddellite, brushite, uric acid) or less than 200 Joules (weddellite, carbapatite, struvite). Only cystine and whewellite significantly increased the fragmentation threshold. For the 125 homogeneous calculi, the correlation with microhardness demonstrated an inverse relationship between friability and increased microhardness. A crossover between microhardness and friability to shock waves was only observed for whewellite and cystine. For the 49 heterogeneous calculi, this study showed that when weddellite was the predominant component of a stone, the friability tended to increase. Struvite and whewellite significantly facilitated and decreased fragmentation of heterogenous calculi, respectively. CONCLUSIONS: This study allowed urinary calculi to be classified into three groups: friable (weddellite, carbapatite, struvite), intermediary (brushite, uric acid, whewellite) and resistant (cystine). Although this laser cannot be used clinically, the constants were similar to those of pulsed lasers available in clinical practice and the results of the study corresponded to those already observed empirically by other teams or observed experimentally on a single stone corresponding to each type of chemical composition. The clinical application of this study would be to prospectively compare the results with those observed in clinical lithotripsy.

Doré B; Romain JP; Ingrand P; Irani J; Aubert J

1995-11-01

28

Percutaneous Management of Urinary Calculi in Horseshoe Kidneys  

Directory of Open Access Journals (Sweden)

Full Text Available Urolithiasis in horseshoe kidney presents a unique challenge in decision-making and technical aspects of calculus treatment. We present our experience with a group of patients with symptomatic calculi in their horseshoe kidneys. We had 8 patients with 9 horseshoe kidneys bearing calculi. They all underwent percutaneous nephrolithotomy. The median size of the calculi was 21 mm (range, 12 to 45 mm). Auxiliary therapeutic procedures were required in 2 patients who had residual calculi on control imaging. The stone-free status was observed in 6 patients (75.0%) at discharge, and in 7 (87.5%) after 3 months of follow-up. Surgical complications included bleeding in 2 patients that was controlled with complete bed rest and blood transfusion, and pleural injury in 1 which was managed conservatively.

Heshmatollah Soufi Majidpour; Vahid Yousefinejad

2008-01-01

29

Optimization of supervised self-organizing maps with genetic algorithms for classification of urinary calculi  

Science.gov (United States)

Supervised self-organizing maps were used for classification of 160 infrared spectra of urinary calculi composed of calcium oxalates (whewellite and weddellite), pure or in binary or ternary mixtures with carbonate apatite, struvite or uric acid. The study was focused to such calculi since more than 80% of the samples analyzed contained some or all of the above-mentioned constituents. The classification was done on the basis of the infrared spectra in the 1450 450 cm-1 region. Two procedures were used in order to find the most suitable size and for optimizing the self-organizing map of which that using the genetic algorithms gave better results. Using this procedure several sets of solutions with zero misclassifications were obtained. Thus, the self-organizing maps may be considered as a promising tool for qualitative analysis of urinary calculi.

Kuzmanovski, Igor; Trpkovska, Mira; Šoptrajanov, Bojan

2005-06-01

30

Unique ability of the Proteus mirabilis capsule to enhance mineral growth in infectious urinary calculi.  

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Struvite (MgNH4PO4.6H2O) calculi are a common complication of Proteus mirabilis urinary tract infections. Although urease is a major virulence factor in calculus formation, the polysaccharide capsule (CPS) of this organism also enhances struvite crystallization and growth in vitro (L. Clapham, R. J....

Dumanski, A J; Hedelin, H; Edin-Liljegren, A; Beauchemin, D; McLean, R J

31

Chronological variation in chemical composition of urinary calculi between 1965-68 and 1982-86 in north western India.  

UK PubMed Central (United Kingdom)

The chemical composition of 210 urinary calculi either spontaneously passed or surgically removed during January 1965-December 1968 was compared with the chemical composition of 1338 urinary calculi received during July 1982-June 86. The proportion of vesical calculi had significantly decreased from 30.48% (n = 64) during 1965-68 to 8.37% (n = 112), during 1982-86 (p less than 0.001). During 1965-68, magnesium was present in 16%, ammonium in 31% and urate in 33% of vesical calculi. But during 1982-86, the percentage of vesical calculi containing magnesium and ammonium was nil (p less than 0.001), but 76.8% of vesical calculi contained urate (p less than 0.001). Similarly, during 1965-68, 35.6% of renal calculi containing magnesium, 20% contained ammonium, 13.6% contained carbonate and urate was present in 32.2% of renal calculi. In contrast during 1982-86, magnesium was detected in only 0.24% of renal calculi (p less than 0.001), ammonium in 0.16% (p less than 0.001) and carbonate in 3.9% (p less than 0.001) but 57.4% of renal calculi contained urate (p less than 0.001).

Thind SK; Sidhu H; Nath R; Malakandaiah GC; Vaidyanathan S

1988-10-01

32

Study on concretions developed around urinary catheters and mechanisms of renal calculi development.  

UK PubMed Central (United Kingdom)

AIMS: To study the structure and composition of encrustation and concretions developed on urinary catheters to better understand their formation mechanism to be able to prevent them. METHODS: The surface of catheters was studied by direct and scanning electron microscopy observation. In vitro formation of encrustations was performed in synthetic urine. RESULTS: The surface of catheters was covered by a continuous layer of organic matter, on which a thin scale consisting of crystals of calcium oxalate monohydrate (COM), uric acid anhydrous or calcium phosphate developed. Encrustations observed on catheters generally exhibited the same composition as the previously developed renal calculi. In catheters collected from patients without previous episodes of renal calculi or with previous episodes of infected renal calculi in which infection was afterwards eradicated, on the first organic layer, in that case plate-like COM crystals forming a columnar layer were observed. In vitro experiments demonstrated that COM columnar structures were only formed when normocalciuric urine containing organic matter was used, and the presence of crystallization inhibitors, as phytate, notably delayed their formation. CONCLUSION: Calcium oxalate was the main crystalline phase developed on catheters inserted in patients, specially in the absence of urinary infection or urinary pH values <5.5 and high urinary uric acid levels. Thus, prophylaxis of encrustations may consist of preventive measures usually applied in cases of recurrent idiopathic calcium oxalate urolithiasis.

Grases F; Söhnel O; Costa-Bauzá A; Ramis M; Wang Z

2001-08-01

33

Laser ablation methods for analysis of urinary calculi: Comparison study based on calibration pellets  

Science.gov (United States)

Methods based on laser ablation, such as Laser-Induced Breakdown Spectroscopy (LIBS) and Laser-Ablation Inductively Coupled Plasma Mass/Optical Emission Spectrometry (LA-ICP-MS/OES) are particularly suitable for urinary calculi bulk and micro analysis. Investigation of spatial distribution of matrix and trace elements can help to explain their emergence and growth. However, quantification is still very problematic and these methods are often used only for qualitative elemental mapping. There are no commercially available standards, which would correspond to the urinary calculi matrix. Internal standardization is also difficult, mainly due to different crystalline phases in one kidney stone. The aim of this study is to demonstrate the calibration capabilities and examine the limitations of laser ablation based techniques. Calibration pellets were prepared from powdered human urinary calculi with phosphate, oxalate and urate matrix. For this comparative study, the most frequently used laser-ablation based analytical techniques were chosen, such as LIBS and LA-ICP-MS. Moreover, some alternative techniques such as simultaneous LIBS-LA-ICP-OES and laser ablation LA-LIBS were also utilized.

Št?pánková, K.; Novotný, K.; Vašinová Galiová, M.; Kanický, V.; Kaiser, J.; Hahn, D. W.

2013-03-01

34

Zinc disc implantation model of urinary bladder calculi and humane endpoints.  

Science.gov (United States)

The zinc disc implantation-induced urinary bladder calculi model in the rat is commonly used for preclinical evaluation of the antiurolithiatic activity of test compounds. Certain published reports state that relatively long durations for which zinc discs must be implanted in the bladders of rats. Hence, there is a need to refine this model. These investigations aimed to determine whether long-term studies using the zinc disc implantation model provide any additional data that affect the final outcomes of the study. In this study, we evaluated the effects of a well-known antiurolithiatic polyherbal drug, Cystone, for different treatment durations of 10, 20 and 48 days postimplantation. Our results indicate that even the shortest duration of 10 days is sufficient to reveal antiurolithiatic effects of a test drug. Hence, in the zinc disc implantation-induced urinary bladder calculi model, the study duration is proposed to be minimized so as to reduce the distress caused to the rats due to long-term exposure to the implant. Further, it is suggested that the growth of the bladder calculi can be monitored by taking X-ray radiographs of the bladder deposits to decide the time to terminate the study. Use of preformed calcium oxalate crystal instead of zinc discs, as suggested in earlier reports by others, may also be considered to avoid the sacrifice of rats at the end of the study. PMID:20385652

Singh, P K; Patil, C R; Harlalka, G V; Gaud, N P

2010-04-12

35

Zinc disc implantation model of urinary bladder calculi and humane endpoints.  

UK PubMed Central (United Kingdom)

The zinc disc implantation-induced urinary bladder calculi model in the rat is commonly used for preclinical evaluation of the antiurolithiatic activity of test compounds. Certain published reports state that relatively long durations for which zinc discs must be implanted in the bladders of rats. Hence, there is a need to refine this model. These investigations aimed to determine whether long-term studies using the zinc disc implantation model provide any additional data that affect the final outcomes of the study. In this study, we evaluated the effects of a well-known antiurolithiatic polyherbal drug, Cystone, for different treatment durations of 10, 20 and 48 days postimplantation. Our results indicate that even the shortest duration of 10 days is sufficient to reveal antiurolithiatic effects of a test drug. Hence, in the zinc disc implantation-induced urinary bladder calculi model, the study duration is proposed to be minimized so as to reduce the distress caused to the rats due to long-term exposure to the implant. Further, it is suggested that the growth of the bladder calculi can be monitored by taking X-ray radiographs of the bladder deposits to decide the time to terminate the study. Use of preformed calcium oxalate crystal instead of zinc discs, as suggested in earlier reports by others, may also be considered to avoid the sacrifice of rats at the end of the study.

Singh PK; Patil CR; Harlalka GV; Gaud NP

2010-07-01

36

Percutaneous Imaging-Guided Access for the Treatment of Calculi in Continent Urinary Reservoirs  

International Nuclear Information System (INIS)

Purpose: To describe our long-term experience with percutaneous access to continent urinary reservoirs for calculus removal. Patients and Methods: A retrospective study of 13 procedures in 10 patients was performed. In 2 of the 13 procedures, access and calculus removal was performed in a single session. In the other 11 procedures, initial access was obtained using ultrasonography,fluoroscopy, and/or computed tomography. The patients then returned ata later date for a second step where the access was dilated and the calculi were removed. Results: Access was achieved successfully in all cases with no complications. At mean follow-up time of 13.6 months (range 1-94 months) one patient had died of complications unrelated to her continent urinary reservoir. Another patient had been placed on suppressive antibiotics for recurrent calculi. The remaining patients were stone free and without late complication. Conclusions: Percutaneous removal of reservoir calculi can be performed safely, avoiding potential injury to the continence valve mechanism by a direct cystoscopic approach. We propose a two-stage procedure using CT guidance for initial access as the preferred technique.

2002-01-01

37

Structure and Composition of Non-Infectious Phosphate Calculi Formed in Patients with Low and High Urinary Phosphate Concentrations  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: The aim of this paper was to assess the relationships among chemical, phase and structural composition and etiopathogenic factors of non-infectious phosphate calculi formed in patients with low and high urinary phosphate concentrations, and to characterize the mechanism of their formation related on biochemical results. Material and Methods: Twelve samples of phosphate renal calculi were obtained, 4 from patients with low phosphaturia and 6 from patients with high urinary phosphate concentrations. Their chemical composition was determined qualitatively by energy dispersive X-ray analysis and quantitatively by spectrophotometric and thermal analysis; and their phase composition was determined by Fourier transform infrared transmission spectroscopy and X-ray diffraction. The structure of the calculi was assessed by scanning electron microscopy. Results: Non-infectious phosphate renal calculi of patients with low phosphaturia consist of poorly crystalline carbonate hydroxyapatite, whereas those of patients with high urinary phosphate concentrations consist of poorly crystalline hydroxyapatite with some amount of calcium oxalate crystals. Calculi of patients with high urinary phosphate concentrations are formed at urinary supersaturation with respect to hydroxyapatite and calcium oxalate about 4 times higher than in patients with low phosphaturia. Conclusion: In patients with low phosphaturia, the non-infectious phosphate renal calculi are formed in urine near pH 7 and contain only poorly crystalline carbonate hydroxyapatite. In patients with high urinary phosphate concentrations and hypercalciuria, the calculi are formed in urine near pH 6 and consist of both poorly crystalline hydroxyapatite and some amount of calcium oxalate crystals.

Felix Grases; Otakar Söhnel; Isabel Gomila

2013-01-01

38

Trace element studies in urolithiasis; preliminary investigation on mixed calcium oxalate-struvite urinary calculi  

International Nuclear Information System (INIS)

In this study the levels of the trace elements copper , zinc, lead, iron, aluminum, nickel, chromium along with magnesium, sodium and potassium were estimated in fifteen mixed calcium oxalate-struvite (CaOx/STR) urinary stones. The mean values of the combined results were, copper 4.24, zinc 1302, zinc 1302.10, lead 23.25, iron 36.83,nickel 0.69, chromium 1.93, magnesium 4530441, sodium 54.13 and potassium 5.93 ng mg/sup -1/. It was observed that zinc, aluminum and potassium levels were higher than in calcium oxalate(CaOx) calculi 0.05>P>0.02 and potassium levels were higher than in mixed calcium oxalate-hydroxy appetite (CaOx/APA) calculi, P

1999-01-01

39

[Extracorporeal shockwave destruction of urinary calculi after ultrasonic localization  

UK PubMed Central (United Kingdom)

Shock waves generated by an underwater spark gap discharge, focused by an ellipsoid can destroy most urinary stones extracorporeally. A device were stones are localized by ultrasound and where the ellipsoid itself could move to be positioned in the adequate position would obviate the need for a very expensive two fluoroscopes localisation system, and patient positioning device. A regular ultrasound probe was fixed on a multijointed metallic arm. From the measurements of the angles of every point it was possible to calculate the exact coordinates X, Y, Z, of the probe. This system, thought not extremely flexible allows to perform ultrasound examination of a kidney in the bathtub and localisation of stones in vivo in good conditions. When the stone was seen on the screen, the angles given to the joints were automatically recorded and the coordinates of the stone were instantly calculated with a personal computer. The computer program was able to calculate the displacement of the ellipsoid necessary to adjust its focal point on the X, Y, Z coordinates. The ellipsoid moved through a simple 3 motors system. Destruction of the stone was performed by shock waves. Progression of the disintegration was followed by plain X-rays performed in the bath tube with a portable X-ray apparatus. This device was tested in 7 dogs with stones surgically implanted in the renal pelvis. In every case, the stone was localised and disintegrated in fragments of the order of one millimeter using 700 to 2 000.(ABSTRACT TRUNCATED AT 250 WORDS)

Martin X; Mestas JL; Cathignol D; Margonari J; Gelet A; Dubernard JM

1985-01-01

40

Targeted dual-energy single-source CT for characterisation of urinary calculi: experimental and clinical experience  

International Nuclear Information System (INIS)

To assess the accuracy of targeted dual-energy single-source multi-detector CT (MDCT) for characterisation of urinary calculi. For proof of principle, 71 ex-vivo calculi underwent single-source 256-slice MDCT. Low-dose CT was performed in 154 patients with suspected urinary calculi. In 104 patients with urinary calculi targeted dual-energy imaging within one breath-hold was added. 46 patients with sufficient material for infrared-spectroscopy were analysed. Potential anatomical misregistrations between 80- and 140-kVp-images and HU-values were measured. DEIs (dual-energy-indices) were compared with the standard of reference. Effective doses were calculated. In 26 of 46 patients no misregistration was present. Mean deviations were 2.7 mm in the z-axis (16 patients) and 4.3 mm in the axial plane (10 patients). The DEIs were 0.018 ± 0.016 for uric acid (UA), 0.035 ± 0.015 for mixed UA and 0.102 ± 0.015 for calcified stones in-vitro and 0.017 ± 0.002 for UA, 0.050 ± 0.019 for mixed UA and 0.122 ± 0.024 for calcified calculi in-vivo. Significant differences were noted among calcium, mixed UA and UA stones (p

2012-01-01

 
 
 
 
41

Mineral association composition and trace elements in urinary calculi in Ostrava region patients from 1978 to 2010.  

Czech Academy of Sciences Publication Activity Database

chemical composition and trace elementsKód oboru RIV: DD - GeochemieImpakt faktor: 1.827, rok: 2011 http://www.europeanurology.com/article/S1569-9056%2811%2961151-2/pdf/E03+Mineral+association,+composition+and+trace+elements+in+urinary+calculi+in+Ostrava+region+patients+from+1978+to+2010

Martinec, PetrG; Plasgura, P.; Machat, J.; Stan?k, F.

42

Frequency-doubled dual-pulse freddy lithrotripsy laser in the treatment of urinary tract calculi  

Science.gov (United States)

Background and Purpose: The Frequency-Doubled Dual-Pulse Nd:YAG FREDDY laser is a short-pulsed, solid-state laser with wavelengths of 532 and 1064 nm that was developed for intracorporeal lithothripsy. This clinical study is designed to test its fragmentation efficiency in the treatment of urinary tract calculi. Patients and Methods: 500 urinary tract calculi treated in 194 female and 306 male patients with a mean age of 46 years. All patients were assessed one week post-op with a plain film of the kidneys, ureters and bladder. Stone-free rate and final outcome have been evaluated. Final outcome is defined as stone-free or residual fragments. Analysis has been made according to stone size, location and number of stones. The analgesia requirements during each treatment and complications have also been analyzed. Results: The overall stone-free rate for patients was 92.4%. The success rate for upper ureteral was 85.1% (126/148), while the rate for mid/lower was 95.3% (307/322). Bladder stone success rate 96.6% (29/30). Of all 38 incomplete fragmentations, 20 cases (4%) were treated with ESWL and 18 cases (3.6%) had open surgery. Neither fever nor pyonephrosis was reported. The average laser treatment time was 3.3 minutes and the average post-op hospitalization was 2.5 days. Conclusions: The FREDDY laser is an extremely efficient and safe minimally invasive lithotripsy treatment for urinary stones. It should be considered as an alternative treatment for urolithiasis.

Huang, Xuyuan; Bo, Juanjie; Chen, Bin; Wang, Yi-Xin

2005-07-01

43

Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (32%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in 3 (7%). In 29 (66%) patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007), but not associated with inferior calyx location (p = 0.09). Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure.

Marcello Cocuzza; Jose R. Colombo Jr; Antonio L. Cocuzza; Frederico Mascarenhas; Fabio Vicentini; Eduardo Mazzucchi; Miguel Srougi

2008-01-01

44

Outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper urinary tract calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVE: To assess the perioperative and financial outcomes of flexible ureteroscopic lithotripsy with holmium laser for upper tract calculi in 44 patients. MATERIALS AND METHODS: Between February 2004 and September 2006, 44 patients treated for upper tract stone with flexible ureteroscopic lithotripsy were evaluated. Renal stones were associated with collecting system obstruction in 15 (34%) patients, failed extracorporeal shock-wave lithotripsy (SWL) occurred in 14 (3 (more) 2%) patients, unilateral multiple stones in 18 (41%) patients, and multiple bilateral stones in 3 (7%). In 29 (66%) patients, the stone was located in the inferior calyx. Perioperative and financial outcomes were also evaluated. RESULTS: 50 procedures were performed in 44 patients. The mean stone burden on preoperative CT scan was 11.5 ± 5.8 mm. The mean operative time was 61.3 ± 29.4 min. The stone free rate was 93.1% after one procedure and 97.7% after a second procedure, with overall complication rate of 8%. Therapeutic success occurred in 92% and 93% of patients with lower pole stones and SWL failure, respectively. Treatment failure of a single session was associated with presence of a stone size larger than 15 mm (p = 0.007), but not associated with inferior calyx location (p = 0.09). Surgical disposables were responsible for 78% of overall costs. CONCLUSION: Flexible ureteroscopy using holmium laser is a safe and effective option for the treatment of upper urinary tract calculi. In addition, it can be considered an attractive option as salvage therapy after SWL failure or kidney calculi associated with ureteral stones. Stone size larger than 15 mm is associated with single session treatment failure.

Cocuzza, Marcello; Colombo Jr, Jose R.; Cocuzza, Antonio L.; Mascarenhas, Frederico; Vicentini, Fabio; Mazzucchi, Eduardo; Srougi, Miguel

2008-03-01

45

Application of physico-chemical procedures in the analysis of urinary calculi  

International Nuclear Information System (INIS)

All physico-chemical techniques used in the analysis of urinary calculi have inherent advantages and limitations. Although x-ray powder diffraction can identify constituents unambiguously, certain minor components can be missed. Infrared spectroscopy is more sensitive but band assignment at low concentrations is difficult. Scanning electron microscopy together with energy dispersive x-ray analysis permits the simultaneous investigation of morphology and chemical microstructure. With the electron microprobe, minor constituents can be detected but tedious sample preparation procedures are required. Transmission electron microscopy is extremely useful in determining constituent inter-relationships and ultrastructure but ultramicrotomy is very difficult. Thermal gravimetric analysis gives quantitative information easily but does not satisfactorily distinguish between struvite and brushite. In an attempt to assess the accuracy of chemical analyses, 62 calculi were investigated applying several chemical tests. Those for Mg2+, PO4(3-), NH4+ and uric acid proved highly reliable while that for Ca2+ often yielded an incorrect result. The test for oxalate was totally unsatisfactory. Investigators of stone composition and structure should include x-ray diffraction (or infrared spectroscopy) and scanning electron microscopy as their methods of first choice. In addition, chemical or thermogravimetric analyses should be utilized in an auxiliary capacity

1985-01-01

46

Application of physico-chemical procedures in the analysis of urinary calculi  

Energy Technology Data Exchange (ETDEWEB)

All physico-chemical techniques used in the analysis of urinary calculi have inherent advantages and limitations. Although x-ray powder diffraction can identify constituents unambiguously, certain minor components can be missed. Infrared spectroscopy is more sensitive but band assignment at low concentrations is difficult. Scanning electron microscopy together with energy dispersive x-ray analysis permits the simultaneous investigation of morphology and chemical microstructure. With the electron microprobe, minor constituents can be detected but tedious sample preparation procedures are required. Transmission electron microscopy is extremely useful in determining constituent inter-relationships and ultrastructure but ultramicrotomy is very difficult. Thermal gravimetric analysis gives quantitative information easily but does not satisfactorily distinguish between struvite and brushite. In an attempt to assess the accuracy of chemical analyses, 62 calculi were investigated applying several chemical tests. Those for MgS , PO4(T ), NHU and uric acid proved highly reliable while that for CaS often yielded an incorrect result. The test for oxalate was totally unsatisfactory. Investigators of stone composition and structure should include x-ray diffraction (or infrared spectroscopy) and scanning electron microscopy as their methods of first choice. In addition, chemical or thermogravimetric analyses should be utilized in an auxiliary capacity.

Rodgers, A.L.

1985-01-01

47

[X-ray effect on patients with upper urinary tract calculi during extracorporeal shock wave lithotripsy].  

Science.gov (United States)

This study reports the results of radiation exposure to 90 patients with upper urinary tract calculi during Extracorporeal Shock Wave Lithotripsy (ESWL). A domestically made JT-ESWL-I lithotripter was used. Radiation exposure to the patients averaged 67.02 mSv at 65-70 kV, 2 mA. The data indicated that the amount of radiation exposure is related to the number, size, location and the radiodensity of the stone, and also the number of shock wave and the time of fluoroscopy exposure given to the patients. The results of the chromosome aberration and the micronucleus of lymphocytes assay in the human blood are reported and the prevention of radiation exposure is discussed. PMID:2086075

Wang, G M

1990-11-01

48

[X-ray effect on patients with upper urinary tract calculi during extracorporeal shock wave lithotripsy  

UK PubMed Central (United Kingdom)

This study reports the results of radiation exposure to 90 patients with upper urinary tract calculi during Extracorporeal Shock Wave Lithotripsy (ESWL). A domestically made JT-ESWL-I lithotripter was used. Radiation exposure to the patients averaged 67.02 mSv at 65-70 kV, 2 mA. The data indicated that the amount of radiation exposure is related to the number, size, location and the radiodensity of the stone, and also the number of shock wave and the time of fluoroscopy exposure given to the patients. The results of the chromosome aberration and the micronucleus of lymphocytes assay in the human blood are reported and the prevention of radiation exposure is discussed.

Wang GM

1990-11-01

49

[Oral purine loading test for latent metabolic disorders of uric acid in patients with calcium containing upper urinary calculi  

UK PubMed Central (United Kingdom)

For the detection of metabolic disorders of uric acid in upper urolithiasis, an oral purine loading test was performed in 78 patients with calcium-containing calculi, 5 patients with uric acid calculi, and 34 stone free subjects. From the results of the normal subject group, the criteria of hyperuricemia, latent hyperuricemia, hyperuricosuria and latent hyperuricosuria were proposed. In calcium-containing stone formers, 6 male patients showed hyperuricosuria, 18 male patients and 4 female patients showed latent hyperuricemia or latent hyperuricosuria. In uric acid urinary stone formers, all cases showed latent hyperuricemia or latent hyperuricosuria. These findings indicated that the metabolic disorders of uric acid might be one of the risk factors for the formation of calcium containing urinary stones, as well as uric acid urinary stones.

Yoneda K

1992-08-01

50

Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol  

Energy Technology Data Exchange (ETDEWEB)

The efficiency and radiation dose of a low-dose dual-energy (DE) CT protocol for the evaluation of urinary calculus disease were evaluated. A low-dose dual-source DE-CT renal calculi protocol (140 kV, 46 mAs; 80 kV, 210 mAs) was derived from the single-energy (SE) CT protocol used in our institution for the detection of renal calculi (120 kV, 75 mAs). An Alderson-Rando phantom was equipped with thermoluminescence dosimeters and examined by CT with both protocols. The effective doses were calculated. Fifty-one patients with suspected or known urinary calculus disease underwent DE-CT. DE analysis was performed if calculi were detected using a dedicated software tool. Results were compared to chemical analysis after invasive calculus extraction. An effective dose of 3.43 mSv (male) and 5.30 mSv (female) was measured in the phantom for the DE protocol (vs. 3.17/4.57 mSv for the SE protocol). Urinary calculi were found in 34 patients; in 28 patients, calculi were removed and analyzed (23 patients with calcified calculi, three with uric acid calculi, one with 2,8-dihyxdroxyadenine-calculi, one patient with a mixed struvite calculus). DE analysis was able to distinguish between calcified and non-calcified calculi in all cases. In conclusion, dual-energy urinary calculus analysis is effective also with a low-dose protocol. The protocol tested in this study reliably identified calcified urinary calculi in vivo. (orig.)

Thomas, C. [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Patschan, O.; Nagele, U.; Stenzl, A. [University of Tuebingen, Department of Urology, Tuebingen (Germany); Ketelsen, D.; Tsiflikas, I.; Reimann, A.; Brodoefel, H.; Claussen, C.; Kopp, A.; Heuschmid, M.; Schlemmer, H.P. [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Buchgeister, M. [University of Tuebingen, Medical Physics, Department of Radiation Oncology, Tuebingen (Germany)

2009-06-15

51

Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol  

International Nuclear Information System (INIS)

The efficiency and radiation dose of a low-dose dual-energy (DE) CT protocol for the evaluation of urinary calculus disease were evaluated. A low-dose dual-source DE-CT renal calculi protocol (140 kV, 46 mAs; 80 kV, 210 mAs) was derived from the single-energy (SE) CT protocol used in our institution for the detection of renal calculi (120 kV, 75 mAs). An Alderson-Rando phantom was equipped with thermoluminescence dosimeters and examined by CT with both protocols. The effective doses were calculated. Fifty-one patients with suspected or known urinary calculus disease underwent DE-CT. DE analysis was performed if calculi were detected using a dedicated software tool. Results were compared to chemical analysis after invasive calculus extraction. An effective dose of 3.43 mSv (male) and 5.30 mSv (female) was measured in the phantom for the DE protocol (vs. 3.17/4.57 mSv for the SE protocol). Urinary calculi were found in 34 patients; in 28 patients, calculi were removed and analyzed (23 patients with calcified calculi, three with uric acid calculi, one with 2,8-dihyxdroxyadenine-calculi, one patient with a mixed struvite calculus). DE analysis was able to distinguish between calcified and non-calcified calculi in all cases. In conclusion, dual-energy urinary calculus analysis is effective also with a low-dose protocol. The protocol tested in this study reliably identified calcified urinary calculi in vivo. (orig.)

2009-01-01

52

Litiasis urinaria en adultos con mielomeningocele/ Urinary calculi in myelomeningocele adults  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción y objetivos: Los avances en el tratamiento de los nacidos con mielomeningocele (MMC) han logrado un gran aumento en su supervivencia, permitiéndoles una longevidad nunca antes alcanzada, pero todavía son escasos los datos concernientes a los problemas urológicos que estos enfermos plantean durante su vida adulta. Hemos evaluado las características de la litiasis urinaria en adultos nacidos con MMC así como los tratamientos empleados en la misma. Materia (more) l y métodos: Revisamos 52 pacientes nacidos con MMC de entre 18 y 40 años, atendidos durante los últimos 14 años en nuestro hospital, con una media de seguimiento de 6,7 años. Resultados: Se diagnosticaron de litiasis urinaria 10 pacientes (19,2%). Tres formaron cálculos renales (5,7%), y uno de ellos, junto con 7 pacientes más, desarrollaron cálculos vesicales (15,3%). El nivel neurológico fue S1 en otros dos. El tipo de disfunción neurógena del tracto urinario inferior fue de lesión múltiple pura de neurona motora inferior en 6 casos, de neurona motora superior en 1, lesión múltiple mixta en otro, no pudiéndose valorar en el restante. Dos pacientes tenían una ampliación vesical y uno de estos junto con otros 3 pacientes era portador de AMS-800 no funcionantes. La litiasis vesical se trató endoscopicamente en 14 ocasiones y mediante cistolitotomía suprapúbica en 4, junto a la retirada de AMS-800 en 3 de ellas. Un paciente expulsó un pequeño cálculo. En un paciente fueron necesarias 2 litotricias extracorpóreas y 2 nefrolitotomías percutáneas. Tres pacientes tuvieron múltiples recidivas. Conclusiones: La litiasis urinaria es frecuente en los adultos con MMC. Determinadas características de estos pacientes, junto con su configuración anatómica y algunos tratamientos empleados en ellos, ocasionan problemas de diagnostico, tratamiento y prevención de los cálculos que forman. Abstract in english Introduction and objectives: the improvements in the management of newborns with myelomeningocele (MMC) have obtained a big increase in survival, allowing them to get longevity like never before, but data regarding urologic diseases during adult age are still missing. We herein evaluate the features of urinary lithiasis in adults born with MMC and the therapies used for its treatment. Material and method: we review 52 patients diagnosed at birth of MMC, between 18 and 40 (more) years old, treated in our institution, with a mean follow-up of 6.7 years. Results: 10 patients (19.2%) were diagnosed of urolithiasis. Three developed kidney calculi and one of them, with 7 more patients, developed bladder calculi (15.3%). The neurological level was S1 in the other two. The type of neurogenic dysfunction of inferior urinary tract was multiple lesion of lower motor neurone in 6 cases, upper motor neurone in 1 case, multiple mixed lesion in 1 case and in case it was impossible to determine. Two patients had a bladder augmentation procedure and one of these with other 3 patients had a non-functional AMS-800 artificial urinary sphincter. Bladder stones were treated endoscopically in 14 procedures and by suprapubic cystolithotomy in 4 procedures, combined with removal of AMS-800 in 3 of them. One patient spontaneously passed a small stone. In one case, 2 ESWL and 2 percutaneous nephrolithotomies were needed. Three patients developed multiple recurrences during follow-up. Conclusions: urinary lithiasis is common in adults with MMC. Some distinct features of these patients, together with their anatomical configuration and some therapies used in them, cause diagnostic, therapeutic and prophylaxis issues for the calculi they may develop.

Verdú Tartajo, F.; Salinas Casado, J.; Herranz Amo, F.; Díez Cordero, J.M.; Durán Merino, R.; Hernández Fernández, C.

2006-08-01

53

Fluoroless ureteroscopy: zero-dose fluoroscopy during ureteroscopic treatment of urinary-tract calculi.  

UK PubMed Central (United Kingdom)

PURPOSE: Fluoroscopy usage during endoscopic procedures exposes the patient and operating room staff to ionizing radiation. Pooled mean fluoroscopy usage time during ureteroscopy reported from recent literature is 144 seconds per case. The purpose of this study was to evaluate radiation exposure using a minimal-use fluoroscopy protocol during ureteroscopic treatment of urinary-tract calculi and determine patient and perioperative factors associated with increased fluoroscopy time. MATERIALS AND METHODS: A protocol was developed to access the ureter with the ureteroscope without fluoroscopy usage, and minimize radiation utilization during each portion of the case. Over a 16-month period, fluoroscopy usage and radiation dose for all cases involving retrograde ureteroscopy for a single surgeon were prospectively recorded. A chart review was performed on patient factors and intraoperative events. RESULTS: In 162 consecutive ureteroscopic procedures for nephrolithiasis, there were 156 renal units with fluoroscopic usage data, of which total mean and median fluoroscopy time, including stent placement, was 3.3 and 2.0 seconds (0-35 seconds), respectively. Excluding fluoroscopy usage to confirm ureteral stent placement, 75% of all cases did not require any fluoroscopy time (fluoroless), and 85% required 2 seconds or less. Of the 98 renal units with radiation dosage data, the total mean and median radiation dose measured as air kerma was estimated at 1.1 and 0.6 mGy (0.0-17.5 mGy), respectively. Reasons for utilization of total fluoroscopy time more than 5 seconds included stone impaction, ureteral tortuosity or narrowing, collecting system aberrant anatomy, and difficult ureteral stent placement. CONCLUSIONS: The reduced fluoroscopy protocol resulted in minimal fluoroscopy time and radiation exposure, significantly lower than reported in the literature. Fluoroless ureteroscopy is safe and feasible in the majority of ureteroscopic cases and lessens exposure to patients and staff.

Hsi RS; Harper JD

2013-04-01

54

Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to evaluate the efficacy of helical CT using a combination of CT-attenuation values and visual assessment of stone density as well as discriminant linear analysis to predict the chemical composition of urinary calculi. One hundred human urinary calculi were obtained from a stone-analysis laboratory and placed in 20 excised pig kidneys. They were scanned at 80, 120 and 140 kV with 3-mm collimation. Average, highest and lowest CT-attenuation values and CT variability were recorded. The internal calculus structure was assessed using a wide window setting, and visual assessment of stone density was recorded. A stepwise discriminant linear analysis was performed. The following three variables were discriminant: highest CT-attenuation value, visual density, and highest CT-attenuation value/area ratio, all at 80 kV. The probability of correctly classifying stone composition with these three variables was 0.64, ranging from 0.54 for mixed calculi to 0.69 for pure calculi. The probabilities of correctly classifying calculus composition were: 0.91 for calcium oxalate monohydrate and brushite, 0.89 for cystine, 0.85 for uric acid, 0.11 for calcium oxalate dihydrate, 0.10 for hydroxyapatite, and 0.07 for struvite calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, 81% of the calculi were correctly classified. Assessment at 80 kV of the highest CT-attenuation value, visual density and the highest CT-attenuation value/area ratio accurately predicts the chemical composition of 64-81% of urinary calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, all cystine, calcium oxalate monohydrate and brushite calculi were correctly classified. (orig.)

Bellin, Marie-France; Meric, Jean-Baptiste [AP-HP, Department of Radiology, Hopital Paul-Brousse, Villejuif Cedex (France); Renard-Penna, Raphaelle; Grenier, Philippe [AP-HP, Department of Radiology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Conort, Pierre; Richard, Francois [AP-HP, Department of Urology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Bissery, Anne; Mallet, Alain [AP-HP, Department of Biostatistics, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Daudon, Michel [AP-HP, Department of Biochemistry, Hopital Necker, Paris Cedex 15 (France)

2004-11-01

55

Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density  

International Nuclear Information System (INIS)

The aim of this study was to evaluate the efficacy of helical CT using a combination of CT-attenuation values and visual assessment of stone density as well as discriminant linear analysis to predict the chemical composition of urinary calculi. One hundred human urinary calculi were obtained from a stone-analysis laboratory and placed in 20 excised pig kidneys. They were scanned at 80, 120 and 140 kV with 3-mm collimation. Average, highest and lowest CT-attenuation values and CT variability were recorded. The internal calculus structure was assessed using a wide window setting, and visual assessment of stone density was recorded. A stepwise discriminant linear analysis was performed. The following three variables were discriminant: highest CT-attenuation value, visual density, and highest CT-attenuation value/area ratio, all at 80 kV. The probability of correctly classifying stone composition with these three variables was 0.64, ranging from 0.54 for mixed calculi to 0.69 for pure calculi. The probabilities of correctly classifying calculus composition were: 0.91 for calcium oxalate monohydrate and brushite, 0.89 for cystine, 0.85 for uric acid, 0.11 for calcium oxalate dihydrate, 0.10 for hydroxyapatite, and 0.07 for struvite calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, 81% of the calculi were correctly classified. Assessment at 80 kV of the highest CT-attenuation value, visual density and the highest CT-attenuation value/area ratio accurately predicts the chemical composition of 64-81% of urinary calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, all cystine, calcium oxalate monohydrate and brushite calculi were correctly classified. (orig.)

2004-01-01

56

[Effect of the chemical nature of urinary calculi on the results of extracorporeal shockwave lithotripsy  

UK PubMed Central (United Kingdom)

137 patients were treated by ESWL with a Sonolith 2000 lithotriptor using ultrasonography localization. 132 patients were eligible for review. Calculi were caliceal in 85 cases, pelvic in 51 cases, in the upper ureter in 1 case; 26 stones were treated by the "push and bang" technique with ureteric stent. Fragmentation rate was 83.9% and stone free rate at 3 months was 68.5%. Failure cases were reviewed: non fragmentation (16.1%) and insufficient fragmentation (15.6%): 14 calculi were analysed by infra red spectrophotometry and correlated with radiodensity on pre ESWL plain X-ray. Hardness and friability criteria were described. Calculi with different radiographic appearances respond differently to shock wave fragmentation. Some stone compositions such as calcium oxalate monohydrate pure or mixed with apatite and calcified uric acid are difficult to break by ESWL. These calculi represented almost 30% of the series. Another treatment should be proposed to improve the results of ESWL.

Doré B; Grange P; Aubert J

1990-01-01

57

Melamine-induced urinary calculi in infants--sonographic manifestations and outcomes 1 year after exposure.  

UK PubMed Central (United Kingdom)

BACKGROUND: In 2008, the melamine-tainted-milk incident started with reports of increased incidence of urolithiasis in infants in China. Affected children were screened for urolithiasis. OBJECTIVE: The purpose of this study was to analyze sonographic characterization of infant melamine-induced urolithiasis. MATERIALS AND METHODS: Transabdominal US examination was done in 603 infants with melamine-induced calculi. The imaging characteristics of calculi and hydronephrosis were analyzed. Follow-up US imaging was performed. RESULTS: Comet-tail sign was seen behind the calculus of <4 mm. Calculi of ? 4 mm were found in 299 inpatients with clear posterior border and with or without light shadowing. Solitary and multiple stones had similar incidence. Incidence of calculi in the inferior renal calyx was the highest (55.2%) in inpatients. Calculus size in inpatients age 2-3 years was smaller than that of children younger than 2 years old (P < 0.05). Inpatients age 2-3 years had the highest incidence rate (48.0%) of hydronephrosis. CONCLUSION: Calculi of <4 mm manifested as hyperechoic foci near the renal papillae, while calculi of ? 4 mm usually manifested as echogenic foci with visible inferior edge in the renal calyx. Hydronephrosis was a common imaging finding in inpatients ages 2-3 years.

Nie F; Li XJ; Shang PF; Wang Y

2013-04-01

58

Microsecond-long flash photography of laser-induced ablation of biliary and urinary calculi.  

UK PubMed Central (United Kingdom)

High-speed flash photographs of laser-induced fragmentation of biliary and renal calculi under water were obtained using one-microsecond-long dye-laser pulses for both illumination and ablation. The photographs show the presence of a bubble with irregularities on the surface that suggest the early presence of debris or microbubbles. Fragmentation occurs before the bubble collapses, suggesting that fragmentation is due to laser-induced acoustic transients rather than to collapse of a laser-induced cavitation bubble.

Teng P; Nishioka NS; Farinelli WA; Anderson RR; Deutsch TF

1987-01-01

59

Increased risk of urinary tract calculi among patients with diabetes mellitus--a population-based cohort study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the inter-relationship among diabetes, urinary tract infection (UTI), and urinary tract calculi (UTC). METHODS: This study used Taiwan's National Health Insurance claims data of ambulatory care visits and hospitalizations. A total of 12,257 newly diagnosed diabetes cases in 2000-2002 and 96,781 controls were followed to the end of 2007. The person-year approach with Poisson assumption was used to estimate the incidence density (ID) of UTC by diabetic status. Relative risk of UTC in relation to diabetes and UTI were estimated from Cox proportional hazard model with adjustment for sociodemographic variables and comorbidities. RESULTS: Over nearly 8 years of follow-up, 8.9% of diabetes and 7.2% of control subjects sought ambulatory care or were hospitalized for UTC, representing the ID of 14.4 and 11.4 per 1000 person-years, respectively. The multivariate analysis indicated that UTC risk was independently associated with diabetes (hazard ratio 1.18, 95% CI 1.10-1.27) and UTI (HR 1.68, 95% CI 1.60-1.76). The hazard ratio of UTC in relation to diabetes in men and women without UTI was 1.24 and 1.26, respectively. Diabetes may further increase the rate of UTC in women with UTI, with an hazard ratio increased from 1.79-2.12. Such additive effect by diabetes in men with UTI was only marginal (HR 1.68 vs 1.67). CONCLUSION: This cohort study provides epidemiologic support for the causal association between diabetes and UTC, which is independent of UTI. In addition, female patients with UTI accompanied by diabetes tended to be associated with a greater rate of UTC.

Chen HS; Su LT; Lin SZ; Sung FC; Ko MC; Li CY

2012-01-01

60

[Effects of diuretic therapy on spontaneous expulsion of urinary calculi, urinary pH, and crystalluria in lithiasic patients  

UK PubMed Central (United Kingdom)

OBJECTIVE: High urine volume is known to be an effective measure for preventing stone recurrence. However, only few studies have investigated its effects on crystalluria and spontaneous passage of calculi. The aim of the study was to assess the effects of high diuresis on stone expulsion and recurrence. PATIENTS AND METHODS: 219 patients were consulting for a first stone episode in Urology units in the Mostaganem area between September 1996 and December 1999. All stones were under 6 mm in size. The patients were divided in two groups: group I included 129 patients (68 males, 61 females) who agreed to be on a high water intake, at least 3 liters per day, over a two months period and to be followed periodically by crystalluria examination in the first morning urine; group II included 90 patients (63 males, 27 females) who declined diuresis advice and urine collection for crystalluria examination. First morning urine collected in patients of group I were examined before (2.95 voidings per subject) and while on diuresis course (2.84 voidings per subject). For each sample, the urine pH was measured and crystals were looked for by polarizing microscopy. Stones spontaneously passed were collected and analyzed by infrared spectroscopy. Group II represented the control group for stone passing and recurrence. RESULTS: Crystalluria was present in 52.4% of urine samples before starting diuresis and decreased at 22.9% of urine samples on high diuresis. Mean pH value increased from 5.73 +/- 0.46 before to 6.09 +/- 0.47 (p < 10-6) while on diuresis course in males and from 5.8 +/- 0.68 to 6.24 +/- 0.66 in females (p < 10-6). The most frequent crystalline species was weddellite. Over the study period, 98 patients (76%) in group I and only 13 patients (14.4%) in group II passed stones spontaneously (p < 10-6 contre group I). No stone recurrence was observed in group I while 37.8% of patients in group II presented at least one stone recurrence (p < 10-7). CONCLUSION: A high diuresis is an effective measure (1) to make easier the passing of stone under 6 mm in size; (2) to reduce the occurrence of crystalluria; (3) to reduce significantly, because of its favourable effect on urine pH, the formation of pH-dependent crystalline phases, thus decreasing heterogeneous nucleation process of calcium oxalate and stone recurrence.

Kaid-Omar Z; Belouatek A; Driouch A; Taleb-Bendiab H; Lacour B; Addou A; Daudon M

2001-06-01

 
 
 
 
61

Urinary biochemical profile of patients with ureteric calculi in Jodhpur region (north western India).  

UK PubMed Central (United Kingdom)

Urine chemistry of 42 normal subjects (NS) and 59 ureteric stone formers (SF) from Jodhpur region of Rajasthan, India is presented. Twenty four hour urinary levels of calcium, oxalic acid and uromucoids were significantly higher and levels of magnesium, citric acid and inorganic phosphorus were significantly lower in SF as compared to NS. No significant difference was observed in the uric acid, sodium and potassium levels in the two groups. Significant correlation was observed between calcium and magnesium; calcium and oxalic acid; calcium and citric acid; magnesium and oxalic acid; and oxalic acid and citric acid in NS on the basis of mmol/l but not on the basis of mmol/24 h. Calcium and oxalic acid correlation was uninfluenced by magnesium and citric acid levels. The log of risk factor index (RI) was higher (p less than 0.001) in SF (-1.652) as compared to NS (-2.103). The log of ion activity product (IAP) was also higher (p less than 0.001) in SF (-3.192 X 10(-3)) than in NS (-2.914 X 10(-1)). Based on RI and IAP, a scale has been devised for the prediction of the risk of stone formation and recurrence.

Singh PP; Pendse AK; Rathore V; Dashora PK

1988-01-01

62

A simple objective method to assess the radiopacity of urinary calculi and its use to predict extracorporeal shock wave lithotripsy outcomes.  

UK PubMed Central (United Kingdom)

PURPOSE: We describe an objective method to evaluate kidney stone radiopacity for use in selection of cases suitable for ESWL. MATERIALS AND METHODS: We recruited 76 adult patients with a solitary 1 to 2 cm renal pelvic stone. All patients underwent routine plain x-ray of the urinary tract but an aluminum step wedge (Gammex) was adapted to the cassette before x-ray exposure. This x-ray was then digitized and analyzed by histogram to calculate the gray level of the stone and of each step of the aluminum step wedge. This allowed radiographic stone density to be expressed in mm aluminum equivalent. All patients also underwent abdominopelvic computerized tomography and then ESWL was started. RESULTS: Stone density on plain x-ray was 1.83 to 5.93 mm aluminum equivalent. There was a positive correlation between these values and stone attenuation values on computerized tomography (r(2) 0.83, p <0.005). The 12 patients in whom ESWL failed were found to have stones of significantly higher density than stones in patients with complete stone fragmentation (mean +/- SD 4.8 +/- 0.74 vs 3.35 +/- 0.88 mm aluminum equivalent, p <0.005). There was also a positive correlation between stone radiopacity in mm aluminum equivalent and the total number of shock waves required to achieve complete fragmentation (r(2) 0.66, p <0.005). CONCLUSIONS: The aluminum step wedge with plain x-ray of the urinary tract provides a good reference for objectively assessing the radiopacity of renal calculi.

el-Gamal O; el-Badry A

2009-07-01

63

[Crystallography in the analysis of urinary calculi in Spain. Historical review of the Spanish contribution to the subject].  

Science.gov (United States)

We make a review of the Spanish contribution to the field of crystallography applied to the study of Urinary Lithiasis and assess the current state of the same. We emphasize, by virtue of the number and quality of their works, CIFUENTES, DELATTE and COLLS, SOMACARRERA and ALONSO as pioneers of ultramicroscopic studies. GUILEN CAVERO because of his impressive explanation of Lithogenesis and B. PINTO for his contribution to the generalization of the knowledge of analysed calculation by means of crystallographic methods. PMID:6994662

Torres Ramírez, C; Aguilar Ruíz, J; Zuluaga Gómez, A; del Río Samper, S; Martínez Torres, J L

64

[Crystallography in the analysis of urinary calculi in Spain. Historical review of the Spanish contribution to the subject  

UK PubMed Central (United Kingdom)

We make a review of the Spanish contribution to the field of crystallography applied to the study of Urinary Lithiasis and assess the current state of the same. We emphasize, by virtue of the number and quality of their works, CIFUENTES, DELATTE and COLLS, SOMACARRERA and ALONSO as pioneers of ultramicroscopic studies. GUILEN CAVERO because of his impressive explanation of Lithogenesis and B. PINTO for his contribution to the generalization of the knowledge of analysed calculation by means of crystallographic methods.

Torres Ramírez C; Aguilar Ruíz J; Zuluaga Gómez A; del Río Samper S; Martínez Torres JL

1980-05-01

65

El artefacto de centelleo en la caracterización de los cálculos urinarios/ Role of twinkling artifact in characterization of urinary calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción: La caracterización de los cálculos renales está cada vez cobrando mayor importancia como paso previo a la toma de decisiones terapéuticas tales como la nefrolitotomía percutánea (NLP) y la litotricia extracorpórea por ondas de choque (LEOC). En algunos estudios se ha publicado que el artefacto de centelleo (artefacto de ecografía de flujo en color) puede ser de utilidad en la detección de piedras en el riñón. En este estudio se pretende dilucidar (more) si la presencia o ausencia del artefacto de centelleo tendría alguna relación con la composición química de los cálculos. Material y método: En un estudio prospectivo se incluyó a pacientes con cálculos renales de > 0,5cm. Se examinó a 70 pacientes mediante rayos X, pielografía intravenosa, tomografía computarizada sin contraste y ecografía doppler espectral y a color. El artefacto se consideró de grado 1 si sólo ocupaba una parte de la sombra acústica, considerándose de grado 2 si ocupaba la totalidad de la sombra. Se trató a los pacientes con cálculos de menos de 2cm con LEOC, y a aquellos con piedras de mayor tamaño se les derivó a tratamiento con NLP. Resultados: No se detectó artefacto alguno (grado 0) en 11 sujetos, detectándose el grado 1 en 25 y el grado 2 en 24. Se encontró una relación significativa entre el aumento en artefactos de centelleo y tamaño del cálculo (p Abstract in english Introduction: Stone characterization is becoming important before decision of treatment such as percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL). Some studies have reported that the twinkling artifact (color-flow ultrasonography artifact) may be useful to detect urinary stones. This study aims to determine whether the presence or absence of the twinkling artifact is correlated with the chemical composition of the stones. Material and me (more) thod: Patients with renal stones > 0.5cm were included in a prospective study. Sixty patients were examined with x-ray film, intravenous pyelography, non-contrast computerized tomography, and color and spectral doppler ultrasonography. The artifact was considered grade 1 when occupied only one portion of the acoustic shadowing and when the artifact occupied the entire acoustic shadowing was considered grade 2. Patients with stones smaller than 2 cm were treated with SWL and patients with stones larger than 2cm were treated with PCNL. Results: No artifact (grade 0) was detected in 11 subjects, grade 1 in 25 and grade 2 in 24. Significant relationship was found between the increase in twinkling artifact and stone size (p

Alan, C.; Koçoglu, H.; Kosar, S.; Karatag, O.; Resit Ersay, A.; Erhan, A.

2011-08-01

66

Por qué y cómo hemos de analizar los cálculos urinarios/ Why and how we must analyse urinary calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Contexto: Existe una heterogeneidad de criterio sobre la utilidad del análisis del cálculo urinario, así como de cuál es la metodología más adecuada. En esta revisión se presenta el análisis de la litiasis mediante la técnica del estudio morfoconstitucional basada en la combinación de la microscopía estereoscópica (MEST) con el estudio de infrarrojos (EIR). Resumen de la evidencia: Existen múltiples técnicas de análisis del cálculo: análisis químico, mic (more) roscopía electrónica, difracción por rayos X, MEST y EIR. Mediante la revisión de cada una de estas técnicas y el estudio de varios casos clínicos, el presente trabajo muestra la utilidad clínica del análisis del cálculo, así como las ventajas e inconvenientes de cada uno de los citados métodos. Por otro lado, se evidencia cómo el análisis mediante el estudio morfoconstitucional es el que más información clínica de utilidad ofrece al urólogo. Asimismo, se presenta la clasificación de las litiasis basadas en este método y su correlación clínica con el paciente. Conclusiones: El análisis del cálculo mediante la técnica del estudio morfoconstitucional aporta más información que el resto de técnicas y permite establecer una clasificación del cálculo de gran utilidad clínica y diagnóstica. Abstract in english Context: There is heterogeneity of criteria on the utility of urinary stone analysis as well as on which is the most suitable methodology. This review presents the analysis of the lithiasis using the morphoconstitutional analysis technique based on the combination of the stereoscopic microscopy (SM) with infrared study (IRS). Summary of the evidence: There are many techniques to analyze the stone: chemical analysis, electron microscopy, X-ray diffraction, SM and IRS. Revi (more) ewing each one of these techniques and through the study of several clinical cases, this review shows the usefulness of stone analysis and the pros and cons of each one of the mentioned techniques. Furthermore, it can be clearly seen how the morphoconstitutional analysis is the one that offers the most useful clinical information to the urologist. In addition, classification of the lithiasis based on this method and its clinical correlation with patients is presented. Conclusions: Using the morphoconstitutional study to analyze the stone offers more information than the other techniques and it makes it possible to establish a stone classification of important clinical and diagnostic utility.

Gràcia-Garcia, S.; Millán-Rodríguez, F.; Rousaud-Barón, F.; Montañés-Bermúdez, R.; Angerri-Feu, O.; Sánchez-Martín, F.; Villavicencio-Mavrich, H.; Oliver-Samper, A.

2011-06-01

67

Origin and types of calcium oxalate monohydrate papillary renal calculi.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Subepithelial hydroxyapatite calcification of renal papilla is thought to be involved in the formation of calcium oxalate monohydrate (COM) papillary calculi. To assess the mechanism of formation, we sought to correlate the fine structure of papillary renal calculi with specific pathophysiologic conditions and urinary alterations. METHODS: The study included 831 COM papillary renal calculi with established fine inner structures. A total of 24 patients with chronic stone formation were randomly selected, and their urine was collected and analyzed. The case history and lifestyle habits of these patients were obtained. RESULTS: The 831 papillary calculi could be classified into 1 of 4 main groups. Type I included small calculi in which COM columnar crystals begin to develop in the concave zone in close contact with papillary tissue. Type II calculi contained a hydroxyapatite core located in or near the concave zone. Type III consisted of calculi that developed on the tip of the papillae and in the concave zone, containing hydroxyapatite, calcified tissue, and calcified tubules. Type IV consisted of papillary calculi in which the core, which is situated near, but not in, the concave zone, is formed by intergrown COM crystals and organic matter. Many factors, including urinary alterations (eg, hyperoxaluria), associated diseases (eg, hypertension, diabetes), and consumption or exposure to cytotoxic substances (eg, analgesic abuse) were associated with these types of calculi. CONCLUSIONS: Our findings have indicated that injury is the first cause of papillary COM calculus formation, with the location of the injury determining the morphology of the resulting calculus.

Grases F; Costa-Bauzá A; Gomila I; Conte A

2010-12-01

68

First order optimum calculi  

CERN Document Server

A new notion of an optimum first order calculi was introduced in [Borowiec, Kharchenko and Oziewicz, 1993]. A module of vector fields for a free differential is defined. Some examples of optimum algebras for homogeneous bimodule commutations are presented. Classification theorem for homogeneous calculi with commutative optimum algebras in two variables is proved.

Borowiec, A; Oziewicz, Z; Borowiec, A; Kharchenko, V K; Oziewicz, Z

1995-01-01

69

Giant prostatic calculi.  

UK PubMed Central (United Kingdom)

Prostatic parenchymal calculi are common, usually incidental, findings on morphological examinations. They are typically asymptomatic and may be present in association with normal glands, benign prostatic hyperplasia, and prostate cancer. However giant prostatic calculi are rare. Less than 20 cases have been reported in the literature. We present the case of a 35-year-old man with two giant prostatic calculi that replaced the entire gland. He underwent an open cystolithotomy, two giant stones were removed from the prostate, and we used a lithotripsy in situ for extraction of stone fragments.

Najoui M; Qarro A; Ammani A; Alami M

2013-01-01

70

Giant prostatic calculi.  

Science.gov (United States)

Prostatic parenchymal calculi are common, usually incidental, findings on morphological examinations. They are typically asymptomatic and may be present in association with normal glands, benign prostatic hyperplasia, and prostate cancer. However giant prostatic calculi are rare. Less than 20 cases have been reported in the literature. We present the case of a 35-year-old man with two giant prostatic calculi that replaced the entire gland. He underwent an open cystolithotomy, two giant stones were removed from the prostate, and we used a lithotripsy in situ for extraction of stone fragments. PMID:23565316

Najoui, Mohammed; Qarro, Abdelmounaim; Ammani, Abdelghani; Alami, Mohammed

2013-02-19

71

Staghorn calculi in children.  

Science.gov (United States)

Nineteen children who underwent extensive nephrotomies and anatrophic nephrotomies for staghorn calculi (bilateral in 4 cases) are presented. Proteus infection was the cause of the calculus in most cases. In the absence of recurrent stones, renal growth and function were excellent post-operatively. Stone recurrence was minimal if all calculi were removed and infection was controlled. Followup ranged from a few months to 13 years. PMID:875206

Bartone, F F; Johnston, J H

1977-07-01

72

Staghorn calculi in children.  

UK PubMed Central (United Kingdom)

Nineteen children who underwent extensive nephrotomies and anatrophic nephrotomies for staghorn calculi (bilateral in 4 cases) are presented. Proteus infection was the cause of the calculus in most cases. In the absence of recurrent stones, renal growth and function were excellent post-operatively. Stone recurrence was minimal if all calculi were removed and infection was controlled. Followup ranged from a few months to 13 years.

Bartone FF; Johnston JH

1977-07-01

73

Cystine calculi: challenging group of stones.  

UK PubMed Central (United Kingdom)

Cystinuria is an autosomal recessive disorder in renal tubular and intestinal transport of dibasic amino acids, which results in increased urinary excretion of cystine, ornithine, lysine and arginine. It affects 1 in 20 000 people and is caused by a defect in the rBAT gene on chromosome 2. Development of urinary tract cystine calculi is the only clinical manifestation of this disease. Owing to recurrent episodes of stone formation, these patients require a multi-modal approach to management. The role of medical management and minimally invasive surgery was reviewed for the treatment of cystinuria.

Ahmed K; Dasgupta P; Khan MS

2006-12-01

74

[Studies on the crystallization tendency of calcium oxalate in urine--a study of experimental and computer-assisted determination of the risk of urinary calculi formation  

UK PubMed Central (United Kingdom)

In this study a method o the semiquantitative determination of the crystallization tendency for calcium oxalate in urine is described. It is based on the addition of a well-defined amount of ammonium oxalate (31.3 nmol) to a urine sample (30 ml). The so caused clouding of the urine is measured by a photometer 20 min later. The method guarantees an acceptable reproducibility and is simple to be performed in each clinical laboratory. The results of mathematical correlation and discriminant analysis show that the calcium concentration influences the crystallization of calcium oxalate as most of all urinary constituents. Furthermore, evidence of a high specificity of the method is given by a reclassification rate of about 80% in the discriminant analytical computation.

Berg W; Bothor C; Geyer H

1990-07-01

75

A Novel Technique of Ultra-Mini-Percutaneous Nephrolithotomy: Introduction and an Initial Experience for Treatment of Upper Urinary Calculi Less Than 2?cm.  

UK PubMed Central (United Kingdom)

Objectives. To describe our novel modified technique of ultra-mini-percutaneous nephrolithotomy (UMP) using of a novel 6?Fr mininephroscope through an 11-13?Fr metal sheath to perform holmium: YAG laser lithotripsy. Methods. The medical records of 36 patients with moderate-sized (<20?mm) kidney stones treated with UMP from April to July 2012 were retrospectively reviewed. Patients were assessed at the 1st day and 1st month postoperatively by KUB and US to assess stone-free status. Results. The mean stone size was 14.9 ± 4.1?mm (rang: 6-20). The average operative time was 59.8 ± 15.9 (30-90)?min. The stone-free rate at postoperative 1st day and 1st month was 88.9% and 97.2%. The mean hospital stay was 3.0 ± 0.9 (2-5) days. Complications were noted in 6 (16.7%) cases according to the Clavien classification, including sepsis in 2 (5.6%) cases (grade II), urinary extravasations in 1 (2.8%) case (grade IIIa), and fever in 3 (8.3%) cases (grade II). No patients needed blood transfusion. Conclusions. UMP is technically feasible, safe, and efficacious for moderate-sized renal stones with an advantage of high stone-free rates and low complication rates. However, due to the limits of its current unexplored indications, UMP is therefore a supplement to, not a substitute for, the standard mini-PCNL technology.

Desai J; Zeng G; Zhao Z; Zhong W; Chen W; Wu W

2013-01-01

76

Proteus mirabilis viability after lithotripsy of struvite calculi  

Science.gov (United States)

Urinary calculi composed of struvite harbor urease-producing bacteria within the stone. The photothermal mechanism of holmium:YAG lithotripsy is uniquely different than other lithotripsy devices. We postulated that bacterial viability of struvite calculi would be less for calculi fragmented with holmium:YAG irradiation compared to other lithotripsy devices. Human calculi of known struvite composition (greater than 90% magnesium ammonium phosphate hexahydrate) were incubated with Proteus mirabilis. Calculi were fragmented with no lithotripsy (controls), or shock wave, intracorporeal ultrasonic, electrohydraulic, pneumatic, holmium:YAG or pulsed dye laser lithotripsy. After lithotripsy, stone fragments were sonicated and specimens were serially plated for 48 hours at 38 C. Bacterial counts and the rate of bacterial sterilization were compared. Median bacterial counts (colony forming units per ml) were 8 X 106 in controls and 3 X 106 in shock wave, 3 X 107 in ultrasonic, 4 X 105 in electrohydraulic, 8 X 106 in pneumatic, 5 X 104 in holmium:YAG and 1 X 106 in pulsed dye laser lithotripsy, p less than 0.001. The rate of bacterial sterilization was 50% for holmium:YAG lithotripsy treated stones versus 0% for each of the other cohorts, p less than 0.01. P. mirabilis viability is less after holmium:YAG irradiation compared to other lithotripsy devices.

Prabakharan, Sabitha; Teichman, Joel M.; Spore, Scott S.; Sabanegh, Edmund; Glickman, Randolph D.; McLean, Robert J.

2000-05-01

77

[Comparative bacteriological and chemical analysis of kidney calculi. Apropos of 135 cases  

UK PubMed Central (United Kingdom)

The formation of some urinary tract stones (struvite stones) is known to be related to infection by urease-possessing microorganisms, such as Proteus sp. and some other bacteria. Ureaplasma urealyticum, a genital mycoplasma, contains also urease and is predominantly located in the urogenital tract. Its significance in the production of human urinary stones has not yet been elucidated. In this study, 135 human calculi obtained by surgery were analysed chemically and were cultured for the presence of conventional bacteria and U. urealyticum, 51 were ammonium magnesium phosphate stones and contained Proteus (27), E. coli (4), Staphylococcus epidermidis (3), Streptococcus D (2), Pseudomonas aeruginosa (1), Staphylococcus aureus (1), Corynebacterium (1), Candida albicans (1). U. urealyticum was isolated in one patient, from two different calculi (left and right) taken after an interval of fifteen days. Different bacteria were isolated from other calculi (oxalate, uric acid). This findings suggest that Ureaplasma urealyticum should be looked for in struvite calculi.

Bébéar C; Aparicio M; Clerc M; Renaudin H; Potaux L

1984-01-01

78

Limits for Paraconsistent Calculi  

UK PubMed Central (United Kingdom)

This paper discusses how to define logics as deductive limits ofsequences of other logics. The case of da Costa's hierarchy of increasinglyweaker paraconsistent calculi, known asIn , 1n , is carefully studied.The calculusI, in particular, constitutes no more than a lower deductivebound to this hierarchy, and differs considerably from its companions. A longstanding problem in the literature (open for more than 35 years) is to definethe deductive limit to this hierarchy, i.e. its greatest lower deductive bound.The calculus I min , stronger thanI, is first presented as a step towards thislimit. As an alternative to the bivaluation semantics ofImin presented thereupon,possible-translations semantics are then introduced and suggested asthe standard technique both to give this calculus a more reasonable semanticsand to derive some interesting properties about it. Possible-translationssemantics are then used to provide both a semantics and a decision proce...

Walter A. Carnielli

79

Coordinate calculi on associative algebras  

CERN Multimedia

A new notion of an optimal algebra for a first order coordinate differential was introduced in \\cite{BKO}. Some relevant examples are indicated. Quadratic identities in the optimal algebras and calculi on quadratic algebras are studied. Canonical construction of a quantum de Rham complex for the coordinate differential is proposed. The relations between calculi and various generalizations of the Yang--Baxter equation are established.

Borowiec, A; Borowiec, A; Kharchenko, V K

1995-01-01

80

Factors affecting calcium oxalate dihydrate fragmented calculi regrowth  

Science.gov (United States)

Background The use of extracorporeal shock wave lithotripsy (ESWL) to treat calcium oxalate dihydrate (COD) renal calculi gives excellent fragmentation results. However, the retention of post-ESWL fragments within the kidney remains an important health problem. This study examined the effect of various urinary conditions and crystallization inhibitors on the regrowth of spontaneously-passed post-ESWL COD calculi fragments. Methods Post-ESWL COD calculi fragments were incubated in chambers containing synthetic urine varying in pH and calcium concentration: pH = 5.5 normocalciuria (3.75 mM), pH = 5.5 hypercalciuria (6.25 mM), pH = 6.5 normocalciuria (3.75 mM) or pH = 6.5 hypercalciuria (6.25 mM). Fragment growth was evaluated by measuring increases in weight. Fragment growth was standardized by calculating the relative mass increase. Results Calcium oxalate monohydrate (COM) crystals formed on COD renal calculi fragments under all conditions. Under pH = 5.5 normocalciuria conditions, only COM crystals formed (growth rate = 0.22 ± 0.04 ?g/mg·h). Under pH = 5.5 hypercalciuria and under pH = 6.5 normocalciuria conditions, COM crystals and a small number of new COD crystals formed (growth rate = 0.32 ± 0.03 ?g/mg·h and 0.35 ± 0.05 ?g/mg·h, respectively). Under pH = 6.5 hypercalciuria conditions, large amounts of COD, COM, hydroxyapatite and brushite crystals formed (growth rate = 3.87 ± 0. 34 ?g/mg·h). A study of three crystallization inhibitors demonstrated that phytate completely inhibited fragment growth (2.27 ?M at pH = 5.5 and 4.55 ?M at pH = 6.5, both under hypercalciuria conditions), while 69.0 ?M pyrophosphate caused an 87% reduction in mass under pH = 6.5 hypercalciuria conditions. In contrast, 5.29 mM citrate did not inhibit fragment mass increase under pH = 6.5 hypercalciuria conditions. Conclusion The growth rate of COD calculi fragments under pH = 6.5 hypercalciuria conditions was approximately ten times that observed under the other three conditions. This observation suggests COD calculi residual fragments in the kidneys together with hypercalciuria and high urinary pH values may be a risk factor for stone growth. The study also showed the effectiveness of specific crystallization inhibitors in slowing calculi fragment growth.

Costa-Bauza, A; Perello, J; Isern, B; Sanchis, P; Grases, F

2006-01-01

 
 
 
 
81

Factors affecting calcium oxalate dihydrate fragmented calculi regrowth  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The use of extracorporeal shock wave lithotripsy (ESWL) to treat calcium oxalate dihydrate (COD) renal calculi gives excellent fragmentation results. However, the retention of post-ESWL fragments within the kidney remains an important health problem. This study examined the effect of various urinary conditions and crystallization inhibitors on the regrowth of spontaneously-passed post-ESWL COD calculi fragments. Methods Post-ESWL COD calculi fragments were incubated in chambers containing synthetic urine varying in pH and calcium concentration: pH = 5.5 normocalciuria (3.75 mM), pH = 5.5 hypercalciuria (6.25 mM), pH = 6.5 normocalciuria (3.75 mM) or pH = 6.5 hypercalciuria (6.25 mM). Fragment growth was evaluated by measuring increases in weight. Fragment growth was standardized by calculating the relative mass increase. Results Calcium oxalate monohydrate (COM) crystals formed on COD renal calculi fragments under all conditions. Under pH = 5.5 normocalciuria conditions, only COM crystals formed (growth rate = 0.22 ± 0.04 ?g/mg·h). Under pH = 5.5 hypercalciuria and under pH = 6.5 normocalciuria conditions, COM crystals and a small number of new COD crystals formed (growth rate = 0.32 ± 0.03 ?g/mg·h and 0.35 ± 0.05 ?g/mg·h, respectively). Under pH = 6.5 hypercalciuria conditions, large amounts of COD, COM, hydroxyapatite and brushite crystals formed (growth rate = 3.87 ± 0. 34 ?g/mg·h). A study of three crystallization inhibitors demonstrated that phytate completely inhibited fragment growth (2.27 ?M at pH = 5.5 and 4.55 ?M at pH = 6.5, both under hypercalciuria conditions), while 69.0 ?M pyrophosphate caused an 87% reduction in mass under pH = 6.5 hypercalciuria conditions. In contrast, 5.29 mM citrate did not inhibit fragment mass increase under pH = 6.5 hypercalciuria conditions. Conclusion The growth rate of COD calculi fragments under pH = 6.5 hypercalciuria conditions was approximately ten times that observed under the other three conditions. This observation suggests COD calculi residual fragments in the kidneys together with hypercalciuria and high urinary pH values may be a risk factor for stone growth. The study also showed the effectiveness of specific crystallization inhibitors in slowing calculi fragment growth.

Costa-Bauzá A; Perelló J; Isern B; Sanchis P; Grases F

2006-01-01

82

PHARMACOLOGICAL SCREENING OF MUSA PARADISICA LINN AGAINST ETHYLENE GLYCOL INDUCED RENAL CALCULI  

Directory of Open Access Journals (Sweden)

Full Text Available The effect of ethanol extract of dried roots of Musa paradisica Linn against ethylene glycol induced renal calculi in albino wistar rats are studied in this research. A renal calculus was induced in rats by ingesting 0.75% ethylene glycol in drinking water for 28 days and was manifested by high urinary calcium, oxalate, and low urinary magnesium contents. Simultaneous administration of 1ml (1 in 10) Musa paradisica Linn orally for 28 days along with ethylene glycol (0.75% v/v) reduced urinary calcium, oxalate and elevated urinary magnesium level. It also increased urinary volume thereby reducing the tendency for crystallization. The histopathological studies confirmed the induction as degenerated glomeruli, necrotic tubule and inflammatory cells was observed in section of kidney from animals treated with ethylene glycol. This was reduced; however after treatment with Musa paradisica Linn. These observations enable to conclude that Musa paradisica Linn is effective against ethylene glycol induced renal calculi.

Jha U; Shelke TT; Oswal RJ; Adkar PP; Navgire VN

2011-01-01

83

How accurate is unenhanced multidetector-row CT (MDCT) for localization of renal calculi?  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate the correlation between unenhanced MDCT and intraoperative findings with regard to the exact anatomical location of renal calculi. DESIGN, SETTING, AND PARTICIPANTS: Fifty-nine patients who underwent unenhanced MDCT for suspected urinary stone disease, and who underwent subsequent flexible ureterorenoscopy (URS) as treatment of nephrolithiasis were included in this retrospective study. All MDCT data sets were independently reviewed by three observers with different degrees of experience in reading CT. Each observer was asked to indicate presence and exact anatomical location of any calcification within pyelocaliceal system, renal papilla or renal cortex. Results were compared to intraoperative findings which have been defined as standard of reference. Calculi not described at surgery, but present on MDCT data were counted as renal cortex calcifications. RESULTS: Overall 166 calculi in 59 kidneys have been detected on MDCT, 100 (60.2%) were located in the pyelocaliceal system and 66 (39.8%) in the renal parenchyma. Of the 100 pyelocaliceal calculi, 84 (84%) were correctly located on CT data sets by observer 1, 62 (62%) by observer 2, and 71 (71%) by observer 3. Sensitivity/specificity was 90-94% and 50-100% if only pyelocaliceal calculi measuring >4 mm in size were considered. For pyelocaliceal calculi?4 mm in size diagnostic performance of MDCT was inferior. CONCLUSION: Compared to flexible URS, unenhanced MDCT is accurate for distinction between pyelocaliceal calculi and renal parenchyma calcifications if renal calculi are >4 mm in size. For smaller renal calculi, unenhanced MDCT is less accurate and distinction between a pyelocaliceal calculus and renal parenchyma calcification is difficult.

Goetschi S; Umbehr M; Ullrich S; Glenck M; Suter S; Weishaupt D

2012-11-01

84

Comparison of Computerized Spiral Tomography with Ultrasonography for Detection of Ureteral Calculi  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: We aimed to compare accuracy levels of ultrasonography and spiral computerized tomography for detection of the ureteral calculi in patients admitted to the emergency department with flank pain. Methods: The patients presented with either unilateral or bilateral flank pain to the emergency department over a four-month period and who were suspected to be renal colic were included into the study. All of the study patients with distended bladder after hydration had ultrasonography (USG) and unhanced helical computerized tomography (UHCT) performed by two independent radiologists. Results: Of the 76 patients with flank pain, CT detected ureteral calculi in 47 out of 48 patients (97.9%) and USG detected ureteral calculi in 34 out of the 48 patients (70.83%). CT detected uretral calculi in 14 patients which was not detected by USG. CT also detected renal calculi in 7 patients which was not detected by USG. A kappa value of 0.62 (p<0.001) was determined, indicating a moderate concordance between CT and USG in detecting ureteral calculi. Also a kappa value of 0.65 (p<0.001) was determined in the overall diagnostic performance of the both imaging tools in detecting renal calculi. Conclusions: Computerized tomography is better than ultrasonography in detecting urinary calculus in patients presented to the emergency department with flank pain. However, as a bedside, non-invasive and non-ionized tool, USG should be preffered as the first line diagnostic choice in ED for detecting urinary calculus. CT should be used as an second choice in patients with negative USG exam in ED.

Can AKTAS; Esin YENCILEK; Didem AY; Baki EKCI; Sezgin SARIKAYA; Ugur OZALP

2010-01-01

85

The Mineralogy and Chemistry of Urinary Stones from the United Arab Emirates ????? ??????? ??????? ??? ????? ?? ???? ??????? ??????? ???????  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The purpose of this study is to characterize urinary stones from the United Arab Emirates using mineralogical techniques and compare it with stones in nature. Twenty six urinary calculi were subjected to chemical analysis, XRD, DTA, TGA and polarizing microscopy. The results show that the calculi be...

Nasir, Sobhi J. [???? ???? ???

86

CT of acute urinary obstruction  

Energy Technology Data Exchange (ETDEWEB)

The diagnosis of acute urinary obstruction (AUO) mostly caused by urinary calculi is not difficult from the clinical findings and IVP that shows prolonged dense nephrogram and nonvisualization of pelvocalyceal system. We demonstrated CT of AUO on three patients, which were taken immediately, two hours and 24 hours after IVP. CT findings showed little difference from those on IVP. But CT can reveal directly the dilated, not opacified urinary tract, and the cause as well as the level of obstruction.

Seo, H.; Kojima, K.; Kawase, Y.

1987-04-01

87

Computed tomographic analysis of renal calculi  

International Nuclear Information System (INIS)

An in vitro study sought to determine the feasibility of using computed tomography (CT) to analyze the chemical composition of renal calculi and thus aid in selecting the best treatment method. Sixty-three coded calculi were scanned in a water bath. Region-of-interest measurements provided the mean, standard deviation, and minimum and maximum pixel values for each stone. These parameters were correlated with aspects of the stones' chemical composition. A multivariate analysis showed that the mean and standard deviation of the stones' pixel values were the best CT parameters for differentiating types of renal calculi. By using computerized mapping techniques, uric acid calculi could be perfectly differentiated from struvite and calcium oxalate calculi. The latter two types also were differentiable, but to a lesser extent. CT has a potential role as an adjunct to clinical and laboratory methods for determining the chemical composition of renal calculi in an effort to select optimal treatment

1984-01-01

88

Computed tomographic analysis of renal calculi  

Energy Technology Data Exchange (ETDEWEB)

An in vitro study sought to determine the feasibility of using computed tomography (CT) to analyze the chemical composition of renal calculi and thus aid in selecting the best treatment method. Sixty-three coded calculi were scanned in a water bath. Region-of-interest measurements provided the mean, standard deviation, and minimum and maximum pixel values for each stone. These parameters were correlated with aspects of the stones' chemical composition. A multivariate analysis showed that the mean and standard deviation of the stones' pixel values were the best CT parameters for differentiating types of renal calculi. By using computerized mapping techniques, uric acid calculi could be perfectly differentiated from struvite and calcium oxalate calculi. The latter two types also were differentiable, but to a lesser extent. CT has a potential role as an adjunct to clinical and laboratory methods for determining the chemical composition of renal calculi in an effort to select optimal treatment.

Hillman, B.J.; Drach, G.W.; Tracey, P.; Gaines, J.A.

1984-03-01

89

Verification of Stochastic Process Calculi  

DEFF Research Database (Denmark)

Stochastic process calculi represent widely accepted formalisms within Computer Science for modelling nondeterministic stochastic systems in a compositional way. Similar to process calculi in general, they are suited for modelling systems in a hierarchical manner, by explicitly specifying subsystems as well as their interdependences and communication channels. Stochastic process calculi incorporate both the quantified uncertainty on probabilities or durations of events and nondeterministic choices between several possible continuations of the system behaviour. Modelling of a system is often performed with the purpose to verify the system. In this dissertation it is argued that the verification techniques that have their origin in the analysis of programming code with the purpose to deduce the properties of the code's execution, i.e. Static Analysis techniques, are transferable to stochastic process calculi. The description of a system in the syntax of a particular stochastic process calculus can be analysed in a compositional way, without expanding the state space by explicitly resolving all the interdependencies between the subsystems which may lead to the state space explosion problem. In support of this claim we have developed analysis methods that belong to a particular type of Static Analysis { Data Flow / Pathway Analysis. These methods have previously been applied to a number of non-stochastic process calculi. In this thesis we are lifting them to the stochastic calculus of Interactive Markov Chains (IMC). We have devised the Pathway Analysis of IMC that is not only correct in the sense of overapproximating all possible behaviour scenarios, as is usual for Static Analysis methods, but is also precise. This gives us the possibility to explicitly decide on the trade-o between precision and complexity while post-processing the analysis results. Another novelty of our methods consists in the kind of properties that we can verify using the results of the Pathway Analysis. We can check both qualitative and quantitative properties of IMC systems. In particular, we have developed algorithms for constructing bisimulation relations, computing (overapproximations of) sets of reachable states and computing the expected time reachability, the last for a linear fragment of IMC. In all the cases we have the complexities of algorithms which are low polynomial in the size of the syntactic description of a system. The presented methods have a clear application in the areas of embedded systems, (randomised) protocols run between a fixed number of parties etc.

Skrypnyuk, Nataliya

2011-01-01

90

The feasibility of using microwave-induced thermoacoustic tomography for detection and evaluation of renal calculi  

International Nuclear Information System (INIS)

Imaging of renal calculi is important for patients who suffered a urinary calculus prior to treatment. The available imaging techniques include plain x-ray, ultrasound scan, intravenous urogram, computed tomography, etc. However, the visualization of a uric acid calculus (radiolucent calculi) is difficult and often impossible by the above imaging methods. In this paper, a new detection method based on microwave-induced thermoacoustic tomography was developed to detect the renal calculi. Thermoacoustic images of calcium oxalate and uric acid calculus were compared with their x-ray images. The microwave absorption differences among the calcium oxalate calculus, uric acid calculus and normal kidney tissue could be evaluated by the amplitude of the thermoacoustic signals. The calculi hidden in the swine kidney were clearly imaged with excellent contrast and resolution in the three orthogonal thermoacoustic images. The results indicate that thermoacoustic imaging may be developed as a complementary method for detecting renal calculi, and its low cost and effective feature shows high potential for clinical applications.

2010-09-07

91

Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi.  

UK PubMed Central (United Kingdom)

UNLABELLED: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Large upper tract urinary calculi, greater than 2 cm, have historically been treated with percutaneous nephrostolithotomy. In general, there has been a growing interest in employing retrograde, flexible ureteroscopy and laser lithotripsy in select patients who are either poor medical candidates for percutaneous lithotripsy or who may prefer a less invasive intervention. Properly selecting patients for this approach, designing specific treatments based on complex stone presentation and offering general information with regard to long-term outcomes and surgical risks have historically been based on results from small, multicentre series lacking uniformity of technique and long-term outcomes. Our initial multicentre experience employing ureteroscopic techniques to treat large upper urinary tract calculi was presented in 1998. This current work represented the largest single-centre experience, accrued prospectively over 10 years, where there was uniformity of technique and treatment algorithms. This study frames an argument for retrograde ureteroscopic lithotripsy not only in those who are at high risk for percutaneous nephrostolithotomy but in all who present with large, non-infected stone burdens. OBJECTIVE: To define the safety and efficacy of retrograde ureteroscopic lithotripsy in treating large, non-infectious intrarenal and proximal ureteral stone burdens. PATIENTS AND METHODS: Between 2000 and 2011, 145 patients with 164 large (2 cm or greater in diameter on standard imaging) non-infectious upper intrarenal and proximal ureteral calculi were chosen for retrograde ureteroscopic lithotripsy. Patients were treated with small diameter flexible fibre-optic ureteroscopes and holmium laser lithotripsy by a single surgeon. Second-look ureteroscopy was performed in patients with the largest calculi in whom there was a high index of suspicion of significant residual fragments. Stone clearance was defined as no fragments or a single fragment less than or equal to 4 mm in diameter on standard radiograph and sonography at 3-month follow-up. RESULTS: Our study included 103 male patients and 42 female patients with an average age of 55 years (range 16-86 years) and a mean stone diameter of 29 mm (range 20-70 mm) including 36 partial staghorn stone burdens (mean diameter 37 mm). Overall, 266 ureteroscopies were performed on 164 stone burdens (1.6 procedures per stone burden), clearing 143 stone burdens (87%). The highest clearance rates were observed for proximal ureteral (97%) and renal pelvic (94%) stones, while the lowest clearance rates were observed for lower pole (83%) and staghorn calculi (81%). Three patients required subsequent percutaneous therapy due to infectious material encountered at the time of ureteroscopy or inaccessible stone burdens secondary to infundibular stenosis. There were five minor postoperative complications, including four fevers and one patient with gross haematuria and clot retention, with no major intraoperative complications. CONCLUSIONS: In select patients, large, complex, metabolic upper urinary tract calculi can be treated safely and efficiently with retrograde ureteroscopic techniques. Staged, retrograde, flexible ureteroscopy is an alternative to percutaneous therapy with acceptable efficacy and low morbidity.

Cohen J; Cohen S; Grasso M

2013-03-01

92

Endoscopically guided removal of cloacal calculi in three African spurred tortoises (Geochelone sulcata).  

UK PubMed Central (United Kingdom)

CASE DESCRIPTION: 3 female African spurred tortoises (Geochelone sulcata) of various body weights (0.22, 0.77, and 2.86 kg [0.48, 1.69, and 6.29 lb]) were examined because of reduced food intake and lack of fecal output. Owners reported intermittent tenesmus in 2 of the tortoises. CLINICAL FINDINGS: Physical examinations revealed no clinically important abnormalities in the tortoises. Cloacal calculi were diagnosed on the basis of radiography and cloacoscopy in all 3 tortoises. One tortoise had another calculus in the urinary bladder. TREATMENT AND OUTCOME: Tortoises were anesthetized, and cloacal calculi were removed by use of a cutting burr (plain-fissure cutting burr and a soft tissue protector mounted to a dental handpiece that had a low-speed motor and a straight nose cone) and warm water irrigation with endoscopic guidance. Complete removal of calculus fragments was achieved by use of forceps and irrigation. In 1 tortoise, removal of the cloacal calculus was staged (2 separate procedures). In another tortoise, a second cloacal calculus (which had been located in the urinary bladder during the first examination) was successfully removed 25 days after removal of the first calculus. All 3 tortoises recovered uneventfully, and serious complications secondary to removal of the cloacal calculi were not detected. CLINICAL RELEVANCE: Cloacoscopy combined with the use of a low-speed dental drill and warm water irrigation should be considered a simple, safe, and nontraumatic treatment option for removal of obstructive cloacal calculi in tortoises.

Mans C; Sladky KK

2012-04-01

93

Transurethral holmium-YAG laser lithotripsy for large symptomatic prostatic calculi: initial experience.  

Science.gov (United States)

Symptomatic prostatic calculi are a rare clinical entity with wide range of management options, however, there is no agreement about the preferred method for treating these symptomatic calculi. In this study we describe our experience of transurethral management of symptomatic prostatic calculi using holmium-YAG laser lithotripsy. Patients with large, symptomatic prostatic stones managed by transurethral lithotripsy using holmium-YAG laser over 3-year duration were included in this retrospective study. Patients were evaluated for any underlying pathological condition and calculus load was determined by preoperative X-ray KUB film/CT scan. Urethrocystoscopy was performed using 30° cystoscope in lithotomy position under spinal anesthesia, followed by transurethral lithotripsy of prostatic calculi using a 550 ?m laser fiber. Stone fragments were disintegrated using 100 W laser generators (VersaPulse PowerSuite 100 W, LUMENIS Surgical, CA). Larger stone fragments were retreived using Ellik's evacuator while smaller fragments got flushed under continuous irrigation. Five patients (median age 42 years) with large symptomatic prostatic calculi were operated using the described technique. Three patients had idiopathic stones while rest two had bulbar urethral stricture and neurogenic bladder, respectively. Median operative time was 62 min. All the patients were stone free at the end of procedure. Median duration of catheterization was 2 days. Significant improvement was observed in symptoms score and peak urinary flow and none of the patient had any complication. Transurethral management using holmium-YAG laser lithotripsy is a safe and highly effective, minimally invasive technique for managing symptomatic prostatic calculi of all sizes with no associated morbidity. PMID:23715770

Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan

2013-05-29

94

Transurethral holmium-YAG laser lithotripsy for large symptomatic prostatic calculi: initial experience.  

UK PubMed Central (United Kingdom)

Symptomatic prostatic calculi are a rare clinical entity with wide range of management options, however, there is no agreement about the preferred method for treating these symptomatic calculi. In this study we describe our experience of transurethral management of symptomatic prostatic calculi using holmium-YAG laser lithotripsy. Patients with large, symptomatic prostatic stones managed by transurethral lithotripsy using holmium-YAG laser over 3-year duration were included in this retrospective study. Patients were evaluated for any underlying pathological condition and calculus load was determined by preoperative X-ray KUB film/CT scan. Urethrocystoscopy was performed using 30° cystoscope in lithotomy position under spinal anesthesia, followed by transurethral lithotripsy of prostatic calculi using a 550 ?m laser fiber. Stone fragments were disintegrated using 100 W laser generators (VersaPulse PowerSuite 100 W, LUMENIS Surgical, CA). Larger stone fragments were retreived using Ellik's evacuator while smaller fragments got flushed under continuous irrigation. Five patients (median age 42 years) with large symptomatic prostatic calculi were operated using the described technique. Three patients had idiopathic stones while rest two had bulbar urethral stricture and neurogenic bladder, respectively. Median operative time was 62 min. All the patients were stone free at the end of procedure. Median duration of catheterization was 2 days. Significant improvement was observed in symptoms score and peak urinary flow and none of the patient had any complication. Transurethral management using holmium-YAG laser lithotripsy is a safe and highly effective, minimally invasive technique for managing symptomatic prostatic calculi of all sizes with no associated morbidity.

Goyal NK; Goel A; Sankhwar S

2013-08-01

95

Analysis of renal calculi by X-ray diffraction and electron microprobe: a comparison of two methods  

Energy Technology Data Exchange (ETDEWEB)

We analyzed 48 renal calculi by X-ray powder diffraction and electron microprobe techniques. In 35 of these, the presence of a minor constituent, not detected by X-ray diffraction, was revealed--hydroxyapatite was found in 24 stones, struvite in 6, and calcium oxalate in 5. The results of this study, as well as others, show that incomplete assignment of the crystalline constituents of urinary calculi is an inherent risk of the X-ray method and that conclusions concerning total chemical composition should be based on X-ray diffraction analyses coupled with data obtained from other analytical procedures.

Rodgers, A.L.

1981-07-01

96

Analysis of renal calculi by X-ray diffraction and electron microprobe: a comparison of two methods  

International Nuclear Information System (INIS)

We analyzed 48 renal calculi by X-ray powder diffraction and electron microprobe techniques. In 35 of these, the presence of a minor constituent, not detected by X-ray diffraction, was revealed--hydroxyapatite was found in 24 stones, struvite in 6, and calcium oxalate in 5. The results of this study, as well as others, show that incomplete assignment of the crystalline constituents of urinary calculi is an inherent risk of the X-ray method and that conclusions concerning total chemical composition should be based on X-ray diffraction analyses coupled with data obtained from other analytical procedures

1981-01-01

97

Renal pelvic calculi and neoplasm. New indication for treatment of asymptomatic renal pelvic calculi?  

DEFF Research Database (Denmark)

Metaplasia of the renal pelvis caused by chronic irritation, calculi, infection is a reversible pre-malignant condition. The application of ESWL on renal calculi as a safe treatment in relation to metaplasia is discussed and a case history is presented.

Vibitis, H; JØrgensen, J B

1990-01-01

98

Holmium laser lithotripsy of bladder calculi  

Science.gov (United States)

Although the overall incidence of bladder calculi has been decreasing, it is still a significant disease affecting adults and children. Prior treatment options have included open cystolitholapaxy, blind lithotripsy, extracorporeal shock wave lithotripsy, and visual lithotripsy with ultrasonic or electrohydraulic probes. The holmium laser has been found to be extremely effective in the treatment of upper tract calculi. This technology has also been applied to the treatment of bladder calculi. We report our experience with the holmium laser in the treatment of bladder calculi. Twenty- five patients over a year and a half had their bladder calculi treated with the Holmium laser. This study was retrospective in nature. Patient demographics, stone burden, and intraoperative and post-operative complications were noted. The mean stone burden was 31 mm with a range of 10 to 60 mm. Preoperative diagnosis was made with either an ultrasound, plain film of the abdomen or intravenous pyelogram. Cystoscopy was then performed to confirm the presence and determine the size of the stone. The patients were then taken to the operating room and given a regional or general anesthetic. A rigid cystoscope was placed into the bladder and the bladder stone was then vaporized using the holmium laser. Remaining fragments were washed out. Adjunctive procedures were performed on 10 patients. These included transurethral resection of the prostate, transurethral incision of the prostate, optic internal urethrotomy, and incision of ureteroceles. No major complications occurred and all patients were rendered stone free. We conclude that the Holmium laser is an effective and safe modality for the treatment of bladder calculi. It was able to vaporize all bladder calculi and provides a single modality of treating other associated genitourinary pathology.

Beaghler, Marc A.; Poon, Michael W.

1998-07-01

99

Comparison of 0.625-mm source computed tomographic images versus 5-mm thick reconstructed images in the evaluation for renal calculi in at-risk patients.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: CT has become a well-established modality in the evaluation of urinary calculi. The advent of multidetector CT (MDCT) scanners and submillimeter thick slice acquisitions has yielded CT images with even greater resolution. MDCT scanners allow for source data slice acquisition with submillimeter slice thickness. These source images can then be reconstructed to thicker slices for more convenient interpretation of the CT scan. Previous authors have looked at the effect of slice thickness on detection of urinary calculi. We investigated whether the thin slice source images yielded detection of additional stones and the potential significance of detecting these additional stones. PATIENTS AND METHODS: Ninety-five consecutive patients who were referred to our outpatient imaging center for CT, with a clinical history placing them at risk for urinary calculi, were included in the study. RESULTS: In 49 (52%) of the 95 patients, more calculi were visualized using the 0.625-mm thick images than with the 5-mm thick images. In 34 (69%) of these 49 patients, the additional findings were thought to be "clinically significant," while in the remaining 15 (31%) patients, the additional findings were not thought to be clinically significant. In 46 (48%) of the 95 patients, there were no additional urinary calculi identified on the 0.625-mm thick images compared with that observed on 5-mm thick images. CONCLUSION: The results from this study encourage reviewing the thin slice source images of MDCTs in patients at risk for urinary calculi, because important clinical decisions may hinge on the additional findings made on these images.

Berkenblit R; Hoenig D; Lerer D; Moses M; Minsky L

2013-02-01

100

Flow Logic for Process Calculi  

DEFF Research Database (Denmark)

Flow Logic is an approach to statically determining the behavior of programs and processes. It borrows methods and techniques from Abstract Interpretation, Data Flow Analysis and Constraint Based Analysis while presenting the analysis in a style more reminiscent of Type Systems. Traditionally developed for programming languages, this article provides a tutorial development of the approach of Flow Logic for process calculi based on a decade of research. We first develop a simple analysis for the ?-calculus; this consists of the specification, semantic soundness (in the form of subject reduction and adequacy results), and a Moore Family result showing that a least solution always exists, as well as providing insights on how to implement the analysis. We then show how to strengthen the analysis technology by introducing reachability components, interaction points, and localized environments, and finally, we extend it to a relational analysis. A Flow Logic is a program logic---in the same sense that a Hoare’s logic is. We conclude with an executive summary presenting the highlights of the approach from this perspective including a discussion of theoretical properties as well as implementation considerations. The electronic supplements present an application of the analysis techniques to a version of the ?-calculus incorporating distribution and code mobility; also the proofs of the main results can be found in the electronic supplements.

Nielson, Hanne Riis; Nielson, Flemming

2012-01-01

 
 
 
 
101

Medicinal health agent for preventing and treating canine uric acid calculi  

UK PubMed Central (United Kingdom)

The invention relates to a medicinal health agent for preventing and treating canine uric acid calculi, which is characterized in that the agent is prepared by evenly mixing the following components by weight or unit: 2,000 to 8,000 mg of potassium sodium hydrogen citrate, 100 to 200 mg of allopurinol, 20 mg of organic germanium and 5,000 IU of vitamin A. In the invention, the allopurinol reducesthe generation of uric acid by inhibiting the activity of xanthine oxidase the potassium sodium hydrogen citrate which is orally taken and absorbed increases citrate excretion in urine, raises urinepH, increases the solubility of uric acid, allows crystals to be not easy to precipitate and enables urate stones to dissolve the vitamin A promotes the repair to urinary-tract mucosal epithelium andis favorable for generating crystallization inhibitors and preventing the crystals from adhering to urinary-tract epithelial cells so as to inhibit crystallization and the application of the organicgermanium enhances crystallization inhibition. The health agent is reasonable in compatibility, jointly uses medicaments from different angles to eliminate the inducing factors of canine uric acid calculi, can dissolve generated uric acid stones, and plays a definite role in preventing uric acid calculi after the health agent is added to canine diets.

JINYONG WANG; LIANMIN WANG

102

Idiopathic prostatic giant calculi in a young male patient.  

UK PubMed Central (United Kingdom)

We report a case of 41-year-old man with idiopathic prostatic giant calculi presenting with voiding difficulty. To our knowledge this is the youngest case with idiopathic prostatic giant calculi reported in the literature. The etiopathogenesis of prostatic calculi are also discussed.

Usta MF; Baykara M; Erdo?ru T; Köksal IT

2005-01-01

103

A criterion for separating process calculi  

CERN Multimedia

We introduce a new criterion, replacement freeness, to discern the relative expressiveness of process calculi. Intuitively, a calculus is strongly replacement free if replacing, within an enclosing context, a process that cannot perform any visible action by an arbitrary process never inhibits the capability of the resulting process to perform a visible action. We prove that there exists no compositional and interaction sensitive encoding of a not strongly replacement free calculus into any strongly replacement free one. We then define a weaker version of replacement freeness, by only considering replacement of closed processes, and prove that, if we additionally require the encoding to preserve name independence, it is not even possible to encode a non replacement free calculus into a weakly replacement free one. As a consequence of our encodability results, we get that many calculi equipped with priority are not replacement free and hence are not encodable into mainstream calculi like CCS and pi-calculus, t...

Banti, Federico; Tiezzi, Francesco; 10.4204/EPTCS.41.2

2010-01-01

104

Mobility in process calculi and natural computing  

CERN Multimedia

The design of formal calculi in which fundamental concepts underlying interactive systems can be described and studied has been a central theme of theoretical computer science in recent decades, while membrane computing, a rule-based formalism inspired by biological cells, is a more recent field that belongs to the general area of natural computing. This is the first book to establish a link between these two research directions while treating mobility as the central topic. In the first chapter the authors offer a formal description of mobility in process calculi, noting the entities that move

Aman, Bogdan

2011-01-01

105

Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION: This work evaluates the results of ureteroscopic treatment of impacted ureteral stones with a pneumatic lithotripter. MATERIALS AND METHODS: From March 1997 to May 2002, 42 patients with impacted ureteral stones were treated by retrograde ureteroscopic pneumatic lithotripsy. Twenty-eight patients were female and 14 were male. The stone size ranged from 5 to 20 mm. The ureteral sites of the stones were distal in 21, middle in 12 and proximal in 9. RESULTS: Considering stones with distal location in the ureter, 1 patient had ureteral perforation and developed a stricture in the follow-up (4.7%). As for stones in the middle ureter, 2 perforations and 1 stricture were observed (8.3%) and regarding stones located in the proximal ureter, 5 perforations and 4 strictures occurred (44%). In the mid ureter, 1 ureteral avulsion was verified. In 34 patients without ureteral perforation, only 1 developed a stricture (2.9%). Of 8 patients who had perforation, 6 developed strictures. The overall incidence of stricture following treatment of impacted ureteral calculi was 14.2%. CONCLUSIONS: Ureteroscopy for impacted ureteral calculi is associated with a higher incidence of ureteral perforation and stricture. Ureteroscopy of proximal ureteral calculi is associated with a high risk of perforation, when compared to mid or distal ureteral calculi. Ureteral perforation at the site of the stone seems to be the primary risk factor for stricture formation in these cases.

Artur H. Brito; Anuar I. Mitre; Miguel Srougi

2006-01-01

106

Ureteroscopic pneumatic lithotripsy of impacted ureteral calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english INTRODUCTION: This work evaluates the results of ureteroscopic treatment of impacted ureteral stones with a pneumatic lithotripter. MATERIALS AND METHODS: From March 1997 to May 2002, 42 patients with impacted ureteral stones were treated by retrograde ureteroscopic pneumatic lithotripsy. Twenty-eight patients were female and 14 were male. The stone size ranged from 5 to 20 mm. The ureteral sites of the stones were distal in 21, middle in 12 and proximal in 9. RESULTS: Co (more) nsidering stones with distal location in the ureter, 1 patient had ureteral perforation and developed a stricture in the follow-up (4.7%). As for stones in the middle ureter, 2 perforations and 1 stricture were observed (8.3%) and regarding stones located in the proximal ureter, 5 perforations and 4 strictures occurred (44%). In the mid ureter, 1 ureteral avulsion was verified. In 34 patients without ureteral perforation, only 1 developed a stricture (2.9%). Of 8 patients who had perforation, 6 developed strictures. The overall incidence of stricture following treatment of impacted ureteral calculi was 14.2%. CONCLUSIONS: Ureteroscopy for impacted ureteral calculi is associated with a higher incidence of ureteral perforation and stricture. Ureteroscopy of proximal ureteral calculi is associated with a high risk of perforation, when compared to mid or distal ureteral calculi. Ureteral perforation at the site of the stone seems to be the primary risk factor for stricture formation in these cases.

Brito, Artur H.; Mitre, Anuar I.; Srougi, Miguel

2006-06-01

107

Extracorporeal shock wave lithotripsy for renal calculi.  

UK PubMed Central (United Kingdom)

PURPOSE: To gain better understanding of ESWL efficacy in children with renal calculi we report our outcomes using this technique. MATERIALS AND METHODS: We reviewed the records of children who underwent ESWL as monotherapy for renal calculi at our institution from 1988 to 2007. Data included clinical characteristics, stone-free rate and its relationship to stone size and location, lithotriptor and complications. RESULTS: The 33 boys and 29 girls with an average age of 10 years underwent a total of 69 treatments. A 53% and 63% stone-free rate was achieved after 1 and 2 ESWL sessions, respectively. A trend toward a higher stone-free rate (61% to 70%) after 1 ESWL session was seen in children with stones less than 50 mm(2), renal pelvic stones and treatment with the Dornier HM3 lithotriptor. Children with stones greater than 100 mm(2), a caliceal location and those treated with the Dornier MFL 5000 lithotriptor had a higher failure rate (25% to 46%). Five patients (8%) required ureteroscopy after ESWL due to retained distal ureteral stone fragments. Five patients (8%) who were not stone-free after therapy required subsequent endoscopic treatment for the stone during followup. CONCLUSIONS: Smaller renal stones, renal pelvic calculi and treatment with an older generation lithotriptor were independent variables associated with a higher stone-free rate in children. While ESWL is a simple method in children with renal calculi, those with large or caliceal stones may do best with a primary endoscopic approach.

Penn HA; DeMarco RT; Sherman AK; Gatti JM; Murphy JP

2009-10-01

108

Spectroscopic and ultrastructural comparative study of cystine calculi in humans and dogs.  

Science.gov (United States)

The careful analysis of cystine calculi may be important to detect the presence of other urinary alterations (such as hyperuricosuria, hypercalciuria, hyperoxaluria or bacterial infections) that coexist with cystinuria in many patients. For this reason, in the present study, 14 human and 17 canine cystine uroliths have been studied by infrared spectroscopy (IR), scanning electron microscopy (SEM), and energy dispersive X-ray analysis (EDX). According to the infrared analysis, most of the human and canine stones were composed of nearly pure cystine. However, in these calculi of apparently pure cystine, the study by SEM and EDX showed in many cases the presence of small amounts of calcium apatite. The infrared study of several samples heated at 750 degrees C confirmed the presence of phosphate, when it was difficult to detect this component in the spectra of the original samples owing to band overlapping. Other components detected in varying proportions in cystine calculi were magnesium ammonium phosphate hexahydrate (struvite), calcium hydrogen phosphate dihydrate (brushite), calcium oxalate (mono and/or dihydrate) and, in one case, a drug (oxolinic acid). PMID:10478954

Escolar, E; Bellanato, J

1999-01-01

109

Treatment of complete staghorn calculi by extracorporeal shock wave lithotripsy monotherapy with special reference to internal stenting.  

UK PubMed Central (United Kingdom)

Extracorporeal shock wave lithotripsy monotherapy was used to treat 41 patients with complete staghorn calculi. In 20 patients polyethylene angiographic pigtail catheters were inserted prophylactically as ureteral stents and the other 21 patients did not receive stents. Prophylactic stenting reduced the incidence of complications and the need for percutaneous nephrostomy tubes to relieve subsequent ureteral obstruction. Internal stenting maintained the sterility of the urinary tract and reduced the average hospital stay by a third. Residual stone fragments representing less than 5 per cent of the original stone mass remained in 56 per cent of the patients, particularly in those with hydronephrotic kidneys. We suggest that extracorporeal shock wave lithotripsy monotherapy with prophylactic stenting is the preferred treatment for noninfected complete staghorn calculi.

Pode D; Verstandig A; Shapiro A; Katz G; Caine M

1988-08-01

110

A standardisation proof for algebraic pattern calculi  

CERN Multimedia

This work gives some insights and results on standardisation for call-by-name pattern calculi. More precisely, we define standard reductions for a pattern calculus with constructor-based data terms and patterns. This notion is based on reduction steps that are needed to match an argument with respect to a given pattern. We prove the Standardisation Theorem by using the technique developed by Takahashi and Crary for lambda-calculus. The proof is based on the fact that any development can be specified as a sequence of head steps followed by internal reductions, i.e. reductions in which no head steps are involved.

Kesner, Delia; Ríos, Alejandro; 10.4204/EPTCS.49.5

2011-01-01

111

Prevalence of scrotal calculi and their relationship with pain.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study was to determine the frequency of scrotal calculi in men referred for scrotal ultrasonography (US), to identify any associated pathologies, and to investigate if any relationship exists between scrotal lithiasis and pain. MATERIALS AND METHODS: This was a retrospective study in which 4084 scrotal US examinations in 3435 men were evaluated. Scrotal US was performed using a high-frequency linear transducer. Forty patients were questioned as to whether scrotal pain was present. Patients were asked to grade their scrotal pain intensity using the Numerical Rating Scale. RESULTS: Sixty-seven of the 3435 patients with scrotal US examinations had scrotal calculi with a mean size of 3.7 ± 1.4 mm (range, 1.6-7 mm). Twenty patients with scrotal calculi had no scrotal pain. Nine patients with scrotal pain (22.5%) had no US or clinical abnormalities except scrotal calculi. CONCLUSION: The frequency of scrotal calculi was 1.95%. Approximately one-quarter of patients with scrotal calculi and pain had no additional abnormalities. Therefore, scrotal calculi should be considered in the differential diagnosis of scrotal pain.

Tan S; Özcan MF; Karao?lano?lu M; Ipek A; Özcan AS; Arslan H

2012-05-01

112

Renal calculi in wild Eurasian otters (Lutra lutra) in England.  

Science.gov (United States)

Macroscopic renal calculi were seen in 50 of 492 (10.2 per cent) wild Eurasian otters found dead in England from 1988 to 2007. Forty-eight adults and two subadults were affected. Calculi were present in 15.7 per cent (31 of 197) of adult males and 12.7 per cent (17 of 134) of adult females. There was an increase in prevalence in the study population over time; no calculi were found in 73 otters examined between 1988 and 1996, but in most subsequent years they were observed with increased frequency. Calculi occurred in both kidneys but were more common in the right kidney. They varied greatly in shape and size; larger calculi were mostly seen in the calyces while the smallest ones were commonly found in the renal medulla. Calculi from 45 cases were examined by x-ray diffraction analysis; in 43 (96 per cent), they were composed solely of ammonium acid urate. Affected otters had heavier adrenal glands relative to their body size than unaffected otters (P0.05). Many otters had fresh bite wounds consistent with intraspecific aggression. The proportion bitten increased over time and this coincided with the increased prevalence of renal calculi. PMID:21676988

Simpson, V R; Tomlinson, A J; Molenaar, F M; Lawson, B; Rogers, K D

2011-06-15

113

Infravesical obstruction results as giant bladder calculi.  

UK PubMed Central (United Kingdom)

A 48-year-old man was hospitalized with the chief complaints of lower abdominal pain, pain during micturation and pollakuria. Plain radiography showed 2 giant bladder stone shadows: one as 6.0 × 5.0 cm and the other one 5.0 × 5.0 cm in size. Cystolithotomy was performed. The first stone weighed 400 g and measured 6.0 × 5.0 × 6.0 cm in size, and the other stone was fragmented to smaller particles with pneumatic lithotriptor. Although a bladder stone is not rare, this case is interesting for 2 huge bladder calculi that were completely obstructing the bladder outlet and observed several years following pelvic trauma. To the best of our knowledge, our patient represents one of the largest bladder stone cases reported to date.

Aydogdu O; Telli O; Burgu B; Beduk Y

2011-08-01

114

Infravesical obstruction results as giant bladder calculi.  

Science.gov (United States)

A 48-year-old man was hospitalized with the chief complaints of lower abdominal pain, pain during micturation and pollakuria. Plain radiography showed 2 giant bladder stone shadows: one as 6.0 × 5.0 cm and the other one 5.0 × 5.0 cm in size. Cystolithotomy was performed. The first stone weighed 400 g and measured 6.0 × 5.0 × 6.0 cm in size, and the other stone was fragmented to smaller particles with pneumatic lithotriptor. Although a bladder stone is not rare, this case is interesting for 2 huge bladder calculi that were completely obstructing the bladder outlet and observed several years following pelvic trauma. To the best of our knowledge, our patient represents one of the largest bladder stone cases reported to date. PMID:21806900

Aydogdu, Ozgu; Telli, Onur; Burgu, Berk; Beduk, Yasar

2011-08-01

115

Minimally invasive options for salivary calculi.  

Science.gov (United States)

The aim of this study was to review the advantages, limitations, and international interdisciplinary expert perspectives and contrasts of salivary gland endoscopy and transoral techniques in the diagnosis and management of salivary gland calculi and their adaptation in North America. The transition from transcervical approaches to strictly sialendoscopic approaches is a broad chasm and often not feasible. Sialendoscopy, sialendoscopy-assisted, intraoral, and transcervical approaches all have surgical value. Diagnostic sialendoscopy, interventional sialendoscopy, sialendoscopy-assisted, and transoral techniques have been a major step forward, not only in providing an accurate means of diagnosing and locating intraductal obstructions, but also in permitting minimally invasive surgical treatment that can successfully manage blockages precluding sialoadenectomy in most cases. A flexible methodology is required. Multiple or combined measured may prove effective. PMID:22460664

Witt, Robert L; Iro, Heinrich; Koch, Michael; McGurk, Mark; Nahlieli, Oded; Zenk, Johannes

2012-03-27

116

Minimally invasive options for salivary calculi.  

UK PubMed Central (United Kingdom)

The aim of this study was to review the advantages, limitations, and international interdisciplinary expert perspectives and contrasts of salivary gland endoscopy and transoral techniques in the diagnosis and management of salivary gland calculi and their adaptation in North America. The transition from transcervical approaches to strictly sialendoscopic approaches is a broad chasm and often not feasible. Sialendoscopy, sialendoscopy-assisted, intraoral, and transcervical approaches all have surgical value. Diagnostic sialendoscopy, interventional sialendoscopy, sialendoscopy-assisted, and transoral techniques have been a major step forward, not only in providing an accurate means of diagnosing and locating intraductal obstructions, but also in permitting minimally invasive surgical treatment that can successfully manage blockages precluding sialoadenectomy in most cases. A flexible methodology is required. Multiple or combined measured may prove effective.

Witt RL; Iro H; Koch M; McGurk M; Nahlieli O; Zenk J

2012-06-01

117

Shockwave lithotripsy in patients with renal calculi  

International Nuclear Information System (INIS)

Objective was to demonstrate the efficacy of shock wave lithotripsy (SWL) in the primary treatment of 1647 patients with renal calculi using a Dornier Doli U/50 lithotripter. One thousand six hundred forty-seven patients underwent SWL as day-cases at King Abdulaziz Hospital, Saudi Arabia between October 2001 and July 2007, using intravenous sedation (Pethidine 1mg/kg and Midazolam 5-10mg) for analgesia in 85.5% of the patients. The treatment outcome of 2241 renal calculi was analyzed and stratified according to the size and site of the stones. Recorded data included shock waves intensity, number of shocks, treatment time, analgesia stone related factors such as size, site, number, nature, composition and any related complications. The stones were grouped into 5 groups, according to the largest stone size in the kidney. Patients were followed up for 6-18 months, mean of 13 months. Complete clearance of the stones occurred in 2154 kidneys (89.5%). At 3-months follow-up, the overall treatment rate was 57.2% and for each group it was 132 (23.5%) for Group I, 254 (36.1%) for Group II, 473 (85.5%) for Group III, 278 (100%) for Group IV and 147 (100%) for Group V. Treatment failed in 87 patients with stone size of 30-39 mm. Fifty-six were solitary pelvic stones treated with ureteroscopy, while 31 were calyceal stoned treated by other modalities such as per-cutaneousnephro-lithotomy. The most common complication was pyelonephritis with or without obstruction. Shock wave lithotripsy treatment was a successful primary management of renal stones of variable sizes in 89.5% of the treated kidneys. (author)

2008-01-01

118

Leukonychia totalis, multiple sebaceous cysts and renal calculi: a syndrome.  

UK PubMed Central (United Kingdom)

We have presented a family of 4 generations demonstrating total leukonychia. Multiple sebaceous cysts and renal calculi are associated features of the syndrome. Inheritance is autosomal dominant. We cannot determine whether renal glycosuria is a component of this syndrome.

Gorlin RJ; Bushkell LL; Jensen G

1975-01-01

119

Development of multiple calculi in the duplex system ureterocele.  

Science.gov (United States)

A 61-year-old man presented complaining of pollakisuria and nocturia. A plain radiograph of his kidney, ureter and bladder and intravenous urography revealed numerous calculi in the upper kidney of his left renal pelvis and ureterocele. A transurethral incision of ureterocele (TUI-ureterocele) and extracorporeal shock wave lithotripsy were performed. On TUI-ureterocele, the many calculi were found to be almost the same size and spherical in form. The postoperative clinical course was uneventful. PMID:17083401

Nakane, Akihiro; Hayashi, Yutaro; Kojima, Yoshiyuki; Mizuno, Kentaro; Kurokawa, Satoshi; Kohri, Kenjiro

2006-11-01

120

Percutaneous Treatment of Bladder Calculi in Children: 5 Years Experience  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: We sought to evaluate the safety and efficacy of percutaneous cystolithotripsy in children.Materials and Methods: Thirty children (27 boys and 3 girls; mean age, 6.06 ± 2.64 years; range, 1.5 to 12 years) with bladder calculi underwent percutaneous stone removal. The mean size of the largest diameters of the calculi was 24.8 ± 8.47 mm (range, 13 mm to 50 mm). Under general anesthesia, a 1-cm incision was made 1 to 2 cm above the pubic symphysis. A 26-F nephroscope was introduced into the bladder following tract dilation, and the calculi were removed. If the calculi were larger than 1 cm, fragmentation was performed. The procedure was done without fluoroscopy. Finally, a urethral catheter was placed for 48 hours.Results: All patients became stone free. The mean operative time was 23.13 ± 8.38 minutes (range, 12 to 40 minutes). All patients were discharged 24 hours after operation, except 1, who was hospitalized 2 more days for suprapubic pain and severe irritating symptoms. No significant intraoperative or postoperative complications were seen.Conclusion: Percutaneous suprapubic cystolithotripsy is an efficient and safe technique for treating bladder calculi in children. We recommend this technique for treating large bladder calculi (larger than 1 cm) in children.

Hassan Ahmadnia; Mehdi Younesi Rostami; Ali Asghar Yarmohammadi; Seyed Mohammad Javad Parizadeh; Mohammad Esmaeili; Mohammad Movarekh

2006-01-01

 
 
 
 
121

[XRD, FTIR and thermoluminescence spectra of different types of urinary stones].  

Science.gov (United States)

Using thermoluminescence spectrometer, X-ray diffraction and Fourier transform infrared spectroscopy, the chemical compositions of four types of kidney stones were investigated. They are calcium oxalate, uric acid, calcium phosphate and magnesium ammonium phosphate calculi (struvite). Experimental results showed that in the 305 cases of stones, calculi oxalate stones were found to account for 63%, uric acid stones 22%, calcium phosphate stones 8%, struvite 5%, and the stones with other compositions 2%. There were significant differences in the thermoluminescence spectra among the 4 types of urinary stones, which can provide an important basis for the clinic diagnosis of urinary stone types. PMID:22007431

Yang, Jin; He, Jie-Yu; Ouyang, Jian-Ming

2011-08-01

122

Ureteral jets in patients with unilateral ureteral calculi: Using color doppler ultrasonography  

International Nuclear Information System (INIS)

Sonographic detection of ureteral jets entering the urinary bladder is a well-known procedure. Color doppler ultrasound was used to image the ureteral jets in 28 patients with unilateral ureteral calculi proved by intravenous urography. Three major findings of ureteral jets were obtained in the affected ureter with a stone: less frequency (26 patients), weak reflection (20 patients), and lower grade in length (27 patients) that were significant different from the unaffected side in the same patient. No significant differences were found between the ureteral jets and the degree of hydronephrosis or the location of a stone. In conclusion, these results suggest that ureteral jets should be checked routinely during the procedure of color doppler ultrasonogram in patients with possible unilateral ureteral obstruction. Color doppler examination of ureteral jets may be an important adjunct in routine pelvic ultrasonogram especially in patients who have absolute or relative contraindications of intravenous urography

1993-01-01

123

FT-Raman spectral analysis of human urinary stones.  

UK PubMed Central (United Kingdom)

FT-Raman spectroscopy is the most useful tool for the purpose of bio-medical diagnostics. In the present study, FT-Raman spectral method is used to investigate the chemical composition of urinary calculi. Urinary calculi multi-components such as calcium oxalate, hydroxyl apatite, struvite and uric acid are studied. FT-Raman spectrum has been recorded in the range of 3500-400 cm(-1). Chemical compounds are identified by Raman spectroscopic technique. The quantitative estimations of calcium oxalate monohydrate (COM) 1463 cm(-1), calcium oxalate dehydrate (COD) 1478 cm(-1), hydroxyl apatite 959 cm(-1), struvite 575 cm(-1), uric acid 1283 cm(-1) and oxammite (ammonium oxalate monohydrate) 2129 cm(-1) are calculated using particular peaks of FT-Raman spectrum. The quantitative estimation of human urinary stones suitable for the single calibration curve was performed.

Selvaraju R; Raja A; Thiruppathi G

2012-12-01

124

New chemolysis for urological calcium phosphate calculi – a study in vitro  

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Full Text Available Abstract Background Advances in techniques have left very few indications for open surgical extraction of urinary stones currently. These advances notwithstanding, the search continues for medical approaches to urinary stone management. In this study, we perform an in vitro study analyzing the efficiency and prospect of two new complex solutions in urological calcium phosphate calculi dissolution. Methods Eighteen stones composed mainly of calcium phosphates were taken from patients who underwent kidney stone surgery. These stones were large enough (weight range 0.514–0.928 g) to be fragmented and matched equally into six groups. Chemolysis of phosphate stones was done with six different solvents and was repeated 3 times with 6 stones for each solution. At 24, 48 and 72 h, reduction in weight, percentage weight change, and dissolution rate; the dissolution rates at pH 5.0, 7.0 and 8.5 for each solution, using different cations (Na+, K+ or Ca2+), according to different dilutions (1:1, 1:2, 1:3, 1:4) of S1 and S2 were simultaneously determined. Results Calcium phosphate calculi were poorly dissolved by Phys and Art, and they had a low dissolution rate in pH 8.5 EDTA. The most effective solutions were S1, S2 and R, with 72 h mean dissolution rates: 5.75 ± 0.44 mg/hr (S1), 5.2 ± 0.63 mg/hr (S2), 4.55 ± 0.46 mg/hr (R) ( ± s, p p ± s, p +, K+ or Ca2+ greatly reduced the dissolution rates of S1, S2. Conclusion Our data indicate that test solutions S1 and S2 are effective solvents in the chemolysis of calcium phosphate stones. At twice dilutions, these solutions are even more useful in the treatment of stone disease.

Xiang-bo Zhang; Zhi-ping Wang; Jian-min Duan; Jian-zhong Lu; Bao-liang Ma

2005-01-01

125

Urinary Catheterization  

Science.gov (United States)

Diseases and Conditions 9339 catheterization Urinary Catheterization Urinary Catheterization htmUrinaryCatheterization In urinary catheterization, a catheter (hollow tube) is inserted into the bladder to drain or collect urine. ...

126

Urinary Dysfunction  

Science.gov (United States)

... Glossary African American Men Living with Prostate Cancer Urinary Dysfunction Side Effects Urinary Dysfunction Bowel Dysfunction Erectile ... not improve or worsen over time. Management of Urinary Dysfunction Because the urinary symptoms following radiation therapy ...

127

New alternatives for minimally invasive management of uroliths: lower urinary tract uroliths.  

UK PubMed Central (United Kingdom)

In small animals, removal is indicated for lower urinary tract calculi that are not amenable to medical dissolution and are causing, or may cause, urinary tract obstruction, inflammation, or recurrent infection. Surgical removal of lower urinary tract uroliths by cystotomy or urethrotomy has been the traditional method. The current standard of care for human urinary tract stones involves the use of lithotripsy and is minimally invasive. This article reviews the current literature on the various minimally invasive options available for managing lower urinary tract stones in small animal veterinary patients. Options for managing nephroliths and ureteroliths will be presented in forthcoming companion articles.

Defarges A; Dunn M; Berent A

2013-01-01

128

Percutaneous removal of retained calculi from the abdomen.  

UK PubMed Central (United Kingdom)

With rising pressure placed on health service resources minimally invasive techniques requiring only short hospital admissions are increasing in importance. We describe the techniques used to remove calculi from the peritoneal cavity which had been retained after surgery and continued to cause clinical problems. In both cases described the calculi lay within abscess cavities associated with fistulous tracks to the skin. The fistulae were dilated to allow passage of therapeutic radiologic and endoscopic equipment enabling manipulation and subsequent extraction of the stones. In both cases removal of the calculi allowed complete resolution of the fistulae and the patients made a full clinical recovery. Removal of gallstones which have escaped into the peritoneum at laparoscopic cholecystectomy leading to sepsis has been described; we describe the novel management of a patient in whom extraction had already been attempted, at another hospital, without success. Removal of an appendicolith, described here in another patient, does not appear to have been reported previously.

O'Shea SJ; Martin DF

2003-01-01

129

Percutaneous removal of retained calculi from the abdomen.  

Science.gov (United States)

With rising pressure placed on health service resources minimally invasive techniques requiring only short hospital admissions are increasing in importance. We describe the techniques used to remove calculi from the peritoneal cavity which had been retained after surgery and continued to cause clinical problems. In both cases described the calculi lay within abscess cavities associated with fistulous tracks to the skin. The fistulae were dilated to allow passage of therapeutic radiologic and endoscopic equipment enabling manipulation and subsequent extraction of the stones. In both cases removal of the calculi allowed complete resolution of the fistulae and the patients made a full clinical recovery. Removal of gallstones which have escaped into the peritoneum at laparoscopic cholecystectomy leading to sepsis has been described; we describe the novel management of a patient in whom extraction had already been attempted, at another hospital, without success. Removal of an appendicolith, described here in another patient, does not appear to have been reported previously. PMID:12522642

O'Shea, S J; Martin, D F

2003-01-15

130

Phytate acts as an inhibitor in formation of renal calculi.  

Science.gov (United States)

The aim of this study was to assess the inhibitory action of phytate in formation of renal calculi. Hypertension (induced by nicotine) combined with hypercalcemia (induced by D vitamin) was used to induce calcification in renal tissue in male Wistar rats that were fed a purified phytate free diet. Phytate non-treated rats developed significant calcium deposits in kidneys and papillae, as well as in kidney tubules and vessels, whereas calcium deposits were absent in control and phytate treated rats. Fragments of hydroxyapatite (HAP) calculi exhibited the capacity to induce the growth of calcium salts on their surfaces. Presence of 1.5 mg/L of phytate in the synthetic urine inhibited the formation of calcium oxalate monohydrate on HAP renal calculi in normocalciuric conditions. The findings show that the action of phytate as a crystallization inhibitor takes place both in the intrapapillary tissue and urine. PMID:17127264

Grases, Felix; Isern, Bernat; Sanchis, Pilar; Perello, Joan; Torres, Jose Juan; Costa-Bauza, Antonia

2007-01-01

131

Intracorporeal Lithotripsy for Ureteral Calculi Using Swiss Lithoclast : SKIMS Experience  

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Full Text Available At present the techniques available for performing intracorporeal lithotripsy include electrohydraulic,ultrasonic, laser, and ballistic lithotripsy. We present our experience with a unique technology forperforming intracorporeal lithotripsy, namely the Swiss lithoclast, which is a form of ballistic lithotripsy.This simple and inexpensive device uses compressed air to activate a solid probe in a manner similarto that of a jackhammer. We report the use of this lithoclast in 92 patients involving a total of 95ureteral calculi. The lithoclast successfully fragmented 81 of the 95 calculi, a success rate of 85.26%.There were no major complications directly related to the use of this device. The Swiss lithoclastseems to be a safe, effective and an inexpensive means of performing intracorporeal lithotripsy forureteral calculi

Arif Hamid, M. Saleem Wani, B. S. Wazir

2005-01-01

132

Labelled Lambda-calculi with Explicit Copy and Erase  

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Full Text Available We present two rewriting systems that define labelled explicit substitution lambda-calculi. Our work is motivated by the close correspondence between Levy's labelled lambda-calculus and paths in proof-nets, which played an important role in the understanding of the Geometry of Interaction. The structure of the labels in Levy's labelled lambda-calculus relates to the multiplicative information of paths; the novelty of our work is that we design labelled explicit substitution calculi that also keep track of exponential information present in call-by-value and call-by-name translations of the lambda-calculus into linear logic proof-nets.

Maribel Fernández; Nikolaos Siafakas

2010-01-01

133

Treatment of giant ureterocele calculi by Holmium Laser Lithotripsy  

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Full Text Available Aim: Most ureteral stones pass spontaneously. But patients who have a calculi in an ureterocele could not pass their stone, because of narrow ureteral orifice. These stones may remain asymptomatic until hematuria or obstruction occurs.Materials and Methods: Holmium laser has many uses in urology, including soft tissue incision and calculus fragmentation. These properties are ideal for endoscopic management of the ureterocele calculusResults: We present a young patient who has no spesific and severe symptoms with a hypofunctional left kidney because of giant calculi in an ureterocele Conclusion: Its imaging characteristics on intravenous pyelography and endoscopic treatment were emphasized.

Haluk Söylemez; Bülent Alt?noluk; Murat Y. U?ra?

2009-01-01

134

Differential calculi on quantum spaces determined by automorphisms  

International Nuclear Information System (INIS)

If the bimodule of 1-forms of a differential calculus over an associative algebra A is the direct sum of 1-dimensional bimodules, a relation with automorphisms of A shows up. This happens for some familiar quantum-space calculi. (author)

2004-01-01

135

Brown tumor and staghorn calculi in primary hyperparathyroidism.  

UK PubMed Central (United Kingdom)

A case of primary hyperparathyroidism with bilateral renal staghorn calculi and brown tumor right thumb is reported in these images, along with the appropriate sequential management. Percutaneous nephrolithotomy (PCNL)was done after management of hypercalcemia and after parathyroidectomy. This case highlights the need for urologists and general practitioners to have a holistic approach in patient management.

Philip George AJ; Banerji JS

2013-08-01

136

Urostomy and urinary pH.  

UK PubMed Central (United Kingdom)

Significant variations of urinary pH can cause problems for all human beings, but these problems are magnified when an individual has a urostomy. Most significant stomal and peristomal complications are related to an alkaline urine including hyperkeratosis; stoma bleeding, incrustation, and ulceration; stoma stenosis; urinary tract infection; odor; and urinary calculi. Treatment of these conditions includes both external and internal measures. External methods of treatment involve keeping urine away from the stoma and the peristomal skin by use of a correctly fitting clean appliance and a night drainage system. Vinegar solution compresses can help to restore the acid mantle of the skin. Internal methods of treatment that are advocated in the literature include ingestion of cranberry juice and ascorbic acid to promote urine acidity. Increasing oral intake of fluids is the least risky method to promote the production of acidic, dilute urine, and results are equally effective.

Walsh BA

1992-07-01

137

Análise do impacto do progresso tecnológico nos custos do tratamento hospitalar: o caso do tratamento para litíase urinária no Hospital Universitário de Brasília Analysis of the technological change impact in the costs in hospital treatment: the case study of the treatment for urinary calculi in hospital in university hospital of Brasília  

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Full Text Available O progresso tecnológico na área de saúde tem provocado a elevação dos custos da assistência médica, preocupando a população mundial, os agentes privados e os responsáveis pelas políticas públicas. Estetrabalho apresenta uma análise do impacto do progresso tecnológico - delimitado, neste estudo, à incorporação de equipamentos médicos - nos custos do tratamento hospitalar. Para cumprir o objetivo, foram escolhidos ostratamentos médicos para litíase urinária - litotripsia e cirurgia - devido ao histórico de relevantes avanços tecnológicos. O estudo de caso foi realizado no Serviço de Litotripsia e no Centro Cirúrgico do Hospital Universitário de Brasília (HUB), no período de 2001 a 2003. Foram comparados os custos e as receitas diferenciais das alternativas de tratamento para calculose urinária em quatro opções de decisão. Para testar a robustez dos resultados, foi incorporada a variável incerteza, por meio de simulações no sistema Crystall Ball, realizando 50.000 iterações. Os principais impactos do progresso tecnológico nos custos do tratamento paralitíase urinária são: aumento da capacidade instalada, geração de despesa com obsolescência e aumento das receitas.The technological progress in the field of health has been triggering rises of medical assistance costs, worrying the world-wide population, private agents and the responsible ones for public policies. This search presents an analysis of technological evolution impact - here, bounded to the medical equipments incorporation - on thehospital treatment costs. In order to accomplish the objective, the medical care for urinary lithiasis - lithotripsyand surgery - had been chosen due to the record of meaningful technological advances. The case study wascarried through at the Lithotripsy Service and Hospital Universitário de Brasília (HUB) Surgical Center from 2001to 2003. The costs and incomes - differential items inherent to options for urinary calculosis treatment - were compared in four proposals. As a means to prove the results robustness the variable uncertainty wasincorporated through simulations at the Crystal Ball system, achieving 50.000 iterations. The main impacts from technological progress on the medical care for urinary lithiasis costs are: increase of the installed capacity, generation of expense with obsolescence and increase of revenues.

Patrícia de Souza Costa; César Augusto Tibúrcio Silva

2006-01-01

138

Percutaneous Nephrolithotomy of Kidney Calculi in Horseshoe Kidney  

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Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: The aim of this study was to evaluate percutaneous nephrolithotomy (PCNL) in horseshoe kidneys with calculi. Materials and Methods: Between 1995 and 2005, we performed PCNL in 9 patients with horseshoe kidney. In 3 of them, there was a single calculus and the rest had multiple calculi in the pelvis and at least 1 in the calyxes. Ultrasonography, plain abdominal radiography, and intravenous urography (IVU) were performed in all patients. We used fluoroscopy for entering the system and then, pneumatic or ultrasonic lithotripsy was used. Results: In all except 1 patient (88.9%) we could access the system. Single calculi in 3 patients were removed. In 5 patients with multiple calculi, the calculus causing obstruction was removed, and in 3, the calculi located in the calyxes were removed too. Consequently, 66.7% were stone-free at the end of the procedure. In 2 patients, there were residual calculi in the calyxes and they underwent candidates for extracorporeal shockwave lithotripsy. Conclusion: Percutaneous nephrolithotomy can be used in patients with horseshoe kidney if the patient selection is appropriate and the surgeon is experienced enough. The success rate and complications are the same as the patients with normal anatomy. However, access to the lower calyx is more difficult due to its anatomic status.

Mohammad Reza Darabi Mahboub; Ali Ahanian; Maryam Zolfaghari

2007-01-01

139

A Fully Abstract Symbolic Semantics for Psi-Calculi  

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Full Text Available We present a symbolic transition system and bisimulation equivalence for psi-calculi, and show that it is fully abstract with respect to bisimulation congruence in the non-symbolic semantics. A psi-calculus is an extension of the pi-calculus with nominal data types for data structures and for logical assertions representing facts about data. These can be transmitted between processes and their names can be statically scoped using the standard pi-calculus mechanism to allow for scope migrations. Psi-calculi can be more general than other proposed extensions of the pi-calculus such as the applied pi-calculus, the spi-calculus, the fusion calculus, or the concurrent constraint pi-calculus. Symbolic semantics are necessary for an efficient implementation of the calculus in automated tools exploring state spaces, and the full abstraction property means the semantics of a process does not change from the original.

Magnus Johansson; Björn Victor; Joachim Parrow

2010-01-01

140

Experiencia clínica y resultados en el tratamiento de 4402 pacientes con cálculos urinarios únicos con el litotritor extracorpóreo Dornier MFL-5000/ Clinical experience and results iun the treatment of 4402 patients with solitary urinary calculi with the extracorporeal shock wave lithotripter Dornier MFL-500  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Objetivo: Presentamos la casuística de nuestro servicio en el tratamiento de la litíasis urinaria así como la efectividad del litotritor Dornier MFL-5000 Métodos: Tratamos en 12 años un total de 6602 pacientes con un número total de sesiones de litotricia de 17120. Realizamos el estudio del éxito del tratamiento de los 4402 pacientes que presentaban un cálculo, según el tamaño y la localización. Resultados: No hubo complicaciones mayores y apenas 43 pacientes t (more) uvieron calle litiásica. Realizamos el tratamiento de 4402 cálculos. Para todos los cálculos independientemente de su localización y tamaño supone que 2615 (59,4%) se han tratado en una sesión, 801 (18,2%) en dos, 379 (8,6%) en tres, 213 (4,8%) en cuatro y 372 (8,4%) en cinco o más sesiones. Conclusiones: El litotritor MFL-5000 ha permitido el tratamiento de la litiasis urinaria en todas las edades, con unos porcentajes de retratamiento y un número de tratamientos por cálculo similar a otros autores, sin necesidad de analgesia ni medidas anestésicas, salvo en apenas aquellos pacientes de menor edad. Abstract in english Objectives: To report the series of our Urology Department in the treatment of urinary stone disease with extracorporeal lithotripsy as well as the effectiveness of the Dornier lithotripter MFL-5000. Methods: 6.602 patients were treated by extracorporeal lithotripsy during 12 years with a total of 17.120 sessions. We examined the treatment outcome of 4.402 patients with a solitary stone, accordingly to stone size and localization. Results: There were no major complication (more) s and only 43 patients experienced "calle litiásica". We treated 4.402 stones. For all stones, independently of size and localization, 2615 (59.4%) were treated in one session, 801 (18.2%) required two sessions, 379 (8.6%) 3 sessions, 213 (4.8%) 4 sessions and 373 (8.4%) 5 or more sessions. Conclusion: The Dornier MFL-5000 lithotripter successfully treated urinary stone disease in patients of all age groups with a retreatment rate and number of sessions per stone similar to other studies, without analgesia or anesthetic procedures, except in the younger age group.

Palacios, Alberto; Rodrigues, Filipe; Soares, Mário Jorge; Morais, Adérito; Mendes, Apolinário; Pinheiro, Jorge

2007-08-01

 
 
 
 
141

Techniques for holmium laser lithotripsy of intrarenal calculi.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe specific techniques of holmium laser lithotripsy for intrarenal calculi based on characteristics of the stone. METHODS: The dancing, chipping, fragmenting, and popcorn techniques are used to ablate stones ureteroscopically with the holmium laser. RESULTS: All techniques lead to successful stone ablation, with the different techniques being applied preferentially to stones with different characteristics. CONCLUSION: Honing precise techniques of ureteroscopic holmium laser lithotripsy can lead to more efficient lithotripsy.

Hecht SL; Wolf JS Jr

2013-02-01

142

[Ureteroscopy versus in situ extracorporeal shockwave lithotripsy in the treatment of calculi of the distal ureter  

UK PubMed Central (United Kingdom)

In a retrospective study from a unique center (St. Luc Hospital, Montreal) stone clearance of 88 consecutive distal ureteral calculi (below pelvic brim) treated by extracorporeal shock wave lithotripsy in situ were compared to a group of 94 distal ureteral calculi treated by ureteroscopy during the same period. Our results show 84% success rate for ureteroscopy which is clearly superior than 58% stone clearance rate at 3 month follow-up for ESWL Success rate was influenced by stone size in the ESWL group but not in the ureteroscopy group. This study reveals similar success rate for calculi smaller than 6 mm but for larger calculi, success rate of ureteroscopy is significantly superior.

Leblanc B; Paquin JM; Valiquette L; Perreault JP; Faucher R; Mauffette F; Benard F

1996-08-01

143

Ureteral calculi as a source of low back pain- a case report  

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Full Text Available This case report describes a 49 year old male with complaints of back pain that was diagnosed as degenerative low back pain and referred to the physical therapist. The mode of onset was insidious and the pain was intermittent with no relief from specific intervention as in rest, heat or analgesics. There was no report of changes in urinary frequency or color, and any vomiting sensation. This patient was appropriately screened by a physical therapist who suspected a pain origin that could potentially be of a viscerogenic origin. He was referred back to the primary care physician who ordered an ultrasound and a CT-KUB (Computerized Tomography-Kidney, Ureter, Bladder) which revealed a 10.5 mm calculi in the left upper ureter. The patient was then referred to a urologist who confirmed the findings and performed a ureterorenoscopy (URS) lithoclast fragmentation and J-J stenting under spinal anaesthesia. The result was an excellent symptomatic and functional outcome. The need for lateral thinking in the evaluation of non specific low back pain is enumerated. The treatment based classification system is a referenced model. The emerging role of the physical therapist in screening of back pain as a first contact practitioner and the responsibility therein, is described.

Satishkumar Anandan; Deepak Sebastian

2010-01-01

144

Urinary casts  

Science.gov (United States)

Urinary casts are tiny tube-shaped particles made up of white blood cells, red blood cells, or ... your urine is healthy or abnormal. Types of urinary casts include: Fatty casts Granular casts Hyaline casts ...

145

Urinary Diversion  

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... Lorem ipsum dolor sit amet, consectetur adipiscing elit. Urinary Diversion You do not need to have a ... Fortunately, this flow can be accomplished with a urinary diversion procedure. Read on to learn more. What ...

146

Urinary catheters  

Science.gov (United States)

A urinary catheter is a tube placed in the body to drain and collect urine from the bladder. ... Urinary catheters are used to drain the bladder. Your health care provider may recommend that you use ...

147

Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children  

International Nuclear Information System (INIS)

[en] Objective: To determine the safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children. Method: The study included 100 children up to 15 years of age undergoing pneumatic cystolithoclast for bladder stones. The descriptive study was conducted from September 2006 to February 2007 at the Sindh Institute of Urology and Transplantation, Karachi. The inclusion criteria was children up to 15 years of age with a bladder stone of up to 3 cm, pre-operative negative urine culture, no coagulopathy and fit for general anaesthesia. An X-ray and ultrasound of Kidney and Urinary Bladder (KUB) was mandatory. The procedure was done under general anaesthesia with a single dose of pre-operative antibiotic. A mini-scope of 4 FR or a semi-rigid ureteroscope of 7/8.5 FR with pneumatic wolf lithoclast was used for the fragmentation of stones. Duration of procedure, any per-operative and post-operative complications and the duration of hospital stay were recorded. Post-operatively, the patient underwent ultrasound Kidney and Urinary Bladder at the first follow-up to assess stone clearance after one week. Result: Mean patients age was 4.95+-3.3 years. The male-to-female ratio was 11.5: 1 The mean hospital stay was 9.2 +- 2.5 hours. The mean operating time was 25 (10 -65) minutes. Ten (10%) patients developed minor complications out of which 5 (5%) developed haematuria and 4 (4%) developed difficulty in passing urine. One (1%) of the patients developed post-operative retention of urine. All the patients were stone free after the procedure. Conclusion: The transurethral pneumatic lithoclast is very effective and safe in children with bladder stones up to 3 cm. (author)

2012-01-01

148

Safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the safety and efficacy of transurethral pneumatic lithotripsy for bladder calculi in children. METHOD: The study included 100 children up to 15 years of age undergoing pneumatic cystolithoclast for bladder stones. The descriptive study was conducted from September 2006 to February 2007 at the Sindh Institute of Urology and Transplantation, Karachi. The inclusion criteria was children up to 15 years of age with a bladder stone of up to 3cm, pre-operative negative urine culture, no coagulopathy and fit for general anaesthesia. An X-ray and ultrasound of Kidney and Urinary Bladder (KUB) was mandatory. The procedure was done under general anaesthesia with a single dose of pre-operative antibiotic. A mini-scope of 4FR or a semi-rigid ureteroscope of 7/8.5 FR with pneumatic wolf lithoclast was used for the fragmentation of stones. Duration of procedure, any per-operative and post-operative complications and the duration of hospital stay were recorded. Post-operatively, the patient underwent ultrasound Kidney and Urinary Bladder at the first follow-up to assess stone clearance after one week. RESULT: Mean patients age was 4.95 +/- 3.3 years. The male-to-female ratio was 11.5: 1 The mean hospital stay was 9.2 +/- 2.5 hours. The mean operating time was 25 (10 -65) minutes. Ten (10%) patients developed minor complications out of which 5 (5%) developed haematuria and 4 (4%) developed difficulty in passing urine. One (1%) of the patients developed post-operative retention of urine. All the patients were stone-free after the procedure. CONCLUSION: The transurethral pneumatic lithoclast is very effective and safe in children with bladder stones up to 3cm.

Khosa AS; Hussain M; Hussain M

2012-12-01

149

Canonical Differential Calculi For Finitely Generated Abelian Group and Their Fermionic Representations  

CERN Multimedia

Canonical differential calculus is defined for finitely generated abelian group with an involution existing consistently. Two such canonical calculi are found out. Fermionic representation for canonical calculus is defined based on quantized calculus. Fermionic representations for above-mentioned two canonical calculi are searched.

Dai, J; Dai, Jian; Song, Xing-Chang

2001-01-01

150

A journey through resource control lambda calculi and explicit substitution using intersection types (an account)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In this paper we invite the reader to a journey through three lambda calculi with resource control: the lambda calculus, the sequent lambda calculus, and the lambda calculus with explicit substitution. All three calculi enable explicit control of resources due to the presence of weakening and contra...

Ghilezan, Silvia; Ivetic, Jelena; Lescanne, Pierre; Likavec, Silvia

151

[Urinary lithiasis in the child (author's transl)  

UK PubMed Central (United Kingdom)

The authors report a series of 130 children suffering from urinary lithiasis (essentially between the age of 4 to 6 years) and particularly in boys (2.5 to 1). There were 108 cases of reno-ureteric lithiasis as against 23 vesico-urethral. In 69 cases, pyelocalyceal lithiasis predominated. Thirty per cent of the children had bilateral lithiasis, and 19% of all cases of lithiasis were staghorn calculi. Presenting symptoms : haematuria, diffuse abdominal pain, anuria (6 cases), complete urinary retention (5 cases). Study of these cases failed to indicate whether obstruction of the upper urinary tract (14%) or infection (27%) was the cause or the effect of the lithiasis. Particularly notable were 8 cases of cystinuria (6%), 1 of glycinuria, 1 of hyperoxaluria and 7 of hypercalciuria. At least in Spain, lithiasis in children would appear to be essentially idiopathic. However, 40% of these cases of lithiasis were secondary to obstruction of the excretory tract and/or urinary infection. All types of entero-uroplasty were lithogenic (6 cases). 32% of the children had a proteus infection. Treatment : 14 children were treated medically as against 125 surgically. 70% are free of any recurrence. 7% have a residual lithiasis. The rarity of recurrences and the quality of the results obtained indicate that complete surgical treatment represents the essential feature of the treatment of urinary lithiasis in children.

Gosalbez R; Garat JM; Piro C; Martin JA

1980-01-01

152

Quantong Recipe integrated with ureteroscopic laser lithotripsy for ureteral calculi  

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Full Text Available Background: Endoscopic surgery of Western medicine has developed rapidly in treating ureteral calculi while traditional Chinese medicine (TCM) therapy also has its advantage, thus the integrated traditional Chinese and Western medicine therapy may have an even better efficacy in dealing with this problem.Objective: To observe the clinical effects of sequential therapy of Quantong Recipe, a compound traditional Chinese herbal medicine, combined with ureteroscopic laser lithotripsy on ureteral calculi.Design, setting, participants and interventions: A total of 151 patients with ureteral calculi (stone diameter of 3 to 21 mm) from Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were included, of which 106 patients with stone diameter of 3 to 10 mm were treated with Quantong Recipe for the first two weeks. Twenty patients with unexpelled stones and 45 patients with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy. The 65 patients except one open operation were divided into regular treatment group (32 cases) and regular treatment combined with Quantong Recipe group (32 cases) after lithotripsy. The efficacy was assessed after one week.Main outcome measures: Cure rate in the patients with stone diameter of less than 10 mm after two-week Quantong Recipe treatment was calculated, and clearance rate in the patients with residual stone for ureteroscopic laser lithotripsy after one-week Quantong Recipe treatment was also observed.Results: After taking Quantong Recipe for two weeks, the stones in 86 patients were completely discharged, and the stones in 6 patients were not completely discharged, but the unexpelled stones had moved down more than one segment of ureteral stenosis; the total response rate was 86.79% (92/106). The 64 patients with stones unexpelled or with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy, and the clearance rate of residual stone was 93.8% in regular treatment combined with Quantong Recipe group, and was 71.9% in regular treatment group, and there was a significant difference between the two groups (P<0.05).Conclusion: Sequential therapy of Quantong Recipe integrated with ureteroscopic laser lithotripsy demonstrates a significant advantage of integrated traditional Chinese and Western medicine therapy in treating ureteral calculi.

Yu PENG

2010-01-01

153

Ultrasonic fragmentation in the treatment of male urethral calculi.  

Science.gov (United States)

In the last 8 months, 7 patients have presented with acute retention of urine due to impacted urethral stones. Four stones were in the posterior urethra, 2 in the penile urethra and 1 proximal to the external urethral meatus. The patients were managed as emergencies. Stone fragmentation by ultrasound (US) through a 24F obliquely offset eyepiece nephroscope was achieved with minimal urethral trauma. Follow-up was for 6 months and no evidence of urethral stricture or recurrent stones was found. It was concluded that US fragmentation of urethral calculi is a safe and efficient procedure with minimal complications when used in the management of impacted urethral stones. PMID:3208024

Durazi, M H; Samiei, M R

1988-11-01

154

Ultrasonic fragmentation in the treatment of male urethral calculi.  

UK PubMed Central (United Kingdom)

In the last 8 months, 7 patients have presented with acute retention of urine due to impacted urethral stones. Four stones were in the posterior urethra, 2 in the penile urethra and 1 proximal to the external urethral meatus. The patients were managed as emergencies. Stone fragmentation by ultrasound (US) through a 24F obliquely offset eyepiece nephroscope was achieved with minimal urethral trauma. Follow-up was for 6 months and no evidence of urethral stricture or recurrent stones was found. It was concluded that US fragmentation of urethral calculi is a safe and efficient procedure with minimal complications when used in the management of impacted urethral stones.

Durazi MH; Samiei MR

1988-11-01

155

Evaluation of the Raphanus sativus effect on urinary pH  

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Full Text Available BACKGROUND: According to urology texts, urinary calculi are the third most common affliction of the urinary tract and they pose great expenses on health services. The use of oral herbal medication is one of the cheapest ways of treating this disease (in some societies black radish plant is used as a treatment). The scientific term for black radish is Raphanus sativus nigra. Urinary pH is a prominent factor in any crystallization process in urine. This study was conducted to determine the possible effects of Raphanus on urinary pH as a factor in stone formation and crystallization.METHODS: Thirty healthy people including 11 males and 19 females without any history of drug consumption or urinary calculi in their first degree relatives were chosen and underwent a four days trial. The experiment included 2 days of Raphanus juice consumption during which urinary pH was measured 4 times a day. The averages of Urinary pH with or without Raphanus juice consumption were compared by t-paired test.RESULTS: The Study was carried out using 30 participants including 11 males and 19 females with the mean ± SD age of 28.66 ± 10.8 (range 19-55). Out of the eight pairs of urinary pH, only in two pairs P values were 0.05 and 0.028 and the rest were all greater than 0.05 which is not sufficient to show a significant difference between urinary pH with or without Raphanus juice consumption.CONCLUSIONS: In this study, the effect of Raphanus sativus nigra on urinary pH was not proved. However, according to the proved effects of Raphanus as a diuretic and dissolution agent in Rats, it would be reasonable to repeat the same study in a human population.KEY WORDS: Raphanus sativus, urinary pH, urinary calculus.

Hamid Mazdak; Mohammad Masoud Nikkar; Linda Ghanea

2007-01-01

156

[Value of extracorporeal shockwave lithotripsy in the treatment of urinary lithiasis in children  

UK PubMed Central (United Kingdom)

We report our experience with extracorporeal lithotripsy (Dornier HM3) in a series of 26 children with a mean age of 11.6 years, treated for 3 1/2 years. 12 children (46%) had a previous history of calculi and 7 (27%) had already undergone surgery on the same side. Treatment requires two transducer investigations before lithotripsy. With the exception of minor modifications the technique is the same as in the adult. Three (9.7%) postlithotripsy complications were noted, requiring 2 drainage procedures to be carried out on the urinary tract. At 3 months, the success rate (no residual calculi on the plain abdominal film) was 60.7%. This study confirms the efficacy of lithotripsy in the treatment of urinary lithiasis in children.

Charbit L; Terdjman S; Gendreau MC; Guérin D; Quentel P; Cukier J

1989-01-01

157

Current role of microperc in the management of small renal calculi.  

UK PubMed Central (United Kingdom)

'Microperc' is a recently described technique in which percutaneous renal access and lithotripsy are performed in a single step using a 16 G micropuncture needle. 'Mini-microperc' is a further technical modification in which an 8 Fr sheath is used to allow insertion of ultrasonic or pneumatic lithoclast probe with suction. The available evidence indicates that microperc is safe and efficient in the management of small renal calculi in adult and pediatric population. It can also be used for renal calculi in ectopic kidneys and bladder calculi. The high stone clearance rate and lower complication rate associated with microperc make it a viable alternative to retrograde intrarenal surgery.

Sabnis RB; Ganesamoni R; Ganpule AP; Mishra S; Vyas J; Jagtap J; Desai M

2013-07-01

158

Current role of microperc in the management of small renal calculi  

Science.gov (United States)

‘Microperc’ is a recently described technique in which percutaneous renal access and lithotripsy are performed in a single step using a 16 G micropuncture needle. ‘Mini-microperc’ is a further technical modification in which an 8 Fr sheath is used to allow insertion of ultrasonic or pneumatic lithoclast probe with suction. The available evidence indicates that microperc is safe and efficient in the management of small renal calculi in adult and pediatric population. It can also be used for renal calculi in ectopic kidneys and bladder calculi. The high stone clearance rate and lower complication rate associated with microperc make it a viable alternative to retrograde intrarenal surgery.

Sabnis, Ravindra B; Ganesamoni, Raguram; Ganpule, Arvind P; Mishra, Shashikant; Vyas, Jigish; Jagtap, Jitendra; Desai, Mahesh

2013-01-01

159

Differential calculi on quantum (sub)groups and their classical limit  

CERN Document Server

For the two-parameter matrix quantum group GLp,q(2) all bicovariant differential calculi (with a four-dimensional space of 1-forms) are known. They form a one-parameter family. Here, we give an improved presentation of previous results by using a different parametrization. We also discuss different ways to obtain bicovariant calculi on the quantum subgroup SLq(2). For those calculi, we do not obtain the ordinary differential calculus on SL(2) in the classical limit. The structure which emerges here can be generalized to a nonstandard differential calculus on an arbitrary differentiable manifold and exhibits relations with stochastic calculus and "proper time" relativistic quantum theories.

Müller-Hoissen, F

1994-01-01

160

[Urinary excretion of leucine aminopeptidase after extracorporeal shock wave lithotripsy  

UK PubMed Central (United Kingdom)

Extracorporeal shock-wave lithotripsy (ESWL) is the treatment of choice in the majority of urinary calculi. In experimental and clinical research it has been shown that the method has short-term deleterious effects on renal function. Several factors, such as urinary tract infection (UTI), the site of the stone, pre-existing renal abnormalities, the number and intensity of the shock waves may influence the extent of the damage. The aim of this study was to measure the excretion of the renal microsomal enzyme, leucinaminopeptidase (MLAP) as expression of renal damage following ESWL. Our study shows that there was a significant elevation in urinary excretion of MLAP immediately after ESWL, especially in patients with UTI. These results indicate that UTI may be one of the risk factors for aggravation of renal damage after ESWL. However, these changes are transient and expressed less than in patients with light renal trauma arising because of other external influence.

Stepanov VN; Perelman VM; Kadirov ZA; Istratov VG

1995-01-01

 
 
 
 
161

An association between kidney stone composition and urinary metabolic disturbances in children.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine kidney stone composition in children and to correlate stone fractions with urinary pH and metabolic urinary risk factors. PATIENTS AND METHODS: We studied 135 pediatric patients with upper urinary tract lithiasis in whom excreted or extracted stones were available for analyses. Composition of stones was analyzed. A 24-hour urine assessment included volume, pH and daily excretions of calcium, oxalate, uric acid, cystine, creatinine, phosphate, magnesium and citrate. RESULTS: Calcium oxalate was the major component of 73% stones, followed by struvite (13%) and calcium phosphate (9%). Uric acid was present in almost half of stones, but in rudimentary amounts. The calcium oxalate content in calculi showed a strong relationship with calciuria, and moderate association with oxaluria, magnesuria and acidification of urine. The percent content of struvite presented reverse and lower correlations with regard to the above parameters. Calcium phosphate stone proportion had low associations with urinary risk factors. CONCLUSIONS: Calciuria, oxaluria, magnesuria and low urine pH exerted the biggest influence on calcium oxalate content in pediatric renal stones. Relationships of urinary risk factors with calculi calcium phosphate content were of unclear significance. Urinary citrate excretion did not significantly correlate with kidney stone composition in children.

Kirejczyk JK; Porowski T; Filonowicz R; Kazberuk A; Stefanowicz M; Wasilewska A; Debek W

2013-08-01

162

Arithmetical proofs of strong normalization results for symmetric lambda calculi  

CERN Multimedia

We give arithmetical proofs of the strong normalization of two symmetric $\\lambda$-calculi corresponding to classical logic. The first one is the $\\bar{\\lambda}\\mu\\tilde{\\mu}$-calculus introduced by Curien & Herbelin. It is derived via the Curry-Howard correspondence from Gentzen's classical sequent calculus LK in order to have a symmetry on one side between "program" and "context" and on other side between "call-by-name" and "call-by-value". The second one is the symmetric $\\lambda \\mu$-calculus. It is the $\\lambda \\mu$-calculus introduced by Parigot in which the reduction rule $\\mu'$, which is the symmetric of $\\mu$, is added. These results were already known but the previous proofs use candidates of reducibility where the interpretation of a type is defined as the fix point of some increasing operator and thus, are highly non arithmetical.

David, René

2009-01-01

163

[Experiences with transparenchymal coral calculi removal under local hypothermia  

UK PubMed Central (United Kingdom)

Under certain conditions genuine coral calculi are an absolute offication for nephrotomy. In order to achieve complete hygienization of the cavity ischaemia times of more than 25-30 min are often necessary. Controlled surface cooling proved to be very good for improving ischaemia tolerance and reducing post-ischaemic loss of function in 21 necessary nephrotomies out of a total of 651 operations for concrements in the calyx system of the renal pelvis (= 3.2%; = 32.8% of all nephrotomies). A kidney thermometer with a temperature feeler developed by us allows fine control of the hypothermia induced by means of plastic bags filled with ice crystals. The technique of operation together with its advantages and disadvantages are described.

Albert L; Zacher W; Meyer S

1984-06-01

164

[Application of alpha1-adrenoblockers in treatment of ureteral calculi].  

UK PubMed Central (United Kingdom)

The results of evaluation of the efficacy of alpha1-adrenoblockers in treatment of ureteral calculi are presented. Comparative, prospective, placebo-uncontrolled nonrandomized single-center study was performed, which included 118 patients with solitary diagnosed calculi in various parts of ureter. After the pain relief, all the patients underwent conservative therapy aimed at spontaneous discharge of concretions. The maximum duration of conservative treatment was 28 days. Ultrasound monitoring was performed every week in all patients. The control group of patients received only Drotaverinum 40 mg three times a day, and analgesics. The main group received alpha1-adrenoblocker tamsulosin at a standard dose of 0.4 mg once a day along with Drotaverinum and analgesics. The overall probability of a discharge of concrements localized in the distal ureter was significantly (P = 0.02) higher in the patients treated with alpha1-adrenoblockers. Treatment regimen in main group of patients allowed better control of pain during all periods of observation, even if the discharge of concretions was not registered. The overall probability of migration of concrements from the proximal to the distal ureter in main group of patients was 52% versus 32% in controls (P = 0.17). The frequency of adverse effects was comparable in both groups. Vertigo, postural hypotension, and weakness were significantly more frequent in the main group of patients. Univariate and multivariate analyses of the proportional hazards model have demonstrated that the administration of alpha1-adrenoblocker increased the likelihood of a discharge of concrement from the distal ureter. It is shown that the nature of the applied therapy has directly influence on the risk of an earlier discharge of concretions. Inclusion of alpha1-adrenoblockers in the treatment scheme increased the probability of discharge of concrements at 4.11 times.

Dutov VV; Popov DV; Rumiantsev AA; Pashchenko VB

2012-09-01

165

Porfirinas en Cálculos Renales (Revisión)/ Porphyrins in renal calculi (Review)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Hemos realizado una revisión del contenido de porfirinas en una clase peculiar de cálculos renales. Estos son negros como el carbón y presentan un espectro infrarrojo (EIR) similar al conocido como "materia orgánica", el cual no indica la clase de sustancia a la que corresponde. Otros tipos de cálculos renales, principalmente de pequeño tamaño y eliminados espontáneamente, pueden tener un compuesto oscuro o negro de forma difusa o aislada y presentan un espectro d (more) e IR similar al de "materia orgánica". Después de observar que la hemoglobina presentaba un espectro de IR de "materia orgánica", estudiamos, por cromatografía en capa fina, un método sensible para la determinación de porfirinas, la presencia de porfirinas en diversos tipos de cálculos renales negros y oscuros, ya que las porfirinas son los precursores del grupo hemo. Este trabajo ha puesto de manifiesto dos tipos de porfirinas: la coproporfirina, en pacientes que padecen hepatopatías, y la uroporfirina y heptacarboxilporfirina en pacientes con algún tipo de porfiria o bien con fracaso renal crónico. Abstract in english We performed a review of the porphyrines content in a type of black, charcoal-like, renal calculi exhibiting infrarred spectra (IRS) similar to those characteristic of "organic material" which has not yet been fully elucidate. Several other types of renal calculi, mainly those of small size, spontaneous passage renal stone, may also have diffuse or isolated dark charcoal components showing "organic material" IRS. After observing that haemoglobin has an "organic material" (more) IRS, we studied, by a sensitive thin layer chromatography method, the presence of porphyrines in several types of dark or charcoal renal stones, since porphyrines are the physiological precursors of haemo group biosynthesis. We found two types of porphyrine content: coproporphyrin, in patients suffering from hepatopathy, and uroporphyrin and heptacarboxil-porphyrin in patients with some types of porphyria or with chronic renal failure.

Traba Villameytide, MªL.

2005-02-01

166

Percutaneous intervention of large bladder calculi in neuropathic voiding dysfunction  

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Full Text Available PURPOSE: To report our results and rationale for treating large bladder calculi in patients with neuropathic voiding dysfunction (NVD) using percutaneous cystolithalopaxy. MATERIALS AND METHODS: Ten patients with a previously diagnosed NVD presenting with a large stone burden were identified from our department database and a retrospective review of case notes and imaging was performed. RESULTS: Percutaneous access to remove bladder stones (range 8x7 to 3x2 cm) had a mean surgery length of 150 min and blood loss of 23 mL. Six of the seven patients treated percutaneously were discharged on the day of surgery and suffered no complications, while one patient experienced poor suprapubic tube drainage and required overnight admission with discharge the following day. Transurethral removal of stone burden (range 4x4 to 4x3 cm) had a mean surgery length of 111 min and blood loss of 8 mL. Each of these three patients were under our care for less than 23 hours, and one patient required a second attempt to remove 1x0.5 cm of stone fragments. There was no statistical difference between mean operative times and estimated blood loss, p = 0.5064 and p = 0.0944 respectively, for the two treatment methods. CONCLUSION: In this small series, percutaneous cystolithalopaxy was a safe, effective, and often preferred minimally invasive option for removal of large calculi in patients with NVD. We suggest possible guidelines for best endoscopic approach in this population, although a larger and prospectively randomized series will be ideal for definitive conclusions.

Chad P. Hubsher; Joseph Costa

2011-01-01

167

On the Expressiveness of Markovian Process Calculi with Durational and Durationless Actions  

CERN Multimedia

Several Markovian process calculi have been proposed in the literature, which differ from each other for various aspects. With regard to the action representation, we distinguish between integrated-time Markovian process calculi, in which every action has an exponentially distributed duration associated with it, and orthogonal-time Markovian process calculi, in which action execution is separated from time passing. Similar to deterministically timed process calculi, we show that these two options are not irreconcilable by exhibiting three mappings from an integrated-time Markovian process calculus to an orthogonal-time Markovian process calculus that preserve the behavioral equivalence of process terms under different interpretations of action execution: eagerness, laziness, and maximal progress. The mappings are limited to classes of process terms of the integrated-time Markovian process calculus with restrictions on parallel composition and do not involve the full capability of the orthogonal-time Markovian...

Bernardo, Marco

2010-01-01

168

[Urinary retention].  

UK PubMed Central (United Kingdom)

Urinary retention is a lack of ability to urinate. In acute case of urinary retention, some associated symptoms are present such as lower abdominal distention and pain. It is usually a common complication of benign prostatic hyperplasia, prostatic cancer, urethral stricture, neurogenic bladder or medications (including anticholinergics and antidepressants). The ultrasound examination is useful for the diagnosis and shows massive increase in bladder capacity. The treatment requires urgent placement of a urinary catheter into the bladder. However, in case of difficulty for indwelling a catheter, the patient should be sent to the urologist.

Takahashi R; Naito S

2013-06-01

169

Concomitant Treatment of Ureteropelvic Junction Obstruction and Renal Calculi With Robotic Laparoscopic Surgery and Rigid Nephroscopy.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The treatment of ureteropelvic junction obstruction (UPJO) and concomitant calculus poses a technically challenging situation. We present our experience with using rigid nephroscopy for renal calculi removal during robot-assisted pyeloplasy (RAP) for UPJO. TECHNICAL CONSIDERATIONS: From December 2010 to November 2012, 25 patients with UPJO had RAP at our institution; 9 of those had concurrent renal calculi, which were simultaneously treated with rigid nephroscopy. For stone extraction, a rigid ureteroscope was passed through an assistant trocar under laparoscopic vision directly into a previously created pyelotomy. The stones were extracted using a rigid grasper or stone basket through the rigid ureteroscope. For the removal of the stones within the upper and lower calyces, the rigid ureteroscope was introduced into the incised renal pelvis through robotic trocars if the "assistant trocar" route failed. Complete stone clearance was achieved in 8 of 9 patients. Residual calculi in 1 patient were removed with a single session of extracorporeal shock wave lithotripsy. At the mean follow-up of 10.2 months, no patients had obstruction or recurrent stones. The mean operative time was 187.1 minutes, which was 40.9 minutes longer than the mean operative time in patients without renal calculi. There was no significant difference in blood loss, hospital stay, complications, and success rates between patients with and without renal calculi. CONCLUSION: Our data suggest that the use of a concomitant rigid nephroscope and RAP is a safe and feasible option for the treatment of UPJO complicated with renal calculi.

Zheng J; Yan J; Zhou Z; Chen Z; Li X; Pan J; Li W

2013-09-01

170

[Cystine calculi: x-ray diffraction study. Infrared spectroscopy and SEM  

UK PubMed Central (United Kingdom)

The present study investigated cystinuria and cystine calculi. Inexplicably, of 987 calculi that had been analyzed ultrastructurally at the Department of Urology of the University Hospital of Salamanca over a period of 15 years only 3 (0.3%) were cystine. The foregoing finding does not coincide with the 0.5-1% incidence reported in the world literature. Apart from the chemical analyses, infrared spectroscopy disclosed the typical findings of multiple bands 1600-625 cm-1. Analysis by x-ray diffraction revealed a slight variation from the ASTM values. One of the calculi, which we considered to be a mixed calculus (probably of calcium phosphate), showed a peak at 43 degrees, instead of the usual 34.5. Scanning electron microscopy disclosed two forms of crystallization: The typical hexagonal form of cystine stones and the rectangular form of different sizes. The material comprising the matrix was observed in many areas, covering and joining the crystals as if it were cement. Whenever possible, treatment of these recurrent calculi should be conservative. Some advocate the use of ESWL, although others consider these calculi to be extremely hard and, therefore, not amenable to ESWL. Chemical dissolution is advocated by some, although its critics consider it to be of little use. Concerning prophylaxis, forced fluids and alkalinization may reduce recurrence. Ultrastructural studies have provided further insight into the structure and composition of cystine calculi. The foregoing may be useful in determining the most appropriate form of treatment based upon stone size, shape, composition (pure or mixed), etc.

González Mediero JA; Montero Gómez J; Alvarez VA; Alvarez Fernández F; Urrutia Avisrror M

1992-06-01

171

Fine structure and mineral components of primary calculi in some human prostates.  

UK PubMed Central (United Kingdom)

The fine structure of prostatic calculi has not been elucidated yet, although the chemical components were reported in detail. We studied the primary or endogenous calculi removed from eight human prostates by secondary scanning electron microscopy, backscattered electron imaging, energy-dispersive X-ray microanalysis and X-ray diffraction. The primary calculi containing Mg, Zn and S, besides Ca and P were basically classified into four stone groups (I-IV) by fine structure and mineral components. Stone I had the core deposits of calcospherites showing concentric rings and the laminated deposits concentrically around the core. Their deposits were identified as apatite. Stone II was occupied with the calcospherite deposits of apatite although the stone growth showed a rough concentric formation. Stone III contained the core of calcospherites and concentric laminated structures, similar to a smaller type of group I, whereas the wider peripheral region was deposited with needle-like structures, identified as calcium oxalates. Stone IV had the core deposits containing small hexahedral structures, identified as whitlockite, which were surrounded with several incompletely concentric laminated bands of apatite. Whitlockite crystals were also found between the fused large calculi. The initial and formative calculi were basically observed as the deposition of mineralizing spherical structures suggesting variously sized corpora amylaceous bodies. Thus, the primary prostatic calculi of stones I-III will begin from the mineralization of amylaceous bodies as a core, while the organic substances, which form stone IV, might be derived from the simple precipitation of prostatic secretion.

Kodaka T; Hirayama A; Sano T; Debari K; Mayahara M; Nakamura M

2008-08-01

172

Transoral removal of hiloparenchymal submandibular calculi: a long-term clinical experience.  

UK PubMed Central (United Kingdom)

Traditional management of hiloparenchymal submandibular calculi is based on sialadenectomy. Recently, different minimally invasive and conservative techniques have been developed for the treatment of the submandibular calculi. We aimed to investigate the effectiveness of transoral surgical removal of large hiloparenchymal calculi by monitoring the trend for recurrence with clinical and ultrasonographic follow-up. A consecutive series of 84 patients with large (>7 mm) hilar or hiloparenchymal submandibular calculi underwent the transoral surgical removal under general anaesthesia. A video-assisted endoscopic procedure was performed in eight patients. All the patients underwent diagnostic ultrasonography and colour Doppler ultrasonography and clinical evaluation to define the exact location (hilar vs. parenchymal) and the diameter of the stone. The surgical procedure was successful in all but one of the patients. Stone recurrence was observed in 16 patients but obstructive symptoms were observed in only 12 patients during a median follow-up time of 52 months. The risk for recurrence was higher in patients who previously underwent extracorporeal shockwave lithotripsy. Conservative transoral removal of large hiloparenchymal submandibular calculi is a safe and effective surgical procedure. Future studies with longer follow-up will confirm the risk for recurrence of calculi.

Capaccio P; Clemente IA; McGurk M; Bossi A; Pignataro L

2011-07-01

173

Transoral removal of hiloparenchymal submandibular calculi: a long-term clinical experience.  

Science.gov (United States)

Traditional management of hiloparenchymal submandibular calculi is based on sialadenectomy. Recently, different minimally invasive and conservative techniques have been developed for the treatment of the submandibular calculi. We aimed to investigate the effectiveness of transoral surgical removal of large hiloparenchymal calculi by monitoring the trend for recurrence with clinical and ultrasonographic follow-up. A consecutive series of 84 patients with large (>7 mm) hilar or hiloparenchymal submandibular calculi underwent the transoral surgical removal under general anaesthesia. A video-assisted endoscopic procedure was performed in eight patients. All the patients underwent diagnostic ultrasonography and colour Doppler ultrasonography and clinical evaluation to define the exact location (hilar vs. parenchymal) and the diameter of the stone. The surgical procedure was successful in all but one of the patients. Stone recurrence was observed in 16 patients but obstructive symptoms were observed in only 12 patients during a median follow-up time of 52 months. The risk for recurrence was higher in patients who previously underwent extracorporeal shockwave lithotripsy. Conservative transoral removal of large hiloparenchymal submandibular calculi is a safe and effective surgical procedure. Future studies with longer follow-up will confirm the risk for recurrence of calculi. PMID:21298387

Capaccio, Pasquale; Clemente, Ignazio Alessandro; McGurk, Mark; Bossi, Anna; Pignataro, Lorenzo

2011-02-05

174

Unusual Clinical Presentation of Bilateral Adult Non-Obstructing Ureteroceles Containing Urinary Stones  

Directory of Open Access Journals (Sweden)

Full Text Available Ureterocele, while not an uncommon pediatric urologic problem, has been reported only rarely in adults. Adult bilateral ureteroceles with calculi is an uncommon and well tolerated, relatively rare clinical entity. Although ureteroceles in adults are usually asymptomatic, various symptoms tend to appear in ureteroceles with stones, such as flank pain, urinary tract infections and bladder irritability. While ureteroceles occur more commonly in women, stones in ureteroceles tend to be more common in men. Most ureteroceles can be safely managed transurethrally endoscopically which is generally well tolerated by most patients. We present an unusual clinical presentation of bilateral adult non-obstructing ureteroceles containing urinary stones.

Mustafa Ho?can; Mehmet Ekinci; Ahmet Tunçk?ran; Meriç Menek?e

2010-01-01

175

UPPER URINARY TRAT DISEASE IN CHILDREN  

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Full Text Available The urolithiasis has become a significant health problem in our population. Symptoms of urinary calculi inchildren vary with age. Treatment option should be directed towards renal parenchyma. OBJECTIVE: Tofind out various modes of presentation. To find out the advantages of to treatment modalities in childrenwith urinary stone disease. SETTING: The study was conducted in urology department Mayo HospitalLahore. STUDY DESIGN: Forty children below the age of fourteen years with upper urinary tract stonedisease were studies in two groups. Group A thirty patients were treated by open surgery and Group B tenpatients with extracorporeal shockwave lithotripsy. PERIOD: Oct 1996 to Sep 1997. RESULTS: Resultsshowed 97% success rate in open surgery and 80% in ESWL. CONCLUSIONS; ESWL is a safe, noninvasive and effective modality in small sized stones in children. Traditional open surgery may be thepreferred treatment for paediatric urolithiasis in a developing country like Pakistan because of poverty, poorlong term follow up due to lack of health education and infrequent availability of the facility in governmentsector.

Imtiaz Akhtar Bajwa

1998-01-01

176

Ureteral Calculi in Children: What is Best as a Minimally Invasive Modality?  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Minimally invasive treatment of ureteral calculi in children is a challenging topic. In an evidence-based review, we evaluated the efficacy and safety of extracorporeal shock wave lithotripsy (SWL) and ureteroscopic modalities for this group of patients.Materials and Methods: In this study, we performed a comprehensive systematic review on articles appeared in the PubMed from 1998 to March 2008. We selected all papers addressing SWL or ureteroscopic management of the ureteral calculi in children and determined the level of evidence of the presenting data.Results: Thirty-nine articles were reviewed and 24 with valid information on SWL or ureteroscopic management of the pediatric ureteral calculi were analyzed. Six articles (25%) were randomized controlled trials and 18 (75%) were retrospective case-controls or case series. The following data were extracted from the 24 articles: in SWL groups, overall success rate was 84.1% (range, 71% to 100%) for the upper ureteral calculi and 76.2% (range, 19% to 91%) for the lower ureteral calculi. Only 61% of the patients had only 1 treatment course, while 8% and 31% of the cases required 2 and more than 2 sessions of treatment, respectively. With ureteroscopic management, the overall success rates were 93.2% (range, 81% to 100%) and 74.4% (range, 20% to 100%) in the lower and upper ureteral calculi, respectively. Conclusion: The main limitations of the series on minimally invasive treatment of pediatric ureteral calculi are lack of powerful randomized controlled trials or prospective data and insufficient patient numbers. Therefore, it is difficult to draw absolute conclusions about successful treatment based on current knowledge.

Abbas Basiri; Samad Zare; Nasser Shakhssalim; Seyed Mohammadmehdi Hosseini Moghaddam

2008-01-01

177

Urinary Tract Infection (UTI)  

Science.gov (United States)

... cystitis fact sheet Pregnancy Urinary incontinence fact sheet Urinary tract infection fact sheet What is a urinary tract infection ( ... a doctor find out if I have a urinary tract infection (UTI)? To find out if you have a ...

178

Urinary tract infection - children  

Science.gov (United States)

A urinary tract infection (UTI) is an infection of the urinary tract. This article discusses UTIs in children. The urinary tract ... to the outside See also: Catheter-associated UTI Urinary tract infection - adults

179

Urinary Incontinence in Children  

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... of Topics and Titles : Urinary Incontinence in Children Urinary Incontinence in Children On this page: What is ... through Research For More Information Acknowledgments What is urinary incontinence (UI) in children? Urinary incontinence is the ...

180

Urinary Tract Health  

Science.gov (United States)

... NICHD Research Information Clinical Trials Resources and Publications Urinary Tract Health: Overview Page Content The urinary (pronounced ... section focuses on two of the more common urinary tract health problems faced by women: Urinary Tract ...

 
 
 
 
181

Treatment of ipsilateral renal ureteral calculi by combining retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To report and discuss the role of the treatment of ipsilateral renal and upper middle ureteral stones in patients by combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy. PATIENTS AND METHODS: Eleven patients associated with ipsilateral renal and upper middle ureteral stones underwent combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy after failure of shockwave or ureteroscopy lithotripsy. Their data were analyzed retrospectively including stone burden, perioperative complications and outcomes. RESULTS: All the patients underwent retroperitoneal laparoscopic ureterolithotomy and tubeless mini-percutaneous nephrolithotomy successfully. Surgical time ranged from 80 to 160 min with a mean of 118 min. The mean hospital stay was 4 days (3-7 days). The mean length of retroperitoneal urinary drainage was 3 days (2-6 days). There were minor complications in 3 (27.2%) patients. The stone-free rate was 82% (9 patients). Two patients had a residual calyceal fragment that was treated with shockwave lithotripsy. All of them were followed up for 3-24 months. Renal function was improved in different degree. CONCLUSION: In carefully selected patients, combining retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy can treat ipsilateral renal and upper middle ureteral calculi by a single procedure with advantages of high stone-free rate, safety, reliability, rapid recovery and less complications.

Sun L; Peng FL

2013-01-01

182

Uric acid calculi: types, etiology and mechanisms of formation.  

Science.gov (United States)

The study of the composition and structure of 41 stones composed of uric acid was complemented by in vitro investigation of the crystallization of uric acid. Uric acid dihydrate (UAD) precipitates from synthetic urine under physiological conditions when the medium is supersaturated with respect to this compound, though uric acid anhydrous (UAA) represents the thermodynamically stable form. Solid UAD in contact with liquid transforms into UAA within 2 days. This transition is accompanied by development of hexagonal bulky crystals of UAA and appearance of cracks in the UAD crystals. Uric acid calculi can be classified into two groups, differing in outer appearance and inner structure. Type I includes stones with a little central core and a compact columnar UAA shell and stones with interior structured in alternating densely non-columnar layers developed around a central core; both of them are formed mainly by crystalline growth at low uric acid supersaturation. Type II includes porous stones without inner structure and stones formed by a well developed outermost layer with an inner central cavity; this type of stones is formed mainly by sedimentation of uric acid crystals generated at higher uric acid supersaturation. PMID:11074067

Grases, F; Villacampa, A I; Costa-Bauzá, A; Söhnel, O

2000-12-01

183

What is the best choice for chronic urinary retention: indwelling catheter or clean intermittent catheterization?  

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Full Text Available Objective: The aim of this study was to analyze the advantages and disadvantages of clean intermittent catheterization, comparing to indwelling urinary catheter, in the treatment of chronic urinary retention. Methods: This literature review was carried out in order to highlight the best evidences for the choice between treatments. The extensive literature review was made through PubMed and Cochrane National Library. We selected the main articles published between 1950 and 2007, using urinary retention, indwelling urinary catheter, and clean intermittent catheterization as keywords. Results: Twenty five papers were selected, including three meta-analyses evaluating the long-term complications of clean intermittent catheterization, prophylactic intervention, and catheter types. Most articles discussed complications in patients with neurologic dysfunctions. Conclusion: Clean intermittent catheterization is better than indwelling catheter, as it is related to lower complication rates, both short and long-term. Indwelling catheterization was associated with decreased vesical compliance and bladder calculi, among others.

João Paulo Zambon; Caio César Cintra; Carlos Alberto Bezerra; Maria Cláudia Bicudo; Eric Roger Wroclawski

2009-01-01

184

Transureteral Lithotripsy of Ureteral Calculi in Children with Holmium: Yttrium Aluminium Garnet Laser  

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Full Text Available INTRODUCTION: Surgical management of pediatric urinary calculi evolved dramatically over the past two decades. However, with the miniaturization of equipment and with improvisation of endourologic techniques, access to the entire pediatric urinary system is possible. Ho: YAG laser provides more maneuverability during transuretereal lithotripsy (TUL) than the pneumatic system which uses a metal probe, especially when used in pediatrics urinary systems. In this study, we report our experience about treatment of pediatric ureteral stone with HO: YAG laser.METHODS: Between 2008 -2011, 41 children ? 12 years of age with ureteral stones were included in our study. Using K.U.B, sonography, and intravenous urogram, diagnoses were established for all patients. 6F or 8F wolf semi rigid ureteroscope was used for ureteroscopy under general anesthesia and stone fragmentation was implemented by Ho: YAG laser. For the evaluation of stone free rate, we used the following day & week confirmatory KUB, and sonograms additional to the direct visualization of the ureter during ureteroscopy. The patients were scheduled to be followed by control sonograms 2 weeks and 2 months after the operation to rule out past operational ureteral stenosis.RESULTS: From our 40 patients whose ages were in the range of 8 months and twelve years of old with a mean age 3.5 years, 18 patients (45%) had distal ureteral stones, ten (25%) in mid ureter, and twelve of them (30%) had the stone in their proximal ureter. The mean diameter of stones was 9.3 mm (3.5-11 mm). Three patients had encrusted double j stents (DJS). Our overall stone free rate was 89.35% at the end of 1 week. The complications were fever in 5 patients (12.5%) and ureteral stricture due to ureteral perforation in one patient, while one patient had long hospital stay due to refractory pain and nausea. The mean time of post-surgical hospital stay was 42 hours, while for only 20% of patients (8 patients) and in the rest of patients (30 patients) this period was only 24hours.DISCUSSION: Endoscopic lithotripsy in children has gradually become a major technique for the treatment of ureteral stones. This progression has been on the basis of the development of appropriate endoscopes and effective working instruments. The stone-free rate following urteroscopic lithotripsy for ureteral stones has been reported in as high as 98.5-100%. In this study, overall stone free rate was 89.35%. The complications after ureteroscopic laser lithotripsy are uncommon and usually related to passage of the ureteroscope than from laser action. Fever was the most common complication which occurred in 5 (12.5%) of our patients despite the fact that all patients were hospitalized the day before the procedure and were under parenteral antibiotic therapy. Postoperative stenting after ureteroscopic lithotripsy remained controversial. Most children were able to tolerate the attached string and the stent could be removed 5-7 days after without the use of an additional anesthetic. We used suitable ureteral catheters for 24 hours in all patients.CONCLUSION: Although HO: YAG laser lithotripsy is safe in children, we need more controlledtrials to show the best method of lithotripsy in pediatric ureteral stones.

Mohsen Amjadi; Fahimeh Kazemi Rashed; Reza Sari Motlagh; Farzin Sheikh Monazzah

2012-01-01

185

On the Expressiveness of Markovian Process Calculi with Durational and Durationless Actions  

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Full Text Available Several Markovian process calculi have been proposed in the literature, which differ from each other for various aspects. With regard to the action representation, we distinguish between integrated-time Markovian process calculi, in which every action has an exponentially distributed duration associated with it, and orthogonal-time Markovian process calculi, in which action execution is separated from time passing. Similar to deterministically timed process calculi, we show that these two options are not irreconcilable by exhibiting three mappings from an integrated-time Markovian process calculus to an orthogonal-time Markovian process calculus that preserve the behavioral equivalence of process terms under different interpretations of action execution: eagerness, laziness, and maximal progress. The mappings are limited to classes of process terms of the integrated-time Markovian process calculus with restrictions on parallel composition and do not involve the full capability of the orthogonal-time Markovian process calculus of expressing nondeterministic choices, thus elucidating the only two important differences between the two calculi: their synchronization disciplines and their ways of solving choices.

Marco Bernardo

2010-01-01

186

Ammonium and sodium urates precipitating from synthetic urine and fine structure of urate renal calculi.  

Science.gov (United States)

A study of ammonium and sodium urate precipitation in vitro and the fine structure of several urate renal calculi was carried out to contribute to an understanding of the participation of ammonium and sodium urates in urolithiasis. Ammonium urate precipitated in vitro in two different morphologies: a typical spherulite morphology formed at high supersaturation and disorganized needle-like crystals formed at low supersaturation. In all cases sodium urate precipitated in vitro as bundles of curved fibrils, its crystallization being inhibited by calcium in concentrations between 20 and 60 mg/l depending on the sodium urate supersaturation. From a collection of 1300 renal calculi, only three had ammonium urate as their main component (0.2%), three were mixed calculi (0.2%) consisting of ammonium urate and calcium oxalate (two) or uric acid (one), and in one calculus ammonium urate was present as a minor component. Only in a mixed calculus of uric acid and calcium oxalate was sodium urate detected in a very low quantity. The study of the fine structure of the renal calculi constituted mainly by ammonium urate demonstrated similar patterns in which spherulites, needle-like individual crystals and an amorphous mass of ammonium urate with abundant organic matter in non-organized structures coexist. As minor components, struvite or calcium oxalate crystals were found. A general mechanism of the formation of such calculi is proposed. PMID:10424396

Grases, F; Villacampa, A I; Costa-Bauzá, A

1999-04-01

187

Effect of pH on the microhardness of renal calculi.  

UK PubMed Central (United Kingdom)

The effects of synthetic urine environments of pH 4, 6, and 9.5 on the microhardness of renal calculi have been investigated. Tests were made, using both Vickers and Knoop indenters, on three compositions of calculi: 100% calcium oxalate monohydrate (whewellite), 100% uric acid, and 98% magnesium ammonium phosphate hexahydrate (struvite) mixed with 2% carbonate apatite. Whewellite calculi hardness was lowered, relative to (dry) values by 45-55% when saturated with a solution of pH 9.5. Exposure to lower pH conditions was not as effective in lowering hardness in this case. Struvite calculi hardness was lowered by 41-52% compared to the dry hardness and uric acid calculi hardness decreased by 25-36%, compared to dry hardnesses. For uric acid stones the reduction in hardness did not depend on pH within the range of pH values investigated. For struvite stones, acid pH conditions appear to give an increased softening, compared to other pH values.

Johrde LG; Cocks FH

1986-09-01

188

Ammonium and sodium urates precipitating from synthetic urine and fine structure of urate renal calculi.  

UK PubMed Central (United Kingdom)

A study of ammonium and sodium urate precipitation in vitro and the fine structure of several urate renal calculi was carried out to contribute to an understanding of the participation of ammonium and sodium urates in urolithiasis. Ammonium urate precipitated in vitro in two different morphologies: a typical spherulite morphology formed at high supersaturation and disorganized needle-like crystals formed at low supersaturation. In all cases sodium urate precipitated in vitro as bundles of curved fibrils, its crystallization being inhibited by calcium in concentrations between 20 and 60 mg/l depending on the sodium urate supersaturation. From a collection of 1300 renal calculi, only three had ammonium urate as their main component (0.2%), three were mixed calculi (0.2%) consisting of ammonium urate and calcium oxalate (two) or uric acid (one), and in one calculus ammonium urate was present as a minor component. Only in a mixed calculus of uric acid and calcium oxalate was sodium urate detected in a very low quantity. The study of the fine structure of the renal calculi constituted mainly by ammonium urate demonstrated similar patterns in which spherulites, needle-like individual crystals and an amorphous mass of ammonium urate with abundant organic matter in non-organized structures coexist. As minor components, struvite or calcium oxalate crystals were found. A general mechanism of the formation of such calculi is proposed.

Grases F; Villacampa AI; Costa-Bauzá A

1999-04-01

189

Percutaneous transhepatic cholangiography with the Chiba needle in patients with biliary calculi  

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In a prospective study, 276 consecutive patients were evaluated using percutaneous transhepatic cholangiography (PTC) with a Chiba needle prior to surgery for cholestasis. Biliary calculi were diagnosed in 109 patients. The success rate was 92.4% overall, 93.6% among patients with biliary calculi, 83.3% in those with cholelithiasis, 97.3% in those with choledocholithiasis, and 100.0% in those with intrahepatic stones. The overall morbidity rate was 4.6%, including hemoperitoneum in 1.8% and bile leakage in 2.8%. There were no deaths. This technique offers a more definitive diagnosis than noninvasive procedures, especially with small calculi, but is also more traumatic. PTC may play an important role when noninvasive methods are inconclusive or in difficult cases, particularly following surgery on the common bile duct.

Juttijudata, P.; Palavatana, C.; Chiemchaisri, C.; Churnratanakul, S.

1983-03-01

190

Proceedings Fourth Workshop on Membrane Computing and Biologically Inspired Process Calculi 2010  

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The 4th Workshop on Membrane Computing and Biologically Inspired Process Calculi (MeCBIC 2010) is organized in Jena as a satellite event of the Eleventh International Conference on Membrane Computing (CMC11). Biological membranes play a fundamental role in the complex reactions which take place in cells of living organisms. The importance of this role has been considered in two different types of formalisms introduced recently. Membrane systems were introduced as a class of distributed parallel computing devices inspired by the observation that any biological system is a complex hierarchical structure, with a flow of biochemical substances and information that underlies their functioning. The modeling and analysis of biological systems has also attracted considerable interest of the process algebra research community. Thus the notions of membranes and compartments have been explicitly represented in a family of calculi, such as ambients and brane calculi. A cross fertilization of these two research areas has ...

Ciobanu, Gabriel; 10.4204/EPTCS.40

2010-01-01

191

Redundancies in Dependently Typed Lambda Calculi and Their Relevance to Proof Search  

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Dependently typed lambda calculi such as the Logical Framework (LF) are capable of representing relationships between terms through types. By exploiting the "formulas-as-types" notion, such calculi can also encode the correspondence between formulas and their proofs in typing judgments. As such, these calculi provide a natural yet powerful means for specifying varied formal systems. Such specifications can be transformed into a more direct form that uses predicate formulas over simply typed lambda-terms and that thereby provides the basis for their animation using conventional logic programming techniques. However, a naive use of this idea is fraught with inefficiencies arising from the fact that dependently typed expressions typically contain much redundant typing information. We investigate syntactic criteria for recognizing and, hence, eliminating such redundancies. In particular, we identify a property of bound variables in LF types called "rigidity" and formally show that checking that instantiations of ...

Snow, Zachary; Nadathur, Gopalan

2010-01-01

192

Association of minor and trace elements with mineralogical constituents of urinary stones: a hard nut to crack in existing studies of urolithiasis.  

UK PubMed Central (United Kingdom)

The role of metals in urinary stone formation has already been studied in several publications. Moreover, urinary calculi can also be used for assessing exposure of humans to minor and trace elements in addition to other biological matrices, for example, blood, urine, or hair. However, using urinary calculi for biomonitoring of trace elements is limited by the association of elements with certain types of minerals. In this work, 614 samples of urinary calculi were subjected to mineralogical and elemental analysis. Inductively coupled plasma mass spectrometry and thermo-oxidation cold vapor atomic absorption spectrometry were used for the determination of major, minor, and trace elements. Infrared spectroscopy was used for mineralogical analysis, and additionally, it was also employed in the calculation of mineralogical composition, based on quantification of major elements and stoichiometry. Results demonstrate the applicability of such an approach in investigating associations of minor and trace elements with mineralogical constituents of stones, especially in low concentrations, where traditional methods of mineralogical analysis are not capable of quantifying mineral content reliably. The main result of this study is the confirmation of association of several elements with struvite (K, Rb) and with calcium phosphate minerals, here calculated as hydroxylapatite (Na, Zn, Sr, Ba, Pb). Phosphates were proved as the most important metal-bearing minerals in urinary calculi. Moreover, a significantly different content was also observed for Fe, Zr, Mo, Cu, Cd, Se, Sn, and Hg in investigated groups of minerals. Examination of such associations is essential, and critical analysis of mineral constituents should precede any comparison of element content among various groups of samples.

Kuta J; Machát J; Benová D; ?ervenka R; Zeman J; Martinec P

2013-08-01

193

Association of minor and trace elements with mineralogical constituents of urinary stones: a hard nut to crack in existing studies of urolithiasis.  

Science.gov (United States)

The role of metals in urinary stone formation has already been studied in several publications. Moreover, urinary calculi can also be used for assessing exposure of humans to minor and trace elements in addition to other biological matrices, for example, blood, urine, or hair. However, using urinary calculi for biomonitoring of trace elements is limited by the association of elements with certain types of minerals. In this work, 614 samples of urinary calculi were subjected to mineralogical and elemental analysis. Inductively coupled plasma mass spectrometry and thermo-oxidation cold vapor atomic absorption spectrometry were used for the determination of major, minor, and trace elements. Infrared spectroscopy was used for mineralogical analysis, and additionally, it was also employed in the calculation of mineralogical composition, based on quantification of major elements and stoichiometry. Results demonstrate the applicability of such an approach in investigating associations of minor and trace elements with mineralogical constituents of stones, especially in low concentrations, where traditional methods of mineralogical analysis are not capable of quantifying mineral content reliably. The main result of this study is the confirmation of association of several elements with struvite (K, Rb) and with calcium phosphate minerals, here calculated as hydroxylapatite (Na, Zn, Sr, Ba, Pb). Phosphates were proved as the most important metal-bearing minerals in urinary calculi. Moreover, a significantly different content was also observed for Fe, Zr, Mo, Cu, Cd, Se, Sn, and Hg in investigated groups of minerals. Examination of such associations is essential, and critical analysis of mineral constituents should precede any comparison of element content among various groups of samples. PMID:23430472

Kuta, J; Machát, J; Benová, D; ?ervenka, R; Zeman, J; Martinec, P

2013-02-22

194

Analytical scanning electron microscopy and x-ray microdiffractometry of renal calculi using etched plastic sections  

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We describe the technique and illustrate results of renal calculi analyses utilizing correlative analytical scanning electron microscopy and x-ray microdiffractometry on the same 100 micrometer Spurr embedded sections. Essential to the technique is the employment of an extremely sensitive x-ray microdiffractometer, and for morphological analysis, pretreatment of the sections with a sodium ethoxide etching solution. This technique facilitates more precise identification of crystalline constituents especially calcium apatite and magnesium ammonium phosphate hexahydrate (struvite). Further, the technique permits detection and mapping of both crystalline and amorphous constituents within calculi.

Cheng, P.T.; Pritzker, K.P.; Tausch, J.; Pittaway, A.; Millard, J.

1981-01-01

195

Analytical scanning electron microscopy and x-ray microdiffractometry of renal calculi using etched plastic sections  

International Nuclear Information System (INIS)

We describe the technique and illustrate results of renal calculi analyses utilizing correlative analytical scanning electron microscopy and x-ray microdiffractometry on the same 100 micrometer Spurr embedded sections. Essential to the technique is the employment of an extremely sensitive x-ray microdiffractometer, and for morphological analysis, pretreatment of the sections with a sodium ethoxide etching solution. This technique facilitates more precise identification of crystalline constituents especially calcium apatite and magnesium ammonium phosphate hexahydrate (struvite). Further, the technique permits detection and mapping of both crystalline and amorphous constituents within calculi

1981-01-01

196

Microperc for the management of renal calculi in pelvic ectopic kidneys  

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Management of stone disease in an ectopic kidney is challenging. Laparoscopy or ultrasound guided percutaneous nephrolithotomy and retrograde intra-renal surgery are the preferred techniques for these stones. We performed ultrasound guided microperc using a 16 G needle for the management of renal calculi in pelvic ectopic kidneys in two patients. There was no intraoperative or post-operative complication. Both patients had complete stone clearance and were discharged on the first post-operative day. Ultrasound guided microperc is a safe and effective option for the management of small renal calculi in pelvic ectopic kidneys.

Ganesamoni, Raguram; Sabnis, Ravindra B; Mishra, Shashikant; Desai, Mahesh R

2013-01-01

197

US and MDCT findings in a caudal blind ending bifid ureter with calculi  

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Full Text Available Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU) and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US) and mainly with multidetector computerized tomography (MDCT) imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula.

Evren Ustuner; Ebru Dusunceli Atman; Cemil Yagci; Zafer Nida Tokatli; Caglar Uzun

2011-01-01

198

Renal calculi in pregnancy? The role of ultralow-dose CT.  

Science.gov (United States)

Presented is a case of an acute, right flank, loin to groin pain in the third trimester of an otherwise uncomplicated pregnancy. Renal calculi was suspected clinically and supported by radiological evidence. Temporising treatment was undertaken successfully by retrograde ureteric stenting, which became blocked, secondarily resulting in a percutaneous nephrostomy. Good symptomatic control was achieved before the delivery at 38 weeks and 1 day gestation. Postpartum intravenous urogram and ureteroscopy did not reveal evidence of calculi. The patient does not recall passing a stone. With existing diagnostic modalities having poor sensitivity and specificity, the clinical role of ultralow-dose CT is explored, in light of recent new evidence. PMID:23729704

Nash, Zachary; Mascarenhas, Lawrence

2013-05-31

199

Struvite urolithiasis and chronic urinary tract infection in a murine model of urinary diversion.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To characterize the clinical course after cutaneous vesicostomy (CV) in megabladder (mgb(-/-)) mice with functional urinary bladder obstruction. MATERIALS AND METHODS: A total of 45 mgb(-/-) male mice underwent CV at a median age of 25 days. The 34 mice that survived >3 days after CV were evaluated by serial observation and renal ultrasonography. The moribund mice were killed. The urinary bladders and kidneys were analyzed by histopathologic analysis, and urine biochemical studies were performed. RESULTS: At a median duration of 11 weeks after CV, 35% of mgb(-/-) male mice (12 of 34) had become moribund with pelvic masses, which were identified as bladder stones at necropsy. The urine pH was alkaline, and microscopic examination demonstrated struvite crystals. The urine samples contained Gram-positive cocci, and the urine cultures were polymicrobial. The stone composition was chiefly struvite (88%-94%) admixed with calcium phosphate. In 40% of cases (2 of 5), retained intravesical polypropylene suture was identified as the presumed nidus. No stones were detected in >100 male mice before CV or in 25 cases when CV was performed using polydioxanone suture. The kidneys from 33% of the mice (4/12) with bladder stones contained staghorn calculi. The histopathologic findings from the mice with struvite stones demonstrated active cystitis, pyelitis, and chronic pyelonephritis. CONCLUSION: These findings attest to the importance of the nidus in lithogenesis and provide a novel murine model for struvite urolithiasis and chronic infection of the diverted urinary tract.

Becknell B; Carpenter AR; Bolon B; Asplin JR; Ingraham SE; Hains DS; Schwaderer AL; McHugh KM

2013-05-01

200

Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients.  

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Phyllanthus niruri is a plant used for years in Brazil to treat urinary calculi. We prospectively evaluated the effect of P. niruri intake on 24 h urinary biochemical parameters in an attempt to assess its in vivo effect in calcium stone forming (CSF) patients. A total of 69 CSF patients (39 males and 30 females, 38+/-8 years old) were randomized to take either P. niruri ( n=33) (450 mg capsules, td) or placebo ( n=36) for 3 months. Blood calcium, uric acid, citrate, magnesium, oxalate, sodium and potassium were determined at baseline and at the end of the study. A subset analysis was made in patients classified according to the presence of metabolic abnormalities (hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia and hypomagnesiuria). Overall, there were no significant differences in the mean values of urinary parameters between the urine samples before and after P. niruri intake, except for a slight reduction in mean urinary magnesium after P. niruri, which was within the normal range. However, in the subset analysis, we observed that P. niruri induced a significant reduction in the mean urinary calcium in hypercalciuric patients (4.8+/-1.0 vs 3.4+/-1.1 mg/kg/24 h, P<0.05). In this short-term follow-up, no significant differences in calculi voiding and/or pain relief between the groups taking P. niruri or the placebo were detected. Our data suggest that P. niruri intake reduces urinary calcium based on the analysis of a subset of patients presenting with hypercalciuria. Larger trials including primary hypercalciuric stone formers should be performed in order to confirm these findings and to determine the possible clinical consequences of urinary calcium reduction during P. niruri administration. PMID:15221244

Nishiura, J L; Campos, A H; Boim, M A; Heilberg, I P; Schor, N

2004-06-19

 
 
 
 
201

Renal papillary calcification and the development of calcium oxalate monohydrate papillary renal calculi: a case series study.  

UK PubMed Central (United Kingdom)

BACKGROUND: The objective of this study is to determine in a case series (four patients) how calcified deposits in renal papillae are associated with the development of calcium oxalate monohydrate (COM) papillary calculi. METHODS: From the recently collected papillary calculi, we evaluated retrospectively patients, subjected to retrograde ureteroscopy, with COM papillary lithiasis. RESULTS: The COM papillary calculi were found to result from subepithelial injury. Many of these lesions underwent calcification by hydroxyapatite (HAP), with calculus morphology and the amount of HAP in the concave zone dependent on the location of the calcified injury. Most of these HAP deposits grew, eroding the epithelium covering the renal papillae, coming into contact with urine and starting the development of COM calculi. Subepithelial HAP plaques may alter the epithelium covering the papillae, resulting in the deposit of COM crystals directly onto the epithelium. Tissue calcification depends on a pre-existing injury, the continuation of this process is due to modulators and/or crystallization inhibitors deficiency. CONCLUSIONS: Since calculus morphology and the amount of detected HAP are dependent on the location and widespread of calcified injury, all types of papillary COM calculi can be found in the same patient. All patients had subepithelial calcifications, with fewer papillary calculi, demonstrating that some subepithelial calcifications did not further evolve and were reabsorbed. A high number of subepithelial calcifications increases the likelihood that some will be transformed into COM papillary calculi.

Grases F; Costa-Bauzá A; Prieto RM; Conte A; Servera A

2013-01-01

202

Renal papillary calcification and the development of calcium oxalate monohydrate papillary renal calculi: a case series study  

Science.gov (United States)

Background The objective of this study is to determine in a case series (four patients) how calcified deposits in renal papillae are associated with the development of calcium oxalate monohydrate (COM) papillary calculi. Methods From the recently collected papillary calculi, we evaluated retrospectively patients, subjected to retrograde ureteroscopy, with COM papillary lithiasis. Results The COM papillary calculi were found to result from subepithelial injury. Many of these lesions underwent calcification by hydroxyapatite (HAP), with calculus morphology and the amount of HAP in the concave zone dependent on the location of the calcified injury. Most of these HAP deposits grew, eroding the epithelium covering the renal papillae, coming into contact with urine and starting the development of COM calculi. Subepithelial HAP plaques may alter the epithelium covering the papillae, resulting in the deposit of COM crystals directly onto the epithelium. Tissue calcification depends on a pre-existing injury, the continuation of this process is due to modulators and/or crystallization inhibitors deficiency. Conclusions Since calculus morphology and the amount of detected HAP are dependent on the location and widespread of calcified injury, all types of papillary COM calculi can be found in the same patient. All patients had subepithelial calcifications, with fewer papillary calculi, demonstrating that some subepithelial calcifications did not further evolve and were reabsorbed. A high number of subepithelial calcifications increases the likelihood that some will be transformed into COM papillary calculi.

2013-01-01

203

Cystic calculi removal in African spurred Tortoise (Geochelone sulcata) using transplstron coeliotomy  

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The present report was carried out to manage a case of calculi in the bladder of African spurred tortoise. A 6 year old African spurred tortoise presented with history of anorexia and whitish discharged from the vent. Upon physical examination, the tortoise were 10% dehydrated, hindlegs muscle wasti...

Azlan Che' Amat; Benny Gabriel; Ng Wen Chee

204

Renal colic: comparison of spiral CT, US and IVU in the detection of ureteral calculi  

International Nuclear Information System (INIS)

[en] The aim of our study was to compare noncontrast spiral CT, US and intravenous urography (IVU) in the evaluation of patients with renal colic for the diagnosis of ureteral calculi. During a period of 17 months, 112 patients with renal colic were examined with spiral CT, US and IVU. Fifteen patients were lost to follow-up and excluded. The remaining 97 patients were defined to be either true positive or negative for ureterolithiasis based on the follow-up data. Sensitivity, specificity, positive and negative predictive value and accuracy of spiral CT, US and IVU were determined, and secondary signs of ureteral stones and other pathologies causing renal colic detected with these modalities were noted. Of 97 patients, 64 were confirmed to have ureteral calculi based on stone recovery or urological interventions. Thirty-three patients were proved not to have ureteral calculi based on failure to recover a stone and diagnoses unrelated to ureterolithiasis. Spiral CT was found to be the best modality for depicting ureteral stones with a sensitivity of 94 % and a specificity of 97 %. For US and IVU, these figures were 19, 97, 52, and 94 %, respectively. Spiral CT is superior to US and IVU in the demonstration of ureteral calculi in patients with renal colic, but because of its high cost, higher radiation dose and high workload, it should be reserved for cases where US and IVU do not show the cause of symptoms. (orig.)

1998-01-01

205

[Treatment of staghorn calculi by extracorporeal shock-wave lithotripsy in children].  

UK PubMed Central (United Kingdom)

UNLABELLED: To evaluate the efficacy of monotherapy with extracorporeal shock-wave lithotripsy (ESWL) for staghorn calculi in children. MATERIAL AND METHODS: Between September 1987 and December 1998, 27 children (18 boys and 9 girls) with a mean age of 5.2 years (9 months to 147 years) were managed in our department for staghorn or pseudo-staghorn calculi. They were treated with a Lithostar Siemens-Ultra lithotriptor ith ultrasound detection. The "Puigvert method", which starts with low energy which is then gradually increased, allows satisfactory painless fragmentation, avoiding the need for general anaesthesia. RESULTS: the success rate was 70% with two sessions (37% with a single session). In one case, lithotripsy was not indicated and percutaneous nephrolithotomy was necessary. Two cystine stones ina girl (probably longstanding stones) could not be fragmented and open surgery was required. The other five systine staghorn calculi ere treated successfully. Ureteral catheterization was not required and only one double J stent was placed preventively in a girl with a solitary kidney. No major complication was detected. CONCLUSION: ESWL with the Siemens-Ultra lithotriptor is a safe and effective first-line method for the treatment of staghron calculi in children.

Garat JM

1999-01-01

206

Distal ureteral calculi: the usefulness of transrectal ultrasound and comparison with intravenous urography  

International Nuclear Information System (INIS)

To determine the usefulness of transrectal ultrasound (TRUS) and to compare TRUS with intravenous urography (IVU) in the evaluation of distal ureteral calculi. TRUS and IVU were performed in 24 patients with distal ureteral calculi. Using TRUS, we evaluated the presence and size of calculus, type of ureteral jet at the affected site and diameter of ureter proximal to calculus, and using IVU evaluated the presence and size of calculus, degree of ureteral obstruction, and degree of hydroureter. TRUS and IVU findings, were compared. In each patient, TRUS detected calculus of the distal ureter;in only 18 cases (75%), were the calculi demonstrated with IVU. In 18 cases where calculi were detected by both modalities, average calculus size was 4.5x3.0mm (longest and shortest dimensions) by IVU, and 6.1x3.7mm by TRUS. Between TRUS and IVU(p0.05). TRUS appears to be a useful adjunctive method for the evaluation of distal ureteral calculus.

1996-01-01

207

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi-a large single center experience.  

UK PubMed Central (United Kingdom)

AIM: Large pancreatic ductal calculi and pain are a feature of chronic calcific pancreatitis (CCP) in the tropics. This large single center study evaluates the role of extracorporeal shock wave lithotripsy (ESWL) in fragmentation of large pancreatic stones and relief of pain in patients with CCP. METHODS: Patients with CCP presenting with pain and large pancreatic duct (PD) calculi (>5 mm diameter) not amenable to extraction at routine endoscopic retrograde cholangio pancreatography (ERCP) were taken up for ESWL using a 3rd generation lithotripter. Stones in the head and body of pancreas were targeted at ESWL; 5,000 shocks were given per session. The calculi were fragmented to <3 mm size and then cleared by endotherapy. Pancreatic duct stents were deployed when indicated. A total of 1,006 patients underwent ESWL. Complete clearance was achieved in 762 (76%), partial clearance in 173 (17%) and unsuccessful in the rest. More than 962 (90%) of patients needed less than three sessions of ESWL. At 6 months, 711 (84%) of 846 patients who returned for follow up had significant relief of pain with a decrease in analgesic use. Complications were mild and minimal. CONCLUSION: ESWL is an effective and safe modality for fragmentation of large PD calculi in patients with CCP.

Tandan M; Reddy DN; Santosh D; Vinod K; Ramchandani M; Rajesh G; Rama K; Lakhtakia S; Banerjee R; Pratap N; Venkat Rao G

2010-07-01

208

Transureteral Lithotripsy of Ureteral Calculi in Children with Holmium: Yttrium Aluminium Garnet Laser  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Please cite this article as follows:

Amjadi M, Kazemi Rashed F, Sari Motlagh R, Sheikh Monazzah F. Transureteral lithotripsy of ureteral calculi in children with Holmium:Yttrium Aluminium Garnet (YAG ) laser: J Lasers Med Sci 2011;2(4):148-51

Mohsen Amjadi; Fahimeh Kazemi Rashed; Reza Sari Motlagh; Farzin Sheikh Monazzah

209

Unenhanced helical CT in the evaluation of the urinary tract in children and young adults following urinary tract reconstruction: comparison with sonography  

International Nuclear Information System (INIS)

[en] Purpose. To compare the accuracy of unenhanced, helical CT with sonography for the detection of complications of urinary tract reconstruction. Materials and methods. Forty-six kidneys in 24 patients were examined with CT and sonography. All scans were assessed for ease of renal visualization, presence of renal, ureteral, and bladder calculi, renal scars, hydronephrosis, and abdominal wall hernia. The results of both imaging modalities were independently reported. Results. CT provided excellent visualization of all 46 kidneys, while sonography provided poor visualization of 8 kidneys (17 %) (P

2001-01-01

210

Urinary Incontinence in Men  

Science.gov (United States)

... of Topics and Titles : Urinary Incontinence in Men Urinary Incontinence in Men On this page: What causes ... Kegel exercises? Hope through Research For More Information Urinary incontinence (UI) is the accidental leakage of urine. ...

211

Urinary Tract Infections (UTIs)  

Science.gov (United States)

... Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system ... of your body. Ahhh! That feels better. Continue Urinary Tract Troubles Girls are more likely than boys ...

212

Urinary Incontinence in Women  

Science.gov (United States)

... Bladder Control for Women : Urinary Incontinence in Women Urinary Incontinence in Women On this page: What are ... the coughing spells cease. [ Top ] The Types of Urinary Incontinence Stress Leakage of small amounts of urine ...

213

Distal ureteral calculi: the usefulness of transrectal ultrasound and comparison with intravenous urography  

Energy Technology Data Exchange (ETDEWEB)

To determine the usefulness of transrectal ultrasound (TRUS) and to compare TRUS with intravenous urography (IVU) in the evaluation of distal ureteral calculi. TRUS and IVU were performed in 24 patients with distal ureteral calculi. Using TRUS, we evaluated the presence and size of calculus, type of ureteral jet at the affected site and diameter of ureter proximal to calculus, and using IVU evaluated the presence and size of calculus, degree of ureteral obstruction, and degree of hydroureter. TRUS and IVU findings, were compared. In each patient, TRUS detected calculus of the distal ureter;in only 18 cases (75%), were the calculi demonstrated with IVU. In 18 cases where calculi were detected by both modalities, average calculus size was 4.5x3.0mm (longest and shortest dimensions) by IVU, and 6.1x3.7mm by TRUS. Between TRUS and IVU(p<0.05) there was a statistically significant difference in the longest dimension of calculi. Color Doppler imaging revealed three patterns of ureteral jets in TRUS:normal periodic jet (7 cases);continuous low-level flow (8 cases); and no detectable jet (9 cases). There was a positive correlation between type of ureteral jets on TRUS and between degree of obstruction on IVU (r=0.59, p<0.05). There was, however, no significant correlation between diameter of ureter proximal to calculus on TRUS and degree of hydroureter on IVU (r=0.32, p>0.05). TRUS appears to be a useful adjunctive method for the evaluation of distal ureteral calculus.

Choi, Moon Hae; Yoon, Dae Young; Shim, Joo Eun; Kim, Ho Chul; Yi, Jeong Geun; Choi, Chul Sun; Bae, Sang Hoon; Kim, Ha Young [Hallym Univ. College of Medicine, Chunchon (Korea, Republic of)

1996-07-01

214

Robust detection of renal calculi from non-contract CT images using TV-flow and MSER features  

Science.gov (United States)

Renal calculi are one of the most painful urologic disorders causing 3 million treatments per year in the United States. The objective of this paper is the automated detection of renal calculi from CT colonography (CTC) images on which they are one of the major extracolonic findings. However, the primary purpose of the CTC protocols is not for the detection of renal calculi, but for screening of colon cancer. The kidneys are imaged with significant amounts of noise in the non-contrast CTC images, which makes the detection of renal calculi extremely challenging. We propose a computer-aided diagnosis method to detect renal calculi in CTC images. It is built on three novel techniques: 1) total variation (TV) flow to reduce image noise while keeping calculi, 2) maximally stable extremal region (MSER) features to find calculus candidates, 3) salient feature descriptors based on intensity properties to train a support vector machine classifier and filter false positives. We selected 23 CTC cases with 36 renal calculi to analyze the detection algorithm. The calculus size ranged from 1.0mm to 6.8mm. Fifteen cases were selected as the training dataset, and the remaining eight cases were used for the testing dataset. The area under the receiver operating characteristic curve (AUC) values were 0.92 in the training datasets and 0.93 in the testing datasets. The testing dataset confidence interval for AUC reported by ROCKIT was [0.8799, 0.9591] and the training dataset was [0.8974, 0.9642]. These encouraging results demonstrated that our detection algorithm can robustly and accurately identify renal calculi from CTC images.

Liu, Jianfei; Wang, Shijun; Linguraru, Marius George; Summers, Ronald M.

2013-03-01

215

Scanning electron microscopy and electron probe microanalyses of the crystalline components of human and animal dental calculi  

Energy Technology Data Exchange (ETDEWEB)

A review of the use of scanning electron microscopy (SEM) and electron probe microanalyses in the study of dental calculus showed that such studies provided confirmatory and supplementary data on the morphological features of human dental calculi but gave only limited information on the identity of the crystalline or inorganic components. This study aimed to explore the potential of combined SEM and microanalyses in the identification of the crystalline components of the human and animal dental calculi. Human and animal calculi were analyzed. Identification of the crystalline components were made based on the combined information of the morphology (SEM) and Ca/P molar ratios of the crystals with the morphology and Ca/P molar ratio of synthetic calcium phosphates (brushite or DCPD; octacalcium phosphate, OCP; Mg-substituted whitlockite, beta-TCMP; CO/sub 3/-substituted apatite, (CHA); and calcite. SEM showed similarities in morphological features of human and animal dental calculi but differences in the forms of crystals present. Microanalyses and crystal morphology data suggested the presence of CaCO/sub 3/ (calcite) and CHA in the animal (cat, dog, tiger) and of OCP, beta-TCMP and CHA in human dental calculi. X-ray diffraction and infrared (IR) absorption analyses confirmed these results. This exploratory study demonstrated that by taking into consideration what is known about the crystalline components of human and animal dental calculi, combined SEM and microanalyses can provide qualitative identification.

LeGeros, R.Z.; Orly, I.; LeGeros, J.P.; Gomez, C.; Kazimiroff, J.; Tarpley, T.; Kerebel, B.

1988-03-01

216

Scanning electron microscopy and electron probe microanalyses of the crystalline components of human and animal dental calculi  

International Nuclear Information System (INIS)

[en] A review of the use of scanning electron microscopy (SEM) and electron probe microanalyses in the study of dental calculus showed that such studies provided confirmatory and supplementary data on the morphological features of human dental calculi but gave only limited information on the identity of the crystalline or inorganic components. This study aimed to explore the potential of combined SEM and microanalyses in the identification of the crystalline components of the human and animal dental calculi. Human and animal calculi were analyzed. Identification of the crystalline components were made based on the combined information of the morphology (SEM) and Ca/P molar ratios of the crystals with the morphology and Ca/P molar ratio of synthetic calcium phosphates (brushite or DCPD; octacalcium phosphate, OCP; Mg-substituted whitlockite, beta-TCMP; CO3-substituted apatite, (CHA); and calcite. SEM showed similarities in morphological features of human and animal dental calculi but differences in the forms of crystals present. Microanalyses and crystal morphology data suggested the presence of CaCO3 (calcite) and CHA in the animal (cat, dog, tiger) and of OCP, beta-TCMP and CHA in human dental calculi. X-ray diffraction and infrared (IR) absorption analyses confirmed these results. This exploratory study demonstrated that by taking into consideration what is known about the crystalline components of human and animal dental calculi, combined SEM and microanalyses can provide qualitative identification

1988-01-01

217

O que há de novo no diagnóstico e tratamento da litíase urinária? What's new in the diagnosis and management of urinary lithiasis?  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO. Atualizar aspectos do diagnóstico e do tratamento da litíase urinária. MÉTODOS. Uma revisão dos principais artigos publicados sobre o tema em revistas indexadas no "Medline" entre 1979 e 2009. RESULTADOS. A ocorrência de cálculos é maior em pacientes com IMC > 30. A TC sem contraste promove o diagnóstico correto em até 98% dos casos. O uso de bloqueadores alfa-adrenérgicos aumenta a eliminação de cálculos ureterais menores que 8 mm em 29%. O índice de pacientes livres de cálculo após LEOC varia entre 35% e 91%, conforme seu tamanho e localização. Cálculos renais maiores que 2 cm são eliminados pela NLPC entre 60% e 100% dos casos. Cálculos de ureter distal são tratados com sucesso em até 94% dos casos pela ureteroscopia semirrígida contra 74% da LEOC. Já para cálculos de ureter superior as taxas de sucesso situam-se entre 77% e 91% para ureteroscopia e 41% e 82% para a LEOC. CONCLUSÃO. A associação da calculose urinária com obesidade e Diabetes mellitus está bem estabelecida. A TC sem contraste é atualmente o padrão-ouro no diagnóstico da litíase urinária. A LEOC é o método de eleição em nosso meio para tratamento de cálculos renais menores que 2 cm e com densidade tomográfica OBJECTIVE. To review developments in the diagnosis and treatment of urinary lithiasis. METHODS. A review of the most important articles on the subject published in Medline indexed periodicals between 1979 and 2009.RESULTS. Stones occur with greater frequency among people with BMI > 30. Computerized tomography without contrast provides the correct diagnosis in up to 98% of cases. Alpha-adrenergic blockers increase elimination of ureteral calculi smaller than 8 mm by 29%. The proportion of patients free from calculi after ESWL varies from 35% to 91%, depending on size and location. In between 60% and 100% of cases, renal calculi larger than 2 cm are eliminated with PCNL. Calculi of the distal ureter are successfully treated in up to 94% of cases using semi-rigid ureteroscopy, compared to 74% using ESWL. For calculi of the upper ureter success rates are around 77% and 91% for ureteroscopy and 41% and 82% for ESWL. CONCLUSION. The association between urinary lithiasis and Diabetes mellitus, is well-established. Computerized tomography without contrast is currently the gold standard for diagnosis of urinary lithiasis. In Brazil, ESWL is the method of choice for treating renal calculi smaller than 2 cm and with tomographic density < 1000 HU, except those of the lower pole, where the ideal limit for treatment is 1 cm. Percutaneous nephrolithotripsy is the best method of treating renal calculi larger than 2 cm and semi-rigid ureteroscopy is the best treatment for calculi of the distal ureter. Flexible ureteroscopy is an option for calculi of the upper ureter and renal calculi smaller than 1.5 cm that do not respond to ESWL or where PCNL is contraindicated.

Eduardo Mazzucchi; Miguel Srougi

2009-01-01

218

Cystic calculi removal in African spurred Tortoise (Geochelone sulcata) using transplstron coeliotomy  

Directory of Open Access Journals (Sweden)

Full Text Available The present report was carried out to manage a case of calculi in the bladder of African spurred tortoise. A 6 year old African spurred tortoise presented with history of anorexia and whitish discharged from the vent. Upon physical examination, the tortoise were 10% dehydrated, hindlegs muscle wasting and whitish materials came out from the vent. Plain radiograph revealed increased radiopacity in the bladder and also both right and left kidney. Contrast gastrointestinal radiograph showed less possibility of foreign body. Inconclusive radiological findings required the decision to proceed with exploratory transplastron coeliotomy by using dental burr. About 4 cm solid, hard whitish mass was removed from the bladder and both kidney was congested with whitish material. The findings were suggestive for urates crystal calculi based on histology result. [Vet. World 2012; 5(8.000): 489-492

Azlan Che' Amat; Benny Gabriel; Ng Wen Chee

2012-01-01

219

Ibn-Sina's life and contributions to medicinal therapies of kidney calculi.  

UK PubMed Central (United Kingdom)

Ibn-Sina (commonly known as Avicenna) is one of the most famous and influential scientists in the history of medicine. The Canon of Medicine, which is his most celebrated book in medicine, presents a summary of all the medical knowledge of his time. Ibn-Sina wrote a complete section about kidney calculi in his book. Totally, 65 herbal, 8 animal, and 4 mineral medicines are mentioned in the Canon of Medicine as beneficial drugs for dissolving, expelling, and preventing kidney calculi. Ibn-Sina introduced very advanced drug designing based on drug delivery, targeting the organ, deposition in the site of action, pain control, wound healing, clearance after action, and supporting the organ. Using Ibn-Sina's ideas help scientists to choose better drugs with a historical background to reduce the cost of therapies and research projects.

Faridi P; Roozbeh J; Mohagheghzadeh A

2012-09-01

220

Ibn-Sina's life and contributions to medicinal therapies of kidney calculi.  

Science.gov (United States)

Ibn-Sina (commonly known as Avicenna) is one of the most famous and influential scientists in the history of medicine. The Canon of Medicine, which is his most celebrated book in medicine, presents a summary of all the medical knowledge of his time. Ibn-Sina wrote a complete section about kidney calculi in his book. Totally, 65 herbal, 8 animal, and 4 mineral medicines are mentioned in the Canon of Medicine as beneficial drugs for dissolving, expelling, and preventing kidney calculi. Ibn-Sina introduced very advanced drug designing based on drug delivery, targeting the organ, deposition in the site of action, pain control, wound healing, clearance after action, and supporting the organ. Using Ibn-Sina's ideas help scientists to choose better drugs with a historical background to reduce the cost of therapies and research projects. PMID:22976258

Faridi, Pouya; Roozbeh, Jamshid; Mohagheghzadeh, Abdoali

2012-09-01

 
 
 
 
221

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND MHETODS: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92) using Dornier lithotriptor S (MedTech Europe GmbH) or URS (n = 120). Patient and stone characteristics, treatment parameter (more) s, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p

Ghalayini, Ibrahim F.; Al-Ghazo, Mohammed A.; Khader, Yousef S.

2006-12-01

222

Primary Giant Cell Malignant Fibrous Histiocytoma of the Kidney with Staghorn Calculi  

Directory of Open Access Journals (Sweden)

Full Text Available Malignant fibrous histiocytomas (MFH) as primary renal tumours are rare, with less than 50 cases described in the literature. We report a case of primary renal MFH of giant cell type in a 56-year-old man, who presented with bilateral dull flank pain, intermittent gross haematuria and body weight loss (6 kg in 3 months). Intravenous urography, computerized tomography (CT) and magnetic resonance image (MRI) showed right ureteral stones with mild hydronephrosis, and a solid mass at the lower pole of the left kidney associated with staghorn calculi, as well as tumour thrombi in the left renal vein and inferior vena cava. Left radical nephrectomy and evacuation of tumour thrombi from the left renal vein and inferior vena cava were performed. Histopathologic examination revealed malignant fibrous histiocytoma (MFH) of giant cell type. To the best of our knowledge, this is the first report of primary renal MFH associated with staghorn calculi.

Chen C; Lee P; Han W; Shen K

2003-01-01

223

Continuation-Passing Style and Strong Normalisation for Intuitionistic Sequent Calculi  

CERN Document Server

The intuitionistic fragment of the call-by-name version of Curien and Herbelin's lambda-mu-mu-tilde-calculus is isolated and proved strongly normalising by means of an embedding into the simply-typed lambda-calculus. Our embedding is a continuation-and-garbage-passing style translation, the inspiring idea coming from Ikeda and Nakazawa's translation of Parigot's lambda-mu-calculus. The embedding strictly simulates reductions while usual continuation-passing-style transformations erase permutative reduction steps. For our intuitionistic sequent calculus, we even only need "units of garbage" to be passed. We apply the same method to other calculi, namely successive extensions of the simply-typed lambda-calculus leading to our intuitionistic system, and already for the simplest extension we consider (lambda-calculus with generalised application), this yields the first proof of strong normalisation through a reduction-preserving embedding. The results obtained extend to second and higher-order calculi.

Santo, Jose Espirito; Pinto, Luis

2009-01-01

224

Trends and Inequalities in the Surgical Management of Ureteral Calculi in the United States.  

UK PubMed Central (United Kingdom)

OBJECTIVE: ? To assess trends in surgical management of ureteral calculi over a ten year period. MATERIALS AND METHODS: ? An analysis of the 5% Medicare Public Use Files (years 2001, 2004, 2007 and 2010) was performed to assess the use of URS, SWL and UL in treating ureteral calculi. ? Patients were identified using ICD-9 (cm) and CPT codes. ? Statistical analyses, including the Fisher, ?(2) tests, and multivariate logistic regression analysis (dependent variables: URS, SWL, UL, treatment, no treatment; independent variables: age, gender, ethnicity, geography and year of treatment) were performed using SAS 9.3 (SAS Institute Inc., Cary, NC) and SPSS v20 (IBM Corp., Armonk, NY). RESULTS: ? A total of 299,920 patients were identified with ureteral calculi. Of these, 115,200 underwent surgery. ? Men (OR=1.15, p<0.0001) were more, while minorities (OR=0.84, p=0.004) were less likely to be treated. Patients in the West were also less likely to be treated (OR=0.76, p<0.0001) as were patients aged <65 or > 84 years old (p=0.29). ? URS represented the predominant surgical approach (65.2%), followed by SWL (33.6%) and UL (1.2%). ? The relative usage of URS increased over time, while SWL and UL declined. ? Women (OR=1.25, p<0.0001) were more likely to undergo URS. Patients in the South (OR=1.51, p<0.0001) and minorities were more likely to undergo SWL (OR=1.23, p=0.03). CONCLUSIONS: ? The surgical treatment of ureteral calculi changed significantly from 2001-2010. ? The utilization of URS expanded at the expense of SWL and UL. ? Multiple inequalities existed in overall surgical treatment rates and in the choice of treatment: Age, gender, ethnicity, and geography influenced both whether patients underwent surgical intervention and the type of surgical approach used.

Seklehner S; Laudano MA; Jamzadeh A; Del Pizzo JJ; Chughtai B; Lee RK

2013-07-01

225

Surgical decompression is associated with decreased mortality in patients with sepsis and ureteral calculi.  

UK PubMed Central (United Kingdom)

PURPOSE: The combination of sepsis and ureteral calculus is a urological emergency. Traditional teaching advocates urgent decompression with nephrostomy tube or ureteral stent placement, although published outcomes validating this treatment are lacking. National practice patterns for such scenarios are currently undefined. Using a retrospective study design, we defined the surgical decompression rate in patients admitted to the hospital with severe infection and ureteral calculi. We determined whether a mortality benefit is associated with this intervention. MATERIALS AND METHODS: Patient demographics and hospital characteristics were extracted from the 2007 to 2009 Nationwide Inpatient Sample. We identified 1,712 patients with ureteral calculi and sepsis. Multivariate logistic regression was performed to determine the association between mortality and surgical decompression. RESULTS: Of the patients 78% underwent surgical decompression. Mortality was higher in those not treated with surgical decompression (19.2% vs 8.82%, p <0.001). Lack of surgical decompression was independently associated with an increased OR of mortality even when adjusting for patient demographics, comorbidities and geographic region of treatment (OR 2.6, 95% CI 1.9-3.7). CONCLUSIONS: Absent surgical decompression is associated with higher odds of mortality in patients with sepsis and ureteral calculi. Further research to determine predictors of surgical decompression is necessary to ensure that all patients have access to this life saving therapy.

Borofsky MS; Walter D; Shah O; Goldfarb DS; Mues AC; Makarov DV

2013-03-01

226

Use of nonabsorbable staples for urinary diversion: a step in the wrong direction.  

UK PubMed Central (United Kingdom)

BACKGROUND: The use of bowel segments incorporated into the urinary tract is well established in urological surgery. OBJECTIVE: To describe and compare the use of absorbable and nonabsorbable staples for creation of a urine reservoir after radical cystectomy. MATERIALS AND METHODS: This review is based on a systematic Medline search assessing the period 1950-2010. RESULTS: Use of the autosuture stapling device for the construction of the urinary diversion significantly reduces operating time. Johnson and Fuerst reported its use for the first time to construct a ureteroileocutaneous urinary diversion in 1973. However, many studies demonstrated that exposed metal staples represent a nidus for stone formation when they are in direct contact with urine, particularly in urinary diversions such as Kock pouch and ileal conduit. Stone formation has been attributed in part to the use of nonabsorbable artificial materials, such as metal staples and Marlex mesh, strictures of the pouch and accumulation of mucus. The treatment options for pouch calculi include observation for spontaneous passage, extracorporeal shockwave lithotripsy, percutaneous or endoscopic lithotripsy/lithotomy. CONCLUSIONS: Historically, the mean time to stone formation with nonabsorbable material (staples, Marlex mesh) is 34 months. None of the studies on use of nonabsorbable staples in urinary diversion has such a long follow-up. Until further studies with more appropriate observation time are completed, the use of nonabsorbable staples for continent and noncontinent urinary diversion should be discouraged.

Suriano F; Daneshmand S; Buscarini M

2013-01-01

227

O que há de novo no diagnóstico e tratamento da litíase urinária?/ What's new in the diagnosis and management of urinary lithiasis?  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO. Atualizar aspectos do diagnóstico e do tratamento da litíase urinária. MÉTODOS. Uma revisão dos principais artigos publicados sobre o tema em revistas indexadas no "Medline" entre 1979 e 2009. RESULTADOS. A ocorrência de cálculos é maior em pacientes com IMC > 30. A TC sem contraste promove o diagnóstico correto em até 98% dos casos. O uso de bloqueadores alfa-adrenérgicos aumenta a eliminação de cálculos ureterais menores que 8 mm em 29%. O índic (more) e de pacientes livres de cálculo após LEOC varia entre 35% e 91%, conforme seu tamanho e localização. Cálculos renais maiores que 2 cm são eliminados pela NLPC entre 60% e 100% dos casos. Cálculos de ureter distal são tratados com sucesso em até 94% dos casos pela ureteroscopia semirrígida contra 74% da LEOC. Já para cálculos de ureter superior as taxas de sucesso situam-se entre 77% e 91% para ureteroscopia e 41% e 82% para a LEOC. CONCLUSÃO. A associação da calculose urinária com obesidade e Diabetes mellitus está bem estabelecida. A TC sem contraste é atualmente o padrão-ouro no diagnóstico da litíase urinária. A LEOC é o método de eleição em nosso meio para tratamento de cálculos renais menores que 2 cm e com densidade tomográfica Abstract in english OBJECTIVE. To review developments in the diagnosis and treatment of urinary lithiasis. METHODS. A review of the most important articles on the subject published in Medline indexed periodicals between 1979 and 2009.RESULTS. Stones occur with greater frequency among people with BMI > 30. Computerized tomography without contrast provides the correct diagnosis in up to 98% of cases. Alpha-adrenergic blockers increase elimination of ureteral calculi smaller than 8 mm by 29%. T (more) he proportion of patients free from calculi after ESWL varies from 35% to 91%, depending on size and location. In between 60% and 100% of cases, renal calculi larger than 2 cm are eliminated with PCNL. Calculi of the distal ureter are successfully treated in up to 94% of cases using semi-rigid ureteroscopy, compared to 74% using ESWL. For calculi of the upper ureter success rates are around 77% and 91% for ureteroscopy and 41% and 82% for ESWL. CONCLUSION. The association between urinary lithiasis and Diabetes mellitus, is well-established. Computerized tomography without contrast is currently the gold standard for diagnosis of urinary lithiasis. In Brazil, ESWL is the method of choice for treating renal calculi smaller than 2 cm and with tomographic density

Mazzucchi, Eduardo; Srougi, Miguel

2009-01-01

228

Transitional cell carcinoma of the ureter and struvite calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese CONTEXTO: A associação de carcinoma primário de ureter e litíase é muito rara, sendo observado em 30 a 50% o carcinoma de células escamosas. Relatamos um caso raro de carcinoma de células transicionais e cálculo de estruvita.RELATO DE CASO: Descreve-se caso raro de carcinoma primário de ureter associado a cálculo corariforme. A apresentação clínica inicial estava predominantemente ligada ao quadro de litíase renal, não detectando-se o tumor pela urografia e (more) xcretora, cistoscopia ou ultrassonografia. Dois meses após a eliminação do cálculo, a paciente evoluiu com alterações clínicas importantes, sendo então diagnosticado carcinoma de células transicionais de ureter, grau III. Nefroureterectomia radical e quimioterapia M.V.A.C. foram tentadas, sem sucesso. Enfatizamos a dificuldade diagnóstica na concomitância das duas patologias e a rápida evolução do caso, ao nosso ver, diretamente ligada ao grau tumoral. Abstract in english CONTEXT: The association of primary carcinoma of the ureter and lithiasis is extremely rare. We report a rare case of a primary carcinoma of the ureter with corariform calculus. CASE REPORT: 60-year-old phaeodermal female, reported a history of right-side nephritic colic, hyperthermia and pyuria during the past 20 years and had received treatment for urinary infections a number of times. The first clinical presentation was related to lithiasis and the tumor had not been s (more) hown up by excretory urography, cystoscopy or ultrasonography. Two months after the calculus had been eliminated, the patient began to have serious symptoms and a grade III transitional cell carcinoma of the ureter was discovered. Total nephroureterectomy and M.V.A.C. (Metotrexate + Vinblastina + Doxo Rubicina + Cisplatina) chemotherapy were tried unsuccessfully. In this report we emphasize the diagnostic difficulty caused by the concomitant presence of the two pathologies. In our opinion, the rapid evolution in this case is directly related to the high grade of the tumor.

Freitas, Danielo Garcia de; Garcia, Adriano Scaff; Freitas Filho, Osvaldo de

1999-05-01

229

Pediatric Urinary Tract Infection  

Science.gov (United States)

Pediatric Urinary Tract Infection Why is it important to begin urologic care in infancy and continue throughout life? There are two ... To protect the kidneys from damage By preventing urinary tract infections (UTI) By identifying and treating vesicoureteral reflux (VUR). ...

230

Urinary Bladder Adenocarcinoma  

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... your surgeon performs a partial or radical (complete) cystectomy. (continued on next page) Urinary Bladder Cancer Urinary ... small tumors, a transurethral resection or partial/segmental cystectomy is performed to remove the cancerous tissue from ...

231

Percutaneous urinary procedures  

Science.gov (United States)

Percutaneous (through the skin) urinary procedures help drain urine from your bladder and get rid of kidney stones . ... inside your body. The kidney stone is causing urinary tract infections . The kidney stone is damaging your ...

232

Urinary incontinence - retropubic suspension  

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Urinary leakage decreases for most women who have this surgery. But you may still have some leakage. ... may be because other problems are causing your urinary incontinence. Over time, some or all of the ...

233

Urinary tract infection.  

UK PubMed Central (United Kingdom)

The urinary tract is a common source for life-threatening infections. Most patients with sepsis or septic shock from a urinary source have complicated urinary tract infection. This article explains the epidemiology, risk factors, and treatment. Effective management, appropriate collection of microbiology specimens, prompt initiation of antimicrobial therapy, source control, and supportive therapy are described.

Nicolle LE

2013-07-01

234

Urinary tract infection.  

Science.gov (United States)

The urinary tract is a common source for life-threatening infections. Most patients with sepsis or septic shock from a urinary source have complicated urinary tract infection. This article explains the epidemiology, risk factors, and treatment. Effective management, appropriate collection of microbiology specimens, prompt initiation of antimicrobial therapy, source control, and supportive therapy are described. PMID:23830659

Nicolle, Lindsay E

2013-07-01

235

Urinary catheter - infants  

Science.gov (United States)

A urinary catheter is a small, soft tube placed in the bladder. WHY IS A URINARY CATHETER USED? A catheter may be needed if ... has low blood pressure or an abnormally developed urinary system, or uses medicine that decreases urine production ...

236

The chemistry of urinary stones around 1800: a first in clinical chemistry.  

UK PubMed Central (United Kingdom)

At the end of the 18th century, as soon as modern chemistry was created, dedicated physicians tried to apply it to medicine. A rewarding field was that of urinary lithiasis. Stones offered a sufficient amount of a relatively pure chemical present in the body. Indeed, urine and the solidified matter was within the analytical grasp of the existing techniques. The first step was made by Scheele in Sweden who identified uric acid in calculi and normal human urine. During the following thirty years, Fourcroy and Vauquelin in Paris and Wollaston, Pearson, Marcet and Prout in London identified the various salts, uric acid, urate, various phosphates, oxalate, calcium, ammonium and magnesium forming current calculi. The conditions of their solubility in vitro were described. Even rare components such as cystine and xanthine were unraveled in London. The impetus given by these studies offered a good start to clinical chemistry in general and to the understanding of urinary lithiasis in particular. This led to the discovery of the corresponding solutes in the urine of such patients. Unfortunately, during the following decades nothing was added to these chemical investigations, and most of what had been acquired was forgotten. Research was concentrated on clinical pathology. The implementation of chemistry to medicine had to wait.

Richet G

1995-09-01

237

Development of a urinary lithiasis localizer mechanism to couple ultrasound and extracorporeal lithotripsy equipment in canine model  

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Full Text Available INTRODUCTION: Due to the evolution of extracorporeal lithotripsy equipment (ESWL) and presently, the fact that most part of the equipment does not present ultrasound to localize urinary calculi, a system that allows adapting ultrasound equipment to ESWL equipment was developed, disposing only of fluoroscopy. Thus, this equipment was developed and was tested in urinary stones in canine models, to check its precision in relation to fluoroscopy. METHOD: Seven male dogs were utilized with the introduction, in the bladder through the ureteral route, of chalkstones, with initial localization by fluoroscopy, with a further ultrasound coincidence check localization of the vesical stones, being submitted to ESWL with a 3-hour, 21 days and 60 days follow-up after the procedure. RESULTS: Success of localization in all animals was verified presenting elimination of stones in the first micturitions, after ESWL. No complications were verified in those animals for 60 days. CONCLUSION: We verified that this equipment can lead to an update of the equipment that use only fluoroscopy, increasing in this way, their technical capacity in the treatment of urinary calculi, mainly in cases of non-radiopaque stones.

Enrico Andrade; Gustavo Alarcon; Eduardo Pompeu; Archimedes Nardozza Jr; Joaquim A. Claro; Valdemar Ortiz; Miguel Srougi

2006-01-01

238

Comparison of pyelolithotomy and percutaneous nephrolithotomy in patients with pelvis renalis calculi  

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Full Text Available Objective: To compare, retrospectively, results of cases undergoing pyelolithotomy and percutaneous nephrolithotomy (PNL) for pelvis renalis (PR) calculi in our clinic. Materials and Methods: Sixty patients had undergone PNL between December 2004-June 2006 and 46 patients undergone pyelolithotomy between January 2005-August 2006 for PR calculi. Percutaneous intervention was performed under C-armed ?ouroscopy on patients in prone position. A subcostal ?ank approach was used for pyelolithotomy. Results: Mean age was 44±11 and 42±8 years for PNL and pyelolithotomy groups, respectively. Mean operative time was 140.6 minutes in PNL group. Stone-free rate was 93.33% and when residual fragments<4mm accepted clinically insignificant increased to 98.33% in PNL group. Differences between pre and postoperative hemoglobin and hematocrit were 1.34 gr/dl and 4.22, respectively. Blood transfusion required in 3 (5%) patients during early postoperative period. A postoperative fever of 39.5°C occured in one patient. Mean operative time was 165.3 minutes in pyelolithotomy group. Stone-free rate was 100%. Differences between pre and postoperative hemoglobin and hematocrit were 1.17 gr/dl and 3.42, respectively. Blood transfusion during early postoperative period required in 2 (4.35%) patients. A double-j catheter was inserted in 19 patients. Mean duration for nephrostomy removal and mean hospital stay in PNL group were 2.30 and 3.50 days, respectively. Mean duration for drain removal and mean hospital stay in pyelolithotomy group were 3.45 and 5.20 days, respectively. Conclusion: Indications of open stone surgery have been changed and it became to be used only for difficult cases. Our results show that PNL is successful in treatment of PR calculi.

Volkan Tu?cu; Fuat Ernis Su; Ekrem Güner; Ali ?hsan Ta?ç?

2008-01-01

239

Extracorporeal shock wave lithotripsy for distal ureteral calculi: improved efficacy using low frequency.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To compare low versus high frequency for lithotripsy in the management of distal ureteral calculi. METHODS: A total of 154 patients with radio-opaque calculi (0.5-1 cm diameter) in the distal ureter were randomized to be given either lithotripsy at 80 or 60 pulses per min (high frequency or low frequency groups, respectively). The number of waves and sessions received, and time to total resolution were measured. A Dornier Compact Delta lithotripter was used. RESULTS: A total of 72 patients were assigned to the high frequency group and 78 to the low frequency group. Four patients were excluded from the study because of intolerance of the procedure. The size was slightly lower in low frequency group, whereby an analysis of covariance was carried out to eliminate the size factor, with the limit established as 0.7 cm. The low frequency group received 2980 ± 1211 waves, and the high frequency group received 5752 ± 3121 (P<0.001). The success rate was higher in the low frequency group (100%) than in the high frequency group (92.9%; P=0.02). If adjusted to the size of the calculus with a threshold of 0.7 cm, there was a difference, although it was not statistically significant. The time to elimination of the fragments was higher in the high frequency group (17.68 days) than in the low frequency group (7.15 days; P<0.001). The number of sessions necessary for resolution was higher in the high frequency group (1.56) than in the low frequency group (1.14; P<0.001). CONCLUSIONS: Lithotripsy at 60 pulses provides better outcomes than lithotripsy at 80 pulses for the treatment of distal ureteral calculi.

Anglada-Curado FJ; Campos-Hernández P; Carrasco-Valiente J; Anaya-Henares F; Carazo-Carazo JL; Alvarez-Kindelán J; Regueiro-López JC; Requena-Tapia MJ

2013-02-01

240

Extracorporeal shockwave lithotripsy versus ureteroscopy for distal ureteric calculi: efficacy and patient satisfaction  

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Full Text Available OBJECTIVE: We compared the efficacy of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) for the treatment of distal ureteral calculi with respect to patient satisfaction. MATERIALS AND MHETODS: This is a prospective study where a total of 212 patients with solitary, radiopaque distal ureteral calculi were treated with ESWL (n = 92) using Dornier lithotriptor S (MedTech Europe GmbH) or URS (n = 120). Patient and stone characteristics, treatment parameters, clinical outcomes, and patient satisfaction were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, stone size, and side of treatment. The stone-free status for ESWL and URS at 3 months was 81.5% and 97.5%, respectively (p < 0.0001). In addition, 88% of patients who underwent ESWL versus 20% who underwent URS were discharged home the day of procedure. Minor complications occurred in 3.3% and 8.3% of the ESWL and URS groups, respectively (p = 0.127). No ureteral perforation or stricture occurred in the URS group. Postoperative flank pain and dysuria were more severe in the URS than ESWL group, although the differences were not statistically significant (p = 0.16). Patient satisfaction was high for both groups, including 94% for URS and 80% for ESWL (p = 0.002). CONCLUSIONS: URS is more effective than ESWL for the treatment of distal ureteral calculi. ESWL was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was significantly higher for URS according to the questionnaire used in this study.

Ibrahim F. Ghalayini; Mohammed A. Al-Ghazo; Yousef S. Khader

2006-01-01

 
 
 
 
241

Impacted upper-ureteral calculi >1 cm: blind access and totally tubeless percutaneous antegrade removal or retrograde approach?  

UK PubMed Central (United Kingdom)

PURPOSE: To compare blind access and totally tubeless percutaneous antegrade removal and pneumatic transurethral ureterolithotripsy for the management of impacted upper-ureteral calculi >1 cm. Patients and METHODS: Seventy patients (41 male, 29 female) with impacted upper-ureteral calculi >1 cm were selected in randomized order for pneumatic transurethral ureterolithotripsy (35 patients) or blind access and totally tubeless percutaneous nephrolithotomy (PCNL) (35 patients). Ultrasonography and intravenous urography were performed for all patients before surgery. After operation, plain films and ultrasonography were done. RESULTS: In the PCNL group, blind access was achieved from the lumbar notch area in all 35 patients, but in 3 patients, the exposure was not optimal for approaching the ureteropelvic junction (UPJ). So we injected contrast material into the collecting system, and, under fluoroscopic control, another access was achieved. In 33 patients (94.3%), intact removal of the stones was performed. In the other two patients, we fragmented the stones with the Swiss Lithoclast by an antegrade approach. The success rate thus was 100%. The mean operative time was 38 minutes (range 25-48 minutes). In the transurethral lithotripsy group, 12 stones (34.2%) migrated upward to the pelvis of kidney, and 5 stones (14.2%) fragmented incompletely. In these cases, a double- J stent was inserted, and SWL was performed. In follow-up, plain films and ultrasonography showed complete clearance in these patients. Eighteen calculi (51.4%) fragmented completely with the Lithoclast. The mean operative time in this group was 34 minutes (range 20-58 minutes). CONCLUSION: In the presence of moderate to severe hydronephrosis, blind access and totally tubeless PCNL is an effective option for large, impacted upper-ureteral calculi. Flexible ureteroscopy with laser lithotripsy is expensive and not readily available. Pneumatic transurethral ureterolithotripsy has a back-pressure effect and pushes back the calculi to the kidney. Thus, this procedure does not have satisfactory results in the management of these calculi.

Karami H; Arbab AH; Hosseini SJ; Razzaghi MR; Simaei NR

2006-09-01

242

Classification of Bicovariant Differential Calculi on Quantum Groups (a Representation-Theoretic Approach)  

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The restricted dual of a quantized enveloping algebra can be viewed as the algebra of functions on a quantum group. According to Woronowicz, there is a general notion of bicovariant differential calculus on such an algebra. We give a classification theorem of these calculi. The proof uses the notion (due to Reshetikhin and Semenov-Tian-Shansky) of a factorizable quasi-triangular Hopf algebra and relies on results of Joseph and Letzter. On the way, we also give a new formula for Rosso's bilinear form.

Baumann, Pierre; Schmitt, Frédéric

243

X-ray diffraction studies of pancreatic calculi associated with nutritional pancreatitis.  

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The composition of pancreatic calculi in patients with tropical pancreatitis is unknown. At present, except for malnutrition, there are no known etiologic factors for chronic calcific pancreatitis in the tropics. We report the results of an x-ray diffraction study of 41 stones from 26 patients obtained at autopsy in the Kerala state in India. Calcite was present in all stones, vaterite in 12%, and a central amorphous material in 30%. The latter may be analogous to the protein plugs as nuclei for stones described by Sarles et al in patients with alcoholic pancreatitis. PMID:3698763

Schultz, A C; Moore, P B; Geevarghese, P J; Pitchumoni, C S

1986-05-01

244

X-ray diffraction studies of pancreatic calculi associated with nutritional pancreatitis.  

UK PubMed Central (United Kingdom)

The composition of pancreatic calculi in patients with tropical pancreatitis is unknown. At present, except for malnutrition, there are no known etiologic factors for chronic calcific pancreatitis in the tropics. We report the results of an x-ray diffraction study of 41 stones from 26 patients obtained at autopsy in the Kerala state in India. Calcite was present in all stones, vaterite in 12%, and a central amorphous material in 30%. The latter may be analogous to the protein plugs as nuclei for stones described by Sarles et al in patients with alcoholic pancreatitis.

Schultz AC; Moore PB; Geevarghese PJ; Pitchumoni CS

1986-05-01

245

Female stress urinary incontinence.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Stress urinary incontinence is a common and costly condition amongst community dwelling women. It can have a significant negative impact on the quality of life and yet less than half of women with urinary incontinence seek medical attention. It is important for primary care physicians to have a clear understanding of stress urinary incontinence in order to screen and manage patients who may have bothersome symptoms. OBJECTIVE: This article aims to outline the terminology, pathophysiology, clinical evaluation and treatment of female stress urinary incontinence. CONCLUSION: Female stress urinary incontinence can be effectively evaluated and managed in the primary setting. Specialist referral is warranted when there is complex urinary symptomatology, hematuria on work-up or failure of conservative therapy.

Wang A; Carr LK

2008-08-01

246

Binary Sequent Calculi for Truth-invariance Entailment of Finite Many-valued Logics  

CERN Document Server

In this paper we consider the class of truth-functional many-valued logics with a finite set of truth-values. The main result of this paper is the development of a new \\emph{binary} sequent calculi (each sequent is a pair of formulae) for many valued logic with a finite set of truth values, and of Kripke-like semantics for it that is both sound and complete. We did not use the logic entailment based on matrix with a strict subset of designated truth values, but a different new kind of semantics based on the generalization of the classic 2-valued truth-invariance entailment. In order to define this non-matrix based sequent calculi, we transform many-valued logic into positive 2-valued multi-modal logic with classic conjunction, disjunction and finite set of modal connectives. In this algebraic framework we define an uniquely determined axiom system, by extending the classic 2-valued distributive lattice logic (DLL) by a new set of sequent axioms for many-valued logic connectives. Dually, in an autoreferential ...

Majkic, Zoran

2011-01-01

247

Effect of Thymoquinone on Ethylene Glycol-Induced Kidney Calculi in Rats  

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Full Text Available Introduction: The aim of this study was to investigate the effects of thymoquinone, a major component of Nigella Sativa seeds on ethylene glycol-induced kidney calculi in rats. Materials and Methods: Sixty male Wistar rats were randomly divided into 6 groups (intact control, ethylene glycol control, and 4 experimental groups) and treated for 28 days according to the protocol of the study. The rats in experimental groups received ethylene glycol and intraperitoneal injection of thymoquinone either from the first day of the study or the 15th day, with either doses of 5 mg/kg or 10 mg/kg. Blood and 24-hour urine samples were collected at baseline and on day 28. Urine oxalate and citrate and serum electrolytes were also measured. On day 29, all rats were decapitated and their kidney specimens were studied. Results: On day 28, urine oxalate concentration significantly decreased in the experimental groups compared to the ethylene glycol group (P P = .001). Calcium oxalate deposits were smaller in the experimental groups than the ethylene glycol group. The mean number of deposits was lower in these groups, too (P Conclusion: Thymoquinone significantly decreased the number and size of calcium oxalate deposits in the renal tubules. The dose and duration of treatment, however, does not have a linear relation with the outcomes. Further studies on thymoquinone as a preventive and therapeutic drug for kidney calculi are suggested.

Mousa-Al-Reza Hadjzadeh; Nama Mohammadian; Zeynab Rahmani; Fatemeh Behnam Rassouli

2008-01-01

248

Ureteroscopy-assisted retrograde nephrostomy for lower calyx calculi in horseshoe kidney: two case reports  

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Full Text Available Abstract Introduction We previously reported on the effectiveness of ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy and report two cases of lower calyx calculi in horseshoe kidney that were successfully treated with ureteroscopy-assisted retrograde nephrostomy. During the ureteroscopy-assisted retrograde nephrostomy procedure, a ureteroscope is advanced in the desired calyx and a Lawson retrograde nephrostomy puncture wire is inserted. The wire is advanced through the calyx to exit the skin. The wire is then used for the percutaneous dilation. Case presentation Case 1 was a 68-year-old man who was shown on radiography to have left lower calyx calculi (19?×?15mm, 7?×?5mm, and 7?×?3mm) in horseshoe kidney. Case 2 was a 36-year-old woman shown on radiography to have a left lower calyx calculus (10?×?8mm) in horseshoe kidney. Conclusions Both patients were stone-free after ureteroscopy-assisted retrograde nephrostomy during percutaneous nephrolithotomy. Ureteroscopy-assisted retrograde nephrostomy is a promising procedure for safely and effectively treating lower calyx stones in horseshoe kidney.

Kawahara Takashi; Ito Hiroki; Terao Hideyuki; Tanaka Katsuyuki; Ogawa Takehiko; Uemura Hiroji; Kubota Yoshinobu; Matsuzaki Junichi

2012-01-01

249

Avicenna's Canon of Medicine and modern urology: part II: bladder calculi.  

UK PubMed Central (United Kingdom)

In the previous issue of the Urology Journal, a comparison of Avicenna's Canon of Medicine with modern urologic findings was done in part I of this article, addressing bladder anatomy and physiology and bladder calculi. In part II of this review, the remaining chapters of the Canon of Medicine on bladder calculi are reviewed. Avicenna points to perineal urethrostomy (perineostomy), which is today performed as the last therapeutic line or as a temporary remedy before surgical treatment. He also describes surgery via transperineal route and warns the surgeon of the proximity of vasa deferentia, prostate gland, and neurovascular bundle and their exposure in this position. Usage of grasping forceps for removal of bladder calculus and emphasis on removing all calculus fragments are the interesting points of this chapter. Avicenna explains a technique similar to the use of a Babcock forceps for prevention of calculus migration. Complications of bladder calculus surgery and cystostomy are also addressed with scientific precision in the Canon. It is noteworthy that 8 centuries before Fournier described necrotizing fasciitis in male genitalia, Avicenna had described Fournier gangrene in his book.

Madineh SM

2009-01-01

250

[Peroperative ultrasonics in excision of renal and ureteral calculi by the surgical approach. Apropos of 30 cases  

UK PubMed Central (United Kingdom)

Ultrasound imaging was conducted in 30 patients during operation for removal of renal and ureteral stones, in most cases after contact radiography with small sterile films, and in all cases before opening the renal pelvis to avoid penetration of an air bubble into the intrarenal excretory tract. Each bubble may, because of its weak acoustic impedance, provoke total reflection of the waves simulating the image of a stone. Ultrasound provides data on cortical projection of calculi, the thickness of the parenchyma and the echoless avascular zones. All complex calculi (from Staghorn to caliceal types) should be investigated by ultrasound since it allows economy of time and reduced risks of excision of calculi. All stones greater than 1 mm give a hyperechogenic image with a cone shadow, the only differential diagnoses being air bubbles and intraparenchymatous calcification. Nonrecognition of calculi 1 mm in diameter is acceptable insofar as this type of caliceal or pyelic calculus may be excreted spontaneously. Ultrasound imaging during operation provides marked economy in time, of particular value during nephrotomy with pedicle clamping. Time is saved as a result of the three-dimensional detection of stones. Results in 30 cases showed a sensitivity of 97% for the method with excellent specificity, with only one false negative (residual microlithiasis) and one false positive (air bubble).

Plainfosse MC; Bourquelot P; Hernigou A; Vaucamps P; Verderi D

1985-01-01

251

Risk factors for recurrent urinary tract infection in kidney transplant recipients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Urinary tract infections (UTIs) are the most common infectious complication in kidney transplant recipients (KTRs). The aim of this study to investigate the risk factors for and causative organisms of UTI as well as to evaluate the impact these diseases on allograft function in KTRs. METHODS: We analyzed patients who underwent kidney transplantation (KT) between January 2000 and December 2010. Among a total of 344 KTRs, 50 (14.5%) patients experienced 106 UTI episodes during a mean follow-up of 35.9 ± 26.0 months. Twenty three patients experiencing recurrent UTI were compared with 27 nonrecurrent UTI patients and with 50 non-UTI patients matched for age, gender, and transplantation date. RESULTS: The number of patients with renal calculi, diabetes, or prior dialysis was significantly greater among the UTI group compared with control subjects. In addition, the number of patients with renal calculi was significantly higher among the recurrent compared with the nonrecurrent cohort (43.5 vs 7.4%; P = .003). The most common causative organism was Escherichia coli (64.1%), followed by Enterococcus species (20.5%). Higher rates of antibiotic resistance, especially Extended Spectrum Beta-Lactamasc (ESBL) production, were observed among the recurrent compared with the nonrecurrent group (53.1 vs 0%; P = .013). The rate of decline of estimated glomerular filtration rate was significantly faster in the UTI than the non-UTI group, whereas it did not differ between the recurrent and nonrecurrent group. CONCLUSIONS: Adequate treatment of an initial UTI to prevent as recurrent infection and prolong graft longevity is especially reasonable for KTRs with renal calculi or in cases of antibiotic-resistant microorganisms.

Lim JH; Cho JH; Lee JH; Park YJ; Jin S; Park GY; Kim JS; Kang YJ; Kwon O; Choi JY; Kim CD; Kim YL; Kim HK; Huh S; Park SH

2013-05-01

252

Is continent urinary diversion feasible in children under five years of age?  

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Full Text Available Purpose: To review our clinical experience with urinary continent catheterizable reservoir in children under five years of age. Materials and Methods: A total of 23 patients (16 males, 7 females) with a median age of 3.64 years were evaluated. Among these, 6 (26.08%) had a posterior urethral valve, 9 (39.13%) myelomeningocele, 4 (17.39%) bladder exstrophy, 2 (8.69%) genitourinary rabdomyosarcoma, 1 (4.34%) had spinal tumor and 1 (4.34%) an ano-rectal anomaly. Results: Perioperative complications were observed in four patients consisting of one febrile urinary tract infection, one partial operative wound dehiscence, one partial stomal dehiscence and one vesico-cutaneous fistula after a secondary exstrophy repair. The overall long-term complications rate was 40.90% and consisted of two stomal stenoses (9.09%), one neobladder mucosal extrusion (4.54%), three neobladder calculi (13.63%) and persistence of urinary incontinence in three patients (13.63%). The overall surgical revision was 36.36% and final continence rate was 95.45% with mean follow-up of 39.95 months Conclusion: Continent urinary diversion is technically feasible even in small children, with acceptable rates of complications.

Luiz L. Barbosa; Riberto Liguori; Sergio L. Ottoni; Ubirajara Barroso Jr; Valdemar Ortiz; Antonio Macedo Junior

2009-01-01

253

Renoscintigram in urinary stones  

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Seventy six patients who suffered from urinary stones on either side of the upper urinary tract were reviewed. The 99m-Tc DTPA renoscintigram was analyzed to examine whether stasis presented on the contralateral side of the urinary stone retrospectively. Though excretory urogram showed neither apparant stasis nor other abnormalities on the contralateral sides, 55 of these 76 cases showed stasis to some degree in the renoscintigram. Thirty five of these 55 cases also showed elongation of T1/2 in the ROI curve. Since 72.4% showed urinary stasis on the contralateral side of the urinary stone, we suggest the possibility that stasis can well be a cause of stone formation. In addition we warn of the possibility of future stone formation on the now healthy contralateral side.

Egawa, Shin; Lee, Kanei; Ikeda, Shigeru; Ishibashi, Akira (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

1984-05-01

254

Initial investigation of childhood urinary tract infection: does the plain abdominal X ray still have a role?  

Science.gov (United States)

To reassess the plain abdominal X ray (AXR) in the initial investigation of childhood urinary tract infection, radiologists from four paediatric units prospectively collected data on the yield from the AXR in 683 children. Five children had renal calculi. All were detected on ultrasound, but one was not visible on the initial AXR. Four spinal abnormalities were identified, none of which prompted any action by the clinician involved. While the costs, in both financial and radiation risk terms, may be small, the benefit of the AXR appears equally small. Where expert paediatric ultrasonography is available we would recommend that the AXR be reserved for patients with haematuria, loin pain, family history of calculus disease, or where further urinary tract infection occurs despite a normal ultrasound scan. PMID:1742579

Kenney, I J; Arthur, R J; Sweeney, L E; Hendry, G M

1991-11-01

255

Initial investigation of childhood urinary tract infection: does the plain abdominal X ray still have a role?  

UK PubMed Central (United Kingdom)

To reassess the plain abdominal X ray (AXR) in the initial investigation of childhood urinary tract infection, radiologists from four paediatric units prospectively collected data on the yield from the AXR in 683 children. Five children had renal calculi. All were detected on ultrasound, but one was not visible on the initial AXR. Four spinal abnormalities were identified, none of which prompted any action by the clinician involved. While the costs, in both financial and radiation risk terms, may be small, the benefit of the AXR appears equally small. Where expert paediatric ultrasonography is available we would recommend that the AXR be reserved for patients with haematuria, loin pain, family history of calculus disease, or where further urinary tract infection occurs despite a normal ultrasound scan.

Kenney IJ; Arthur RJ; Sweeney LE; Hendry GM

1991-11-01

256

Ureteroscopic and Extracorporeal Shock Wave Lithotripsy for Rather Large Renal Pelvis Calculi  

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Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Introduction: The aim of this study was to compare the results and complications of extracorporeal shock wave lithotripsy (SWL) plus retrograde ureteroscopic lithotripsy using laser and pneumatic lithotriptors with SWL monotherapy for renal pelvic calculi between 2 cm and 3 cm. Materials and Methods: A total of 55 patients with 2- to 3-cm pelvic calculi were assigned into groups 1 and 2, including 22 and 33 patients, respectively. Patients in group 1 first underwent laser pneumatic lithotripsy and insertion of a double-J ureteral catheter and then underwent SWL 2 to 4 weeks thereafter. In group 2, the patients underwent SWL after double-J ureteral catheter insertion. The stone-free rate, complications, and cost effectiveness were evaluated 3 months postoperatively. Results: Five patients (22.7%) in group 1, had their calculi completely fragmented after ureteroscopy and retrograde lithotripsy without any need for further SWL. In 9 patients (40.9%), after a single session of SWL, and in 3 (13.6%), after 2 sessions, fragmentation was completed. In group 2, successful treatment was achieved after 1 and 2 SWL sessions in 6 (18.2%) and 8 (24.2%) patients, respectively. The stone-free rate was significantly higher in the patients of group1 than those in group 2 (77.3% versus 42.4%, respectively; P = .01). The period of anesthesia was 23.1 minutes (during ureteroscopy) in group 1 and 13.2 minutes in group 2 (during cystoscopy or ureteroscopy and insertion of ureteral catheter). No significant complication was reported in neither of the groups. The mean costs of the treatment were US $ 400 and US $ 370 in groups 1 and 2, respectively. Conclusion: Ureteroscopic lithotripsy before SWL is a rational method for the treatment of the rather large renal pelvic calculi with fairly acceptable costs.

Kamyar Tavakkoli Tabasi; Mehri Baghban Haghighi

2007-01-01

257

Some Results on the Full Abstraction Problem for Restricted Lambda Calculi  

UK PubMed Central (United Kingdom)

ion Problemfor Restricted Lambda CalculiFurio Honsell and Marina LenisaDipartimento di Matematica e Informatica,Universit`a di Udine, via Zanon,6 - ItalyE-mail:fhonsell,lenisag@udmi5400.cineca.itdedicated to Corrado Bohmon the occasion of his 70thbirthdayAbstract. Issues in the mathematical semantics of two restrictions ofthe -calculus, i.e. I-calculus and V -calculus, are discussed. A fullyabstract model for the natural evaluation of the former is defined usingcomplete partial orders and strict Scott-continuous functions. A correct,albeit non-fully abstract, model for the SECD evaluation of the latter isdefined using Girard's coherence spaces and stable functions. These resultsare used to illustrate the interest of the analysis of the fine structureof mathematical models of programming languages.1 IntroductionD. Scott, in the late sixties, discovered a truly mathematical semantics for -calculus using continuous lattices. His D1 model was the first ...

Furio Honsell; Marina Lenisa; Dedicated To Corrado Bohm

258

Studies on the function of upper urinary tract, 13  

International Nuclear Information System (INIS)

In order to clarify the changes of the ureteral function after ureterolithotomy, 131I-Hippuran renograms were recorded at 3 times before, immediately after (i.e. 1 - 2 days after) and 10 days after the lithotomy in 52 patients. The influences of preoperative hydronephrosis or urinary tract infection upon the postoperative renogram patterns were studied. The following results were obtained. 1. In the renogram findings of the preoperative 52 cases, 28 delayed excretion types, 15 obstructive types and 9 standard types were shown. 2. The postoperative renogram patterns showed a tendency of increased obstruction immediately after the operation (56.9%) irrespective of the location of the calculi in the ureter, and the recovering excretion phases became visible on the 10th postoperative day (51.1%). 3. In the findings on the postoperative renograms, a tendency of increased obstruction was noted in many of the patients of the non-hydronephrotic group than the hydronephrotic group immediately after the operation, but no statistically significant difference was noted. On the 10th postoperative day, slightly more patients of the hydronephrotic group tended to show improvements of obstruction than those of the non-hydronephrotic group, but with no statistically significant difference. 4. In the relationship between the hydronephrosis and urinary tract infection, the infection rate was 26.9% (7 out of 26) in the non-hydronephrotic group and 52.4% (11 out of 21) in the hydronephrotic group. 5. In the findings on the renograms viewed from presence of urinary tract infection, slightly more cases of increased obstruction were found out immediately after the operation in the non-infected group than in the infected group. On the 10th postoperative day, slightly more cases of improvements of obstruction were noted in the infected group than in the non-infected group, but no statistically significant difference was seen between the two groups at either of the two points. (author)

1980-01-01

259

Urinary adenylate kinase and urinary tract infections.  

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Positive correlations were found among the appearance of adenylate kinase activity in the urine and the existence of bacteriuria, the Fairley test, and other criteria of urinary infection. Since the adenylate kinase isozymes of human tissues are organ specific and can be distinguished from one anoth...

Bernstein, L H; Horenstein, J M; Russell, P J

260

Ibn-Sina's Life and Contributions to Medicinal Therapies of Kidney Calculi  

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Full Text Available Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Ibn-Sina (commonly known as Avicenna) is one of the most famous and influential scientists in the history of medicine. The Canon of Medicine, which is his most celebrated book in medicine, presents a summary of all the medical knowledge of his time. Ibn-Sina wrote a complete section about kidney calculi in his book. Totally, 65 herbal, 8 animal, and 4 mineral medicines are mentioned in the Canon of Medicine as beneficial drugs for destructing, expelling, and preventing kidney calculi. Ibn-Sina introduced very advanced drug designing based on drug delivery, targeting the organ, deposition in the site of action, pain control, wound healing, clearance after action, and supporting the organ. Using Ibn-Sina's ideas help scientists to choose better drugs with a historical background to reduce the cost of therapies and research projects.

Pouya Faridi; Jamshid Roozbeh; Abdoali Mohagheghzadeh

2012-01-01

 
 
 
 
261

Trends in the utilization of percutaneous and open nephrolithotomy in the treatment of renal calculi.  

UK PubMed Central (United Kingdom)

Abstract Purpose: To evaluate trends in the use of percutaneous nephrolithotomy (PCNL) and nephrolithotomy (NL) in patients with renal pelvis calculi. Materials and Methods: An analysis of the 5% Medicare Public Use Files (years 2001, 2004, 2007, and 2010) was performed to assess changes in the use of PCNL and NL over a 10-year period. Patients were identified using the International Classification of Diseases-9 (cm) and Current Procedure Terminology codes. Statistical analyses, including the Fisher and chi-square tests and multivariate regression analyses, were performed using SAS 9.3 (SAS Institute Inc, Cary, NC) and SPSS v20 (IBM Corp., Armonk, NY). Results: A total of 26,100 patients underwent either PCNL or NL. Use of PCNL and NL decreased from 3.1% to 2.5% in patients with a diagnosis of stones (P<0.0001). Women (odds ration [OR]=1.19, P=0.003) were more likely to undergo surgery. Patients aged ?65 years were less likely to be treated (OR=0.65-0.71, P<0.05). Patients treated after 2004 were less likely to undergo surgery (OR=0.77-0.84, P<0.05). The use of PCNL exceeded NL at a stable 10:1 ratio. Conclusions: The use of PCNL and NL for treatment of patients with stone disease slightly decreased from 2001 to 2010, although the number of patients with renal calculi increased. The use of PCNL vs NL was unchanged during this period. Multiple inequalities existed in overall surgical treatment rates and were influenced by sociodemographic factors such as age and sex.

Seklehner S; Laudano MA; Chughtai B; Jamzadeh A; Pizzo JJ; Engelhardt PF; Lee RK

2013-08-01

262

Prospective Randomized Controlled Trial Comparing Laser Lithotripsy with Pneumatic Lithotripsy in Miniperc for Renal Calculi.  

UK PubMed Central (United Kingdom)

Background and purpose: Energy source used for stone fragmentation is important in miniperc. In this study, we compared the stone fragmentation characteristics and outcomes of laser lithotripsy and pneumatic lithotripsy in miniperc for renal calculi. Patients and methods: After institutional review board approval, sixty patients undergoing miniperc for renal calculi of size 15 to 30 mm were equally randomized to laser and pneumatic lithotripsy groups. Miniperc was performed using 16.5 Fr Karl StorzTM miniperc sheath and 12 Fr nephroscope. Laser lithotripsy was performed using 550-µm laser fiber and 30 watts laser with variable settings according to the need. Pneumatic lithotripsy was performed using EMS Swiss lithoclast. Patient demographics, stone characteristics, intraoperative parameters and postoperative outcomes were analyzed. Results: The baseline patient demographics and stone characteristics were similar in both the groups. The total operating time (p = 0.433) and fragmentation time (p = 0.101) were similar between the groups. The surgeon assessed Likert score (1 to 5) for fragmentation was similar in both groups (2.1 ± 0.8 vs 1.9 ± 0.9, p = 0.313). Stone migration was lower with laser (1.3 ± 0.5 vs 1.7 ± 0.8, p = 0.043) and fragment removal was easier with laser (1.1 ± 0.3 vs 1.7 ± 1.1, p = 0.011). Need for fragment retrieval using a basket was significantly more in pneumatic lithotripsy group (10% vs 37%, p = 0.002). The hemoglobin drop, complication rates, auxiliary procedures, postoperative pain and stone clearance rates were similar between the groups (p > 0.2). Conclusion: Both laser lithotripsy and pneumatic lithotripsy are equally safe and efficient stone fragmentation modalities in miniperc. Laser lithotripsy is associated with lower stone migration and easier retrieval of the smaller fragments it produces.

Ganesamoni R; Sabnis RB; Mishra S; Parekh N; Ganpule A; Vyas JB; Jagtap J; Desai M

2013-09-01

263

Comparing the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi.  

Science.gov (United States)

Background: Urolithiasis is a chronic disease of mankind, which has enormous public health importance and it accounts for a substantial economic burden on our society. Hence, it becomes all the more important to formulate cheaper and easier means for treating this condition. The past few years have seen a number of drugs being introduced and successfully used in the medical expulsion therapy of small, uncomplicated ureteral calculi, with each drug claiming to provide better results than the others. Ours is perhaps the first study which has compared the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi. Aims: To compare the efficacy of tamsulosin (0.4mg) vs silodosin (8mg), both in terms of the stone expulsion rate and the time to stone expulsion. Settings and Design: A prospective and a randomized controlled study was conducted in the Department of Urology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. Material and Methods: From February to August 2012, 100 patients who were between the age group of 18-50 years, who had unilateral, uncomplicated middle or lower ureteral stones silodosin (8mg) daily for a maximum period of 4 weeks. The patients were followed up weekly or biweekly with imaging studies. The primary endpoint was the stone expulsion rate and the secondary endpoints were the stone expulsion time, the rate of the interventions and the side effects. Statistical Analysis: The statistical analysis was performed by using the Student's t-test and the Chi-squared test. A p value of silodosin was found to be clinically superior to tamsulosin, both in terms of the stone expulsion rate and the stone expulsion time. PMID:24086871

Gupta, Sandeep; Lodh, Bijit; Singh, Akoijam Kaku; Somarendra, Khumukcham; Meitei, Kangjam Sholay; Singh, Sinam Rajendra

2013-08-01

264

Efficacy of alfuzosin after shock wave lithotripsy for the treatment of ureteral calculi.  

UK PubMed Central (United Kingdom)

PURPOSE: We evaluated the efficacy of alfuzosin for the treatment of ureteral calculi less than 10 mm in diameter after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: A randomized, single-blind clinical trial was performed prospectively by one physician between June 2010 and August 2011. A total of 84 patients with ureteral calculi 5 to 10 mm in diameter were divided into two groups. Alfuzosin 10 mg (once daily) and loxoprofen sodium 68.1 mg (as needed) were prescribed to group 1 (n=41), and loxoprofen sodium 68.1 mg (as needed) only was prescribed to group 2 (n=44). The drug administration began immediately after ESWL and continued until stone expulsion was confirmed up to a maximum of 42 days after the procedure. RESULTS: Thirty-nine of 41 (95.1%) patients in group 1 and 40 of 43 (93.0%) patients in group 2 ultimately passed stones (p=0.96). The number of ESWL sessions was 1.34±0.65 and 1.41±0.85 in groups 1 and 2, respectively (p=0.33). The patients who required analgesics after ESWL were 8 (19.5%) in group 1 and 13 (30.2%) in group 2 (p=0.31). Visual analogue scale pain severity scores were 5.33±1.22 and 6.43±1.36 in groups 1 and 2, respectively (p=0.056). The time to stone expulsion in groups 1 and 2 was 9.5±4.8 days and 14.7±9.8 days, respectively (p=0.005). No significant adverse effects occurred. CONCLUSIONS: The use of alfuzosin in combination with ESWL seems to facilitate stone passage and to reduce the time of stone expulsion but does not affect the stone-free rate.

Cho HJ; Shin SC; Seo do Y; Min DS; Cho JM; Kang JY; Yoo TK

2013-02-01

265

Method of dissolving cholesterol-rich calculi with short chain halogenated organic solvents and cosolvents  

UK PubMed Central (United Kingdom)

Disclosed is a method for dissolving cholesterol-rich calculi, most preferably gallstones in vivo, comprising contacting the calculus with a fluid compound of the formula R-X, R having 2 to 4 carbon atoms with substituents consisting of hydrogen of halogen, X being halogen, and wherein if X is fluorine, at least one substituent is selected from the group consisting of hydrogen, chlorine, bromine, or iodine. Usually R-X is 2-bromo-2-chloro-1,1,1-trifluoroethane (also referred to as Halothane.) Other compounds of particular interest are 2-chloro-1,2,-dibromo-1,1,2-trifluoroethane, 1-bromo-2-chloro-1,1,2-trifluoroethane, 2,3-dibromo-1,1,1-trifluoropropane, 2-iodo-1,1,1-trifluoroethane, 1,2-dichloro-1,1-difluoroethane, 1,1,2-trichloro-2,3,3-trifluorocyclobutane, hexafluoro-1,1,3,4,-tetrachlorobutane, 1,1,1-trichlorotrifluoroethane, and 1,2-dibromo-tetrafluoroethane. Furthermore, Halothane and MtBE in combination effectively dissolve cholesterol-rich calculi. Finally, dissolution can be enhanced by adding to the dissolution solvent up to about 50 percent by volume of a lower alcohol. Usually the lower alcohol is ethanol in the amount of about 5 to 40, usually 10 to 30 and preferably about 10 percent by volume. Most preferably in this case, R-X is Halothane or 1,1,1-trichlorotrifluoroethane. Dissolution using previously known solvents such as MtBE is also enhanced by such addition of lower alcohols. In addition, the practical use of MtBE for dissolution can be improved by the addition of the compounds described above as R-X, particularly Halothane, and usually at levels of about 5 to 50 volume percent Halothane.

DEANTONIO PAUL; MAYHAN KENNETH G; SORENSEN JOHN T

266

Avicenna’s Canon of Medicine and Modern Urology: Part II: Bladder Calculi  

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Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} In the previous issue of the Urology Journal, a comparison of Avicenna’s Canon of Medicine with modern urologic findings was done in part I of this article, addressing bladder anatomy and physiology and bladder calculi. In part II of this review, the remaining chapters of the Canon of Medicine on bladder calculi are reviewed. Avicenna points to perineal urethrostomy (preineostomy), which is today performed as the last therapeutic line or as a temporary remedy before surgical treatment. He also describes surgery via transperineal route and warns the surgeon of the proximity of vasa deferentia, prostate gland, and neurovascular bundle and their exposure in this position. Usage of grasping forceps for removal of bladder calculus and emphasis on removing all calculus fragments are the interesting points of this chapter. Avicenna explains a technique similar to the use of a babcock for prevention of calculus migration. Complications of bladder calculus surgery and cystostomy are also addressed with scientific precision in the Canon.

Sayed Mohammad Ali Madineh

2009-01-01

267

Symptomatology Of Urinary Tract Infection  

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Patients with urinary symptoms are commonly seen in family practice. This study reports the rate of urinary symptoms in three teaching practices over one year. The response of the physician to such patients is described. The predictive value of urinary symptoms in the diagnosis of urinary tract infe...

Dickie, Gordon L.

268

Classification of bicovariant differential calculi on the Jordanian quantum groups $GL_{h_{bg}}(2)$ and $SL_{h}(2)$ and quantum Lie algebras  

CERN Document Server

We classify all 4-dimensional first order bicovariant calculi on the Jordanian quantum group $GL_{h,g}(2)$ and all 3-dimensional first order bicovariant calculi on the Jordanian quantum group $SL_{h}(2)$. In both cases we assume that the bicovariant bimodules are generated as left modules by the differentials of the quantum group generators. It is found that there are 3 1-parameter families of 4-dimensional bicovariant first order calculi on $GL_{h,g}(2)$ and that there is a single, unique, 3-dimensional bicovariant calculus on $SL_{h}(2)$. This 3-dimensional calculus may be obtained through a classical-like reduction from any one of the three families of 4-dimensional calculi on $GL_{h,g}(2)$. Details of the higher order calculi and also the quantum Lie algebras are presented for all calculi. The quantum Lie algebra obtained from the bicovariant calculus on $SL_{h}(2)$ is shown to be isomorphic to the quantum Lie algebra we obtain as an ad-submodule within the Jordanian universal enveloping algebra $U_{h}(sl...

Jacobs, A D; Jacobs, Andrew D.

1998-01-01

269

Urinary incontinence - injectable implant  

Science.gov (United States)

Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

270

[Urinary tract infections  

UK PubMed Central (United Kingdom)

During the past ten years, new concepts on host-parasite interaction have allowed better understanding of the pathogenesis of urinary tract infections (UTI). In addition, significant progress has been achieved with the development of new methods for differentiating upper and lower UTI. This review is intended to discuss current information about virulence factors of Escherichia coli, host genetic risk markers associated to recurrence and complications, and new diagnostic tools for localizing the anatomic place of urinary tract infections.

Lagos R; Bravo I

1991-05-01

271

Genito-urinary tuberculosis  

International Nuclear Information System (INIS)

Tuberculosis continues to be one of the most frequently recurring specific infectious diseases. In this context, genito-urinary tuberculosis, followed by lymph node tuberculosis, presents itself as the most important extrapulmonary organ manifestation. Due to its steady incidence rate, an often insidious disease process as well as the increasing number of immunosuppressed patients, it is more important than ever to focus our clinical attention on the knowledge of epidemiology, pathogenesis, diagnosis and therapy of genito-urinary tuberculosis. (orig.).

1997-01-01

272

Drug-induced MR urography: the effects of furosemide and intravenous saline injection on MR urography of obstructed and non-obstructed urinary tract  

Energy Technology Data Exchange (ETDEWEB)

To determine the usefulness of MR urography technique for the evaluation of urinary systems in patients with obstructed urinary tract and normal volunteers with non-obstructed urinary tract after intravenous normal saline and diuretic injection. Three normal volunteers and 12 patients with urinary tract obstruction [ureteral calculi (n=8), extraurinary mass (n=1), ureteral tumor invasion (n=3)] underwent MR urography using a 1.0T scanner and a 2D non-breath-hold heavily T2-weighted fast spin-cho sequence. These acquisition were post-processed with a maximum intensity projection (MIP) algorithm. Two acquisitions were performed, the first prior to saline solution infusion following standard MR urography procedures, and the second, within 2-3 minutes of the infusion of 250 ml saline solution followed by 20 mg of Lasix administered intravenously. For this latter, drug-induced MR urography procedures were followed. In healthy volunteer (n=3) and those experiencing partial obstruction (n=4) by a urinary stone, drug-induced MR urography provided better images of the urinary tract than did standard MR urography. In those in whom a urinary stone or tumor had caused complete obstruction (n=8), standard MR urography provided good images, as did drug-induced MR urography. In patients with a partially or non-obstructed urinary tract, drug-induced MR urography provided better anatomic and functional details of the kidney and urinary tract than did standard MR urography. In those experiencing complete obstruction of the urinary tract, however, standard or drug-induced MR urography permitted very adequate evaluation of the tract, and drug-induced MR urography was unnecessary.

Park, Jeong Ha; Lee, Myung Jun; Lee, Chang Joon [National Medical Center, Seoul (Korea, Republic of)

2001-10-01

273

Comparing the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi.  

UK PubMed Central (United Kingdom)

Background: Urolithiasis is a chronic disease of mankind, which has enormous public health importance and it accounts for a substantial economic burden on our society. Hence, it becomes all the more important to formulate cheaper and easier means for treating this condition. The past few years have seen a number of drugs being introduced and successfully used in the medical expulsion therapy of small, uncomplicated ureteral calculi, with each drug claiming to provide better results than the others. Ours is perhaps the first study which has compared the efficacy of tamsulosin and silodosin in the medical expulsion therapy for ureteral calculi. Aims: To compare the efficacy of tamsulosin (0.4mg) vs silodosin (8mg), both in terms of the stone expulsion rate and the time to stone expulsion. Settings and Design: A prospective and a randomized controlled study was conducted in the Department of Urology, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. Material and Methods: From February to August 2012, 100 patients who were between the age group of 18-50 years, who had unilateral, uncomplicated middle or lower ureteral stones

Gupta S; Lodh B; Singh AK; Somarendra K; Meitei KS; Singh SR

2013-08-01

274

Treatment of urinary incontinence.  

UK PubMed Central (United Kingdom)

The treatment of urinary incontinence is a dynamic and evolving field. New therapies, techniques, and procedures, as well as some subtle refinements in treatments currently used, offer hope for the millions of people suffering from this condition. Recent attention has been directed toward reevaluating the efficacy and durability of some standard treatments for stress urinary incontinence, including pelvic floor exercise, bladder neck suspensions, and pubovaginal slings. Occlusive or supportive devices have evolved into a suitable alternative in some patients. Extracorporeal magnetic therapy and alternative periurethral injectable agents may offer additional treatment strategies for the relief of symptomatic stress urinary incontinence. New drugs for the treatment of overactive bladder and urge urinary incontinence have been introduced recently and, in combination with neuromodulation, offer the first new treatments for this condition in over 25 years. Yet, as rapidly as new therapies become available for the treatment of urinary incontinence, problems have become evident with some that were introduced just a short time ago. Thus, cautious skepticism regarding these "new and improved" treatments should be maintained until long-term data become available with respect to safety, efficacy, and durability.

Rovner ES

2000-10-01

275

Pediatric urinary tract infection  

Energy Technology Data Exchange (ETDEWEB)

Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs.

Blickman, J.G.

1991-02-06

276

Pediatric urinary tract infection  

International Nuclear Information System (INIS)

Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs

1991-01-01

277

Medicament for treating urinary system calculus and preparation method thereof  

UK PubMed Central (United Kingdom)

The invention discloses a medicament for treating urinary system calculi and a preparation method thereof, wherein the medicament is prepared from the following raw materials in proportion by weight: 25 to 35g of honeysuckle, 15 to 18g of forsythia, 25 to 35g of peach kernel, 8 to 12g of liquorice, 10 to 15g of desmodium, 12 to 18g of achyranthes, 15 to 25g of pyrrosia lingua, 8 to 12g of talcum, 10 to 15g of Japanese fern spore, 10 to 15g of rhizoma sparganii, 10 to 15g of rhizoma zedoariae, 3 to 5g of amber, 10 to 15g of endothelium corneum gigeriae galli and 8 to 12g of corydalis tuber the preparation method comprises the following steps: firstly respectively packing talcum and Japanese fern spore through gauze bags, then decocting and concentrating desmodium, pyrrosia lingua, peach kernel, achyranthes, rhizoma sparganii, rhizoma zedoariae, talcum bag and Japanese fern spore bag, then mixing the concentrated solution with honeysuckle, the forsythia, liquorice, amber, endothelium corneum gigeriae galli and corydalis tuber, uniformly stirring, baking, pulverizing, sieving, pelletizing, drying and finally sterilizing and packaging pills.

DELI CAO; ZHIYONG CAO; FUPENG LI; PEILING ZHANG

278

Braided Lie algebras and bicovariant differential calculi over coquasitriangular Hopf algebras  

CERN Multimedia

We show that if $g_\\Gamma$ is the quantum tangent space (or quantum Lie algebra in the sense of Woronowicz) of a bicovariant first order differential calculus over a co-quasitriangular Hopf algebra $(A,r)$, then a certain extension of it is a braided Lie algebra in the category of $A$-comodules. This is used to show that the Woronowicz quantum universal enveloping algebra $U(g_\\Gamma)$ is a bialgebra in the braided category of $A$-comodules. We show that this algebra is quadratic when the calculus is inner. Examples with this unexpected property include finite groups and quantum groups with their standard differential calculi. We also find a quantum Lie functor for co-quasitriangular Hopf algebras, which has properties analogous to the classical one. This functor gives trivial results on standard quantum groups $O_q(G)$, but reasonable ones on examples closer to the classical case, such as the cotriangular Jordanian deformations. In addition, we show that split braided-Lie algebras define `generalised-Lie alg...

Gómez, X

2001-01-01

279

Minimally Invasive Radiologically Guided Intervention for the Treatment of Salivary Calculi  

International Nuclear Information System (INIS)

Purpose: To describe the technique and examine the value of salivary stone extraction using a minimally invasive, radiologically guided approach as an alternative to salivary gland surgery for the treatment of benign salivary gland obstruction. Methods: Eighty-six cases of sialolithiasis (83 patients) were treated by stone removal using a Dormia basket under local anesthesia and fluoroscopic guidance. Postoperative assessment was made clinically at review, by sialogram and by questionnaire. Results: Of 86 cases of sialolithiasis treated, in 55 (64%)it was possible to remove all stones. In 12 cases (14%) part of a stone or some of a number of calculi were removed and in 19 cases (22%) the procedure failed. The commonest reason for failure was fixation of the stone within the duct. Symptoms at review (range 1-49 months, mean 17 months) were relieved in 55 of 67 (82%) of cases where a stone or portion of stone was removed. Conclusions:Stone removal from the salivary duct system by radiologically guided,minimally invasive approach is a simple procedure with low morbidity and high patient acceptance when appropriate selection criteria are applied. These criteria are considered and recommendations made

2002-01-01

280

Imaging of the Urinary Tract  

Science.gov (United States)

... the shape of the urinary tract. Intravenous pyelogram (IVP). An IVP is an x ray of the urinary tract. ... in medical imaging; anesthesia is not needed. An IVP can help locate problems in the kidneys, ureters, ...

 
 
 
 
281

Urinary incontinence - vaginal sling procedures  

Science.gov (United States)

... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when ... Vaginal sling procedures are done to treat stress urinary incontinence. Before discussing surgery, your doctor will have ...

282

Pseudotumor of urinary bladder  

International Nuclear Information System (INIS)

The case of an old male is presented who had postoperative spindle cell nodule of urinary bladder. This benign condition mimics a sarcoma. However, the treatment modalities and the outcome are entirely different. Inflammatory pseudotumor/PSCN and leiomyosarcoma of the bladder overlap in clinical and immunohistochemical findings but are histologically as well as clinically distinct, correlating with different natural histories. Inflammatory Pseudotumors'/ PSCN are benign, not prone to metastasize, and is outside the spectrum of low-grade inflammatory sarcoma of urinary bladder. (author)

2004-01-01

283

The upper urinary tract  

International Nuclear Information System (INIS)

Pyelography is superior to all other imaging techniques for the demonstration of fine detail in the pelveocalyceal system and the ureter. For almost 90 years it has been performed through a retrogradely inserted catheter, but during the recent 30 years antegrade injection via a transparenchymally inserted needle or catheter has become an accepted alternative, especially in case of dilated upper urinary tract. Both methods have their advantages and their disadvantages. This article presents a review of indications, techniques, and complications. Furthermore, interventional procedures on the upper urinary tract - such as stent placement and ballon dilatation - are now handled by the radiologist, mainly through an antegrde approach. These therapeutic procedures are also reviewed. (orig.).

1987-01-01

284

[Lymphomas of the urinary tract  

UK PubMed Central (United Kingdom)

OBJECTIVES: The present study discusses both primary and secondary malignant lymphoreticular proliferative tumors of the urinary tract. METHODS: Two patients with urinary tract involvement are described: one female and one male with bladder and prostate involvement, respectively. RESULTS: Both cases presented clinical features that were not distinct from those of other tumors of the urinary tract. CONCLUSIONS: The anatomopathological study is essential to the differential diagnosis of urinary tract involvement from non-Hodgkin lymphoma and discards other extralymphatic conditions.

Rodríguez de Ledesma JM; López-Tello J; de Castro J; Picazo M; Jiménez JA; Alonso-Dorrego JM; Cisneros J; de La Peña J; Martínez-Piñeiro JA

1996-07-01

285

Urinary retention for the neurologist.  

UK PubMed Central (United Kingdom)

Urinary retention is a common problem, most often due to an anatomical lesion in the urinary tract causing obstruction, such as a urethral stricture or prostate enlargement. However, a subset of patients have no structural urological lesion, and so require neurological evaluation. We present a patient with acute urinary retention who was found to have chronic meningitis, and review the neurological causes for urinary retention.

Smith MD; Seth JH; Fowler CJ; Miller RF; Panicker JN

2013-10-01

286

Urinary biomarkers in hydronephrosis.  

UK PubMed Central (United Kingdom)

Hydronephrosis is diagnosed in 0.5-1% of all newborns, and ureteropelvic junction obstruction (UPJO) accounts for 35% of those cases. A urinary tract obstruction that occurs during early kidney development affects renal morphogenesis, maturation, and growth, and in the most severe cases, this will ultimately lead to progressive renal tubular atrophy and interstitial fibrosis with the loss of nephrons. The clinical management of these patients remains a controversial topic. The aim is to preserve renal function by identifying the 15-20% of children who require early surgical intervention from those for whom watchful waiting may be appropriate because of spontaneous resolving/stabilization without significant loss of renal function. Although the patients attend regular follow-ups, including repetitive blood tests, ultrasonographies, and the more invasive diuretic renograms, the surgeons still miss reliably biomarkers that could be used as predictors for renal parenchymal damage and decreased renal function, and thereby provide more clear indications for surgical intervention. The aim of this PhD thesis was to further elucidate the pathophysiology of obstructive nephropathy (study I) and to search for potential candidate biomarkers that may have a predictive and/or diagnostic value in the management of hydronephrosis (study II). Study I: Urine and kidney cytokine profiles in experimental unilateral acute and chronic hydronephrosis. Aim: To study the dynamics of the urinary secretion of cytokines after the release of unilateral ureteral obstruction, and to study whether the urinary concentrations of these compounds reliably reflects changes in the renal parenchyma. This was tested in 2 experimental rat models: an acute obstruction model and a chronic obstruction model. Results: The acute obstruction model demonstrated significant differences in the renal levels of IL-1?, IL-6, TNF-?, and IL-10 in comparison with controls, and these differences were associated with similar differences in their urinary excretion. Such results were not obtained in the chronic obstruction model in which significant differences were only demonstrated in the urinary concentrations of IL-6. Study II: Candidate urinary biomarkers in hydronephrosis - a clinical study. Aim: To study the dynamics of the urinary excretion of selected potential biomarkers in children after the relief of UPJO, and to compare their findings with healthy controls. Results: Twenty-eight children with UPJO were included in the study from 2007-2011 together with 13 healthy children. Pre-, peri- and post-operatively (1 year) urine samples were collected. The median age of the patients was 8.1 (3.5-14.5) years. Five proteins (EGF, IP-10, MCP-1, RANTES, and MIP-1?) were examined in study IIa, and 4 proteins (NGAL, CyC, ?M-2, and OPN) were examined in study IIb. In brief, significantly increased urinary concentrations of EGF and MCP-1 were demonstrated in children with UPJO compared to controls, which was followed by a decline in the post-operative period to levels similar to the controls. This indicates that the urinary concentrations of EGF and MCP-1 are regulated as a response to the obstruction, suggesting that they may have a potential as urinary biomarkers in hydronephrosis. In general, urine from the obstructed kidney exhibited higher concentrations of the proteins compared to urine from the nonobstructed kidney. Furthermore, CyC, ?-2M, and OPN were negatively correlated with age, and IP-10 and MCP-1 were negatively correlated with DRF. In conclusion, this PhD study confirmed increased concentrations of selected proteins in urine from kidneys suffering from obstruction. Interestingly, it was observed that some urinary proteins had an age-dependent excretion. Further investigations are required to test the ability of the examined proteins to identify an obstruction and reveal disease progression and, thereby, be useful clinical tools.

Madsen MG

2013-02-01

287

[Urinary incontinence after radical prostatectomy. Urinary artificial sphinter].  

UK PubMed Central (United Kingdom)

Urinary artificial sphincter (UAS) is currently the gold standard treatment for urinary incontinence after radical prostatectomy. 5-25% of the patients under-going radical prostatectomy develop urinary incontinence. This complication generates important deterioration in the quality of life of these patients. Conservative and minimally invasive treatments, such as Kegel exercises, use of pads, drugs, and electrostimulation, or minor surgery have been used without success. This review summarizes the advantages and complications of the urinary artificial sphincter and its efficacy in the management of urinary incontinence after radical prostatectomy.

Rodríguez Escobar F; Arañó Bertran P

2009-12-01

288

Kidneys and urinary system  

International Nuclear Information System (INIS)

Nuclear medicine studies, through primarily concerned with the functional aspects of the organ, can also provide useful information about the anatomy. An understanding of the anatomy and physiology of the kidneys and urinary system greatly helps in the interpretation of data from radionuclide studies

1992-01-01

289

Urinary Tract Infections.  

Science.gov (United States)

This module on urinary tract infections is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are…

Plummer, Nancy; Michael, Nancy, Ed.

290

Method for preparing Chinese medicine desmodium anti-calculi fractionated extracts and uses thereof  

UK PubMed Central (United Kingdom)

The invention belongs to the technical field of medicines, in particular to a preparation method of antilithic fractionated extract of desmodium, a Chinese medicine, which can be used for preventing and treating urinary calculus. Desmodium is extracted with ethanol by heating reflux, ethanol is recovered, concentration is carried out so as to obtain total extract the total extract is concentrated in a water bath to obtain alcoholic extract, then petroleum ether, ethyl acetate, normal butanol and water are sequentially adopted for fractional extraction, solvents are recycled, and concentration is carried out to obtain the petroleum ether part, ethyl acetate part, normal butanol part and water layer part of the desmodium fractionated extract respectively. Proved by pharmacological tests, the alcoholic extract and fractionated extract of desmodium can significantly reduce the content of oxalic acid and urinary calcium in the urine of rates, remarkably reduce the damage to kidney tissues and restrain the sediment of calculus as the active ingredients for preventing and treating urinary calculus, the alcoholic extract and fractionated extract of desmodium can be prepared into various medicine preparations with convenient application directly or in a compound form, or can be taken as food additives for the prevention and treatment of urinary calculus.

HUAFANG CAI; YANXI LUO; YUSEN ZHONG

291

Anti-urolithiatic effect of cow urine ark on ethylene glycol-induced renal calculi.  

UK PubMed Central (United Kingdom)

Purpose: To investigate the anti-urolithiatic effect of cow urine ark (medicinal distilled cow urine) on ethylene glycol (EG) induced renal calculi. Materials and Methods: 36 male Wistar rats were randomly divided into 6 equal groups. Group I animals served as vehicle control and received distilled water for 28 days. Group II to VI animals received 1% v/v EG in distilled water for 28 days. Group II served as EG control. Group III and IV (preventive groups) received cow urine ark orally for 28 days in doses of 1 mL/kg and 2 mL/kg, respectively. Group V and VI (treatment groups) received 1 mL/kg and 2 mL/kg cow urine ark orally, respectively from 15th to 28th days. 24-hour urine samples were collected on day 0 and 28. Urine volume and oxalate levels were measured. On day 28, blood was collected for biochemical parameters. Animals were sacrificed and kidneys were harvested, weighed and histopathologically evaluated for calcium oxalate (CaOx) crystals. To calculate the percentage of inhibition of mineralization, simultaneous flow static in-vitro model was used. Results: EG significantly increased urine oxalate, serum creatinine, blood urea level; kidney weight and CaOx deposits. Provision of cow urine ark resulted in significantly lower levels of urine oxalate, serum creatinine, blood urea and CaOx depositions as compared to Group II. (p value < 0.05) It also significantly restored kidney weight. (p value < 0.05) Cow urine ark inhibited 40% and 35% crystallization of CaOx and calcium phosphate, respectively. Conclusion: Cow urine ark is effective in prevention and treatment of EG induced urolithiasis in Wistar rats.

Shukla AB; Mandavia DR; Barvaliya MJ; Baxi SN; Tripathi CB

2013-07-01

292

Anti-Urolithiatic Effect of Cow Urine Ark on Ethylene Glycol-Induced Renal Calculi  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Purpose To investigate the anti-urolithiatic effect of cow urine ark (medicinal distilled cow urine) on ethylene glycol (EG) induced renal calculi. Materials and Methods 36 male Wistar rats were randomly divided into 6 equal groups. Group I animals served as vehicle control and received distilled water for 28 days. Group II to VI animals received 1% v/v EG in distilled water for 28 days. Group II served as EG control. Group III and IV (preventive groups) received cow u (more) rine ark orally for 28 days in doses of 1 mL/kg and 2 mL/kg, respectively. Group V and VI (treatment groups) received 1 mL/kg and 2 mL/kg cow urine ark orally, respectively from 15th to 28th days. 24-hour urine samples were collected on day 0 and 28. Urine volume and oxalate levels were measured. On day 28, blood was collected for biochemical parameters. Animals were sacrificed and kidneys were harvested, weighed and histopathologically evaluated for calcium oxalate (CaOx) crystals. To calculate the percentage of inhibition of mineralization, simultaneous flow static in-vitro model was used. Results EG significantly increased urine oxalate, serum creatinine, blood urea level; kidney weight and CaOx deposits. Provision of cow urine ark resulted in significantly lower levels of urine oxalate, serum creatinine, blood urea and CaOx depositions as compared to Group II. (p value < 0.05) It also significantly restored kidney weight. (p value < 0.05) Cow urine ark inhibited 40% and 35% crystallization of CaOx and calcium phosphate, respectively. Conclusion Cow urine ark is effective in prevention and treatment of EG induced urolithiasis in Wistar rats.

Shukla, A.B; Mandavia, D.R; Barvaliya, M.J; Baxi, S.N; Tripathi, C.B

2013-07-01

293

Focused ultrasound to expel calculi from the kidney: safety and efficacy of a clinical prototype device.  

UK PubMed Central (United Kingdom)

PURPOSE: Focused ultrasound has the potential to expel small stones or residual stone fragments from the kidney, or move obstructing stones to a nonobstructing location. We evaluated the efficacy and safety of ultrasonic propulsion in a live porcine model. MATERIALS AND METHODS: Calcium oxalate monohydrate kidney stones and laboratory model stones (2 to 8 mm) were ureteroscopically implanted in the renal pelvicalyceal system of 12 kidneys in a total of 8 domestic swine. Transcutaneous ultrasonic propulsion was performed using an HDI C5-2 imaging transducer (ATL/Philips, Bothell, Washington) and the Verasonics® diagnostic ultrasound platform. Successful stone relocation was defined as stone movement from the calyx to the renal pelvis, ureteropelvic junction or proximal ureter. Efficacy and procedure time was determined. Three blinded experts evaluated histological injury to the kidney in the control, sham treatment and treatment arms. RESULTS: All 26 stones were observed to move during treatment and 17 (65%) were relocated successfully to the renal pelvis (3), ureteropelvic junction (2) or ureter (12). Average ± SD successful procedure time was 14 ± 8 minutes and a mean of 23 ± 16 ultrasound bursts, each about 1 second in duration, were required. There was no evidence of gross or histological injury to the renal parenchyma in kidneys exposed to 20 bursts (1 second in duration at 33-second intervals) at the same output (2,400 W/cm(2)) used to push stones. CONCLUSIONS: Noninvasive transcutaneous ultrasonic propulsion is a safe, effective and time efficient means to relocate calyceal stones to the renal pelvis, ureteropelvic junction or ureter. This technology holds promise as a useful adjunct to surgical management for renal calculi.

Harper JD; Sorensen MD; Cunitz BW; Wang YN; Simon JC; Starr F; Paun M; Dunmire B; Liggitt HD; Evan AP; McAteer JA; Hsi RS; Bailey MR

2013-09-01

294

[Value of posterior vertical lombotomy in the surgical treatment of calculi of the lumbar ureter. Apropos of 42 cases  

UK PubMed Central (United Kingdom)

Whereas surgery is no longer used for treatment of pyelocaliceal and lower ureter lithiasis, it remains a valid method in lithiasis of lumbar ureter poorly accessible to endoscopy. A direct approach to lumbar (or pelvic) ureter by posterior vertical lombotomy considerably reduces operation time, pain and duration of hospital stay and disability. Results in a series of 42 cases indicate that surgery remains an excellent and perhaps most effective therapy for lumbar ureter calculi, with the condition that the conventional posterolateral lombotomy be abandoned.

Aubert J; Sillard P; Dore B; Grange P; Orget J

1987-03-01

295

Urolitíase no alotransplante renal Urinary lithiasis in renal allografts  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: A litíase urinária é uma complicação incomum no alotransplante renal, a incidência varia de 0,02 a 3,4%. A maioria dos cálculos forma-se após o transplante, porém alguns podem ser transferidos junto com o enxerto para o hospedeiro. O tratamento desta complicação está baseado em alguns casos descritos na literatura. O objetivo deste trabalho é o de relatar a incidência da litíase renal no paciente com transplante renal, assim como a conduta adotada no HCFMRPUSP. MÉTODOS: Foram analisados 953 pacientes submetidos a transplante renal no HCFMRPUSP, de fevereiro 1968 a maio de 2003. A idade média foi de 47,2 anos (35 a 63 anos). Em 09 pacientes, o rim foi proveniente de doador cadáver e apenas 01 doador vivo. RESULTADOS:Foram diagnosticados 10 casos de litíase (1,05%). Em 02 pacientes (20%) o cálculo foi diagnosticado no intraoperatório, em 01 (10%) no peri-operatório (5º. dia), os 07 restantes (70%) no pós-operatório tardio. Em 04 pacientes (57%) não havia sintomatologia específica, 02 (29%) apresentaram ITU, em 03 (43%) ocorreu elevação da creatinina sérica. De 8 pacientes com litíase no pós-operatorio, em 06 os cálculos estavam localizados no rim e 02 no ureter. Dos pacientes com cálculos renais, 02 foram observados, 02 submetidos a LECO, 01 a nefrolitripsia percutânea, 01 à pielolitotomia. Em 01 paciente com cálculo ureteral foi realizada pielovesicostomia (cálculo + estenose), no outro paciente foi feita a ureterorrenoscopia retrógrada. CONCLUSÃO: A urolitíase é complicação rara no transplante renal, a conduta terapêutica no pós-operatório tardio é semelhante à da população geral.Purpose: Urinary lithiasis is an uncommon complication in recipient of kidney allografts. The prevalence varies from 0.02 to 3.4%. The majority of calculi arises de novo in the recipient, however some of them are transferred with the transplanted kidney. The treatment relies on few reports published previously. The aim of the study is to determine the prevalence of lithiasis as well as the treatment in an university hospital. METHODS: We analyzed 953 recipients of renal transplant undertaken in Hospital das Clínicas - FMRP-USP, from February of 1968 to May of 2003. The mean age of patients bearing lithiasis was 47.2 years (range 35 to 63 years). RESULTS: The prevalence of lithiasis was 10/953 (1.0%). Nine patients received kidneys from cadaver donor and 1 from living donor. The diagnosis occurred during the surgery in 2 (20%), within few days after transplantation in 1 (10%) and in the late postoperative period in 7 (70%). Seven patients had no complains, 2 had associated urinary tract infection and 1 a rise in serum creatinine. Of 8 cases with lithiasis in the postoperative period, the stones were localized in the kidney in 6 and in the ureter in 2. Renal calculi were managed as follows: watchful-waiting - 2, extracorporeal lithotrypsy - 2, percutaneous nepholithotrypsy - 1 and open pyelolithomy - 1. One patient with ureteric lithiasis associated ureteral stenosis underwent a pyelo-vesicostomy. The other patient with ureteric lithiasis was treated by retrograde endoscopic ureterolithothrypsy. CONCLUSION: Urinary lithiasis is rare in transplanted kidneys and can be managed as to the general population.

Adauto José Cologna; Antonio Carlos Pereira Martins; Haylton Jorge Suaid; Silvio Tucci Júnior; Rodolfo Borges dos Reis; Ricardo Mesquita Paschoal; André Luis Alonso Domingos; Lucy Vieira da Silva-Lima

2003-01-01

296

GENITO-URINARY FISTULA  

Directory of Open Access Journals (Sweden)

Full Text Available Genito Urinary Fistula is an abnormal communication between the urinary and genital tract.Vesico vaginal Fistula (VVF) is the commonest type. Setting: Department of Obstetrics & Gynaecology, LadyWillingdon Hospital, Lahore Period: From Jan 2000 to Dec 2003. Patients & Methods: Forty seven (47)patients admitted with genitourinary Fistula (GUF). Twenty-five out of 47 cases were in third decade of theirlife and 19 women were Para 5 or more. Majority of the patients (37 out of 47) had fistula due to obstetricaltrauma. Results: Among the 43 cases repaired, 95% were done through the vaginal route. Overall success ratewas 88.5%. Discussion & Conclusions: Prevention of obstetric fistula poses a great challenge for obstetriciansin developing countries. It should be the highest priority of reproductive health care. Efforts should be directedtowards creating awareness, better education and provision of emergency obstetric care at the grass root level.Physicians, philanthropists and public should also take initiative in this regard.

AMTULLAH ZARREEN

2004-01-01

297

Urinary steroid profiling.  

UK PubMed Central (United Kingdom)

Urinary steroid profiling is a long-established technique which has wide application in the study of disorders of human steroid biosynthesis and catabolism. The method divides into extraction of free and conjugated steroids, steroid conjugate hydrolysis, free steroid re-extraction, derivatization and analysis by GC or GC-MS. Several developments have led to better understanding of these processes and of ways to simplify and speed them up. The core method is described, together with some alternative options.

Taylor NF

2013-01-01

298

Recurrent urinary tract infection.  

UK PubMed Central (United Kingdom)

OBJECTIVE: to provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. OPTIONS: continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. EVIDENCE: a search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions. VALUES: this update is the consensus of the Sub-Committee on Urogynaecology of the Society of Obstetricians and Gynaecologists of Canada. Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). OPTIONS: recurrent urinary tract infections need careful investigation and can be efficiently treated and prevented. Different prophylaxis options can be selected according to each patient's characteristics.

Epp A; Larochelle A; Lovatsis D; Walter JE; Easton W; Farrell SA; Girouard L; Gupta C; Harvey MA; Robert M; Ross S; Schachter J; Schulz JA; Wilkie D; Ehman W; Domb S; Gagnon A; Hughes O; Konkin J; Lynch J; Marshall C; Society of Obstetricians and Gynaecologists of Canada

2010-11-01

299

Diagnosis of urinary incontinence.  

UK PubMed Central (United Kingdom)

Urinary incontinence is common, increases in prevalence with age, and affects quality of life for men and women. The initial evaluation occurs in the family physician's office and generally does not require urologic or gynecologic evaluation. The basic workup is aimed at identifying possible reversible causes. If no reversible cause is identified, then the incontinence is considered chronic. The next step is to determine the type of incontinence (urge, stress, overflow, mixed, or functional) and the urgency with which it should be treated. These determinations are made using a patient questionnaire, such as the 3 Incontinence Questions, an assessment of other medical problems that may contribute to incontinence, a discussion of the effect of symptoms on the patient's quality of life, a review of the patient's completed voiding diary, a physical examination, and, if stress incontinence is suspected, a cough stress test. Other components of the evaluation include laboratory tests and measurement of postvoid residual urine volume. If the type of urinary incontinence is still not clear, or if red flags such as hematuria, obstructive symptoms, or recurrent urinary tract infections are present, referral to a urologist or urogynecologist should be considered.

Khandelwal C; Kistler C

2013-04-01

300

[The role of environmental factors in the formation of kidney calculi].  

Science.gov (United States)

Various endo- and exogenous factors play a role in the urinary stones formation tract. The aim of the study was to define the type and frequency of hyperexcretion of lithogenic substances in school children population and to determine an influence of risk factors on hyperexcretion of crystallizing substances. The study included 220 school children. Preurolithiasis state (PS) was found in 30% children. The most frequently hyperoxaluria, hyperuricosuria and hypercalciuria were diagnosed and it may be connected with abnormal nutritional habits, excessive application of multivitamins, vitamin D and calcium, disturbances in drinking water chemical composition (higher amount of calcium, smaller amount of magnesium, abnormal pH). Urinary tract infections, particularly in children with obstructive uropathy are an important risk factor in the examined population. Positive familial history of urolithiasis in 43.3% children may indicate for the important role of the genetic factor in the pathogenesis of the disease. PMID:10897597

Jung, A; Kami?ska, A; Samol, B; Zuber, J

2000-04-01

 
 
 
 
301

Stress urinary incontinence as a rare presentation of large prostatic stones in neurogenic bladder: implications and management.  

UK PubMed Central (United Kingdom)

We report a case of a 38-year-old man with a background of a neglected neurogenic bladder, who presented with a recent onset history of stress urinary incontinence. He was diagnosed as having large prostatic stones along with a low-compliance, small capacity bladder and bilateral hydronephrosis with deranged renal functions. As self-catheterisation was not possible due to obstructing prostatic stones, holmium-YAG laser lithotripsy of prostatic stones was performed as initial procedure that resulted in complete resolution of stress incontinence as well. Successful gastrocystoplasty was performed as a second step to deal with the underlying condition of neurogenic poorly compliant bladder. The present case describes the successful endoscopic management of prostatic calculi using holmium-laser lithotripsy and draws attention to other important issues that need to be addressed in certain special situations like neurogenic bladder.

Goyal NK; Goel A; Sankhwar S

2013-01-01

302

Stress urinary incontinence as a rare presentation of large prostatic stones in neurogenic bladder: implications and management.  

Science.gov (United States)

We report a case of a 38-year-old man with a background of a neglected neurogenic bladder, who presented with a recent onset history of stress urinary incontinence. He was diagnosed as having large prostatic stones along with a low-compliance, small capacity bladder and bilateral hydronephrosis with deranged renal functions. As self-catheterisation was not possible due to obstructing prostatic stones, holmium-YAG laser lithotripsy of prostatic stones was performed as initial procedure that resulted in complete resolution of stress incontinence as well. Successful gastrocystoplasty was performed as a second step to deal with the underlying condition of neurogenic poorly compliant bladder. The present case describes the successful endoscopic management of prostatic calculi using holmium-laser lithotripsy and draws attention to other important issues that need to be addressed in certain special situations like neurogenic bladder. PMID:23749833

Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan

2013-06-06

303

Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCTION: Our aim was compare of two types of lithotripter include holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for the management of ureteral calculi ?1 cm.METHODS: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images.RESULTS: Success rate was 85.7% in pneumatic group and 100% in holmium: YAG laser group (p =0.003). Stone migration up in the pelvicalyceal system was observed only in 8 cases of pneumatic group. No statically differences were observed in terms of patient’s age, hospital stay, and complications between two groups.CONCLUSION: According to our experience, for ureteral stone larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication.

Mohammad Reza Razzaghi; Abdollah Razi; Mohammad Mohsen Mazloomfard; Hooman Mokhtarpour; Babak Javanmard; Reza Mohammadi

2011-01-01

304

[Cerebellum and lower urinary tract].  

UK PubMed Central (United Kingdom)

OBJECTIVES: To review the role of cerebellum on the lower urinary tract dynamics. METHODS: Anatomic-functional methodology including structural, functional and neurotransmitters study. RESULTS: We describe the complex connections of the cerebellum and its influence on the lower urinary tract function. CONCLUSIONS: It is surprising the functional relationship between cerebellum and lower urinary tract, playing a inhibitory modulating role during the filling phase and facilitating the voiding phase.

Díez Rodríguez JM; Salinas Casado J; Mañas Pelillo A; Mora Durbán M; Navarro Sebastián J; Arrizabalaga Moreno M

2005-06-01

305

[Urinary ascites following open myomectomy].  

UK PubMed Central (United Kingdom)

OBJECTIVE: A case of urinary ascites following a bladder injury during laparoscopic myomectomy, and its resolution. CLINICAL CASE: 42-year-old woman referred for urologic consultation for acute urinary retention 11 days after myomectomy. RESULTS: Ultrasound showed abdominal ascites. Cystoscopy gave evidence of one-centimeter bladder dome injury. During retrograde cystography contrast material leaked out through the bladder. CONCLUSION: Early treatment with drainage of urinary ascites and bladder injury surgical repair had excellent results.

Nuevo Adalla OO; Olguín Ortega AA; Ramírez Isarraraz C; Escobar del Barco LG; Rodríguez Colorado ES

2012-08-01

306

Diagnosis of urinary tract diseases  

International Nuclear Information System (INIS)

Radiological exploration of the urinary tract has become highly sophisticated. The information provided by the new imaging techniques is extremely accurate and useful in the diagnosis and pretherapeutic assessment of most urinary tract diseases. Interventional radiology has given radiologists an important role in the treatment of some types of pathology. The authors describe the value of modern imaging and its different aspects in each of the principal branches of urinary tract pathology. viz.: tumours, obstructions, infections, vascular and prostatic diseases.

1989-01-01

307

In vitro crystallization, characterization and growth-inhibition study of urinary type struvite crystals  

Science.gov (United States)

The formation of urinary stones, known as nephrolithiasis or urolithiasis, is a serious, debilitating problem throughout the world. Struvite—NH4MgPO4·6H2O, ammonium magnesium phosphate hexahydrate, is one of the components of urinary stones (calculi). Struvite crystals with different morphologies were grown by in vitro single diffusion gel growth technique with different growth parameters. The crystals were characterized by powder XRD, FT-IR, thermal analysis and dielectric study. The powder XRD results of struvite confirmed the orthorhombic crystal structure. The FT-IR spectrum proved the presence of water of hydration, metal-oxygen bond, N-H bond and P-O bond. For thermal analysis TGA, DTA and DSC were carried out simultaneously. The kinetic and thermodynamic parameters of dehydration/decomposition process were calculated. Vickers micro-hardness and related mechanical parameters were also calculated. The in vitro growth inhibition studies of struvite by the juice of Citrus medica Linn as well as the herbal extracts of Commiphora wightii, Boerhaavia diffusa Linn and Rotula aquatica Lour were carried out and found potent inhibitors of struvite.

Chauhan, Chetan K.; Joshi, Mihir J.

2013-01-01

308

Extracorporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi.  

UK PubMed Central (United Kingdom)

BACKGROUND: Ureteral stones frequently cause renal colic, and if left untreated, can lead to obstructive uropathy. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy, with or without intracorporeal lithotripsy, are the most common interventions used to treat ureteral stones. ESWL treatment is less invasive than ureteroscopy, but has some limitations such as a high retreatment rate, and is not available in all centres. Recent advances in ureteroscopy have increased success rates and reduced complication rates. OBJECTIVES: To examine evidence from randomised controlled trials (RCTs) on the outcomes of ESWL or ureteroscopy in the treatment of ureteric calculi. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library Issue 2, 2011), MEDLINE (1966 to March 2011), EMBASE (1980 to March 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles and abstracts from conference proceedings, all without language restriction. SELECTION CRITERIA: RCTs that compared ESWL with ureteroscopic retrieval of ureteric stones were included in this review. Study participants were adults with ureteric stones requiring intervention. Published and unpublished sources were considered for inclusion. DATA COLLECTION AND ANALYSIS: Three authors independently assessed study quality, risk of bias, and extracted data. Statistical analyses were performed using the random-effects model. Results were expressed as risk ratios (RR) for dichotomous outcomes or mean differences (MD) for continuous data, both with 95% confidence intervals (CI). MAIN RESULTS: Seven RCTs (1205 patients) were included in the review. Stone-free rates were lower in patients who underwent ESWL (7 studies, 1205 participants: RR 0.84, 95% CI 0.73 to 0.96) but re-treatment rates were lower in ureteroscopy patients (6 studies, 1049 participants: RR 6.18, 95% CI 3.68 to 10.38. ESWL-treated patients had less need for auxiliary treatment (5 studies, 751 participants: RR 0.43, 95% CI 0.25 to 0.74; fewer complications (7 studies, 1205 participants: RR 0.54, 95% CI 0.33 to 0.88); and shorter length of hospital stay (2 studies, 198 participants: MD -2.55 days, 95% CI -3.24 to -1.86).Three studies adequately described the randomisation sequence, three studies were unclear on how they randomised, while one study had a high risk of selection bias. All the studies had an unclear risk of performance bias and detection bias, while all had a low risk of attrition bias, reporting bias, or other sources of bias identified. AUTHORS' CONCLUSIONS: Compared with ESWL, ureteroscopic removal of ureteral stones achieves a greater stone-free state, but with a higher complication rate and longer hospital stay.

Aboumarzouk OM; Kata SG; Keeley FX; McClinton S; Nabi G

2012-01-01

309

Tamsulosin to treat uncomplicated distal ureteral calculi: a double blind randomized placebo-controlled trial.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate efficacy and outcome of tamsulosin therapy for 4 mm-10 mm uncomplicated distal ureteral stones. MATERIALS AND METHODS: A total of 150 patients (adults with newly diagnosed single unilateral distal ureteral 4 mm-10 mm stones) were double blindly randomized into GA or GB. All patients received traditional treatment of hydration and analgesia as needed. Additionally, patients received either placebo (GA) or 0.4 mg tamsulosin (GB) oral tablets once daily. Treatment and follow up were continued for up to 4 weeks. Endpoints were spontaneous stone passage rates (SPR) and passage time for different stone sizes within 4 weeks study period. RESULTS: Analysis included 75 patients, in each group, with comparable characteristics. Overall SPR was 56% in GA and 81.3% in GB; achieving significant absolute risk reduction (ARR = 25.3%; p < 0.01) and number needed to treat (NNT) of 3.95. SPR for stones calculi augments SPR, shortens passage time and decrease need for analgesia. Particularly, tamsulosin shortens the passage time for smaller stones, and augments the passage rate for larger stones.

Abdel-Meguid TA; Tayib A; Al-Sayyad A

2010-06-01

310

Male sling procedures for stress urinary incontinence.  

UK PubMed Central (United Kingdom)

Radical prostatectomy is the most common cause of urinary incontinence in males. Urinary slings are a relatively new treatment option for men. This article describes two urinary sling procedures as possible surgical approaches for incontinence in men.

Chau VR; Maxson PM; Joswiak ME; Elliott DS

2013-01-01

311

Major Odorants Released as Urinary Volatiles by Urinary Incontinent Patients  

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In this study, volatile urinary components were collected using three different types of samples from patients suffering from urinary incontinence (UI): (1) urine (A); (2) urine + non-used pad (B); and (3) urine + used pad (C). In addition, urine + non-used pad (D) samples from non-patients were als...

Sudhir Kumar Pandey; Ki-Hyun Kim; Si On Choi; In Young Sa; Soo Yeon Oh

312

Rapid urinary iodide test.  

Science.gov (United States)

Assessment of iodine deficiency and monitoring of iodine supplementation programs demand rapid, simple, and cost-effective methods for the determination of urinary iodide concentrations. We propose a semiquantitative rapid test, based on the iodide-catalyzed oxidation of 3,3',5,5'-tetramethylbenzidine by peracetic acid/H2O2, to yield colored products. The color of the chemical reaction is compared with color categories of a pictogram corresponding to three ranges: 300 microg/L (2.36 micromol/L) of iodide concentrations. The test is very easy to perform and does not require any instrumentation or apparatus. Sample preparation is simple and consists of the removal of interfering substances by disposable columns, 65 x 10.5 mm, packed with purified activated charcoal. For comparison with a reference method for measuring urinary iodide, by high-performance liquid chromatography, we determined the iodide concentrations of 370 random (untimed) urine samples from consecutive patients by both high-performance liquid chromatography and the rapid test. The results obtained by both methods are in close agreement, with respect to classification of the samples according to the above three ranges, with a maximum difference of less than 5% for each range. Median (y) values of a given distribution of urinary iodide concentrations can be calculated from the percent (x) of samples below 100 microg/L (0.79 micromol/L) using the regression equation: y = 179.78 - 1.60x. This rapid test, therefore, is suited to epidemiological surveys of iodine deficiency, especially in developing countries. PMID:9506764

Rendl, J; Bier, D; Groh, T; Reiners, C

1998-03-01

313

Rapid urinary iodide test.  

UK PubMed Central (United Kingdom)

Assessment of iodine deficiency and monitoring of iodine supplementation programs demand rapid, simple, and cost-effective methods for the determination of urinary iodide concentrations. We propose a semiquantitative rapid test, based on the iodide-catalyzed oxidation of 3,3',5,5'-tetramethylbenzidine by peracetic acid/H2O2, to yield colored products. The color of the chemical reaction is compared with color categories of a pictogram corresponding to three ranges: <100, 100-300, and >300 microg/L (<0.79, 0.79-2.36, and >2.36 micromol/L) of iodide concentrations. The test is very easy to perform and does not require any instrumentation or apparatus. Sample preparation is simple and consists of the removal of interfering substances by disposable columns, 65 x 10.5 mm, packed with purified activated charcoal. For comparison with a reference method for measuring urinary iodide, by high-performance liquid chromatography, we determined the iodide concentrations of 370 random (untimed) urine samples from consecutive patients by both high-performance liquid chromatography and the rapid test. The results obtained by both methods are in close agreement, with respect to classification of the samples according to the above three ranges, with a maximum difference of less than 5% for each range. Median (y) values of a given distribution of urinary iodide concentrations can be calculated from the percent (x) of samples below 100 microg/L (0.79 micromol/L) using the regression equation: y = 179.78 - 1.60x. This rapid test, therefore, is suited to epidemiological surveys of iodine deficiency, especially in developing countries.

Rendl J; Bier D; Groh T; Reiners C

1998-03-01

314

UPPER URINARY TRACT STONES  

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Full Text Available This study was conducted in the Department of Pathology, Bolan Medical College, Quetta fromJanuary 1991 to December 1991. Thirty adult patients, both males and females of upper urinarytract stones (Group-1) compared with those of 17 age matched controls (Group-2) from Quetta citywere included in this study. Mean age of Group-1 was 30.63 ± SD 3.58yrs and of Group-2 was28.62 ± SD 2.60yrs. Mean serum calcium level of Group-1 was 9.56 mg/100 ml ± SD 0.7 and of Group-2was 8.8 mg/100 ml ± SD 1.30, which was significant (p<0.05). Mean 24 hours urinary excretion of calciumin Group-1 was 287.79mg (± SD 181.29) and in Group-2 was 187 mg (± SD 88.91), which is significant.Mean serum uric acid was 5.37 mg/dl (± SD 1.66) in Group-1 and 5.40 mg/dl (± SD 1.52) in Group-2 whichis non significant. Mean 24 hour urinary excretion of uric acid in stone patients was 424.31 mg ± SD 142.16and in normal subjects was 314.29 mg ± SD 173.49 (significant at p<0.05). Stone formers had a mean 24-hour urinary out put of 1336.7 ml ± SD 773.83, while non-stone formers had a mean out put of 1129.41 ml± SD 512.36, which is not significant. Mean pH of freshly voided urine of Group-1 had 6.24 ± SD 0.78,while in Group-11 had 6.12 ± SD 0.38 and was not significant. Economic status and family history of bothgroups were also analysed.

Arif Parvez

2001-01-01

315

Urinary tract infections.  

UK PubMed Central (United Kingdom)

Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A complicated UTI is associated with an underlying condition that increases the risk of failing therapy. Primary laboratory tests for UTIs consist of urinalysis and urine culture. The most common pathogen for uncomplicated cystitis and pyelonephritis is Escherichia coli. Nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole are first-line therapies for acute uncomplicated cystitis. Decisions regarding antibiotic agents should be individualized based on patients' allergies, tolerability, community resistance rates, cost, and availability.

Wang A; Nizran P; Malone MA; Riley T

2013-09-01

316

Urinary tract infections.  

Science.gov (United States)

Clinical presentation helps differentiate between upper and lower urinary tract infections (UTIs). UTIs are classified as either complicated or uncomplicated. A complicated UTI is associated with an underlying condition that increases the risk of failing therapy. Primary laboratory tests for UTIs consist of urinalysis and urine culture. The most common pathogen for uncomplicated cystitis and pyelonephritis is Escherichia coli. Nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole are first-line therapies for acute uncomplicated cystitis. Decisions regarding antibiotic agents should be individualized based on patients' allergies, tolerability, community resistance rates, cost, and availability. PMID:23958364

Wang, Alina; Nizran, Parminder; Malone, Michael A; Riley, Timothy

2013-07-12

317

Urinary incontinence products - self-care  

Science.gov (United States)

Adult diapers; Disposable urinary collection devices ... If you have problems with urinary incontinence (leakage), wearing special products will keep you dry and help you avoid embarrassing situations.

318

Urinary tract infection in childhood.  

UK PubMed Central (United Kingdom)

The importance of establishing significant bacteriuria in the diagnosis of urinary tract infection and the need for a keen awareness of its presence, particularly in young children, is stressed. The approach to the diagnosis, investigation, management and follow-up of children with urinary tract infection is described.

Ransome OJ; Thomson PD

1986-09-01

319

Urinary tract infection in childhood.  

Science.gov (United States)

The importance of establishing significant bacteriuria in the diagnosis of urinary tract infection and the need for a keen awareness of its presence, particularly in young children, is stressed. The approach to the diagnosis, investigation, management and follow-up of children with urinary tract infection is described. PMID:3532367

Ransome, O J; Thomson, P D

1986-09-27

320

Rapid urinary iodide test.  

UK PubMed Central (United Kingdom)

Assessment of iodine deficiency and monitoring of iodine supplementation programs demands rapid, simple and cost-effective methods for the determination of urinary iodide concentrations. We propose a rapid test based on the iodide-catalyzed oxidation of 3,3',5,5'-tetramethylbenzidine by peracetic acid/H2O2 to yield colored products. The color of the chemical reaction is compared with color categories of a pictogram corresponding to three ranges (<10, 10-30, and >>30 microg/100 mL) of iodide concentrations. The test is very easy to perform and does not require any instrumentation or apparatus. Sample preparation is simple and consists in the removal of interfering substances by disposable columns, 65 x 10.5 mm, packed with specifically prepared activated charcoal. For comparison with a reference method for measuring urinary iodide (HPLC), we determined the iodide concentrations of 370 random (untimed) urine samples from consecutive patients by both HPLC and the rapid test. The results obtained by both methods are in close agreement with respect to classification of the samples according to the above three ranges, with a maximum difference of <5% for each range. This rapid test is therefore very well suited to epidemiological surveys of iodine deficiency especially in developing countries.

Rendl J; Bier D; Groh T; Reiners C

1998-01-01

 
 
 
 
321

URINARY TRACT BACTERIAL PATHOGENS  

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Full Text Available From November 1993 to March 1996, a total of 1154 urine specimens of patients from in-patient and outpatientdepartments of Bahawal Victoria Hospital, Bahawalpur were cultured on McConkey and blood agarplates to determine the incidence of urinary tract infection, the prevalent aetiological microorganisms andtheir antimicrobial susceptibility. Among these 470 specimens (40.7%) showed significant bacteriuria (105or more cfu/ml). Out of 804 male patients 340 (42.2%) and out of 350 female patients 130 (37.2%) hadsignificant bacteriuria. The commonest organism isolated was Escherichia coli (5 8.9%), followed byPseudomonas aeruginosa (17.5 %), Klebsiella pneumoniae (12.4%), Staphylococcus aureus (5.7%), Proteussp. (5.1) and Citrobacter sp. (0.4%). The predominant organisms in males were Pseudomonas aeruginosaand Proteus sp., while in females Escherichia coli and Staphylococcus aureus were predominant. Thebacterial isolate showed greater resistance to ampicillin, sulphamethoxazole-trimethoprim and doxycycline.However, the organisms showed good sensitivity (62.4-81.3%) to gentamicin, tobramicin, pipemidic acid,norfloxacin. ciprofloxacin and enoxacin. The organisms were relatively less sensitive to cefoperzone,ceftazidime and ceftizoxime. Peudomonas aeruginosa showed good sensitivity to quinolones andaminoglycosides and decreased sensitivity to third generation cephalosporin. Amoxycillin-clavulanic acidand sulbactam-ampicillin had good activity against Staphylococcus aureus. Keeping in view theantimicrobial susceptibility patterns of the bacterial isolates, amoxycillin-clavulanic acid or pipemidic acidare suggested for empirical therapy for urinary tract infections before the bacterial culture and antibioticsensitivity result is received.

Naeem Akhtar

2000-01-01

322

Urinary Tract Infections in Children  

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Full Text Available Urinary tract infections (UTI) are frequent conditions in children. Untreated urinary tract infections can lead to serious kidney problems that could threaten the life of the child. Therefore, early detection and treatment of urinary tract infection is important. In older children, urinary tract infections may cause obvious symptoms such as stomach ache and disuria. In infants and young children, UTIs may be harder to detect because of less specific symptoms. Recurrences are common in children with urinary abnormalities such as neurogenic bladder, vesicourethral reflux or those with very poor toilet and hygiene habits. This article reviews the diagnostic approach and presents the current data related to the roles of radiologic imaging, surgical correction and antibiotic prophylaxis of UTIs in children. [Archives Medical Review Journal 2009; 18(2.000): 57-69

Mustafa Taskesen; Aysun Karabay Bayazit

2009-01-01

323

Acute Urinary Retention in Children  

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Full Text Available Purpose: Acute urinary retention in children is a relatively rare entity. There are a variety of causes that are poorly defined in the literature. We review our cases of acute urinary retention in children at three major pediatrics centers in Iran. Materials and Methods: Between 1996 and 2003, children (up to 14 years old) who had been referred due to acute urinary retention were examined. Urinary retention was defined as inability to empty the bladder volitionally for more than 12 hours with a urine volume greater than expected for age or a palpably distended bladder. All data from the patients’ past medical history, physical examination, and laboratory and radiographic assessments were collected. Also, cystourethroscopy and urodynamic procedures had been carried out according to patient’s conditions. Patients with secondary urinary retention, including those with surgical history, immobility or chronic neurological disorders, mental retardation, and drugs or narcotics consumption were excluded from study. Results: There were 86 patients meeting the inclusion criteria, consisting of 58 males with a median age of 4 years (range 1 month to 14 years) and 58 females with a median age of 4 years (range 4 month to 14 years). Etiologies were lower urinary tract stone in 27.9%, neurological disorders in 10.4%, trauma in 10.4%, local inflammatory causes in 9.1%, urinary tract infection in 7.4%, ureterocele in 7.4%, benign obstructing lesions in 5.8%, iatrogenic in 5.8%, constipation in 4.6%, imperforated hymen in 3.5%, and large prostate utricle, urethral foreign body, and rhabdomyosarcoma each in 1 case (1.1%). Conclusion: The most common cause of acute urinary retention was lower urinary tract stone in our pediatric cases. Ureterocele and stone were the main findings in girls and boys, respectively, and urinary retention in boys was twice as prevalent as that in girls.

Seyyed Alaeddin Asgari; Mandana Mansour Ghanaie; Nasser Simforoosh; Abdolmajid Kajbafzadeh; Alireza Zare

2005-01-01

324

Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare micropercutaneous nephrolithotomy (microperc) and retrograde intrarenal surgery (RIRS) for the management of renal calculi <1.5?cm with regard to stone clearance rates and surgical characteristics, complications and postoperative recovery. PATIENTS AND METHODS: Seventy patients presenting with renal calculi <1.5?cm were equally randomized to a microperc or a RIRS group between February 2011 and August 2012 in this randomized controlled trial. Randomization was based on centralized computer-generated numbers. Patients and authors assessing the outcomes were not blinded to the procedure. Microperc was performed using a 4.85-F (16-gauge) needle with a 272-?m laser fibre. RIRS was performed using a uretero-renoscope. Variables studied were stone clearance rates, operating time, need for JJ stenting, intra-operative and postoperative complications (according to the Clavien-Dindo classification system), surgeon discomfort score, postoperative pain score, analgesic requirement and hospital stay. Stone clearance was assessed using ultrasonography and X-ray plain abdominal film of kidney, ureter and bladder at 3 months. RESULTS: There were 35 patients in each group. All the patients were included in the final analysis. The stone clearance rates in the microperc and RIRS groups were similar (97.1 vs 94.1%, P = 1.0). The mean [sd] operating time was similar between the groups (51.6 [18.5] vs 47.1 [17.5], P = 0.295). JJ stenting was required in a lower proportion of patients in the microperc group (20 vs 62.8%, P < 0.001). Intra-operative complications were a minor pelvic perforation in one patient and transient haematuria in two patients, all in the microperc group. One patient in each group required conversion to miniperc. One patient in the microperc group needed RIRS for small residual calculi 1 day after surgery. The decrease in haemoglobin was greater in the microperc group (0.96 vs 0.56?g/dL, P < 0.001). The incidence of postoperative fever (Clavien I) was similar in the two groups (8.6 vs 11.4%, P = 1.0). None of the patients in the study required blood transfusion. The mean [sd] postoperative pain score at 24?h was slightly higher in the microperc group (1.9 [1.2] vs 1.6 [0.8], P = 0.045). The mean [sd] analgesic requirement was higher in the microperc group (90 [72] vs 40 [41] mg tramadol, P < 0.001). The mean [sd] hospital stay was similar in the two groups (57 [22] vs 48 [18] h, P = 0.08). CONCLUSIONS: Microperc is a safe and effective alternative to RIRS for the management of small renal calculi and has similar stone clearance and complication rates when compared to RIRS. Microperc is associated with higher haemoglobin loss, increased pain and higher analgesic requirements, while RIRS is associated with a higher requirement for JJ stenting.

Sabnis RB; Ganesamoni R; Doshi A; Ganpule AP; Jagtap J; Desai MR

2013-08-01

325

Strategic lithotripsy using the Doli S EMSE 220 F-XP for the management of staghorn renal calculi.  

UK PubMed Central (United Kingdom)

AIM: The presentation of our results using the Dornier lithotripter (Doli) S electromagnetic shockwave emitter (EMSE) 220 F-XP for the strategic management of staghorn renal calculi. METHODS: Sixteen patients with renal staghorn stones of more than 35 mm in maximum length on plain X-rays were treated by shock wave lithotripsy (SWL) monotherapy with the Doli S EMSE 220 F-XP. Double-J ureteral stent was inserted to all prior to the first SWL treatment. Shock wave counts varied from 2,500 to 3,600 with a shock release frequency of 70-80 pulses per minute. The number of sessions varied from 2 to 6. The interval between the SWL sessions was around 1 month. Fragmentation rate of 20-25% of the stone load per session was considered a valid criterion for progressing to further SWL sessions. RESULTS: Nine patients became stone free at the end of SWL sessions and two patients had renal stone fragments smaller than 4 mm, which were eliminated 6 months later. Two patients developed streinstrasse that was managed with ureteroscopy. Auxiliary SWL was also performed on three patients with residual ureteral calculi. The mean follow up period was 12 months. The remaining five patients underwent open surgery for incomplete stone fragmentation. No major complications developed during the follow up period. The predominant composition of stones available for analysis was struvite. CONCLUSION: Doli S EMSE 220 F-XP can be a safe and effective treatment option for renal staghorn stones on an outpatient basis.

Heretis I; Mamoulakis C; Papadimitriou V; Sofras F

2011-03-01

326

Tamsulosin and doxazosin as adjunctive therapy following shock-wave lithotripsy of renal calculi: randomized controlled trial.  

Science.gov (United States)

Alpha-blockers have been established as medical expulsive therapy for urolithiasis. We aimed to assess the effect of tamsulosin and doxazosin as adjunctive therapy following SWL for renal calculi. We prospectively included 150 patients who underwent up to four SWL sessions for renal stones from June 2008 to 2009. Patients were randomized into three groups of 50 patients each, group A (phloroglucinol 240 mg daily), group B (tamsulosin 0.4 mg once daily plus phloroglucinol), and group C (doxazosin 4 mg plus phloroglucinol). The treatment continued up to maximum 12 weeks. Patients were evaluated for stone expulsion, colic attacks, amount of analgesics and side-effects of alpha-blockers. There were no significant differences between the groups regarding stone expulsion rates (84; 92 and 90%, respectively). The mean expulsion time of tamsulosin was significantly shorter than both control group (p = 0.002) and doxazosin (p = 0.026). Both number of colic episodes and analgesic dosage were significantly lower with tamsulosin as compared to control and doxazosin. Steinstrasse was encountered in 10 (6.7%) patients with no significant difference between the groups. 16 patients on tamsulosin and 21 on doxazosin experienced adverse effects related to postural hypotension. Moreover, 2 (4%) patients in the tamsulosin group reported ejaculatory complaints. In conclusion, adjunction of tamsulosin or doxazosin after SWL for renal calculi decreases the time for stone expulsion, amount of the analgesics and number colic episodes. There was no benefit regarding the overall stone expulsion rate. The side-effects of these agents are common and should be weighted against the benefits of their usage. PMID:21837534

Zaytoun, Osama M; Yakoubi, Rachid; Zahran, Abdel Rahman M; Fouda, Khaled; Marzouk, Essam; Gaafar, Salah; Fareed, Khaled

2011-08-12

327

Tamsulosin and doxazosin as adjunctive therapy following shock-wave lithotripsy of renal calculi: randomized controlled trial.  

UK PubMed Central (United Kingdom)

Alpha-blockers have been established as medical expulsive therapy for urolithiasis. We aimed to assess the effect of tamsulosin and doxazosin as adjunctive therapy following SWL for renal calculi. We prospectively included 150 patients who underwent up to four SWL sessions for renal stones from June 2008 to 2009. Patients were randomized into three groups of 50 patients each, group A (phloroglucinol 240 mg daily), group B (tamsulosin 0.4 mg once daily plus phloroglucinol), and group C (doxazosin 4 mg plus phloroglucinol). The treatment continued up to maximum 12 weeks. Patients were evaluated for stone expulsion, colic attacks, amount of analgesics and side-effects of alpha-blockers. There were no significant differences between the groups regarding stone expulsion rates (84; 92 and 90%, respectively). The mean expulsion time of tamsulosin was significantly shorter than both control group (p = 0.002) and doxazosin (p = 0.026). Both number of colic episodes and analgesic dosage were significantly lower with tamsulosin as compared to control and doxazosin. Steinstrasse was encountered in 10 (6.7%) patients with no significant difference between the groups. 16 patients on tamsulosin and 21 on doxazosin experienced adverse effects related to postural hypotension. Moreover, 2 (4%) patients in the tamsulosin group reported ejaculatory complaints. In conclusion, adjunction of tamsulosin or doxazosin after SWL for renal calculi decreases the time for stone expulsion, amount of the analgesics and number colic episodes. There was no benefit regarding the overall stone expulsion rate. The side-effects of these agents are common and should be weighted against the benefits of their usage.

Zaytoun OM; Yakoubi R; Zahran AR; Fouda K; Marzouk E; Gaafar S; Fareed K

2012-08-01

328

Efect of Hydroalcoholic Extract of Hypericum Perforatum L. Leaves on Ethylene Glycol-Induced Kidney Calculi in Rats  

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Full Text Available PURPOSE: To investigate the effects of the hydroalcoholic extract of Hypericum perforatum (H. perforatum) leaves on the kidney calculi in rats. MATERIALS AND METHODS: Fifty-two Wistar male rats were randomly divided into 4 groups: Groups 2, 3, and 4 received ethylene glycol (EG) 1% + ammonium chloride (0.5%)-added drinking water as a stone inducer. The H. Perforatum solution was fed at the same time of EG application and was repeated once for two days until the end of the experimental period. Group 1 (control; n = 10) was provided free access to food and normal drinking water. Group 2 (EG; n = 12) received EG-ammonium chloride-added drinking water and was fed with normal chow. Groups 3 and 4 (n = 15), as EG-treatment groups, received H. Perforatum in low (300 mg/kg) and high (500 mg/kg) doses, respectively. After 28 days, the kidneys were removed and prepared for histologic evaluation of calcium oxalate deposits. RESULTS: Urine level of free calcium in groups EG and EG + H. perforatum (300 mg/kg) and phosphorous in EG + H. perforatum (500 mg/kg) significantly decreased compared to controls (P < .01; P < .05; and P < .05, respectively). Treatment of the rats with high dose of H. Perforatum (500 mg/kg) markedly reduced decrementing effect of EG on serum level of free calcium (P < .05). Histological experiments showed that chronic feeding of H. perforatum (300 and 500 mg/kg, orally) could significantly reduce the size and number of calcium oxalate deposits in EG group. CONCLUSION: Chronic treatment of rats with hydroalcoholic extract of H. perforatum reduced the size and number of calcium oxalate deposits in EG-induced calculi.

Mohsen Khalili; Mohammad Reza Jalali; Mohammad Mirzaei-Azandaryani

2012-01-01

329

Urinary markers of bladder carcinoma.  

UK PubMed Central (United Kingdom)

PURPOSE: Transitional cell carcinoma of bladder is one of the most common tumors of genitourinary tract. Cystoscopy along with cytology is the mainstay for diagnosing bladder cancer. Cytology is specific for diagnosis of bladder carcinomas but less sensitive particularly in low-grade disease. Cystoscopy on the other hand is invasive and relatively costly technique and may also be inconclusive at times particularly in case of cystitis. A simple noninvasive marker for detecting bladder cancer would be helpful. A clinically useful urinary marker should be easy to perform, should have minimum requirements for sample preparations and should have high sensitivity and specificity in diagnosis. In this review we discussed the various urinary markers and their role in detection of bladder cancer. MATERIALS AND METHODS: We reviewed the literature on urinary markers and tests that may have clinical usefulness. RESULTS: Several urinary markers and tests such as BTA Stat, BTA TRAK, NMP22, telomerase, HA and HAse tests, Immunocyt, Quanticyt, FDP, BLCA-4, FISH, CYFRA-21-1 have enough potential for future clinical use. BTA stat, NMP22 (bladder check)and AccuDX (FDP) tests are presently point of care tests. The rest of the tests are laboratory-based and may need trained technicians. Majorities of the urinary markers have higher sensitivity and specificity than cytology. However, voided urinary cytology has the highest specificity. CONCLUSIONS: Till now there is no urinary marker or test that can replace the need of cystoscopy. However, some markers have the potential for future clinical use.

Dey P

2004-02-01

330

[Urinary retention secondary to surgical treatment of stress urinary incontinence  

UK PubMed Central (United Kingdom)

A retrospective, descriptive study at the National Institute of Perinatology (INPer), was carried out. 401 records of patients with stress urinary incontinence who underwent surgical treatment, were reviewed. The objective of this study was to know the urinary retention rate. Urinary retention was present in 103 of 401 patients (25.68%). In modified Pereyra's procedure it was present in 67 of 195 (34.35%); in modified Burch's procedure, in 25 of 131 (19.08%); in Kelly's procedure in 9 of 70 (12.85%) and in 2 of 5 patients with sling procedure with polytetrafluoroethylene (Goretex). The problem of urinary retention was observed more frequently in vaginal surgery (modified Pereyra procedure and/or sling procedure).

Ortíz Luna G; Rodríguez Colorado ES; Argueta Zúñiga M; Kunhardt Rasch J; Delgado Urdapilleta J

1995-05-01

331

Automated analysis of urinary stone composition using Raman spectroscopy - Pilot study for the development of a compact portable system for immediate postoperative ex-vivo application.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate a compact portable system for immediate automated postoperative ex-vivo analysis of urinary stone composition using Raman spectroscopy. Analysis of urinary stone composition provides essential information for treatment and metaphylaxis of urolithiasis. Currently, infrared spectroscopy and x-ray diffraction are used for urinary stone analysis. However, these methods might require complex sample preparation and costly laboratory equipment. In contrast, Raman spectrometers might be simple and quick strategy for immediate stone analysis. MATERIALS AND METHODS: Pure samples of 9 stone components, and 159 human urinary calculi were analysed by Raman spectroscopy using a microscope-coupled system at two different excitation wavelengths. Signal-to-noise ratio, peak positions and the distinctness of the acquired Raman spectra were analysed and compared. Background fluorescence was removed mathematically. Corrected Raman spectra were used as a reference library for automated classification of native human urinary stones (n=50). The results were then compared to standard infrared spectroscopy. RESULTS: Signal-to-noise ratio was superior at an excitation wavelength of 532 nm. An automated, computer-based classifier was capable of matching spectra from patient samples with those of pure stone components. Consecutive analysis of 50 human stones showed a 100% sensitivity and specificity as compared to infrared spectroscopy (for components > 25%). CONCLUSIONS: Our pilot study has indicated that Raman spectroscopy is a valid and reliable technique for determining urinary stone composition. Thus, we propose that the development of a compact and portable system based on Raman spectroscopy for immediate, postoperative stone analysis could represent an invaluable tool for metaphylaxis of urolithiasis.

Miernik A; Eilers Y; Bolwien C; Lambrecht A; Hauschke D; Rebentisch G; Lossin PS; Hesse A; Rassweiler JJ; Wetterauer U; Schoenthaler M

2013-06-01

332

Surprises in the urinary bladder  

Directory of Open Access Journals (Sweden)

Full Text Available Bhushan Wani1, Suhas Jajoo1, Navinchandra Wani2, Anil Bhole11Department of Surgery, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, India; 2Department of Surgery, Annasaheb Chudaman Patil Memorial Medical College, Dhule, IndiaAbstract: Foreign bodies of the urinary bladder may occur by self insertion, iatrogenic means or migration from the neighbouring organs. The variety of objects found self-inserted is impressive. The patient usually presents with dysuria, poor urinary stream or retention, bloody or purulent urethral discharge, ascending urinary tract infection, urgency, and/or pelvic pain. Management should be tailored according to the nature and dimensions of the foreign body. In the following paper, we report three cases with different presentations that were managed successfully.Keywords: urinary, bladder, foreign bodies

Bhushan Wani; Suhas Jajoo; Navinchandra Wani; et al

2010-01-01

333

Urinary Tract Infections in Adults  

Science.gov (United States)

... tract that obstructs the flow of urine—a kidney stone or enlarged prostate, for example—is at risk ... of the urinary tract, such as an obstructive kidney stone or prostate enlargement that squeezes the urethra. Health ...

334

Diseases of the urinary system  

International Nuclear Information System (INIS)

Age-dependent anatomo-physiological regularities of development urogenital system of in children are considered. A description of performing examination methods is given: summarized roentgenography, excretary urography, cystography, kidney angiography. Great attention is given to the choice of contrast media, dose calculation, excretion and pharmokinetic mechanism of contrast media. Particular items of roentgenodiagnosis of urinary tract diseases are given: anomalies and acquired diseases of urinary system.

1988-01-01

335

[Urinary tract duplication].  

UK PubMed Central (United Kingdom)

OBJECTIVES: Review the clinical and radiological characteristics of the different kinds of urinary tract duplications, assessing the outcome of the cases and the incidence of renal parenchymal injury. MATERIAL AND METHODS: A retrospective study was performed including 301 children diagnosed of renal duplication by urological ultrasound, voiding cystourethrogram (VCUG) and 99-technetium renal scintigraphy (DMSA). RESULTS: They were classified in four groups. The first consisted of 166 (55.1%) cases that had complete ureteral duplication without an obstructive component (CD). The cases that had an upper system obstruction due to an ectopic ureter (EU), 19 (6.3%), or an ureterocele (UTC), 35 (11.6%), were divided into two different groups. The fourth group 81 (26.9%) had incomplete ureteral duplication. The nephro-urological study was performed in 181/301 after a urinary tract infection; in 100/301 after a prenatal finding of hydronephrosis. It was a casual diagnosis in 20/301. The percentage upper kidney dilation in the diagnostic ultrasound was significantly higher in those with EU 16/19 (84%) and in those with UTC 33/35 (94%), compared with the upper pole dilations found in the CD 35/166 (21%) and ID 21/81 (25%). Surgery was performed in 96/166 (41%) of the CD, 7/81 of the ID, 16/19 (84%) of the EU, and 34/35 (97%) of the UTC. Three cases with EU and 8 with UTC needed a second surgery, and 3 a third one. No scintigraphy changes were observed in 58% of the patients in the CD group, 87% in the ID group, 29% in the EU group, and 5% in the UTC group. As regards the renal duplications who did not have surgery, it was found that there were 98 refluxing units in the CD, and 74 in the ID. The spontaneous resolution of the vesicoureteral reflux (VUR) was 80% in the CD, and 90% in the ID (McNemar test P<.001). The average healing time ranged from 1 year to 5 years (Mean: 3 years and 3 months). CONCLUSION: The patients with higher risk of having renal injury are those who presented with a duplication with upper kidney obstruction due to ectopic insertion of the ureter, particularly due to an ureterocele.

Ubetagoyena Arrieta M; Sarasqueta Eizaguirre C; Arruebarrena Lizarraga D; Areses Trapote R

2012-10-01

336

Urinary conduits in gynecologic oncology  

Energy Technology Data Exchange (ETDEWEB)

Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injury in 48 patients, and for palliation of disease recurrence in ten patients. Ninety-three percent had prior pelvic radiotherapy. Various segments of the gastrointestinal tract were used, including the ileum (102), sigmoid colon (99), transverse colon (four), jejunum (four), and others (three). Fifty percent of abnormal preoperative intravenous pyelograms reverted to normal after urinary diversion. Revision of the stoma was required in 6%. Other complications included infection (18%), renal loss (17%), and urinary leaks and fistulae (3%). The overall perioperative mortality was 7%, decreasing from 11% in the first five years to 3% during the last six years. Ureteral stents were routinely used. When selecting a segment of bowel for a urinary conduit, both tissue quality and mobility are important. Mortality and morbidity of urinary conduit surgery continues to decrease with experience.

Hancock, K.C.; Copeland, L.J.; Gershenson, D.M.; Saul, P.B.; Wharton, J.T.; Rutledge, F.N.

1986-05-01

337

Urinary conduits in gynecologic oncology  

International Nuclear Information System (INIS)

Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injury in 48 patients, and for palliation of disease recurrence in ten patients. Ninety-three percent had prior pelvic radiotherapy. Various segments of the gastrointestinal tract were used, including the ileum (102), sigmoid colon (99), transverse colon (four), jejunum (four), and others (three). Fifty percent of abnormal preoperative intravenous pyelograms reverted to normal after urinary diversion. Revision of the stoma was required in 6%. Other complications included infection (18%), renal loss (17%), and urinary leaks and fistulae (3%). The overall perioperative mortality was 7%, decreasing from 11% in the first five years to 3% during the last six years. Ureteral stents were routinely used. When selecting a segment of bowel for a urinary conduit, both tissue quality and mobility are important. Mortality and morbidity of urinary conduit surgery continues to decrease with experience

1986-01-01

338

Telocytes in the urinary system  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Telocytes, a new type of interstitial cells, have been identified in many organs in mammals. The present studies aimed at investigating the ultrastructure, distribution and interactions of telocytes with surrounding cells in the urinary system of rats, to confirm the existence of telocytes in kidneys, ureter and urinary bladder. Methods Samples of kidney, ureter, or urinary bladder were harvested for the ultrastructure by the electron microscope. The primary culture of telocytes was performed to investigate the dynamic alterations. Results Telocytes mainly located in the sub-capsular space of kidney, or between smooth muscle bundles and in the lamina propria of ureter and urinary bladder. Telocytes established numerous contacts with macrophages in the sub-capsular space of kidney, or with smooth muscle cells, nerve endings as well as blood capillaries in the ureter and urinary bladder. The complete morphology of telocytes with telopodes was observed clearly through the primary cell culture from the kidney tissues of rats. Conclusions Our data evidenced the existence of telocytes in the urinary system, which may contribute to the tissue reparation and regeneration.

Zheng Yonghua; Zhu Tongyu; Lin Miao; Wu Duojiao; Wang Xiangdong

2012-01-01

339

[Modified T-catheter and its use for transvenous hypothermic in situ perfusion in the surgical restoration of the kidney with staghorn calculi  

UK PubMed Central (United Kingdom)

The operative treatment of kidneys with staghorn calculi requires intraoperative X-ray and fluoroscopic checks and also ischaemia. Regional transvenous hypothermic perfusion of the kidneys is a method which is technically simple to implement and offers advantages over both clamping of the hilum and transarterial perfusion methods. The catheter used by us requires no great expenditure on material: it can be constructed anywhere out of readily available sterile materials.

Seiter H; Pietruschka U; Bog H; Görlitz H

1983-06-01

340

Urinary tract infection.  

Science.gov (United States)

The University of Michigan Health System Urinary Tract Infection CPG provides a summary of evidence-based recommendations on the treatment of UTIs in a format that can easily applied in practice. The authors include a statement of the importance of clinical judgement in the application of the recommendations and the recognition that other treatment approaches may be appropriate. The panel of authors includes physicians of various specialties, an ambulatory care nurse, and a medical education specialist. While the specialties of general and family medicine, OB/GYN, and infectious medicine are represented, there is no urologist or nephrologist listed on the panel. The CPG includes a brief annotated bibliography, summarizing six of the articles considered in the guideline's development. There is no further extended list of references included in the content. The CPG is limited to the treatment of adult women, although there is no specific age cited at which the guideline would begin to apply. It provides the reader with ideas for not only managing women who present to the clinic with symptoms consistent with a UTI, but also ideas for not only managing women who patient self-treatment strategies to minimize the cost associated with recurrent infections. Health care professionals interested in using the CPG in practice are encouraged to obtain and review a full-copy. It is available on the World Wide Web ate cme.medumich.edu.pdf/guideline/UTI.pdf. PMID:11930851

Goolsby, M J

2001-09-01

 
 
 
 
341

Urinary tract infection.  

UK PubMed Central (United Kingdom)

The University of Michigan Health System Urinary Tract Infection CPG provides a summary of evidence-based recommendations on the treatment of UTIs in a format that can easily applied in practice. The authors include a statement of the importance of clinical judgement in the application of the recommendations and the recognition that other treatment approaches may be appropriate. The panel of authors includes physicians of various specialties, an ambulatory care nurse, and a medical education specialist. While the specialties of general and family medicine, OB/GYN, and infectious medicine are represented, there is no urologist or nephrologist listed on the panel. The CPG includes a brief annotated bibliography, summarizing six of the articles considered in the guideline's development. There is no further extended list of references included in the content. The CPG is limited to the treatment of adult women, although there is no specific age cited at which the guideline would begin to apply. It provides the reader with ideas for not only managing women who present to the clinic with symptoms consistent with a UTI, but also ideas for not only managing women who patient self-treatment strategies to minimize the cost associated with recurrent infections. Health care professionals interested in using the CPG in practice are encouraged to obtain and review a full-copy. It is available on the World Wide Web ate cme.medumich.edu.pdf/guideline/UTI.pdf.

Goolsby MJ

2001-09-01

342

Neonatal urinary prostanoid excretion.  

Science.gov (United States)

Urinary excretion of prostanoids prostaglandin E2 (PGE2), PGE-M (7alpha-hydroxy-5,11-diketo-2,3,4,5,20-penta-19-carboxyprostano ic acid), 6-keto-PGF1alpha, 2,3-dinor-6-keto-PGF1alpha, thromboxane B2 (TxB2) 2,3-dinor-TxB2 and 11-dehydro-TxB2 was determined by gas chromatography/mass spectrometry in preterm and term infants to show that there is an age-dependent excretion rate of the above prostanoids in infants this young. Group I included premature children with normal postnatal development, Groups II and III included term children who were admitted in the neonatal period for observation because of feeding problems but who were subsequently found to be completely healthy. We present normal data of three primary prostanoids and four prostanoid metabolites. In Group I, excretion rates of 2,3-dinor-TxB2 were significantly lower than in Group II (P = 0.04) and in Group III (P = 0.05). Furthermore, the excretion rate of 11-dehydro-TxB2 in group I was significantly lower than in Group II (P = 0.05). We found no significant age-dependent differences between the three groups in excretion rates of PGE2, PGE-M, 6-keto-PGF1alpha, 2,3-dinor-6-keto-PGF1alpha, and TxB2. PMID:10680771

Hoch, B; Bernhard, M; Seyberth, H W; Watzer, B; Schweer, H

2000-01-01

343

Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position.  

UK PubMed Central (United Kingdom)

CONTEXT: The treatment for patients with large impacted proximal ureteral stone remains controversial, especially at institutions with limited resources. AIM: The aim of this study is to compare and to evaluate the outcome and complications of two main treatment procedures for impacted proximal ureteral calculi, retrograde ureterolithotripsy (URS), and percutaneous antegrade ureterolithotripsy (Perc-URS). SETTINGS AND DESIGN: Our inclusion criteria were solitary, radiopaque calculi, >15 mm in size in a functioning renal unit. Only those patients in whom the attempt at passing a guidewire or catheter beyond the calculus failed were included in this study. PATIENTS AND METHODS: Between January 2007 and July 2011, a total of 52 patients (13 women and 39 men) with large impacted upper-ureteral calculi >15 mm and meeting the inclusion criteria were selected. Of these, Perc-URS was done in 22 patients (group 1) while retrograde ureteroscopy was performed in 30 patients (group 2). We analyzed operative time, incidence of complications during and after surgery, the number of postoperative recovery days, median total costs associated per patient per procedure, and the stone-free rate immediately after 5 days and after 1 month. STATISTICAL ANALYSIS USED: Bivariate analysis used the Student t-test and the Mann-Whitney test to compare two means and Chi-square and Fisher's exact tests to compare two percentages. The significance level was set at 0.05. RESULTS: The mean age was 42.3 years (range 22-69). The mean stone sizes (mm) were 34 ± 1.2 and 29.3 ± 1.8 mm in group 1 and 2, respectively. In the Perc-URS group, 21 patients (95.45%) had complete calculus clearance through a single tract in one session of percutaneous surgery, whereas in the URS group, only 20 patients (66.7%) had complete stone clearance (P = 0.007). The mean operative time was higher in the Perc-URS group compared to group 2 (66.5 ± 21.7 vs. 52.13 ± 17.3 min, respectively; P = 0.013). Complications encountered in group 1 included transient postoperative fever (2 pts) and simple urine outflow (2 pts). Ten patients (33%) of group 2 experienced failure: Migration to the kidney (3 pts), ureteral perforation (2 pts), tortuosity of the ureter (2 pts), and epithelial polyps (2 patients). Group 1 patients had an average visual analog (VAS) pain score of 47 mm compared with 31 mm in group 2 patients. The mean hospital stay (days) in group 1 was higher than the group 2 (2.27 ± 0.8 vs. 1.67 ± 0.6, respectively; P = 0.01). The mean analgesia requirement for group 1 (paracetamol chlorhydrate + codeine 12 ± 3 g) was significantly more compared with group B (6.8 ± 2 g) (P < 0.01). The difference in average blood loss between the two groups was not statistically significant. Total costs was slightly higher in group 1 but the difference was not statistically significant between the two groups (15000 vs. 13400 MDH respectively; P > 0.05). After 1 month, the stone free-rate remained higher in group 1 (95.5% vs. 66.7%, respectively; P = 0.012). CONCLUSIONS: In our series, Perc-URS is a safe and efficient treatment option for proximal ureteral stone, especially when the stone size is superior to 15 mm with the presence of moderate or severe hydronephrosis.

Moufid K; Abbaka N; Touiti D; Adermouch L; Amine M; Lezrek M

2013-07-01

344

La incontinencia urinaria/ Urinary incontinence  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish La incontinencia urinaria, entendida como cualquier pérdida involuntaria de orina, constituye un problema médico y social importante. Puede clasificarse en incontinencia urinaria de esfuerzo, incontinencia urinaria de urgencia e incontinencia urinaria mixta, principalmente. Las proporciones de estos tres tipos principales de incontinencia urinaria son difíciles de establecer y varían notablemente según las fuentes, pero, podrían estar en torno a 40, 33 y 20%, respec (more) tivamente. Su diagnóstico requiere una correcta historia clínica y exploración física, junto con algunas exploraciones complementarias. El primer escalón terapéutico lo constituyen las medidas higiénico-dietéticas y las técnicas de modificación de la conducta. El tratamiento farmacológico es específico para cada tipo de incontinencia urinaria, utilizándose anticolinérgicos e inhibidores de la recaptación de serotonina. Por último, las diferentes técnicas quirúrgicas tienen su papel ante el fracaso de los tratamientos conservadores o frente a incontinencia urinaria severa. Abstract in english Urinary incontinence, understood as any involuntary loss of urine, constitutes an important medical and social problem. It can be classified as stress urinary incontinence, urgent urinary incontinence or mixed urinary incontinence. The proportions of these three types of urinary incontinence are difficult to establish and vary notably between sources, but they might be about 40, 33 and 20% respectively. Its diagnosis requires a correct clinical history and physical explor (more) ation, together with some complementary explorations. The first therapeutic step consists of hygienic-dietary measures and behaviour modification techniques. Pharmacological treatment is specific for each type of urinary incontinence, using anticholinergics and inhibitors of serotonin reuptake. Finally, different surgical techniques have a role in cases where conservative treatments fail or when dealing with severe urinary incontinence.

Robles, J. E.

2006-08-01

345

La incontinencia urinaria Urinary incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available La incontinencia urinaria, entendida como cualquier pérdida involuntaria de orina, constituye un problema médico y social importante. Puede clasificarse en incontinencia urinaria de esfuerzo, incontinencia urinaria de urgencia e incontinencia urinaria mixta, principalmente. Las proporciones de estos tres tipos principales de incontinencia urinaria son difíciles de establecer y varían notablemente según las fuentes, pero, podrían estar en torno a 40, 33 y 20%, respectivamente. Su diagnóstico requiere una correcta historia clínica y exploración física, junto con algunas exploraciones complementarias. El primer escalón terapéutico lo constituyen las medidas higiénico-dietéticas y las técnicas de modificación de la conducta. El tratamiento farmacológico es específico para cada tipo de incontinencia urinaria, utilizándose anticolinérgicos e inhibidores de la recaptación de serotonina. Por último, las diferentes técnicas quirúrgicas tienen su papel ante el fracaso de los tratamientos conservadores o frente a incontinencia urinaria severa.Urinary incontinence, understood as any involuntary loss of urine, constitutes an important medical and social problem. It can be classified as stress urinary incontinence, urgent urinary incontinence or mixed urinary incontinence. The proportions of these three types of urinary incontinence are difficult to establish and vary notably between sources, but they might be about 40, 33 and 20% respectively. Its diagnosis requires a correct clinical history and physical exploration, together with some complementary explorations. The first therapeutic step consists of hygienic-dietary measures and behaviour modification techniques. Pharmacological treatment is specific for each type of urinary incontinence, using anticholinergics and inhibitors of serotonin reuptake. Finally, different surgical techniques have a role in cases where conservative treatments fail or when dealing with severe urinary incontinence.

J. E. Robles

2006-01-01

346

Leiomyoma of urinary bladder with bladder stone  

International Nuclear Information System (INIS)

Leiomyoma of the urinary bladder is a rare benign mesenchymal tumour. We describe here a case of leiomyoma of the urinary bladder in a 65-year-old gentleman who presented with haematuria, passage of clots and combined obstructive and irritative urinary symptoms. The investigations revealed a vesical calculus and a mass on the left lateral wall of the urinary bladder. Cystolitholapaxy and transurethral resection of the tumour was performed. Histopathological report of the resected tumour revealed a leiomyoma of the urinary bladder. So far, a leiomyoma of the urinary bladder and a concomitant vesical calculus have not been described in literature. (author)

2008-01-01

347

Predictors of Success for Stone Fragmentation and Stone-Free Rate After Extracorporeal Shockwave Lithotripsy in the Treatment of Upper Urinary Tract Stones  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To evaluate factors affecting the success rate of stone fragmentation and stone-free rate after extracorporeal shockwave lithotripsy (SWL) in treatment of upper urinary tract stones. MATERIALS AND METHODS: A total of 121 patients with upper urinary tract calculi underwent SWL treatment. RESULTS: Success rate of stone fragmentation after SWL was 73.6% (89/121). In 89 patients who had success of breaking stones, 71 patients were followed up for the assessment of stone-free status, of whom 51 (71.8%) patients were stone-free at 3-month follow-up. Among four prognostic factors, including body mass index (BMI), stone size, stone position, and hydronephrosis, BMI and stone position had a significant impact on the success rate of stone fragmentation (P = .04 and U1: P = .0108, respectively). Among five prognostic factors of BMI, stone size, stone position, hydronephrosis, and times of SWL treatments, stone size was the only factor with significant impact on the stone-free rate (middle: P = .0229). CONCLUSION: Our study suggests that stone fragmentation and stone-free rate after SWL treatment for upper urinary tract stones can be predicted.

Kiyoshi Takahara; Naokazu Ibuki; Teruo Inamoto; Hayahito Nomi; Takanobu Ubai; Haruhito Azuma

2012-01-01

348

[Urinary tract malformations. Symptomatology, delayed diagnosis and urinary tract infections].  

Science.gov (United States)

The authors examined 88 patients (32 Males and 56 Females) aged between 1 day and 13 years, suffering from urinary tract malformation, diagnosed during 1981-82 . The vesicoureteral reflux was the urinary tract malformation most frequently observed (56.81%). The patients showed symptoms of the illness within the first year of life in a percentage of 52%, while the 82% was symptomatic in 5 years. 30 months and 11 days was the average age at which the symptoms of the illness appeared, while the diagnosis was effected at an average of 47 months and 15 days. The authors pointed out the reasons of this diagnostic delay and the possibilities of filing it up. Urinary tract infection was found at the time of hospitalization in a percentage of 55%. The authors described the kind of germs isolated and their resistance to the most common antibiotics. PMID:3313295

Benigno, V; Attardo, S; Dolce, A F; Di Peri, S; Boncori, R; La Grutta, A

349

Palliative urinary conduit diversion in cases of intolerable urinary discomfort  

Energy Technology Data Exchange (ETDEWEB)

Fifteen patients with incurable gynecological cancers, all primary radiation treated and all having severe urinary discomfort due to urinary tract injuries were retrospectively examined after urinary conduit diversion. All have been followed-up until termination or until all survivors had lived for 6 months after the operation. Twelve of the 15 were discharged from the hospital, 10 of whom survived the first 6 months. Of those discharged 82% of the cumulated sum of postoperative observations days was spent out of the hospital. At the end of the observation period nine patients had been supplied with a colostomy as well, thus having double stomas. All six patients still alive declared in retrospect that given the choice again, they would still be willing to undergo the operation.

Lyndrup, J.; Sorensen, B.L.

1983-12-01

350

FAQs about Catheter-Associated Urinary Tract Infection  

Science.gov (United States)

FAQs (frequently asked questions) “Catheter-Associated Urinary Tract Infection” about What is “catheter-associated urinary tract infection”? A urinary tract infection (also called “UTI”) is an infection in the urinary system, ...

351

Use of traditional Chinese medicine in the management of urinary stone disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Objective: To assess the evidence-based literature supporting the use of traditional Chinese medicine Kampo herbal and Acupuncture in stone disease management. Materials and Methods: Four of the most commonly used herbal components of Kampo medicine in the treatment of stone disease are described according to their in vitro and in vivo effects. We also reviewed the role of Acupuncture in urologic clinical setting as well as its proposed mechanisms of action and results. M (more) edline database was assessed using isolated and conjugated key words (Chinese Medicine, Kampo, Chinese Herbal, Calculi, Stone Disease, Kidney, Acupuncture, Herbal Medicine). Articles were reviewed and summarized. Results: Herbal medicine has been proven to be free from side-effects and therefore suitable for long term use therapy. Its antilithic beneficial effects include increased urinary volume, increased magnesium excretion (Takusya), inhibitory activity on calcium oxalate aggregation (Takusya, Wulingsan and Desmodyum styracyfolium), inhibition of calcium oxalate nucleation and hydroxyapatite internalization (Wulingsan). In contrast, acupuncture, has shown to be effective as a pre-treatment anxiolytic and analgesic during colic pain and extracorporeal shock wave lithotripsy treatment, reducing the need for complementary sedative drugs. Conclusion: Chinese traditional medicine is promising as regards its role in stone prevention. An effort must be made in order to standardize study protocols to better assess acupuncture results since each procedure differs in regards to selected acupoints, electrostimulation technique and adjunct anesthetics. Similarly, standardization of Kampo formulations and acceptable clinical endpoints (imaging vs. symptomatic events) is needed.

Miyaoka, Ricardo; Monga, Manoj

2009-08-01

352

Use of traditional Chinese medicine in the management of urinary stone disease  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To assess the evidence-based literature supporting the use of traditional Chinese medicine Kampo herbal and Acupuncture in stone disease management. Materials and Methods: Four of the most commonly used herbal components of Kampo medicine in the treatment of stone disease are described according to their in vitro and in vivo effects. We also reviewed the role of Acupuncture in urologic clinical setting as well as its proposed mechanisms of action and results. Medline database was assessed using isolated and conjugated key words (Chinese Medicine, Kampo, Chinese Herbal, Calculi, Stone Disease, Kidney, Acupuncture, Herbal Medicine). Articles were reviewed and summarized. Results: Herbal medicine has been proven to be free from side-effects and therefore suitable for long term use therapy. Its antilithic beneficial effects include increased urinary volume, increased magnesium excretion (Takusya), inhibitory activity on calcium oxalate aggregation (Takusya, Wulingsan and Desmodyum styracyfolium), inhibition of calcium oxalate nucleation and hydroxyapatite internalization (Wulingsan). In contrast, acupuncture, has shown to be effective as a pre-treatment anxiolytic and analgesic during colic pain and extracorporeal shock wave lithotripsy treatment, reducing the need for complementary sedative drugs. Conclusion: Chinese traditional medicine is promising as regards its role in stone prevention. An effort must be made in order to standardize study protocols to better assess acupuncture results since each procedure differs in regards to selected acupoints, electrostimulation technique and adjunct anesthetics. Similarly, standardization of Kampo formulations and acceptable clinical endpoints (imaging vs. symptomatic events) is needed.

Ricardo Miyaoka; Manoj Monga

2009-01-01

353

Variability in urinary mercury excretion  

Energy Technology Data Exchange (ETDEWEB)

This report investigates quantitatively the extent to which 24-hour urinary mercury excretion can be predicted from the concentration of mercury in spot samples. The correlation between these quantities can be significantly improved by the application of a correction for urinary dilution and by restricting spot samples to the day's first excretion. If these precautions are taken, we find that for 68% of the samples the 24-hour excretion, Q, is in the range of 0.75 C' less than Q less than 1.31 C', where C' is the mercury concentration of a day's first excretion. The width of this range appears to be primarily determined by variations in a person's daily urinary volume and by the frequent occurrence of diurnal cycles.

Wallis, G.; Barber, T.

1982-08-01

354

Holmium: YAG laser lithotripsy versus pneumatic lithotripsy for treatment of distal ureteral calculi: a meta-analysis.  

UK PubMed Central (United Kingdom)

The objective of this study was to estimate the treatment effect of Pneumatic Lithotripsy (PL) versus holmium: YAG laser lithotripsy (LL) in the treatment of distal ureteric calculi. A bibliographic search covering the period from 1990 to April 2012 was conducted using search engines such as MEDLINE, EMBASE, and Cochrane library. Data were extracted and analyzed with RevMan5.1 software. A total of 47 studies were scant, and 4 independent studies were finally recruited. Holmium: YAG LL conveyed significant benefits compared with PL in terms of early stone-free rate [odds ratio (OR)=4.42, 95% confidence interval (CI) (1.14, 17.16), p=0.03], delayed stone-free rate [OR=4.42, 95%CI (1.58, 12.37), p=0.005], mean operative time [WMD=-16.86, 95%CI (-21.33, -12.39), p<0.00001], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), p=0.004], and stone migration incidence [OR=0.26, 95%CI (0.11, 0.62), p=0.003], but not yet in the postoperative hematuria rate and the ureteral perforation rate according to this meta-analysis. Precise estimates on larger sample size and trials of high quality may provide more uncovered outcomes in the future.

Yin X; Tang Z; Yu B; Wang Y; Li Y; Yang Q; Tang W

2013-04-01

355

[Preoperative intravenous cholangiography and residual common bile duct calculi. 600 cases reviewed 2 to 15 years after operation  

UK PubMed Central (United Kingdom)

The authors have carried out as a routine since 1960 before operation a good intravenous cholangiography, i.e. showing up satisfactorily the bile ducts from the bifurcation of the common bile duct to the duodenum and have abandoned routine per-operative radiography. Satisfactory cholangiography was obtained in 96% of cases of simple cholecystitis and in 80% of complicated cases. 600 cases were questionned 2 to 15 years after operation (average 7 years). The 567 controllable cases were all questionned or seen again. The reliability of pre-operative cholangiography is excellent: no common bile duct declared normal on X-ray was found to contain a gall stone either during or after operation and the negative choledocotomies were only 0.17%. The operative simplification permitted us to reduce the operative mortality of simple cholecystectomy to 0.4%. The number of controlled residual calculi was 5.8%. With routine per-operative radiomanometry, the average level without control at the Lille Colloquium in 1968 was 7%. But with late control according to the estimation of the authors it should be about 10%.

Henrion C; Wallon P; Van Eygen B

1978-11-01

356

Holmium: YAG laser lithotripsy versus pneumatic lithotripsy for treatment of distal ureteral calculi: a meta-analysis.  

Science.gov (United States)

The objective of this study was to estimate the treatment effect of Pneumatic Lithotripsy (PL) versus holmium: YAG laser lithotripsy (LL) in the treatment of distal ureteric calculi. A bibliographic search covering the period from 1990 to April 2012 was conducted using search engines such as MEDLINE, EMBASE, and Cochrane library. Data were extracted and analyzed with RevMan5.1 software. A total of 47 studies were scant, and 4 independent studies were finally recruited. Holmium: YAG LL conveyed significant benefits compared with PL in terms of early stone-free rate [odds ratio (OR)=4.42, 95% confidence interval (CI) (1.14, 17.16), p=0.03], delayed stone-free rate [OR=4.42, 95%CI (1.58, 12.37), p=0.005], mean operative time [WMD=-16.86, 95%CI (-21.33, -12.39), p<0.00001], retaining double-J catheter rate [OR=0.44, 95%CI (0.25, 0.78), p=0.004], and stone migration incidence [OR=0.26, 95%CI (0.11, 0.62), p=0.003], but not yet in the postoperative hematuria rate and the ureteral perforation rate according to this meta-analysis. Precise estimates on larger sample size and trials of high quality may provide more uncovered outcomes in the future. PMID:23016622

Yin, Xiangrui; Tang, Ziwei; Yu, Bei; Wang, Yarong; Li, Yuehua; Yang, Qi; Tang, Wei

2012-12-06

357

Bacterial adherence and urinary tract infection.  

Science.gov (United States)

Bacterial adherence is important in the initiation of disease of the respiratory, gastrointestinal, and urinary tracts. This article reviews the mechanisms by which it occurs and presents specific examples of its importance in urinary tract infections. PMID:2881359

Roberts, J A

1987-03-01

358

Bacterial adherence and urinary tract infection.  

UK PubMed Central (United Kingdom)

Bacterial adherence is important in the initiation of disease of the respiratory, gastrointestinal, and urinary tracts. This article reviews the mechanisms by which it occurs and presents specific examples of its importance in urinary tract infections.

Roberts JA

1987-03-01

359

Urinary incontinence - tension-free vaginal tape  

Science.gov (United States)

... vaginal tape is surgery to help control stress urinary incontinence . This is urine leakage that happens when ... Urinary leakage decreases for most women who have this procedure. But you may still have some leakage. ...

360

A Surprising Attempt for Urinary Incontinence  

Directory of Open Access Journals (Sweden)

Full Text Available Although there are various treatment types, majority of women with urinary incontinence do not seek care for that disorder. We present a case of woman who used a walnut for the treatment of urinary incontinence by herself.

Mustafa Hoscan; Mehmet Ekinci; Ahmet Tunçk?ran

2012-01-01

 
 
 
 
361

Angiographic diagnosis pheochromocytoma of urinary bladder  

International Nuclear Information System (INIS)

Roentgenological investigation, where pelvis angiography is the main technique, are shown to have leading role concerning diagnosis of pheochromocytoma of urinary bladder. Observations of three cases of urinary bladder pheochromocytoma are presented. All three patients are operated.

1989-01-01

362

Urinary incontinence - what to ask your doctor  

Science.gov (United States)

You have urinary incontinence. This means that you are not able to keep urine from leaking from your urethra, the tube ... urine out of your body from your bladder. Urinary incontinence may occur as you get older. It ...

363

Animal models in urinary diversion.  

UK PubMed Central (United Kingdom)

We set out to critically assess the value of animal experimentation in urinary diversion through intestinal segments, as some authors question the effectiveness of animal research, criticising the methodological quality, lack of standardization, inadequate reporting and the few systematic reviews in this field. Based on a comprehensive MEDLINE literature search (MeSH database; search terms: urinary diversion, urinary reservoirs, continent, rat, dog, animal models) we retrieved and evaluated all full-length papers published in English, German, French, and Spanish languages from 1966 to 2011 reporting the use of animal models in the setting of urinary diversion. Studies were stratified according to the addressed research question. Within each category species, gender, number of animals, age at procedure, type of diversion, mortality, length of follow-up, experimental procedure and outcome were recorded and tabulated. In all, 159 articles were judged to be relevant and while there are numerous animal models only a few have been used in more than one study. Animals were used for the systematic study of new surgical techniques (93 articles) or metabolic and functional consequences of urinary reconstruction (66 articles). For the latter purpose, the most often used animal is the rat, whereas the dog model is preferred for technical experimentation. In many studies, the validity of the model is at least questionable. Animal experiments have repeatedly been conducted addressing the same question, often with striking discrepancies in outcome. Animal studies were even performed after a surgical technique had been pioneered in humans. The use of animal models in urinary diversion is far from standardized rendering the results less than ideal for comparison across studies. Due to differences in anatomy and physiology, the applicability of findings in animal experiments to clinical urology is limited. Continued effort is needed to optimise the use of animal models in experimental urology.

Roosen A; Woodhouse CR; Wood DN; Stief CG; McDougal WS; Gerharz EW

2012-01-01

364

Urinary stone size estimation: a new segmentation algorithm-based CT method.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The size estimation in CT images of an obstructing ureteral calculus is important for the clinical management of a patient presenting with renal colic. The objective of the present study was to develop a reader independent urinary calculus segmentation algorithm using well-known digital image processing steps and to validate the method against size estimations by several readers. METHODS: Fifty clinical CT examinations demonstrating urinary calculi were included. Each calculus was measured independently by 11 readers. The mean value of their size estimations was used as validation data for each calculus. The segmentation algorithm consisted of interpolated zoom, binary thresholding and morphological operations. Ten examinations were used for algorithm optimisation and 40 for validation. Based on the optimisation results three segmentation method candidates were identified. RESULTS: Between the primary segmentation algorithm using cubic spline interpolation and the mean estimation by 11 readers, the bias was 0.0 mm, the standard deviation of the difference 0.26 mm and the Bland-Altman limits of agreement 0.0 ± 0.5 mm. CONCLUSIONS: The validation showed good agreement between the suggested algorithm and the mean estimation by a large number of readers. The limit of agreement was narrower than the inter-reader limit of agreement previously reported for the same data. KEY POINTS: The size of kidney stones is usually estimated manually by the radiologist. An algorithm for computer-aided size estimation is introduced. The variability between readers can be reduced. A reduced variability can give better information for treatment decisions.

Lidén M; Andersson T; Broxvall M; Thunberg P; Geijer H

2012-04-01

365

Management of stress urinary incontinence.  

UK PubMed Central (United Kingdom)

Although there is renewed interest in conservative therapies for stress urinary incontinence, such as pelvic floor exercises, electrical stimulation, and duloxetine therapy, surgery remains the primary choice in managing this condition. Surgical options include paravaginal defect repair, the Marshall-Marchetti-Krantz procedure, open and laparoscopic Burch urethropexy, and pubovaginal sling procedures. There is a growing trend in the United States toward use of the pubovaginal sling procedure as the primary operation for urinary incontinence due to less invasive techniques. Studies comparing the pubovaginal sling with open urethropexy have shown similar short-term cure rates. More large prospective, randomized studies are needed to assess long-term rates.

Cornella JL

2004-01-01

366

Artificial urinary sphincters. Radiographic evaluation.  

Science.gov (United States)

A small selected group of patients with urinary incontinence can be treated effectively with an artificial urinary sphincter. Since the fluid in the hydraulic system of this device is radiopaque, radiography is useful in its evaluation. An immediate postoperative radiogram should be performed to control the position and integrity of the system. It also serves as a useful baseline study in case of later complications. It should include radiograms both in the deactivated and activated state. A few cases of tube kinking may be overlooked when exposures in only one projection are used. Experience with 110 implanted sphincters is presented. PMID:2952144

Lorentzen, T; Dorph, S; Hald, T

367

Mullerianosis involving the urinary bladder.  

Science.gov (United States)

We report a case of mullerianosis involving the urinary bladder. A 45-year-old woman presented with complaints of chronic pelvic pain, dysmenorrhoea, irritative lower urinary tract symptoms and cyclical haematuria. Cystoscopy and transurethral biopsy suggested mullerianosis involving the posterior bladder wall; she subsequently had surgery including partial cystectomy with complete excision of the lesion. Histology reported presence of endometrial, endocervical and endosalpingeal tissues within the bladder mass confirming mullerianosis. She made satisfactory postoperative recovery. Awareness of this lesion is necessary for proper diagnosis and appropriate treatment. PMID:21617982

Ogah, Kenneth; Hartis, Rachael; Hilton, Paul

2011-05-27

368

Mullerianosis involving the urinary bladder.  

UK PubMed Central (United Kingdom)

We report a case of mullerianosis involving the urinary bladder. A 45-year-old woman presented with complaints of chronic pelvic pain, dysmenorrhoea, irritative lower urinary tract symptoms and cyclical haematuria. Cystoscopy and transurethral biopsy suggested mullerianosis involving the posterior bladder wall; she subsequently had surgery including partial cystectomy with complete excision of the lesion. Histology reported presence of endometrial, endocervical and endosalpingeal tissues within the bladder mass confirming mullerianosis. She made satisfactory postoperative recovery. Awareness of this lesion is necessary for proper diagnosis and appropriate treatment.

Ogah K; Hartis R; Hilton P

2012-01-01

369

Massive bilateral perirenal hematoma following urinary catheterization for urinary obstruction.  

Science.gov (United States)

Urinary tract obstruction is a common problem associated with many complications. Decompression of an enlarged bladder has been associated with several complications, mainly vesicular bleeding. We report a case of a 42-year-old male patient who developed bilateral renal subcapsular hematomas secondary to relief of an extremely enlarged bladder. PMID:15285759

Haydar, Ali A; Hujairi, Nabil M; Quateen, Aiman; Hatoum, Tarek; Goldsmith, David J A

2004-08-01

370

Urinary incontinence in Norwegian nursing home residents  

Directory of Open Access Journals (Sweden)

Full Text Available Urinary incontinence is a multi-factorial condition that has a high impact on older persons living in nursing homes. While urinary incontinence is common, only a small percentage of nursing home residents have an official diagnosis. Factors influencing urinary incontinence in this population are poorly understood. The aim of this study was to evaluate the prevalence of urinary incontinence in Norwegian nursing home residents and to study the factors associated with urinary incontinence in this population. Residents from six different nursing homes were included in this study. Data on sex, age, medication, comorbid illnesses, urinary incontinence and the use of absorbent pads was collected. Barthel`s Index of Activities of Daily Living (ADL) was used to estimate residents’ functional levels. Post-voiding residual urine was measured by means of a portable ultrasound. A questionnaire was completed by the nursing staff for each of the residents. In total, 173 residents participated in the study. One hundred and twenty-two residents (69%) were incontinent for urine and 144 used absorbent pads (83%). Fourteen percent of residents used absorbent pads ‘just to make sure’. They did not have a history of urinary incontinence. Low ADL score, dementia and urinary tract infection were significantly associated with incontinence for urine. The prevalence of urinary incontinence in Norwegian nursing homes is high. Absorbent products are frequently used without a history of urinary incontinence. Physical impairment, dementia and urinary tract infections are significantly associated with urinary incontinence.

Liv Heidi Skotnes; Ragnhild Omli; Ulla Romild; Ove Hellzèn; Esther Kuhry

2012-01-01

371

Urinary Tract Infection in South Jordanian Population  

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Urinary tract infections were investigated in order to screen for the linked causative bacterial agent. One hundred seventy patients with clinical symptoms of urinary tract infections were examined. It was found that 119 of the patients had actual laboratory evidence for urinary tract infections. On...

Khaled M. Khleifat; Muayad M. Abboud; Sharaf S. Omar; Jafar H. Al-Kurishy

372

Urinary tract infection in newborn  

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Objective: Urinary tract infection (UTI) is one of the most common encountered infection disease in childhood. UTI of childhood can cause renal damage, and so these children should be examined and observed. In our study, 65 case with UTI in neonatal period was investigated regarding clinical and la...

F ?nci Ar?kan; Banu Çelikel Acar; Ülkü T?ra?; Aysu Tazegül; Y?ld?z Dallar

373

Urinary tract infection in pregnancy.  

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Urinary tract infection is one of the most frequently seen 'medical' complications in pregnancy. The pioneering work of Edward Kass discovered that 6% of pregnant women had asymptomatic bacteriuria associated with increased prematurity and perinatal mortality compared to women with sterile urine. Sc...

MacLean, AB

374

Candida urinary tract infection: pathogenesis.  

UK PubMed Central (United Kingdom)

Candida species are unusual causes of urinary tract infection (UTI) in healthy individuals, but common in the hospital setting or among patients with predisposing diseases and structural abnormalities of the kidney and collecting system. The urinary tract may be invaded in either an antegrade fashion from the bloodstream or retrograde via the urethra and bladder. Candida species employ a repertoire of virulence factors, including phenotypic switching, dimorphism, galvano - and thigmotropism, and hydrolytic enzymes, to colonize and then invade the urinary tract. Antegrade infection occurs primarily among patients predisposed to candidemia. The process of adherence to and invasion of the glomerulus, renal blood vessels, and renal tubules by Candida species was elegantly described in early histopathologic studies. Armed with modern molecular biologic techniques, the various virulence factors involved in bloodborne infection of the kidney are gradually being elucidated. Disturbances of urine flow, whether congenital or acquired, instrumentation of the urinary tract, diabetes mellitus, antimicrobial therapy, and immunosuppression underlie most instances of retrograde Candida UTI. In addition, bacterial UTIs caused by Enterobacteriaceae may facilitate the initial step in the process. Ascending infections generally do not result in candidemia in the absence of obstruction.

Fisher JF; Kavanagh K; Sobel JD; Kauffman CA; Newman CA

2011-05-01

375

Urinary tract infection: immunological aspects.  

Science.gov (United States)

The immunological aspects of urinary tract infection are of great importance in patients with recurrent episodes. Host factors such as immune response to uropathogens and increased susceptibility are reported. The authors describe pathogenic aspects of bacteria, including determinants of aggressiveness and interactions with normal bacterial flora. Initial efforts with vaccines to prevent the recurrence of infection are also considered. PMID:12140717

Girão, Manuel J B C; Baracat, E C; Lima, G R

2002-01-01

376

Urinary tract infection: immunological aspects.  

UK PubMed Central (United Kingdom)

The immunological aspects of urinary tract infection are of great importance in patients with recurrent episodes. Host factors such as immune response to uropathogens and increased susceptibility are reported. The authors describe pathogenic aspects of bacteria, including determinants of aggressiveness and interactions with normal bacterial flora. Initial efforts with vaccines to prevent the recurrence of infection are also considered.

Girão MJ; Baracat EC; Lima GR

2002-01-01

377

Surprises in the urinary bladder  

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Bhushan Wani1, Suhas Jajoo1, Navinchandra Wani2, Anil Bhole11Department of Surgery, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, India; 2Department of Surgery, Annasaheb Chudaman Patil Memorial Medical College, Dhule, IndiaAbstract: Foreign bodies of the urinary bladder may occur by s...

Bhushan Wani; Suhas Jajoo; Navinchandra Wani; et al

378

Post-stroke urinary incontinence.  

UK PubMed Central (United Kingdom)

AIM: To provide a comprehensive review of the current evidence on post-stroke urinary incontinence. METHOD: An electronic database search was performed to identify relevant studies and review articles related to Urinary Incontinence (UI) in the stroke population between the years 1966 and 2012. FINDINGS: Urinary incontinence following stroke is a common problem affecting more than one-third of acute stroke patients and persisting in up to a quarter at 1 year. It is well established that this condition is a strong marker of stroke severity and is associated with poorer functional outcomes and increased institutionalisation and mortality rates compared with those who remain continent. Despite evidence linking better outcomes to those patients who regain continence, the results of national audits have demonstrated that the management of UI following stroke is suboptimal, with less than two-thirds of stroke units having a documented plan to promote continence. CONCLUSION: Current evidence supports a thorough assessment to categorise the type and severity of post-stroke urinary incontinence. An individually tailored, structured management strategy to promote continence should be employed. This has been associated with better stroke outcomes and should be the aim of all stroke health professionals.

Mehdi Z; Birns J; Bhalla A

2013-07-01

379

The history of urinary diversion  

Directory of Open Access Journals (Sweden)

Full Text Available The earliest attempt to divert urine flow from the ureters to the intestine, was performed in 1851 by John Simon. In the absence of antibiotics, ureterosigmoidostomy and its modifications during the 19th and early 20th century have been associated with high rate of surgical and metabolic complications. In 1910, Robert Coffey demonstrated a new method for ureterointestinal anastomosis, which renovated primary enthusiasm in ureterosigmoidostomy and it gained broad popularity during the next forty years. In 1950, Ferris and Odel reported 80% incidence of hyperchloremic metabolic acidosis following ureterosigmoidostomy. Based on further investigations by Lapides in 1951, Parsons, Powel and Pyrah in 1952, and Stamey in 1956, which clearly demonstrated that hyperchloremic metabolic acidosis is inevitable complication of ureterosigmoidostomy, this urinary diversion lost its popularity. In 1950’s ileal conduit, popularized by Bricker, became the gold standard for the subsequent 35 years. Early attempts for continent urinary diversion occurred form 1888, by Guido Tizzoni and Alfonso Poggi, while the first reservoir-type ileal loop urinary diversion was performed by Cuneo in 1911. By better understanding of principles of detubularization, based on works of Kock and principles of clean intermittent catheterization, established by Lapides, interest in continent urinary diversion has increased. Up to date, various continent cutaneous stomal reservoirs, sigmoidorectal pouches and orthotopic bladder substitutes have been described. Regarding encouraging improvements in biocompatible materials, alloplastic bladder replacement could be the next step for the future in bladder replacement surgery.

Baši? Dragoslav; Hadži-?oki? Jovan B.; Ignjatovi? I.

2007-01-01

380

DEFINING VARIATION IN URINARY OXALATE IN HYPEROXALURIC STONE-FORMERS.  

UK PubMed Central (United Kingdom)

Introduction: The development of effective preventative therapy for renal calculi in patients with secondary hyperoxaluria (2°HO) relies upon establishing the pattern of normal variation in urinary oxalate (uOx) and attempting to reduce it. Therefore, we evaluated uOx at baseline and at subsequent time points in stone-formers with 2°HO. Methods: We reviewed the charts of 201 recurrent stone formers with 2°HO (uOx ? 40 mg/day). 24-hour urine collections at baseline and after initiation of clinician-directed therapies were analyzed. Mixed models were constructed to analyze uOx over time for individual patients and as a group. Subgroup analyses were performed for enteric and idiopathic 2°HO. Coefficients of variation were computed using the root mean square error from linear models. Results: The etiology of 2°HO was enteric in 17.9% and idiopathic in 82.1% of patients. Among the 943 urine collections analyzed, 196 oxalate values were derived from the enteric group and 747 from the idiopathic group. The median number of uOx values measured per person was 4. The median 24-hr uOx (mg/day) was significantly higher for the enteric group than for the idiopathic group both at the time of diagnosis [64.4 (interquartile range (IQR) = 48-90)] versus 46.0 (IQR= 38-56), p< 0.001] and during follow-up [58.2 (IQR= 46-86) versus 44.2 (IQR= 35-53), p< 0.001]. Over a median follow-up of 22.5 months, 44.4% of the enteric and 61.8% of the idiopathic patients had at least one normal uOx value (p= 0.06). The coefficients of variation for the enteric and idiopathic groups were 40.8% and 27.3%, respectively, with variation randomly displayed in either direction for both groups. Conclusions: Among patients with 2°HO, uOx demonstrates significant random variation over time even with the incorporation of standard treatments, with enteric HO demonstrating higher values and greater variance than idiopathic HO.

Antonelli JA; Langman CB; Odom C; Poindexter J; Huet B; Pearle MS

2013-09-01

 
 
 
 
381

Computation and modeling of the stone-growth related urinary depletion effect using "depletion V1.0".  

UK PubMed Central (United Kingdom)

PURPOSE: During metabolic evaluation stone patients often present with calculi in the urinary tract or are suffering from high frequent formation of small microliths passing routinely the urinary tract. These concrements are presumably in a state of continuous growth. Consequently, the concentrations of the lithogenic components in the voided urine must decrease. Thus, treatment schemes inevitably fail to focus on the true pathogenic urinary composition. Instead, they focus on underestimated concentrations. This can attain high clinical relevance. In recent publications, we introduced a complex physical approach and provided mathematical equations which can be solved analytically. However, to date, solving the equations with a pocket calculator remains cumbersome. MATERIALS AND METHODS: Depletion V1.0 was developed to integrate the calculation of the depletion effect into the daily treatment of stone patients. Minimum requirement for Depletion V1.0 is the Java 1.2 platform runtime environment, which is supported on nearly all operation systems including Linux, MacOS X, and Windows. The program can be used directly within a Java-compliant web browser (e.g. Firefox, Mozilla, Internet Explorer) or from the program's storage location. The implemented data base provides stone type relevant parameters. Data input is performed via an easy-to-handle graphical user interface. RESULTS: Results are given as values and interactive plots; computation and update of plots are performed in real time. Result sheets can be exported to platform-independent EPS-format or printed out directly. CONCLUSIONS: Depletion V1.0 enables the medical practitioner to obtain an improved interpretation of the stone patient's health status. As input, only one set of easy-to-achieve clinical standard parameters is required. The program will be available from the authors as freeware.

Laube N; Pullmann M

2006-12-01

382

Retrieval methods for urinary stones.  

UK PubMed Central (United Kingdom)

This paper attempts to assess the current status of the various modalities of available treatment for urinary stone disease in the Kerala scenario. A total of 300 patients who attended the stone clinic with urinary stone disease and had stones retrieved by different means were selected for the study. Their clinical symptoms, demographic profile, size, number and position of stones, metabolic profiles, retrieval modalities and end result of treatment in terms of stone clearance were assessed. Instances of failure, incomplete clearance and complication events were noted. Based on the experiences, a flowchart was created for appropriate decision-making in urinary stone management. The modalities of retrieval included nephrectomy, nephrolithotomy, pyelo-nephrolithotomy, extended pyelolithotomy, pyelolithotomy, ureterolithotomy, cystolithotomy, urethrolithotomy, ESWL, PCNL, URS, cystolithotripsy, urethrolithotripsy and spontaneous passage. The clearance rate of stone was maximum in open surgery. The extent of stone clearance by ESWL depended on various factors. PCNL was mostly limited by the difficulties in achieving puncture at the stone site. Availability of a variety of flexible nephroscopes also altered the success rate of the procedure. There were good success rates in pushing stones from the ureter to the pelvis followed by PCNL. In patients who had successful PCNL, postoperative morbidity was significantly reduced in terms of the number of days of hospitalization, time taken for return to work, absence of urinary leak, site infection, urinoma formation and urinary tract infection. URS was performed in many patients and stones retrieved. However, the indication for the procedure remains doubtful as the size of most of the stones thus retrieved was less than 6 mm. These would have passed out spontaneously or with chemotherapeutic support. URS, lithotripsy and basketting were confronted by upward migration of stones to the kidney, requiring further procedures for retrieval. Introduction of double J stents helped in relieving urinary obstruction, particularly in patients presenting with anuria, but retained stents, forgotten stents and failed stone retrieval were common following the procedure. The procedure of URS was simplified by the presence of dilated ureter in spontaneous stone passers or those with distal obstruction and proximal dilatation. It is concluded from the study that open surgery still remains the sheet anchor of treatment of urinary stones in many patients in Kerala. Newer lesser invasive procedures should be ethically selected. Decisions should be patient based, taking into consideration the economic feasibility for the procedure proposed.

Marickar YM; Nair N; Varma G; Salim A

2009-12-01

383

Urinary Biomarkers in Obstructive Nephropathy  

Science.gov (United States)

Summary Background and objectives Obstructive nephropathy is a leading cause of CKD in children. The assessment of severity of renal impairment and the prediction of which children will progress to renal failure are, however, challenging. Design, Setting, Participants, & Measurements This case-control study measured the urinary excretion of candidate biomarkers in 27 prevalent case-patients with posterior urethral valves (PUVs) and 20 age-matched controls, correlated their urinary concentration with GFR, and analyzed receiver-operating characteristic (ROC) curve and regression analyses to assess their performance as tests for low GFR. Results The median urinary protein-to-creatinine ratio was higher in children with PUV (45 g/mol; range, 5–361 g/mol) than in controls (7 g/mol; range, 3–43 g/mol) (P<0.01) and correlated inversely with renal function (r = ?0.44; P<0.05). In whole urine, excretion of aquaporin-2 was significantly decreased, whereas that of TGF? and L1 cell adhesion molecule (L1CAM) was significantly increased. Whole-urine TGF? excretion correlated inversely with GFR (r = ?0.53; P<0.05). As tests for low GFR, whole-urine TGF?, L1CAM, and urinary protein-to-creatinine ratio performed best, with areas under the ROC curves of 0.788, 0.795, and 0.814, respectively. By linear regression analysis, whole-urine TGF?, L1CAM, and urinary protein-to-creatinine ratio were associated with low GFR in the case-patients. Conclusions Candidate biomarkers of obstructive nephropathy can be readily measured in whole urine and in urine exosomes. In boys with PUV, these biomarkers correlate with GFR.

Trnka, Peter; Ivanova, Larissa; Hiatt, Michael J.

2012-01-01

384

A multicenter, randomized, controlled trial of transureteral and shock wave lithotripsy--which is the best minimally invasive modality to treat distal ureteral calculi in children?  

UK PubMed Central (United Kingdom)

PURPOSE: Since there is insufficient evidence to determine the best treatment modality in children with distal ureteral calculi, we designed a multicenter, randomized, controlled trial to evaluate the efficacy and complications of transureteral and shock wave lithotripsy in these patients. MATERIALS AND METHODS: A total of 100 children with distal ureteral calculi were included in the study. Of the patients 50 were randomized consecutively to undergo shock wave lithotripsy using a Compact Delta II lithotriptor (Dornier MedTech, Kennesaw, Georgia), and 50 were randomized to undergo transureteral lithotripsy with holmium laser and pneumatic lithotriptor between February 2007 and October 2009. Stone-free, complication and efficiency quotient rates were assessed in each group. RESULTS: Mean +/- SD patient age was 6.5 +/- 3.7 years (range 1 to 13). Mean stone surface was 35 mm(2) in the transureteral group and 37 mm(2) in the shock wave lithotripsy group. Stone-free rates at 2 weeks after transureteral lithotripsy and single session shock wave lithotripsy differed significantly, at 78% and 56%, respectively (p = 0.004). With 2 sessions of shock wave lithotripsy the stone-free rate increased to 72%. Efficiency quotient was significantly higher for transureteral vs shock wave lithotripsy (81% vs 62%, p = 0.001). Minor complications were comparable and negligible between the groups. Two patients (4%) who underwent transureteral lithotripsy sustained a ureteral perforation. CONCLUSIONS: In the short term it seems that transureteral and shock wave lithotripsy are acceptable modalities for the treatment of distal ureteral calculi in children. However, transureteral lithotripsy has a higher efficacy rate when performed meticulously by experienced hands using appropriate instruments.

Basiri A; Zare S; Tabibi A; Sharifiaghdas F; Aminsharifi A; Mousavi-Bahar SH; Ahmadnia H

2010-09-01

385

Safety and efficacy of pneumatic lithotripters versus holmium laser in management of ureteral calculi: a randomized clinical trial.  

UK PubMed Central (United Kingdom)

PURPOSE: To compare efficacy and safety of holmium:YAG laser and pneumatic lithotripter in the management of ureteral stones. MATERIALS AND METHODS: One hundred and twelve patients with 1 to 2 cm ureteral calculi were selected for pneumatic or holmium:YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and plain abdominal x-ray were performed for all the patients before the operation. The pneumatic lithoclast was Swiss LithoClast, while in laser lithotripsy, holmium:YAG laser frequency was used, which was usually set between 5 and 10 Hz at a power of 10 to 15 Watt. Intravenous urography was performed for all the patients at 3 months to assess functional status and to delineate the ureteral anatomy. RESULTS: The mean patients' age and stones' size were the same in both groups, and there were no statistical differences. Mean duration of lithotripsy was 13.7 ± 12.6 minutes in laser group and 7.9 ± 4.2 minutes in pneumatic lithotripsy group. Immediate stone-free rate was 100% and 82.1% in the laser and pneumatic groups, respectively (P = .001). Stone pushing back occurred only in 10 (17.9%) patients in pneumatic group. In terms of complications, such as perforation, mucosal injury, and bleeding, there were no differences between the two groups. No intravenous pyelography related complication was seen at 3-month follow-up. CONCLUSION: Laser lithotripsy is a superior approach for the management of upper ureteral stones of 1 to 2 cm in size due to its higher rate of stone clearance.

Razzaghi MR; Razi A; Mazloomfard MM; Golmohammadi Taklimi A; Valipour R; Razzaghi Z

2013-01-01

386

Shock wave lithotripsy versus semirigid ureteroscopy for proximal ureteral calculi (<20 mm): a comparative matched-pair study.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To use a matched-pair analysis design to compare the safety and efficacy of shock wave lithotripsy (SWL) and ureteroscopy (URS). Controversy still exists regarding whether SWL or URS is the best management of upper ureteral calculi. METHODS: We reviewed the records of patients with a single radiopaque upper ureteral stone treated by URS or SWL from January 2003 to December 2005. SWL was performed as an outpatient procedure using the electromagnetic lithotripter (Dornier Lithotripter S). URS was performed using an 8F or 8.5F semirigid ureteroscope. Intracorporeal lithotripsy with pneumatic or holmium laser energy was used when needed. A matched-pair analysis was performed using 3 parameters (sex, stone size, and degree of hydronephrosis). The success rates, retreatment rates, auxiliary procedures, and complications were compared in each group. RESULTS: A total of 427 patients were treated for upper ureteral stones. Forty-three matched pairs were identified and compared. The success rate was 83.7% for SWL vs 88.4% for URS (P = .8). The retreatment rate was significantly greater in the SWL group than in the URS group (65% vs 2.3%, respectively; P < .001). The need for auxiliary procedures was equal in both groups (16.3%). The complication rate was 14% in the URS group and 4.7% in the SWL group (P = .1). CONCLUSIONS: SWL and semirigid URS are highly effective in the treatment of proximal ureteral stones <20 mm. The results of our study showed that SWL was safer and less invasive, but that URS was more effective and resulted in a lower retreatment rate.

Youssef RF; El-Nahas AR; El-Assmy AM; El-Tabey NA; El-Hefnawy AS; Eraky I; El-Kenawy MR; El-Kappany HA; Sheir KZ

2009-06-01

387

Therapeutic Effects of Aqueous Extracts of Petroselinum Sativum on Ethylene Glycol-Induced Kidney Calculi in Rats  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: To investigate the therapeutic effects of the aqueous extract of Petroselinum Sativum aerial parts and roots on kidney calculi. Materials and Methods: Thirty-six male Wistar rats were randomly assigned into 6 groups and treated for 30 days. Group A served as normal control and group B received 1% ethylene glycol in drinking water. Groups C, D, E, and F received 1% ethylene glycol from day 0 and were used as the treatment subjects. Rats in groups C and D received 200 and 600 mg/kg body weight of aerial parts aqueous extract, respectively, and those in groups E and F received 200 and 600 mg/kg body weight of root aqueous extract in drinking water, respectively, from the 14th day of the experiment. Results: On the 14th and 30th days of the experiment, serum level of magnesium (1.71 ± 0.12 and 3.81 ± 0.25, respectively) decreased significantly while serum level of calcium (10.45 ± 0.26 and 11.33 ± 0.18, respectively) increased significantly in group B compared with the control group (14th day: magnesium = 2.87 ± 0.17 and calcium = 8.80 ± 0.00 and 30th day: magnesium = 6.01 ± 0.00 and calcium = 8.30 ± 0.22; P < .001). In the treatment groups of C, D, E, and F, the number of deposits decreased significantly compared with group B on the 30th day (P < .001). The weight of the kidneys increased significantly in group B (2.01 ± 0.17) compared with the control group (1.52 ± 0.07) and decreased significantly in treatment groups (P < .05). Conclusion: Petroselinum Sativum has a therapeutic effect on calcium oxalate stones in rats with nephrolithiasis and reduces the number of calcium oxalate deposits.

Jafar Saeidi; Hadi Bozorgi; Ahmad Zendehdel; Jamshid Mehrzad

2012-01-01

388

Safety and Efficacy of Pneumatic Lithotripters Versus Holmium Laser in Management of Ureteral Calculi: A Randomized Clinical Trial  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To compare efficacy and safety of holmium:YAG laser and pneumatic lithotripter in the management of ureteral stones.MATERIALS AND METHODS:One hundred and twelve patients with 1 to 2 cm ureteral calculi were selected for pneumatic or holmium:YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and plain abdominal x-ray were performed for all the patients before the operation. The pneumatic lithoclast was Swiss LithoClast, while in laser lithotripsy, holmium:YAG laser frequency was used, which was usually set between 5 and 10 Hz at a power of 10 to 15 Watt. Intravenous urography was performed for all the patients at 3 months to assess functional status and to delineate the ureteral anatomy.RESULTS: The mean patients’ age and stones’ size were the same in both groups, and there were no statistical differences. Mean duration of lithotripsy was 13.7 ± 12.6 minutes in laser group and 7.9 ± 4.2 minutes in pneumatic lithotripsy group. Immediate stone-free rate was 100% and 82.1% in the laser and pneumatic groups, respectively (P = .001). Stone pushing back occurred only in 10 (17.9%) patients in pneumatic group. In terms of complications, such as perforation, mucosal injury, and bleeding, there were no differences between the two groups. No intravenous pyelography related complication was seen at 3-month follow-up.CONCLUSION:Laser lithotripsy is a superior approach for the management of upper ureteral stones of 1 to 2 cm in size due to its higher rate of stone clearance.

Mohammad Reza Razzaghi; Abdollah Razi; Mohammad Mohsen Mazloomfard; Amin GolmohammadiTaklimi; Reza Valipour; Zahra Razzaghi

2013-01-01

389

Endoscopic combined intrarenal surgery for large calculi: Simultaneous use of flexible ureteroscopy and mini-percutaneous nephrolithotomy overcomes the disadvantageous of percutaneous nephrolithotomy monotherapy.  

UK PubMed Central (United Kingdom)

Background and purpose: Percutaneous nephrolithotomy (PNL) is considered the standard procedure for the removal of large renal calculi. The development of the "minimally invasive PNL" (mini-PNL) has reduced the complications of the surgery; it also appears to be associated with less morbidity than the conventional PNL (con-PNL). This study aimed at evaluating the efficacy of endoscopic intrarenal surgery, employing the prone-split leg position, using flexible ureteroscopy and mini-PNL (mini-ECIRS) by retrospectively comparing this technique with mini-PNL and con-PNL. Patients and methods: In total, 161 consecutive patients who were observed for the follow-up of large renal calculi between February 2004 and January 2013 were selected for mini-ECIRS (60), mini-PNL (19), or con-PNL (82). Mini-ECIRS was performed with patients in the prone split-leg position via 18F mini-percutaneous tract and 14F ureteric access sheath. The mini-PNL was performed via 18F percutaneous tract and con-PNL performed via the 30F tract. Mean size of the renal calculi removed via mini-ECIRS, mini-PNL, and con-PNL were 39.2, 38.4, and 34.6 mm, respectively. Results: Average surgical time for mini-ECIRS was shorter than that for mini-PNL and con-PNL (120.5 vs 181.9 vs 134.1, respectively; p < 0.001). The stone-free rate for mini-ECIRS was significantly higher than that of the other procedures (initial rates: 81.7% vs 38.9% vs 45.1%, respectively; p < 0.001; rates after further treatment: 86.7% vs 61.1% vs 61.0%, respectively; p = 0.002). Only 1 patient in the mini-ECIRS group required blood transfusions. The decrease in hemoglobin during mini-ECIRS and mini-PNL was significantly lower than that during con-PNL (p = 0.011). Conclusion: Mini-ECIRS is better than monotherapy with mini-PNL or con-PNL. The study results show that mini-ECIRS is a safe, efficient, and versatile procedure that can be effective for the management of renal calculi.

Hamamoto S; Yasui T; Okada A; Taguchi K; Kawai N; Ando R; Mizuno K; Kubota Y; Kamiya H; Tozawa K; Kohri K

2013-08-01

390

[Investigation of typical melamine urinary stones using infrared spectra].  

UK PubMed Central (United Kingdom)

A typical melamine kidney stone confirmed by some medicine expert was collected from the first people's hospital of Yunnan. The kidney stone was adequately determined by PE corporation spectra 100(with resolution of 1 cm(-1)). The stone samples for FTIR analysis were prepared using the KBr pellet technique, where 2 mg of the pretreated stone powder was mixed with 200 mg of analytical grade KBr using an agate pestle and mortar. The digital spectrum was then scanned in the mid-infrared region from 4 000 to 400 cm(-1) at room temperature. The appearing bands between 4 000 and 2 000 cm(-1) were 3 487, 3 325, 3 162 and 2 788 cm(-1), those between 1 700 and 1 000 cm(-1) were 1 694, 1 555, 1 383, 1 340, 1 189 and 1 122 cm(-1), and those between 1 000 and 400 cm(-1) were 993, 782, 748, 709, 624, 585, 565 and 476 cm(-1). It was found that the main constituent of calculi showed few comparability with cat kidney stone, which was from cats that died after consuming the contaminated food, and confirmed that these deposits were primarily composed of melamine and cyanuric acid compared to the IR spectra of calculi in literature. It was also found that the main constituent of calculi showed few comparability with popular kidney stone by comparison with the IR spectra of calculi in literature. The spectrum of calculi was 50% respectively similar with melamine and uric acid as compared with the IR spectrum. It was found that the main constituent of calculi was melamine itself and uric acid as compared with the IR spectra of calculi and melamine: (1 : 1), because the spectrum of calculi was 83. 3% similar to melamine and uric acid (1 : 1). The appearing bands of melamine and uric a