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Lee JY, Andonian S, Bhojani N, Bjazevic J, Chew BH, De S, Elmansy H, Lantz-Powers AG, Pace KT, Schuler TD, Singal RK, Wang P, Ordon M. Canadian Urological Association guideline: Management of ureteral calculi - Abridged version. Can Urol Assoc J 2021; 15:383-393. [PMID: 34847343 PMCID: PMC8631858 DOI: 10.5489/cuaj.7652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jason Y. Lee
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Sero Andonian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Naeem Bhojani
- Department of Urology, Université de Montréal, Montreal, QC, Canada
| | - Jennifer Bjazevic
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ben H. Chew
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Shubha De
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hazem Elmansy
- Urology, Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | | | - Kenneth T. Pace
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Trevor D. Schuler
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Rajiv K. Singal
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Peter Wang
- London Health Sciences Centre, Western University, London, ON, Canada
| | - Michael Ordon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Lew HBM, Seow JHS, Hewavitharana CP, Burrows S. Alternatives to the baseline KUB for CTKUB-detected calculi: evaluation of CT scout and average and maximum intensity projection images. Abdom Radiol (NY) 2017; 42:1459-1463. [PMID: 27933480 DOI: 10.1007/s00261-016-1003-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE A CT of the kidneys, ureters, and bladder (CTKUB) is the investigation of choice in suspected renal colic. Plain kidney, ureter, and bladder radiographs (KUB) can be used to monitor the progress of a stone if radiographically visible on a baseline KUB. This study aims to determine if a low-dose CT Scout, thick-slab average intensity projection (AIP), or maximum intensity projection (MIP) images are suitable as substitutes for a baseline KUB. METHOD A retrospective review of patients from a tertiary adult institute that had a positive CTKUB and a KUB within 4 h of the CT was performed. Two consultant radiologists independently reviewed the KUB, CT Scout, AIP, and MIP for stone visibility and their sensitivities and agreement values were compared. Stone characteristics (size, location, and peak Hounsfield units) and patient thickness were recorded and examined for any association with discordant results. RESULTS 74 stones were evaluated for the study. KUB had a sensitivity of 66.2% (95% CI 54.3-76.8), CT Scout 47.3% (95% CI 35.6-59.3), AIP 55.4% (95% CI 43.4-67.0), and MIP 83.8% (95% CI 73.4-91.3). Fair agreement was found between the KUB and both CT Scout (κ=0.363, 95% CI 0.167-0.558) and AIP (κ=0.384, 95% CI 0.175-0.592). Moderate agreement was found between the KUB and MIP (κ=0.412, 95% CI 0.198-0.625). Neither any stone characteristic nor patient thickness had a significant association with discordant results. CONCLUSION None of the possible substitutes for a baseline KUB showed strong agreement with the KUB. Low-dose CT Scouts have a similar sensitivity to the published literature for higher dose CT Scouts.
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Affiliation(s)
| | - James Han-Su Seow
- Royal Perth Hospital, 197 Wellington Street, Perth, WA, 6000, Australia
| | | | - Sally Burrows
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, 6009, Australia
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O'Kane D, Papa N, Manning T, Quinn J, Hawes A, Smith N, McClintock S, Lawrentschuk N, Bolton DM. Contemporary Accuracy of Digital Abdominal X-Ray for Follow-Up of Pure Calcium Urolithiasis: Is There Still a Role? J Endourol 2016; 30:844-9. [DOI: 10.1089/end.2016.0173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Dermot O'Kane
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, University of Melbourne, Victoria, Australia
| | - Nathan Papa
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
| | - Todd Manning
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, University of Melbourne, Victoria, Australia
| | - Jonathan Quinn
- School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Alice Hawes
- School of Medicine, Griffith University, Southport, Queensland, Australia
| | - Neil Smith
- Department of Urology, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Scott McClintock
- Department of Urology, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Nathan Lawrentschuk
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, University of Melbourne, Victoria, Australia
| | - Damien M. Bolton
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, University of Melbourne, Victoria, Australia
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Zhang S, Liu G, Duo Y, Wang J, Li J, Li C. Application of Ureteroscope in Emergency Treatment with Persistent Renal Colic Patients during Pregnancy. PLoS One 2016; 11:e0146597. [PMID: 26751955 PMCID: PMC4709194 DOI: 10.1371/journal.pone.0146597] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/18/2015] [Indexed: 11/21/2022] Open
Abstract
Background Although the application of ureteroscopy in the treatment of ureteral calculi during pregnancy has been on the rise, for persistent renal colic patients without ultrasound-detected ureteral calculi, it may represent a clinical dilemma due to the potential risks for both mother and fetus. Objective The aim of the present study is to present our experience with the application of the ureteroscope in the emergency treatment of persistent renal colic patients during pregnancy. Methods From March 2009 to September 2014, a total of 117 pregnant women who received ureteroscopy for persistent renal colic were retrospectively analyzed. Patients were divided into three groups according to duration of the persistent renal colic: Group A (within 12 hours; 24 cases); Group B (12 to 24 hours; 76 cases); and Group C (more than 24 hours; 17 cases). The stone-free rate, complications, and other qualitative data were analyzed. Results Of the 117 patients, 31 patients who were found not to have renal or ureteral calculi received ureteroscopic double-J (DJ) stent insertion, whereas 86 patients who were found with ureteral calculi received ureteroscopic lithotripsy (URSL) and DJ stent insertion. Among them, 24 patients (27.9%) were found with ureteral calculi by ureteroscopy rather than ultrasound. In addition, 73 patients (84.9%) had complete fragmentation of calculi; 12 patients (10.3%) had a threatened abortion (the rates of threatened abortion in Groups A, B and C were 8.3% vs. 6.5% vs. 29.4%; Group C compared with Groups A and B, p<0.05), and one patient (1.2%) had urosepsis (in Group C). However, these complications were cured with conservative treatment, without postpartum infant and maternal complications. Conclusion For pregnant patients with persistent renal colic/ureteral calculi and hydronephrosis, ureteroscopic DJ stent insertion and URSL are effective and safe options when conservative treatment fails, even if no urinary calculi were found by ultrasound. At the same time, for patients with persistent renal colic during pregnancy, early application of ureteroscopy may reduce the risk of preterm birth.
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Affiliation(s)
- Shilin Zhang
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
- * E-mail:
| | - Guoqing Liu
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
| | - Yongfu Duo
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
| | - Jianfeng Wang
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
| | - Jierong Li
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
| | - Chunjing Li
- Department of Urology, Foshan Maternal and Child Health Hospital, Southern Medical University, People's Road No. 11, Foshan City, Guangdong Province, 528000, China
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Bodmer NA, Thakrar KH. Evaluating the Patient with Left Lower Quadrant Abdominal Pain. Radiol Clin North Am 2015; 53:1171-88. [PMID: 26526432 DOI: 10.1016/j.rcl.2015.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Left lower quadrant pain is a frequent indication for imaging in the emergency department. Most causes of pain originate from the colon, including diverticulitis, colitis, fecal impaction, and epiploic appendagitis. Left-sided urolithiasis and spontaneous hemorrhage in the retroperitoneum or rectus sheath are additional causes of pain. Computed tomography is the preferred imaging modality in the emergent setting for all of these pathologic conditions. Gynecologic, testicular, and neoplastic pathology may also cause left lower quadrant pain but are not discussed in this article.
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Affiliation(s)
- Nicholas A Bodmer
- Department of Radiology, Advocate Good Samaritan Hospital, 3815 Highland Avenue, Downers Grove, IL 60515, USA.
| | - Kiran H Thakrar
- Department of Radiology, Evanston NorthShore University, 2650 Ridge Avenue, Evanston, IL 60201, USA
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Huo J, Liu ZY, Wang KF, Xu ZQ. In Vivo Evaluation of Chemical Composition of Eight Types of Urinary Calculi Using Spiral Computerized Tomography in a Chinese Population. J Clin Lab Anal 2014; 29:370-4. [PMID: 25131309 DOI: 10.1002/jcla.21781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/29/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate the chemical composition of eight types of urinary calculi using spiral computerized tomography (CT) in vivo. METHODS From October 2011 to February 2013, upper urinary tract calculi were obtained from 122 patients in the department of urinary surgery of the First Affiliated Hospital of Soochow University. All patients were scanned with a 64-detector row helical CT scanner using 6.50 mm collimation before ureterorenoscopy. Data from the preoperative spiral CT scans and postoperative chemical composition of urinary calculi were collected. RESULTS The chemical composition analysis indicates that there were five types of pure calculi and three types of mixed calculi, including 39 calcium oxalate calculi, 12 calcium phosphate calculi, 10 calcium carbonate calculi, 8 magnesium ammonium phosphate calculi, 6 carbonated apatite, 21 uric acid/ammonium urate calculi, 10 uric acid/calcium oxalate calculi, and 16 calcium oxalate/calcium phosphate calculi. There were significant differences in the mean CT values among the five types of pure calculi (P < 0.001). Furthermore, we also observed significant differences in the mean CT values among three types of mixed calculi (P < 0.001). Significant differences in the mean CT values were also found among eight types of urinary calculi (P < 0.001). However, no statistically significant difference was observed between the mean CT values of magnesium ammonium phosphate calculi and uric acid/calcium oxalate calculi (P = 0.262). CONCLUSION Our findings suggest that spiral CT could be a promising tool for determining the chemical composition of upper urinary tract calculi.
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Affiliation(s)
- Jun Huo
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, P.R. China
| | - Zhong-Yuan Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, P.R. China
| | - Ke-Feng Wang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, P.R. China
| | - Zhen-Qun Xu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, P.R. China
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