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Mansouri A, Tostivint V, Rouvellat P, Roumiguié M, Gamé X, Huyghe E, Rischmann P, Thanwerdas J, Malavaud P. [Is the ureteral length associated with the patient's size?]. Prog Urol 2019; 29:127-132. [PMID: 30709777 DOI: 10.1016/j.purol.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 08/26/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the relation between the ureteral length and the patients' size. PATIENTS AND METHOD Prospective study made between September 2012 and May 2014, on 87 patients with 42 men and 45 women, in whom the ureteral measure was performed during the various procedures that require the use of a pigtail stent. The average age of the population was 53 years old (±15.9) with an average height of 168.3cm (±8.4). This has been achieved through ureteral catheter combining fluoroscopy and endoscopy. RESULTS The ureteral average length was 23.5cm (±2.33). The ureteral average length was 23.8cm (±2.18) for man and 23.2cm (±2.44) for women. In this population, there were a positive correlation between the size of the patients and the length of the ureters (r=0.75; P=0.01). However, this correlation was not found in all subgroups, particularly among women (r=0.16; P=0.30) and on the right side of men (r=0.34; P=0.12). This correlation was still true for the left side in the men's group (r=0.50; P=0.02). CONCLUSION In this study, there is a positive correlation between the patients' size and the ureteral length. But this correlation is not found in some subgroups. It is better to perform in vivo the ureteral measurement to have the precise length in order to set up a pigtail stent adapted to the patient. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- A Mansouri
- Service d'urologie, hôpital Jean-Rougier, 46000 Cahors, France.
| | - V Tostivint
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - P Rouvellat
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - M Roumiguié
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - X Gamé
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - E Huyghe
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - P Rischmann
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
| | - J Thanwerdas
- Service d'urologie, hôpital Jean-Rougier, 46000 Cahors, France
| | - P Malavaud
- Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 31059 Toulouse, France
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Kassite I, Braïk K, Morel B, Villemagne T, Szwarc C, Maakaroun Z, Cook AR, Lardy H, Binet A. High pressure balloon dilatation of the ureterovesical junction in primary obstructive megaureter: Infectious morbidity. Prog Urol 2017; 27:507-512. [PMID: 28867581 DOI: 10.1016/j.purol.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/31/2017] [Accepted: 07/05/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The objective of this study is to investigate the infectious morbidity associated with high-pressure balloon dilatation (HPBD) and an indwelling double J stent, in primary obstructive megaureter. METHODS We reviewed the cases of 12 patients undergoing endoscopic treatment for primary obstructive megaureter from January 2012 to January 2015. The characteristics of the infection and data concerning the patient and the intervention were analyzed. RESULTS The frequency of preoperative urinary tract infection (UTI) was 58%. The procedure was feasible in 100% of cases. Two patients required a second dilatation. One patient underwent Cohen's ureteral reimplantation after failure of the second dilatation. The frequency of postoperative UTI was 25%. All these infections occurred in patients with a double J stent. None of the patients had UTI after stent removal. None of the patients developed postoperative vesicoureteral reflux (VUR) after HPBD. CONCLUSION Endoscopic balloon dilatation has been shown to have good short- mid- and long-term outcomes. In our experience, the morbidity of this procedure mostly results from infections, exclusively related to the use of a double J stent. The placement of a double J stent has a significant medical and economic impact. A definitive decision about the utility of double J stents will require studies of further dilatation without the placement of a double J stent. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- I Kassite
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - K Braïk
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - B Morel
- Service de radiologie pédiatrique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - T Villemagne
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - C Szwarc
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - Z Maakaroun
- Service de médecine infectieuse, CHU de Tours, hôpital Bretonneau, 37000 Tours, France
| | - A R Cook
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - H Lardy
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France
| | - A Binet
- Service de chirurgie pédiatrique urologique, CHU de Tours, hôpital Gatien de Clocheville, 37000 Tours, France.
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Cerruti A, Lebdai S, Martin F, Hoarau N, Chautard D, Culty T, Azzouzi AR, Bigot P. [Do postoperative drainage types modify outcomes after retrograde intrarenal surgery?]. Prog Urol 2015; 25:331-5. [PMID: 25748790 DOI: 10.1016/j.purol.2015.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/29/2014] [Accepted: 01/23/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aim of the current study was to evaluate if the postoperative drainage type modified the outcomes after retrograde flexible ureteroscopy (f-URS) and intracorporeal lithotripsy f-URS for intrarenal stones. MATERIAL AND METHODS We retrospectively analyzed 162 procedures of f-URS for intrarenal stones between January 2010 and January 2013 at a single institute. Independent-sample t-tests and chi-square tests were used for comparisons of means and proportions between patients with ureteral stent or double pigtail stents. RESULTS There were 86 males (52.8%) and 77 females (47.3%) with a mean age of 52.8 ± 17 years. Double pigtail stents and ureteral stents were used in 117 (72.2%) and 45 (27.8%) cases, respectively. Cases with postoperative double pigtail stents had a longer operative time (96.2 ± 35 min vs 81.2 ± 5 min; P = 0.018) and were less often operated by an experienced surgeon (P = 0.001). Length of hospital staying (P = 0.804), postoperative complication (P = 0.148) and stone free status (P = 0.116) were not different between postoperative drainage by double pigtail and ureteral stents. CONCLUSION Postoperative drainage by double pigtail stent was used more often by surgeons in the beginning of their RIRS experience and was associated with longer operation time. Nevertheless, the postoperative drainage type did not modify the outcomes regarding the postoperative complication rate, the length of hospital staying and the stones free rate.
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Affiliation(s)
- A Cerruti
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - S Lebdai
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - F Martin
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - N Hoarau
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - D Chautard
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - T Culty
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - A R Azzouzi
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France
| | - P Bigot
- Service d'urologie, CHU d'Angers, 5, rue Larrey, 49000 Angers, France.
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Dariane C, Cornu JN, Esteve E, Cordel H, Egrot C, Traxer O, Haab F. [Fungal infections and ureteral material: How to manage?]. Prog Urol 2015; 25:306-11. [PMID: 25724861 DOI: 10.1016/j.purol.2015.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 01/16/2015] [Accepted: 01/24/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Urinary tract infections due to Candida species are mostly encountered in hospital environment. The management of candiduria on ureteral catheter is not consensual. The objective of our work was to make a review of medical literature related to definition, physiopathology, management and prevention of candiduria on ureteral catheter. MATERIAL AND METHODS The research was made on Medline using the following keywords: Candida; fungal; urinary tract infection; ureteral stent; ureteric stent; double-J pigtail. RESULTS The threshold defining candiduria is 10(5) CFU/mL. Candiduria corresponds to many different clinical presentations from colonization to candidemia. Species found are mostly Candida albicans (19-72%) and Candida glabrata (15.6-49.4%). The colonization of ureteral stent due to Candida is of 10% and comes with candiduria in 40% of the cases, due to the presence of biofilm. Prevention of infections on ureteral stents requires a regular change of material every 3-6 months depending on the patients risk groups. In case of symptomatic candiduria on ureteral stent, an anti-fungal therapy should be initiated 48 hours to 3 weeks before the change of the stent, in order to get a sterilization of urines and prevent the recolonization of the stent. Fluconazole is the drug of choice to use. CONCLUSION Colonization of ureteral stents due to Candida is common and can be responsible of symptomatic infection. Anti-fungal therapy should be introduced before the change of the stent but a consensual duration of treatment before surgery is not found in the literature.
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Affiliation(s)
- C Dariane
- Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - J-N Cornu
- Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - E Esteve
- Service de maladies infectieuses, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - H Cordel
- Service de maladies infectieuses, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - C Egrot
- Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - O Traxer
- Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - F Haab
- Service d'urologie, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
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