1/23. Stenturia: An unusual manifestation of spontaneous ureteral stent fragmentation.Two patients presented with passage of worm-like stent fragments in the urine. The first had undergone attempted percutaneous removal of left renal calculus and ureteral stenting 4 months prior to presentation. The second had left-sided stent placement for obstructive anuria on account of bilateral renal calculi 3 months earlier. The stents had fragmented into multiple pieces over a mean indwelling time of only 3.5 months. Apart from calculus disease, both patients had documented urinary tract infection. Stent fragmentation is a relatively rare (0.3%) but major complication. However, spontaneous excretion of these fragments has not been hitherto reported. These cases of rapid stent disintegration highlight the need for closer monitoring of the indwelling stents, especially in patients with calculus disease and associated persistent infection. In such patients the stent should probably be changed within 3 months.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
2/23. radio-contrast enhancement of a urinary tract calculus.We report the case of a woman who presented with obstruction and urosepsis of her left kidney secondary to small cystine calculi. The calculi could not be seen on initial plain abdominal X-ray. However, following percutaneous nephrostogram the calculi became more radio-dense and visible on later x-rays. Experimental enhancement of calculi has been described before but not in man. We presume that the contrast medium was adsorbed by the calculus to increase the radio-density. Further investigation of this phenomenon could prove useful in the management of complex radiolucent calculi.- - - - - - - - - - ranking = 1.6666666666667keywords = calculus (Clic here for more details about this article) |
3/23. Mini-percutaneous antegrade endopyelotomy.Antegrade endopyelotomy is the endourologic treatment of choice for ureteropelvic junction obstruction with a coexisting renal calculus. We report the use of a mini-percutaneous procedure that allows us to perform an antegrade endopyelotomy and stone extraction through a 20F nephrostomy sheath.- - - - - - - - - - ranking = 0.33333333333333keywords = calculus (Clic here for more details about this article) |
4/23. In situ dissolution of ureteral calculus.An obstructing uric acid calculus was successfully managed by dissolution in situ. The methods used are described in detail. Perhaps not applicable in all cases, the ease of the procedure makes it worth considering especially in patients at high risk for open operative intervention.- - - - - - - - - - ranking = 70.882256388602keywords = ureteral calculus, calculus (Clic here for more details about this article) |
5/23. Combined antegrade and retrograde endoscopic approach for the management of urinary diversion-associated pathology.BACKGROUND: Endourologic management of stones and strictures in patients with a urinary diversion is often cumbersome because of the absence of standard anatomic landmarks. We report on our technique of minimally invasive management of urinary diversion-associated pathology by means of a combined antegrade and retrograde approach. patients AND methods: Five patients with urinary diversion-associated pathology were treated at our institution between May 1997 and October 1998. Their problems were: an obstructing ureteral stone in a man with ureterosigmoidostomy performed for bladder extrophy; two men with a valve stricture in their hemiKock urinary diversions; an anastomotic stricture in a man with an ileal loop diversion; and a long left ureteroenteric stricture in a man with a right colon pouch diversion. After percutaneous placement of an guidewire across the area of interest, the targeted pathology was accessed via a retrograde approach using standard semirigid or flexible fiberoptic endoscopes. Postoperative follow-up with intravenous urography, differential renal scan, or both was performed at 3 to 24 months (mean 12 months). RESULTS: The combined antegrade and retrograde approach allowed successful access to pathologic areas in all patients. holmium laser/Acucise incision of stenotic segments or ballistic fragmentation of stones was achieved in all cases without perioperative complications. None of the strictures with an initially successful outcome has recurred; however, in one patient, the procedure failed as soon as the internal stent was removed. The patient with the ureteral calculus remains stone free, and his ureterosigmoidostomy is patent without evidence of obstruction on his last imaging study, 24 months postoperatively. CONCLUSIONS: Combined antegrade and retrograde endoscopic access to the area of interest is our preferred method of approaching pathologic problems in patients with a urinary diversion. An antegrade nephrostogram provides better delineation of anatomy, while through-and-through access enables rapid and easier identification of stenotic segments that may be hidden by mucosal folds. Furthermore, this approach allows the use of larger semirigid or flexible endoscopes in conjunction with more efficient fragmentation devices, resulting in enhanced vision from better irrigation. Finally, an initial endoscopic approach may be preferred because its failure does not compromise the success of future open surgery.- - - - - - - - - - ranking = 17.637230763817keywords = ureteral calculus, calculus (Clic here for more details about this article) |
6/23. Calculus formation on a retained Acucise wire.We report the case of a patient who developed an obstructing calculus embedded at the ureteropelvic junction after treatment of ureteropelvic junction obstruction with the Acucise cutting balloon catheter. Within the length of the stone, we found a wire consistent with the cutting wire. To our knowledge, this is the first report of a fractured and retained cutting wire resulting in calculus formation.- - - - - - - - - - ranking = 0.66666666666667keywords = calculus (Clic here for more details about this article) |
7/23. Giant urinoma in spinal cord injury: report of two cases.BACKGROUND: A urinoma is a cyst formed by the extravasation of urine from any constituent of the urinary tract; that is, via the kidney, ureter, urinary bladder, or the urethra. It may vary in its site and size according to its etiology, the point of the extravasation, and its duration and time of diagnosis. It commonly is associated with obstruction of the lower urinary tract by an impacted urinary calculus. METHOD: case reports. FINDINGS: Two cases of fatal intra-abdominal urinomas in patients with spinal cord injury (SCI). CONCLUSION: Complications of SCI place these patients at risk for the development of urinoma. risk is highest among individuals with recurrent urinary tract infection, stone disease, and obstructive uropathy. Providers need to be alert to this potentially curable condition that may be obscured by the paucity of intra-abdominal findings due to the nature of the spinal cord syndrome.- - - - - - - - - - ranking = 0.33333333333333keywords = calculus (Clic here for more details about this article) |
8/23. Ureterosigmoidostomy and obstructive uropathy.BACKGROUND: A 19-year-old mentally retarded man with failed exstrophy repair and ureterosigmoidostomy urinary diversion presented with high fever, vomiting and right-flank pain of 2 days' duration. Past medical history was notable for a left nephrectomy to treat an infected staghorn calculus in a poorly functioning kidney. physical examination revealed pyrexia and right-flank tenderness. INVESTIGATIONS: physical examination, renal function tests, electrolyte and metabolic assessment, urine and blood cultures, abdominal CT, ANTEGRADE PYELOURETEROGRAPHY, sigmoidoscopy and histopathology. diagnosis: Ureterosigmoidostomy complicated by acute pyelonephritis, obstructive uropathy, recurrent urinary tract infections, renal impairment and the development of renal stones and metabolic acidosis. MANAGEMENT: Fluids, intravenous antibiotics, bicarbonate and potassium supplementation, and rediversion of ureterosigmoidostomy to an ileal conduit.- - - - - - - - - - ranking = 0.33333333333333keywords = calculus (Clic here for more details about this article) |
9/23. Radiolucent urinary calculus in a transplant patient: an unsuspected cause of ureteropelvic obstruction.The occurrence of nephrolithiasis and nephrocalcinosis in the patient who has undergone a renal transplant is rare and is usually related to parathyroid hypersecretion. A case is presented in which the patient had a radiolucent stone that arose as a result of the use of nonabsorbable sutures. It is clear that nonabsorbable sutures. It is clear that nonabsorbable sutures should be avoided in renal allotransplant recipients.- - - - - - - - - - ranking = 1.3333333333333keywords = calculus (Clic here for more details about this article) |
10/23. Giant obstructing calculus in the distal ureter secondary to obstruction by a ureterocele.A 43-year-old man presented with bilateral simple ureteroceles complicated by calculi. A huge left ureteral calculus subsequently developed, causing nonfunctioning of the left kidney. This is apparently the largest calculus associated with an orthotopic ureterocele ever reported in the literature. Its cause, diagnosis, and treatment are discussed.- - - - - - - - - - ranking = 19.303897430484keywords = ureteral calculus, calculus (Clic here for more details about this article) |
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