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Bandac AC, Ristescu AI, Costache CR, Bobeica RL, Pantilimonescu TF, Onofrei P, Radu VD. Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy ( ESWL) in Patients With Infected Ureterohydronephrosis Due to Ureteral Stones Following Double-J Catheter Insertion. Cureus 2024; 16:e51742. [PMID: 38318541 PMCID: PMC10840444 DOI: 10.7759/cureus.51742] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
INTRODUCTION Double-J ureteral catheters in patients with ureteral lithiasis undergoing extracorporeal shockwave lithotripsy (ESWL) procedures reduce the efficacy of the procedure or have no effect on the stone-free rate. However, the effect of double-J catheters on the patients in whom they were inserted for infected hydronephrosis is not known. The aim of our study was to evaluate the efficacy and safety of the ESWL procedure in patients with ureteral lithiasis and double-J catheters previously inserted for infected hydronephrosis. METHOD We conducted a comparative case-control, match-paired study in a group of patients with ureteral lithiasis treated by ESWL from January 1, 2018, to March 1, 2023, who were divided into two groups according to the presence of the double-J catheter. For each patient with the double-J catheter from the study group, we selected one patient for the control group without the double-J catheter and matched them in terms of size, location of stones, and body mass index (BMI). We analyzed the stone-free rate and complications that occurred in the two groups. RESULTS Forty patients with ureteral lithiasis and a double-J catheter inserted for infected hydronephrosis were enrolled in the study group. The control group included 40 patients with ureteral stones without double-J catheters. The patients in the two groups were predominantly men with stones located in the lumbar region and on the right side and with a BMI between 25 and 30 kg/m2. The stones had an average size of 0.9+/-0.12mm and 0.89+/-0.15mm, respectively (p=0.624). There was no statistically significant difference in stone-free rate between the two groups after the first session of ESWL (47.5% vs. 52.5%, p=0.502), the second (70% vs. 75%, p = 0.616), and the third session (85% vs. 87.5%, p=0.761). The rate of complications was similar in both groups (7.5% vs. 5%, p=0.761). CONCLUSIONS The presence of double-J catheters inserted in patients with ureteral stones who underwent ESWL for infected hydronephrosis does not affect the stone-free rate of the procedure or the complication rate. The procedure of ESWL in patients with ureteral lithiasis and double-J catheters inserted for infected hydronephrosis is a safe and efficient method that can be recommended as an initial treatment alongside retrograde ureteroscopy.
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Affiliation(s)
| | - Anca Irina Ristescu
- Anaesthesiology and Intensive Care, Grigore T. Popa University of Medicine and Pharmacy, Iasi, ROU
| | - Cristian Radu Costache
- Urology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, ROU
- Urology, C.I. Parhon University Hospital, Iasi, ROU
| | | | | | - Pavel Onofrei
- Morphofunctional Sciences II, Grigore T. Popa University of Medicine and Pharmacy, Iasi, ROU
- Urology, Elytis Hope Hospital, Iasi, ROU
| | - Viorel Dragos Radu
- Urology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, ROU
- Urology, C.I. Parhon University Hospital, Iasi, ROU
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Seker KG, Arikan Y, Cetin Seker Y, Ozlu DN, Evren I. An Unexpected Complication After Extracorporeal Shock Wave Lithotripsy: Emphysematous Pyelitis. Cureus 2020; 12:e8307. [PMID: 32607291 PMCID: PMC7320654 DOI: 10.7759/cureus.8307] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Emphysematous urinary tract infections (UTI) are life-threatening conditions caused by gas-forming organisms. Emphysematous pyelitis (EP) is a rare, acute bacterial UTI characterized by gas formation only in the renal collecting system. Extracorporeal shock wave lithotripsy (ESWL) treatment was performed for 10-mm sized stone in the left renal pelvis in an 81-year-old female patient with no known comorbidities other than hypertension. In the 10th hour following ESWL treatment, the patient referred to the emergency department with fever and left flank pain. Gas was noticed in the left renal collecting system in non-contrast computed tomography (NCCT). A wide spectrum antibiotic was given to the patient due to EP diagnosis and a nephrostomy catheter was placed in the left renal pelvis. EP should be considered in the patient with fever and flank pain after ESWL and NCCT should be performed for further examination. Quick diagnosis, examination and treatment of these patients in the emergency department are important.
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Affiliation(s)
- Kamil Gokhan Seker
- Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TUR
| | - Yusuf Arikan
- Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TUR
| | | | - Deniz Noyan Ozlu
- Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, TUR
| | - Ismail Evren
- Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, TUR
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Nesheiwat Z, Sheikh T, Patel D, Burmeister C, Balla M. Obstructing Pancreatic Ductal Calculus: A Case Report and Literature Review. Cureus 2020; 12:e7730. [PMID: 32432008 PMCID: PMC7233929 DOI: 10.7759/cureus.7730] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pancreatic calculi are typically a sequela of chronic pancreatitis. Here, we present a patient who was found to have an obstructing one-centimeter pancreatic calculus secondary to recurrent gallstone pancreatitis. Recent retrospective studies have focused on the optimal treatment of large pancreatic calculi that were defined as greater than five millimeters. But most studies fail to comment on much larger stone as in this case report. Further guidelines and investigation need to be done aiming toward the optimal treatment of relatively large pancreatic stones.
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Affiliation(s)
- Zeid Nesheiwat
- Cardiology, University of Toledo Medical Center, Toledo, USA
| | - Taha Sheikh
- Internal Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, USA
| | - Dipen Patel
- Internal Medicine, University of Toledo Medical Center, Toledo, USA
| | | | - Mamtha Balla
- Internal Medicine, Promedical Toledo Hospital, Toledo, USA.,Internal Medicine, University of Toledo, Toledo, USA
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Iqbal N, Assad S, Rahat Aleman Bhatti J, Hasan A, Shabbir MU, Akhter S. Comparison of Extracorporeal Shock Wave Lithotripsy for Urolithiasis Between Children and Adults: A Single Centre Study. Cureus 2016; 8:e810. [PMID: 27800291 PMCID: PMC5085830 DOI: 10.7759/cureus.810] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective To retrospectively evaluate the effectiveness of extracorporeal shock wave lithotripsy (ESWL) for urolithiasis and compare the results between children and adults. Materials and methods From January 2011 to January 2015 (four years), ESWL was performed in 104 children and 300 adults for urolithiasis. MODULITH® SLX-F2 lithotripter (Storz Medical AG, Tägerwilen, Switzerland) equipment was used for ESWL. The stone-free rates, the number of ESWL sessions required, complication rates and ancillary procedures used were evaluated in a comparative manner. Results The mean age ± standard deviation (SD) of children was 7.84±4.22 years and of adults was a 40.22±1.57 years. Mean ± SD of the stone size was 1.28±61 cm in the adults while 1.08 ± 0.59 cm in the children. In adults, the complications included steinstrasse in six (1.98%) patients, fever in 15 (4.95%), hematuria in 19 (6.28%) and sepsis in six (1.98%) patients. In children, steinstrasse was observed in two (1.9%), mild fever in two (1.9%), hematuria in six (5.7%) and sepsis was seen in four (3.8%) patients. The overall complication rate in the adults and in the children, it was found to be 46/300 (15%) and in the children, it was seen to be 14/104 (13%). No statistical difference was found in post-ESWL complications between children and adults (P>0.05). Ancillary procedures including double J (DJ) stent were used in 13 (12.5%) children and 87 (29%) adults. There was a better stone clearance rate in children i.e. 79% as compared to 68% in adults (X2: P=0.036). Conclusion Children can achieve high stone-free rates after ESWL with a lower need for repeat ancillary procedures as compared to adults. However, there is a difference in the post-ESWL complications between these groups.
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Affiliation(s)
- Nadeem Iqbal
- `Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | - Salman Assad
- Department of Neurology & Neurosurgery, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | | | - Aisha Hasan
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
| | | | - Saeed Akhter
- Department of Urology, Shifa International Hospital, Islamabad, Pakistan
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Abstract
BACKGROUND/AIMS We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy. DESIGN A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center. PATIENTS AND METHODS All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL. RESULTS A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis. CONCLUSION Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones.
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Affiliation(s)
- Abdulrahman M. Aljebreen
- Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia,Address for correspondence: Dr. Abdulrahman M. Aljebreen, Department of Internal Medicine, PO Box 2925, King Khalid University Hospital, Riyadh, 11461, Saudi Arabia. E-mail:
| | - Othman R. Alharbi
- Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Nahla Azzam
- Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Majid A. Almadi
- Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia,Gastroenterology Division, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada
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Abstract
Children represent about 1% of all patients with urolithiasis, but 100% of these children are considered high risk for recurrent stone formation, and it is crucial for them to receive a therapy that will render them stone free. In addition, a metabolic workup is necessary to ensure a tailored metaphylaxis to prevent or delay recurrence. The appropriate therapy depends on localization, size, and composition of the calculus, as well as on the anatomy of the urinary tract. In specialized centers, the whole range of extracorporeal shock-wave lithotripsy (ESWL), ureterorenoscopy (URS), and percutaneous nephrolithotomy (PCNL) are available for children, with the same efficiency and safety as in adults.
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Sun CC, Chang P. Prediction of unexpected emergency room visit after extracorporeal shock wave lithotripsy for urolithiasis - an application of artificial neural network in hospital information system. AMIA Annu Symp Proc 2006; 2006:1113. [PMID: 17238732 PMCID: PMC1839485] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Extracorporeal shock wave lithotripsy (ESWL) for urolithiasis was developed for more than 30 years. It benefited most patients suffering from acute renal colic. The ESWL may be performed at outpatient based in most hospital in Taiwan. But the post-ESWL emergency room (ER) visits will be a painful experience for patient and the urologist,especially those patients visited ER immediately on the same day of ESWL. Though most guidelines for ESWL suggest the larger stone burden, the higher risk for post-ESWL ER visits,there are about 10% patients will come back to ER due to renal colic post-operatively. We use artificial neural network(ANN) to predict the post-ESWL ER visit for patient with urolithiasis. The result disclosed high sensitivity and specificity of prediction. In conclusion, it will decrease the rate of post-ER visit rate and patients' suffer by using ANN to predict the post-ESWL ER visits.
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Affiliation(s)
- Chi-Cheng Sun
- Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
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Kim MH, Lee SK, Min YI, Cho KS, Auh YH, Lee SG. Computed tomographic analysis of gallbladder stones: correlation with chemical composition and in vitro shock-wave lithotripsy. Korean J Intern Med 1991; 6:1-7. [PMID: 1742250 PMCID: PMC4535016 DOI: 10.3904/kjim.1991.6.1.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The recent advent of nonsurgical treatment for gallstones requires accurate in vivo analysis of their chemical composition in order to select the best candidates. As a preliminary work, we undertook an in vitro CT examination of 53 surgically removed gallstones and compared their CT patterns with their chemical composition. Those results were correlated with in vitro lithotripsy of the gallstones. The CT appearances were classified as follows: laminated (43%), dense (32%), rimmed (11%), isodense (8%) and faint (6%). The dense pattern contained a high calcium content. As the CT density increased, the calcium content increased, but the cholesterol content decreased proportionally. The number of shock waves needed to break down a gallstone less than 2 mm in size increased with stone volume and the cholesterol content increased but did not have any correlation with the calcium content level. As a result we found the CT examination to be a very sensitive method in detecting small amounts of calcium content in gallstones and the CT pattern and density of the gallstones were well correlated with their chemical composition, therefore in vivo CT examinations for ESWL candidates are desirable.
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Affiliation(s)
- M H Kim
- Department of Internal Medicine, Asan Medical Center, Seoul, Korea
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