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At least 235 records · Page 13Linked to original sources
PubMed2001

[Analysis and clinical course of residual lithiasis after shock wave renal treatment].

OBJECTIVE: Although residual lithiasis after the application of shock waves is a situation that coexists with the procedure, in some cases it can be considered to be a failure of ESWL. The natural history and outcome of 244 cases of residual renal stone followed over a 5-year period are analyzed, and the approach based on a pre-established classification is discussed. METHODS: Of 1,407 patients treated by ESWL for renal lithiasis during 1995, 244 cases with a renal calculus larger than 3 mm were followed for a period of 5 years after treatment and evaluated by clinical, radiological, ultrasound and analytical methods. RESULTS: At 3 months post-ESWL, 1,013 cases (72%) were completely stone-free and 394 (28%) showed residual stone; of these, 244 (62%) had residual stone fragments greater than 3 mm. At 5 years, 190 (78%) remained stable and the remaining 54 (22%) showed stone regrowth that warranted additional treatments: 52 ESWL, 1 PNL and 1 partial nephrectomy. Despite the retreatments, only 42% became completely stone-free. CONCLUSIONS: A classification of residual renal stone can be established based on the data obtained to orient the approach in each case, although the frequency of residual stone can be reduced by the appropriate indication of ESWL. Once a renal stone has formed retreatments with ESWL cannot ensure complete elimination of the stone.

Humans↗
PubMed2001

[Urinary glycosaminoglycans after extracorporeal shock wave lithotripsy in patients with kidney lithiasis].

OBJECTIVE: Extracorporeal shock wave lithotripsy (ESWL) is a technique that is not free of adverse effects. Renal changes detected during complementary exploratory procedures have been described, although these are minimal, resolve within a few days, do not present clinical manifestations and are not detected on ultrasound in most of the cases. For this reason, we studied a marker for renal injury, the urinary excretion of glycosaminoglycans (GAG) in patients with renal calculi, before, immediately after and 30 days following ESWL. The novelty of the study lies in that we have classified the patients with calculi according to the degree of renal function before ESWL, since it is recognized that the obstructive features of lithiasis can cause some degree of renal impairment. METHODS: Urinary GAG was quantified according to the colorimetric method described by Pennock. RESULTS: Urinary GAG levels were found to be lower in patients with renal calculi and preserved renal function than in healthy control subjects. In the presence of renal failure, these levels are elevated due to the obstructive nephropathy caused by calculi. Urinary GAG significantly increased post-ESWL in patients with renal lithiasis and preserved renal function or renal failure. At 30 days post-ESWL, GAG returned to pre-test levels. CONCLUSIONS: Quantification of urinary GAG is a useful biochemical method in the evaluation of renal parenchymal injury produced by ESWL.

Adult↗
PubMedDate not supplied

[Laparoscopic cholecystectomy in non-lithiasis cholecystopathies].

We made a study in 1st Surgery Clinic of Iassy between March 93--November 98, with 2246 laparoscopic cholecystectomies. The reason was to define the place and role of laparoscopy in non-lithiasis cholecystopathies (81 cases). In the same period were operated classically 888 calculous cholecystitis and 38 non-lithiasis cholecystitis. The laparoscopy has a major role in diagnosis to the patients with many abdominal symptoms. We discovered pericholecystic adherences, hepatic cirrhosis, acute appendicitis, etc. Sometimes, the laparoscopy was made for "second look" after surgical treatment for neoplasia, the metastasis diagnosis, for tumors visible echographically. In many situations the laparoscopic cholecystectomy may be considered like a preventive operation. The easy postoperative evolution is an argument to enlarge the indication for laparoscopic cholecystectomy in alithiasis cholecystitis.

Cholecystectomy, Laparoscopic↗
PubMed2002

[Cyst of the prostatic utricle: report of a case complicated by giant lithiasis].

OBJECTIVE: We report a case of prostatic utricle cyst complicated with giant lithiasis. METHOD/RESULTS: A 42 year old man with history of surgery for bilateral cryptorchidism and hypospadias in his infancy, presented with initial and terminal hematuria and a digital rectal examination showing a rocky, smooth enlargement of the anterior rectal wall. Prostatic specific antigen was normal. Transrectal and transabdominal ultrasound showed a large retrovesical calcification and intravenous pyelogram showed normality of the upper urinary tract. The patient underwent a complete resection through a suprapubic extraperitoneal approach without complications. Histopathology revealed a 10 cm long prostatic utricle cyst complicated with lithiasis. CONCLUSIONS: The prostatic utricle cysts are rare in clinical practice and associate with anomalies of testicular descent and hypospadias. They have a difficult differential diagnosis and indication for treatment depends on presenting symptoms, size and complications.

Adult↗
PubMed2003

[Percutaneous endourologic treatment of obstructive ureteral lithiasis in renal transplant].

Donor graft lithiasis is a unusual complication of renal transplantation, however, it is associated to a high morbidity. This pathology is due to several causes such us: metabolic factors, infectious disease, drugs, foreign bodies or transferred in the donor graft. The objective of the treatment is to remove the lithiasis without damaging the renal unit. We report the successful percutaneous anterograde treatment of an ureteral obstructive hard calculi, in renal allograft.

Humans↗
PubMed1992

[Gallstone obstruction of the common bile duct, a severe form of biliary lithiasis. Choice of treatment].

Collection of 10 or more stones in the extrahepatic common bile duct causes lithiasic obstruction of the CBD, a fairly rare entity observed in less than 10% of cases of bile duct lithiasis. This study is based on 35 cases recorded over 10 years, including 60% in patients aged more than 75 years. Endoscopic treatment was attempted in 28% of patients and was totally successful in one case our of four only because of insufficient removal of obstruction after sphincterotomy. Surgery, either necessary (8 cases) or systematic (25 cases) combines cholecystectomy, choledocotomy and biliary fiberendoscopy for a complete treatment minimizing the risks of residual lithiasis. While biliodigestive anastomoses prevailed (58%) during the first years of this study, external biliary drainage was most often chosen during the last 5 years. This surgery in aged patients still entails high morbidity (25%) and considerable mortality (9%). Better efficacy may be provided in the future by the combination of fiberendoscopic means and of lithotrity for aged subjects at high surgical risks.

Adult↗
PubMedDate not supplied

[Recurrent renal lithiasis].

The author discusses, on the basis of 457 cases of recidivating renal lithiasis (representing 16% of the total number lithiasis cases hospitalized over a period of 28 years in the "Panduri" Hospital of Bucharest), the problem of false recidives, the causes that lead to recidive, the chemical composition of the stones, evolution aspects and therapeutical indications.

Humans↗
PubMed2003

[Lithiasis in complete ureteral duplication and prostate cancer: combined surgery treatment].

The diagnosis of congenital anomalies of the urogenital tract in the adult is uncommon. Complete ureteral duplication represents a congenital anomaly of the ureters, usually draining a duplex kidney, with a second orifice entering the bladder, urethra or other structures. In the majority of cases, this pathology is completely asymptomatic; sometimes it's diagnosed because of complications such as infections, hydronephrosis, lithiasis, or in the evaluation of the urinary tract. Early diagnosis of localized prostatic adenocarcinoma is increased due to worldwide use of PSA screening and the optimization of multiple biopsy, increasing radical surgery treatments. The association between these two pathologies is a rare event. We present the case of a 69-years old man diagnosed for localized prostatic cancer and bilateral complete ureteral duplication, megaureter and stenosis of left superior ureteral meatus, leading in the prostatic urethra. Terminal ureter with the ectopic meatus opening in prostatic urethra was occupied by stones. A combined surgical procedure was undertaken: radical prostatectomy, ectopic ureter section, lithiasis removal and reimplantation of left ectopic ureter into the bladder. There is no case described of the association of this urogenital anomaly and prostate cancer and the combined management of both.

Aged↗
PubMedDate not supplied

[Mini invasive treatment of common biliary duct lithiasis].

The aim of the paper is to show modern techniques of treatment in common biliary duct lithiasis, in the context of the remarkable development of laparoscopic surgery. The text, trays to mark some directions for the surgeon to know when and which of the modern techniques to chose for safe treatment of common biliary duct lithiasis. The criteria are bound to the moment of diagnosis, clinical state of the patient and laboratory tests. Of course, a final commitment will be taken after an objective evaluation of the technique possibilities and the experience of the team.

Cholecystectomy, Laparoscopic↗
PubMed2004

[Double bladder lithiasis from an intrauterine device. Report one case].

OBJECTIVES: To report a new case of an intrauterine device causing bladder lithiasis, because of its rarity as a complication of the intrauterine device contraceptive method. METHODS/RESULTS: 27-year-old female patient admitted in the urology department of the "Hospital Medico-quirurgico 10 de Octubre" who having an intrauterine device was pregnant, underwent a caesarean section, and a new intrauterine device implant, and a few months later presented with lower urinary tract infectious syndrome, being diagnosed of double bladder lithiasis secondary to intrauterine device migration, for which cystolithotomy was performed. CONCLUSIONS: We performed a short review of the bladder foreign bodies reported in the literature, and present this case which is very infrequent because of the finding of 2 stones in the bladder and an intrauterine device inside one of them. The intrauterine device was detected after crushing one of the calculi, 2 cm in size. It seems that first intrauterine device had migrated through the uterine wall into the bladder, creating a calcareous concretion around.

Adult↗
PubMed1992

[Extracorporeal shockwave lithotripsy: an alternative treatment for lithiasis of caliceal diverticula].

Among all the patients treated in our Lithotrity Unit, 13 of them had lithiasis inside the calyceal diverticulum. They were all treated by extracorporeal shockwaves. In none of the cases complete expulsion of lithiasic mass was achieved. In 3 (23%) cases it was reduced to half. In 2 (15.3%), 75% of the initial mass remained; and in 8 (61.5%) stones were fragmented but none of their debris was eliminated. Out of all the patients who were symptomatic before starting treatment, only 36.6% become asymptomatic. Extracorporeal lithotrity is, therefore, an approach with limited results in the calyceal intradiverticular lithiasis.

Diverticulum↗
PubMedDate not supplied

[Factitious lithiasis: Case report from Western Algeria].

A 19-year-old woman with recurrent lithiasis was admitted to the urology department for renal colic. Although radiologic examinations and laboratory tests were negative, the patient regularly brought into consultations small "stones", resembling gravel, that she said had been spontaneously expelled. These 42 samples were the object of a preliminary morphological analysis under a binocular magnifier to detect their particulate components. A non-metabolic origin was suspected from the organoleptic characteristics of their surfaces and sections. In view of the diversity of the materials of these apparently false calculi, methods of precise physical analysis were necessary to ascertain their exact origin and thereby confirm the diagnosis of factitious lithiasis. The use of two methods of physical analysis, infrared spectrophotometry and x-ray diffraction, enabled us to determine their exact chemical and mineralogical composition. The samples claimed to be of urinary origin actually consisted of exogenous products of various compositions. Some samples were made of pure calcite, others of mixed calcite and silicates. Moreover several samples of the patient's first morning urine showed no correlation between the nature of the crystalluria and the composition of these stones. These tests made it possible to direct the clinician towards useful complementary investigations. This strange case represents 0.1% of the urinary calculi analysed in Western Algeria.

Adult↗
PubMedDate not supplied

[Treatment of ureteral lithiasis with laser].

We present our experience in the treatment of ureteral lithiasis with pulsed dye lasertripsy (Pulsolith)**. Evaluation of the results achieved in 67 cases of lithiasis that had been treated from January, 1990 to March, 1991 revealed a success rate of 93%. The remaining cases required the use of other complementary energy to achieve stone fragmentation. The approach, the endoscopic technique using the Olympus ureteroscopes (7.2F-9F) and complementary maneuvers are described. The complications were minimal. We consider this to be the procedure of choice for calculi in the pelvic ureter. Furthermore, we discuss the cost/benefit of this therapeutic option within the context of a lithotripsy unit with a high endoscopic dedication and the possibility of using fine caliber ureteroscopes (Olympus) as well as other options for stone fragmentation (shock wave, ultrasound and electrohydraulic energy).

Adult↗
PubMed1992

[Treatment with ESWL of lithiasis in the transplanted kidney].

Report on one case of lithiasis in a transplanted kidney treated successfully with extracorporeal shockwave lithotrity. This is considered to be the choice therapeutical method when there are no bone interposition or urinary tract obstruction which may preclude the correct removal of lithiasis fragments.

Humans↗
PubMed1992

[Biliary lithiasis in childhood].

We have reported 28 cases of pediatric cholelithiasis in our hospital between 1980 and 1990. We found risk factors in 15 of these cases (53.6%). The most frequent risk factors were hereditary spherocytosis, cholestasis and obesity. A high frequency of non-hemolytic cholelithiasis was noted. Lithiasis was a casual finding in 13 cases (46.4%). The most frequent symptom was nonspecific abdominal pain, which occurred in 8 patients. Diagnosis was made with echography in every case. The range of time in which the patients were followed ranged between 1-5 years. Eight children required surgery. Among the other twenty, twelve were asymptomatic and six improved spontaneously. The mean age at the moment of diagnosis was younger in the children that spontaneously recovered than in children with permanent lithiasis. Therefore, for this reason, we recommend an observation period before surgery in children younger than 3 years of age.

Age Factors↗
PubMed1991

2,8-Dihydroxyadenine lithiasis in a Japanese patient heterozygous at the adenine phosphoribosyltransferase locus.

All reported cases of 2,8-dihydroxyadenine (DHA) lithiasis have been due to functional homozygous deficiency of adenine phosphoribosyltransferase (APRT). Here we describe the first case of DHA lithiasis in a patient who has functional APRT activity in cultured lymphoblasts. The patient is heterozygous for Japanese-type (type II) APRT deficiency as demonstrated by starch-gel electrophoresis and DNA sequence analysis. We also demonstrate the use of starch-gel electrophoresis for differentiation between the type II mutant enzyme and the wild-type enzyme.

Adenine↗
PubMed1991

[Percutaneous surgery in renal lithiasis. Current indications].

The indiscriminate use of extracorporeal shock waves in the treatment of urinary calculi has changed the place of percutaneous surgery in the treatment of renal lithiasis. The authors analyse current indications of PCN highlighting stone size. In their view, calculi greater than 2 cm warrant treatment by PCN since only 15-20% of patients are completely stone-free following a single session of ESWL. Attention is focussed on the staghorn calculus and the percutaneous approach. They describe the difficulty encountered in the fragmentation of the cystine calculus owing to its hardness and discuss the difficulties that may arise when using the percutaneous approach in patients with coexisting renoureteral conditions, in the treatment of lithiasis in children and in the obese patients.

Adult↗
PubMed1991

[Intraoperative echography during surgery for biliary lithiasis].

We present the experience with the use of intraoperative ultrasonography in detecting biliary calculi on 55 patients, 19 of which had lithiasis of the common bile duct. Operative ultrasonics imaging of the biliary tree and operative cholangiography had a similar accuracy when both explorations were performed. In this series, accuracy indexes of ultrasonography in diagnosing choledocholithiasis were: sensitivity, 84.21%; specificity, 100%; efficiency, 94%; predictability of a positive test, 100%; predictability of a negative test, 92%. We think ultrasonography is a better exploration in two conditions: when intrahepatic duct lithiasis exists and if calculi are at the end of choledochus, because differentiation with neoplastic changes is easier.

Adult↗