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At least 19 recordsLinked to original sources
PubMed1996

Use of extracorporeal shock wave lithotripsy for treatment of nephrolithiasis and ureterolithiasis in five dogs.

The safety and efficacy of extracorporeal shock wave lithotripsy in 5 dogs with nephrolithiasis and ureterolithiasis was assessed. Three dogs had bilateral nephrolithiasis, 1 had bilateral nephrolithiasis and unilateral ureterolithiasis, and 1 had unilateral nephrolithiasis and unilateral ureterolithiasis. A first-generation lithotriptor was used for all treatments. None of the dogs developed clinically important complications during or after treatment, except for 1 dog treated for bilateral nephrolithiasis that developed transient ureterolithiasis. Renal function was unchanged in all dogs following treatment. Clinical signs resolved in all dogs. Extracorporeal shock wave lithotripsy appears to be a safe and effective means of treating nephrolithiasis and ureterolithiasis in dogs and appears to cause less renal parenchymal damage and renal function loss than does nephrotomy.

Animals↗
PubMed1999

Acute ureterolithiasis: nonenhanced helical CT findings of perinephric edema for prediction of degree of ureteral obstruction.

PURPOSE: To determine whether the extent of perinephric edema on helical computed tomographic (CT) images without contrast material enhancement can be used to predict the degree of ureteral obstruction in patients with acute ureterolithiasis. MATERIALS AND METHODS: Nonenhanced helical CT and excretory urographic images in 82 patients with flank pain were retrospectively reviewed. For each patient, a radiologic diagnosis was established, and the degree of ureteral obstruction determined on urograms was compared with the extent of perinephric edema assessed on CT images. RESULTS: None of 29 patients with no abnormalities seen at urography had evidence of perinephric edema at CT. Of six patients with noncalculous disease, two with acute pyelonephritis had perinephric edema at CT. Of 47 patients with acute ureterolithiasis, eight had no perinephric edema at CT and a nonobstructing calculus at urography, 21 had limited edema at CT and low-grade obstruction at urography, and 15 had extensive edema at CT and high-grade obstruction at urography. Three patients had extensive perinephric edema at CT but low-grade obstruction at urography. The extent of edema allowed accurate prediction of the degree of ureteral obstruction in 44 (94%) of 47 patients with acute ureterolithiasis. CONCLUSION: The extent of perinephric edema on nonenhanced helical CT images can be used to predict the degree of ureteral obstruction in acute ureterolithiasis.

Acute Disease↗
PubMed1997

[Results of treatment of ureterolithiasis with shock-wave extracorporeal lithotripsy].

At the Urological Clinic, Faculty Hospital Hradec Králové the authors performed extracorporeal lithotripsy in ureterolithiasis in 172 patients, mean age 46.5 years. The patients were divided into two groups. The first group was formed by 114 patients (66.3%) with subrenal ureterolithiasis, the second group by 58 patients (33.7%) with iuxtavesical ureterolithiasis. In 56 patients (32.6%) derivation of urine had to be made by means of a stent or nephrostomic puncture drainage because of an obstruction by a concrement. The general success rate of the method was 96.4% in the subrenal localization and 81% in iuxtavesical ureterolithiasis. In 15 patients an alternate solution had to be sought (URS or extraction of the concrement by a Dormi basket, Zeiss loop).

Female↗
PubMed1997

Unenhanced helical CT of ureterolithiasis: value of the tissue rim sign.

OBJECTIVE: The tissue rim sign-a rim or halo of soft-tissue attenuation seen around the circumference of an intraureteral calculus on unenhanced axial CT-has been described as useful in differentiating ureteral calculi from extraurinary abdominal or pelvic calcifications. The purpose of this study was to determine the prevalence of the tissue rim sign in patients with ureterolithiasis and extraurinary calcifications and to determine the relationship between the tissue rim sign, the size of a calculus, and the degree of urinary obstruction. MATERIALS AND METHODS: Unenhanced helical CT studies followed by excretory urography were obtained in 59 patients with suspected acute ureterolithiasis. Each calcification along the expected course of the ureter seen on axial CT scans was categorized as a ureteral calculus or as an extraurinary calcification. Each categorization was based on CT, urographic, and clinical findings and the presence or absence of a tissue rim sign. When the outer wall of the ureter could not be seen because there was no clear fat plane at the level of the calcification on CT, the sign was categorized as "indeterminate." The size of the calculus was measured on CT, and the degree of urinary obstruction was estimated on the basis of the urograms. RESULTS: Thirty-two patients each had a single ureteral calculus. Of these patients, CT revealed a positive tissue rim sign in 16 patients (50%), was negative in five patients (16%), and was indeterminate in 11 patients (34%). In addition, we saw 57 extraurinary calcifications in 18 patients (11 patients with ureteral calculi and seven patients without ureteral calculi). None of the 57 extraurinary calcifications was associated with a positive tissue rim sign. The tissue rim sign was negative in 39 (68%) of the 57 extraurinary calcifications and indeterminate in the remaining 18 (32%). Ureteral calculi with a negative tissue rim sign were larger than ureteral calculi with a positive tissue rim sign (p < .01). A high degree of obstruction was present in four of five patients with ureteral calculi for which CT showed a negative tissue rim sign. Conversely, six of 16 patients in whom CT revealed a positive tissue rim sign also had a high degree of obstruction. Therefore, no clear relationship was found between the degree of obstruction and the presence of a positive tissue rim sign. CONCLUSION: A positive tissue rim sign is specific for the diagnosis of ureterolithiasis. However, a negative tissue rim sign does not preclude such a diagnosis. The presence or absence of this tissue rim sign correlates with the size of a calculus but not with the degree of urinary obstruction. When CT reveals an indeterminate tissue rim sign, careful inspection for other CT findings, such as ipsilateral ureteral dilatation, perinephric edema, dilatation of the intrarenal collecting system, and renal swelling, is necessary.

Acute Disease↗
PubMed2004

Diagnostic value of attenuation measurements of the kidney on unenhanced helical CT of obstructive ureterolithiasis.

OBJECTIVE: The objective of this study was to assess the diagnostic value of attenuation measurements of the kidney on unenhanced helical CT in patients with obstructive ureterolithiasis. MATERIALS AND METHODS: Consecutive unenhanced helical CT scans of patients referred for acute unilateral renal colic were retrospectively reviewed. Patients with CT evidence of other urinary system diseases were excluded. Included scans (n = 145) were assessed for ureteral stone and secondary signs of obstruction such as unilateral collecting system or ureteral dilatation, perinephric stranding, and periureteral edema. Renal attenuation in Hounsfield units was measured in the upper, middle, and lower portions of the parenchyma, and a mean value was determined for each kidney. RESULTS: Ureteral stones were present in 76 patients. Renal attenuation on the side with lithiasis was lower than on the opposite kidney: 27.2 +/- 3.9 H vs 32.6 +/- 3.4 H (p < 0.001). Attenuation differences between kidneys were higher for patients with ureterolithiasis: 5.4 +/- 3.2 H (range, -3.3 to 13.0 H) versus 1.2 +/- 1.0 H (range, 0-4.7 H) (p < 0.001). An attenuation difference between kidneys greater than or equal to 5.0 H had 61% sensitivity, 100% specificity, 100% positive predictive value, 69% negative predictive value, and 79% accuracy for diagnosis of ureteral lithiasis. CONCLUSION: Attenuation difference between kidneys greater than or equal to 5.0 H was a valuable sign and had diagnostic performance similar to other secondary signs of obstructive ureterolithiasis. Furthermore, attenuation difference had the advantage of being an objective, measurement-based indicator.

Adult↗
PubMed1991

[Evaluation of the efficacy of continuous epidural block with low concentration of local anesthetics in patients with ureterolithiasis].

Forty patients with ureterolithiasis were studied to evaluate the efficacy of a continuous epidural block with local anesthetics. The patients were randomly allocated into 3 groups: first group (n = 7) received continuous epidural administration of 1% mepivacaine at a rate of 2 ml.hr-1; second group (n = 19) received intermittent bolus administration of the same anesthetic 4-5 times daily; and third group (control group, n = 14) was treated by conventional therapy including infusion of Ringer's solution and diuretics. Among 3 groups, a comparison of the rate of abortion of ureter stone, the rate of mobilization of stone, and the frequency of operation was performed. The rate of abortion in group 1 was significantly higher than those of group 2 and control. The rate of mobilization of stone in group 1 tended to be higher than group 2 and control. Also the frequency of operation in group 1 tended to be lower than group 2. Effect of continuous administration with 1% mepivacaine in patient with ureterolithiasis was comparable to that of intermittent bolus administration of 2% mepivacaine or 0.5% bupivacaine reported. We conclude that the continuous block with 1% mepivacaine is effective and safe for treating the patient with ureterolithiasis.

Adult↗
PubMed1995

Dry extracorporeal shock wave lithotripsy for treatment of ureterolithiasis and nephrolithiasis in a dog.

A second-generation lithotriptor was used to perform dry extracorporeal shock wave lithotripsy in a dog with ureterolithiasis, nephrolithiasis, and chronic renal failure. Previous studies on the use of lithotripsy in dogs have involved first-generation machines and have primarily concentrated on acute and chronic effects of lithotripsy in experimental models. Treatment in this dog resulted in resolution of ureteral obstruction, ureterolithiasis, and nephrolithiasis, and avoided complications associated with ureteral and renal surgery. The only complication was substantial hematuria of 12 hours' duration immediately after the procedure. Second-generation lithotripsy may offer an effective treatment for ureterolithiasis or nephrolithiasis in selected dogs.

Animals↗
PubMed2000

The role of renal scintigraphy and unenhanced helical computerized tomography in patients with ureterolithiasis.

Unenhanced helical computerized tomography (UHCT) has recently evolved as an accurate imaging modality for determination of the presence or absence of ureterolithiasis in patients with acute flank pain. Functional renal scintigraphy is considered the gold standard for urinary tract obstruction. The objective of this study was to correlate the secondary signs of urinary obstruction on UHCT with findings of functional renal scintigraphy. UHCT was performed in 30 patients admitted to the emergency room with acute flank pain. All patients had a calcified urinary stone identified on UHCT. The location of each urinary stone was classified as ureteral or in the ureterovesical junction. The presence of secondary CT signs of ureteral obstruction was determined for each patient. After oral or intravenous hydration, a technetium-99m diethylene triamine penta-acetic acid renal scan was performed in all patients within 12 h of the CT scan. Follow-up delayed scintigraphic images were obtained at 2 h and 24 h in patients with evidence of ureteral obstruction. The sensitivity, specificity and predictive values of each possible combination of CT findings were determined by comparison with the scintigraphic results. The distal ureter was the most common location for a calculus on UHCT, followed in frequency by the ureterovesical junction, proximal ureter and mid-ureter. The renograms showed high-grade, unilateral obstruction in 12 patients, indeterminate scans in five patients and normal renograms in 13 patients. The sensitivities and specificities of individual CT findings ranged from 50% to 75% and from 8% to 69%, respectively. Perinephric stranding gave the highest positive predictive value (PPV) for obstruction (69% including indeterminate renograms). None of the individual CT findings showed a statistically significant correlation with scintigraphic findings. A combination of one or two positive CT findings had a PPV of only 25% for obstruction. A combination of three or four positive CT findings gave a PPV of 70% for obstruction. Our preliminary study shows that secondary CT signs of ureterolithiasis correlate poorly with the scintigraphic findings and that they do not permit evaluation of the functional status of obstructed kidneys. Even a combination of the most frequent CT findings has a low predictive value, i.e. does not allow a decision to be made as to the most suitable treatment. Therefore, renal scintigraphy should be performed in conjunction with UHCT in all patients with ureteral calculi.

Adult↗
PubMed2002

Speedy elimination of ureterolithiasis in lower part of ureters with the alpha 1-blocker--Tamsulosin.

BACKGROUND: Alpha-I blockers decrease the tension and release the spasm of smooth muscles and thus lessen the obstruction and irritation symptoms in the lower urinary tract (LUTS). They make a faster passing of calculi from the terminal part of the ureters possible. OBJECTIVES: The goal of this study was to objectively assess the improvement of difficulties caused by obstructions in ureterolithiasis localized in the lower part of the ureters of 104 randomly chosen patients (pts.) in a double-blind study. METHODS: During a period of 2 and half years (June 1999-January 2002) 104 pts. suffering from ureterolithiasis of the lower urinary tract were treated and observed. Patients were divided into two groups: A (n:53; later only 51 were evaluated) which was subjected to standard treatment and group B (n:51) where the standard treatment was supplemented by the alpha-1 blocker. As alpha-1 blocker one capsule of Tamsulosin/OMNIC 0.4/ was administered daily. RESULTS: With alpha-1 blocker, we have registered a more speedy passing of calculi from the terminal parts of ureters in 17.6% of pts. Recurrence of renal colics was less frequent and occurred in one of eight pts. as compared with group A (without the alpha-1 blocker) where a recurrence of the renal colic was observed in about every fifth pts. In group A (n:51), 62.8% of the pts. passed the calculi, whereas in group B (n:51), where standard treatment was supplemented by the administration of the alpha-1 blocker Tamsulosin, this percentage increased to 80.4%. CONCLUSION: The treatment by alpha-1 blockers considerably decreased not only LUTS but also helped to accelerate the passing of minor calculi from the terminal parts of the ureters of 80.4% of pts. It seems that alpha-1 blockers potentiate the spasmoanalgetic action of drugs used in standard methods of treatment.

Adolescent↗
PubMed1993

Extracorporeal shock wave lithotripsy for treatment of ureterolithiasis in patients with cystinuria.

Ten of 42 patients with cystinuria admitted for extracorporeal shock wave lithotripsy (ESWL) treatment had ureterolithiasis. Of these, 3 had bilateral stones, 2 had only 1 functioning kidney, and 2 had stones in both the kidney and ureter on the same side. Only 1 patient was on medical treatment at the time of referral. After initiation of medical treatment for cystinuria, 2 patients were discharged without further intervention, 1 was discharged after placement of a ureteric stent and 10 were treated with ESWL. After an average of 1.5 ESWL treatment sessions per ureter, 8 patients became stone-free and in the remaining 2, ureteroscopy was required to complete the treatment. Problems associated with the ESWL treatment of cystine stones are discussed. It was concluded that ESWL is the treatment of choice for ureterolithiasis in patients with cystinuria because it is effective and is the least invasive procedure even in patients with cystinuria.

Adolescent↗
PubMedDate not supplied

Pearls and pitfalls in the diagnosis of ureterolithiasis with unenhanced helical CT.

Several signs to assist interpretation of unenhanced helical computed tomographic (CT) scans obtained for suspected ureterolithiasis have been described. Because signs such as perinephric stranding are not always readily apparent, a methodical approach to interpretation of CT studies is important in determining the presence or absence of ureterolithiasis. Evaluation of the poles of the kidneys is helpful in detecting subtle stranding of the perinephric fat. Inspection of the intrarenal collecting system within the poles of the kidneys is helpful in identifying subtle collecting system dilatation and can help prevent mistaking an extrarenal pelvis for hydronephrosis. Careful inspection of the ureter throughout its course is the most reliable method of distinguishing between ureteral stones and phleboliths. However, when the ureter cannot be followed antegrade, the pelvic portion can often be identified in a retrograde fashion. When secondary signs of obstruction are present but no stone is present, differential diagnostic considerations include a recently passed stone, pyelonephritis, urinary tract obstruction unrelated to stone disease, and protease inhibitor deposition disease.

Adipose Tissue↗
PubMed2000

Extracorporeal shockwave lithotripsy for ureterolithiasis in patients with urinary bilharziasis: efficacy and variables that influence treatment outcome.

OBJECTIVES: Schistosomiasis affecting the ureter is commonly accompanied by ureteric dilatation with or without ureteric stricture and altered ureteric wall motility that can influence extracorporeal shockwave lithotripsy (ESWL) results. This study attempts to identify variables that may influence the outcome of ESWL in the treatment of ureterolithiasis in patients with urinary bilharziasis. PATIENTS AND METHODS: Forty-three patients with urinary schistosomiasis and ureterolithiasis treated with ESWL were reviewed. The study data include characteristics of patients, stones, urinary tract treated and details of ESWL treatment. RESULTS: Thirty-five patients (81.3%) were stone-free at 3 months. Multivariate analysis with logistic regression identified two significant variables that influenced treatment outcome, namely the presence of ureteric stricture (p = 0.004) and the ESWL voltage (p = 0.003). Ten ureteric strictures were encountered in 9 patients (21%), the majority of these were diagnosed post-ESWL when patients failed to pass well-fragmented stones in spite of pre-ESWL evaluation. CONCLUSIONS: In situ ESWL is a safe and effective first line of treatment for urinary stones in bilharzial ureters. The presence of concomitant bilharzial stricture is a significant variable which affects the treatment outcome. Every effort should be made to rule out and deal with possible complicating factors such as ureteric strictures in the pretreatment period.

Adult↗
PubMed1992

Rowatinex for the treatment of ureterolithiasis.

A prospective, randomized, double-blind study was performed on 87 patients with ureterolithiasis, assessing the effect of the essential oil preparation Rowatinex (Rowa Pharmaceuticals, Ireland) for the treatment of ureterolithiasis. Forty-three patients were treated with Rowatinex and 44 patients with placebo. Despite the larger average diameter of calculi in the group of patients treated with Rowatinex, the overall stone expulsion rate was significantly higher in the Rowatinex group as compared to placebo: 81% and 59%, respectively (0.025 > p > 0.01). This higher rate of stone expulsion is observed in patients with disappearance of pretreatment ureteral dilatation (when patients with expelled stones are excluded) (0.05 > p > 0.001). Seven patients in the Rowatinex group had mild to moderate gastrointestinal disturbances; no other significant side effects were noted during the treatment in either group. We conclude that early treatment with Rowatinex for patients with ureteral stones is indicated before other more aggressive measures are considered.

Adult↗
PubMed2005

Electro-acupuncture treatment for the upper segment ureterolithiasis under B-ultrasonography.

In order to explore the effects of the local strong stimulation generated by electro-acupuncture for treatment of the upper segment ureterolithiasis, a controlled study was carried out among the treatment group (electro-acupuncture with strong stimulation), the control group I (medication) and the control group II (conventional acupuncture). The results showed that the differences in the cure rate and the total effective rate between the treatment group and the two control groups were significant in statistical analysis (P<0.05 and P<0.01 respectively). This indicates that better therapeutic effects can be obtained by the local strong stimulation generated by electro-acupuncture for treatment of the upper segment ureterolithiasis.

Acupuncture Therapy↗
PubMed1990

Obstructive nephrolithiasis and ureterolithiasis associated with chronic renal failure in horses: eight cases (1981-1987).

Eight adult horses with obstructive nephrolithiasis and/or ureterolithiasis were examined between 1981 and 1987. One horse had bilateral ureteral obstruction at hospital admission; the others had unilateral ureteral obstruction. All horses had similar bilateral renal pathologic findings that were compatible with chronic intermittent or complete obstruction. Horses were referred for evaluation of weight loss, poor performance, and/or decreased appetite. Clinical findings, laboratory results, and/or postmortem findings in all horses supported the diagnosis of chronic renal failure. Age of the 8 horses varied between 2 and 17 years; 5 of the 8 were between 2 and 3 years old. Seven horses were Thoroughbreds and 1 was a Standardbred. Of the horses examined, 4 were females and 4 were males (2 geldings). Diagnosis of obstructive nephrolithiasis and/or ureterolithiasis was made in all of the hospitalized horses based on examination per rectum and/or renal ultrasonographic findings. Surgical removal of the obstructing calculi was performed in one horse. Although etiopathogenesis could not be proven, histopathologic findings in the kidneys of the horses of our study were suggestive of renal failure secondary to obstructive urinary disease.

Animals↗
PubMed1996

[Ureteroscopy--an alternative treatment in ureterolithiasis].

The authors evaluate the results of 315 ureteroscopies performed in 1991-1995 at the Urological Clinic in Brno Bohunice. 290 ureteroscopies were made on account of ureterolithiasis, diagnostic ureteroscopy was performed in 17 patients, in four instances extraction of a foreign body was involved and in four instances during ureteroscopy the stenosis of the ureter was severed. One-stage operations were successful in 226 patients (78%), in 42 patients (14%) after ureteroscopy ESWL had to be made. Ureteroscopy as a two-stage operation was performed in 12 patients (6%), five cases were resolved by open surgery because ureteroscopy failed. The authors evaluate early and late complications, none of which called for nephrectomy. The authors discuss the position of ureteroscopy in ureterolithiasis which is one of the most frequent indications.

Adult↗
PubMed1985

Transient atrial fibrillation in a patient with acute ureterolithiasis.

A 34-year-old woman with symptoms associated with a confirmed ureteral calculus was found to be in atrial fibrillation on arrival at the emergency department. When her symptoms had improved, it was noted that the atrial fibrillation had reverted spontaneously to a sinus rhythm. Subsequent evaluation did not reveal a common etiology of the atrial fibrillation. Transient atrial fibrillation has been associated with many diverse conditions. It has not been previously reported in association with acute ureterolithiasis.

Acute Disease↗
PubMed2005

Medical-expulsive therapy for distal ureterolithiasis: randomized prospective study on role of corticosteroids used in combination with tamsulosin-simplified treatment regimen and health-related quality of life.

OBJECTIVES: To assess the clinical efficacy of the addition of a corticosteroid drug to tamsulosin in the medical-expulsive therapy of distal ureterolithiasis. METHODS: Sixty consecutive patients with a symptomatic distal ureteral stone were included in our study and randomized to one of two home treatment groups. Group 1 patients (n = 30) received tamsulosin (0.4 mg daily), and group 2 patients (n = 30) were treated with a corticosteroid drug (deflazacort, 30 mg daily) plus tamsulosin. The treatment duration was until stone expulsion or 28 days, whichever came first. The primary endpoint of the study was the stone expulsion rate. The secondary endpoints were the expulsion time; use of analgesics; number of emergency room admissions, hospitalizations, and workdays lost; drug side effects; and quality of life of the patients (EuroQol questionnaire, EQ-5D) during treatment. RESULTS: The two groups had a similar expulsion rate (90% for group 1 and 96.7% for group 2; P = 0.612), but the expulsion time was significantly reduced in group 2 patients (P = 0.036). During the treatment period, we did not observe significant differences between the two groups in the number of emergency room visits or hospitalizations, analgesic use, number of workdays lost, or incidence of drug side effects. The quality of life of the patients during therapy, as determined using the EQ-5D, was similar in both groups. CONCLUSIONS: The use of a corticosteroid drug in association with tamsulosin seemed to induce more rapid stone expulsion. In addition, tamsulosin alone as medical-expulsive therapy for distal ureteral calculi had excellent expulsive effectiveness.

Adrenal Cortex Hormones↗