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Urinary Tract Disease
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Nephrolithiasis is also called renal calculi or stones. The reported incidence of renal stone disease in the pregnant population varies widely, with rates of hospitalization ranging from 0.03–0.8% [62]. Up to 12% of the general population has had a urinary stone during their lifetime, with recurrence rates approaching 50%. Given the low incidence, it is unclear if the occurrence of nephrolithiasis is or is not increased in pregnancy, with some authors reporting an incidence as high as 1/200.
The patient with acute renal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Renal calculi are usually diagnosed by a combination of history taking, clinical assessment and investigative procedures, such as abdominal X-ray (90% of renal stones are radio-opaque), intravenous pyelogram (IVP) or a computerised tomography (CT) scan. Once diagnosed, treatment includes analgesia for the pain, an increase in water intake to help flush the stones out, an increase in dietary fibre because this binds calcium in the bowel and reduces its absorption and excretion in the urine, and, finally, antibiotic therapy to treat any infection. Historically, surgical intervention was always required for the removal of stones that could not be passed. Whereas this method of treatment may still be an option for very large stones, more recently shock wave lithotripsy has been used to remove most calculi. In this radiological procedure, high-energy shock waves are used to reduce the stone to smaller fragments which can then be excreted in the urine (Tortora et al. 2017.)
The cases
Published in Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young, Paediatric Radiology for MRCPCH and FRCR, 2020
Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young
Renal calculi are rare in children; they may be related to an underlying metabolic disorder (40%) or secondary to obstruction or infection. Associations also include congenital abnormalities of the renal tract, prematurity, prolonged immobility and urinary tract infection.
The value of postoperative HLA-DR expression and high mobility group box 1 level in predictive diagnosis of sepsis in percutaneous nephrolithotomy surgery
Published in Renal Failure, 2022
Hai Feng Hou, Ying Liu, Xiaoyang Zhang, Zhenhua Han, Tianming Chen
This prospective observational study enrolled 387 patients with renal calculus who received percutaneous nephrolithotomy (PCNL) surgery from January 2017 to October 2020 in our hospital, and 167 patients agreed to participate in the clinical study and signed the informed consent form. Inclusive criteria: Patients with renal calculi confirmed by clinical B-ultrasound or CT examination; patients with complete case and postoperative data. Exclusion criteria: (1) patients with sepsis before operation; (2) patients with a history of acute or chronic infection within the last 14 days; (3) patients with autoimmune diseases or using immunosuppressive drugs; (4) patients with previous urological surgery; (5) patients with severe liver, renal, malignancy, cardiovascular dysfunctions (6) patients with mental disorders or unable to cooperate with treatment. After exclusion criteria, 33 patients with sepsis and 78 patients with no sepsis remained. All experiments using human samples in this study was approved by the Medical Ethics Committee of the Chongqin Jiangjin District Central Hospital (No. CQDH-20170009) and conducted according to the Declaration of Helsinki principles. In addition, the study was in accordance with the medical ethics standards, and all the examinations were informed by the family members of the patients.
Bilateral same session flexible ureterorenoscopy for endoscopic management of bilateral renal calculi is noninferior to unilateral flexible ureterorenoscopy for management of multiple unilateral renal calculi: outcomes of a prospective comparative study
Published in Scandinavian Journal of Urology, 2022
Indraneel Banerjee, Abhishek Bhat, Jonathan E. Katz, Rashmi H. Shah, Nicholas Anthony Smith, Hemendra N. Shah
The rising prevalence and incidence of renal stones globally is continuously increasing the overall cost burden to the health care system [1]. Around 15% of the patients with renal calculi will have bilateral and multiple stones [2]. Flexible ureterorenoscopy (FURS) is a currently preferred treatment option for renal stones ≤ 2 cm [3]. It is also the technique of choice in patients with coagulopathy, obesity, renal anomalies and solitary kidney [4]. Bilateral same session(BSS) FURS has a potential of treating patients with bilateral renal stones in the same sitting thereby avoiding unnecessary hospital visit and saving undue health care expenses. Inspite of these perceived advantages, the clinical research office of The Endourological Society study on multiple urolithiasis involving 11,885 patients from 32 countries revealed that only 273 patients had BSS ureteroscopy. Surprisingly, none of the patients in this large prospective study underwent BSS ureteroscopy for bilateral renal stones [5]. These real-world data clearly show that many patients with bilateral renal stones are usually not offered BSS-FURS.
Concomitant Treatment of Ureteropelvic Junction Obstruction Complicated by Renal Calculi with Laparoscopic Pyeloplasty and Pyelolithotomy via 19.5F Rigid Nephroscope: A Report of 12 Cases
Published in Journal of Investigative Surgery, 2022
Lizhe An, Liulin Xiong, Liang Chen, Xiongjun Ye, Xiaobo Huang
As a common complication of UPJO, the incidence of concomitant renal calculi was reported up to 16–30%.1–4 Besides conventional symptoms induced by renal stones including flank pain, hematuria, and urinary tract infection, renal calculi could also lead to edema and friability of tissue, which may make surgical suture more complex and thus the operative time as well as blood loss were increased.2,10 Therefore, the retrieval of stones is necessary. But how to select the appropriate management for those patients was still a therapeutic dilemma. Open pyeloplasty and pyelolithtomy has been the “golden standard” to treat UPJO complicated with renal calculi, with a success rate of 90%.3 But the drawbacks of open surgery are inherent and obvious, including large incision, longer hospital stay, and longer recovery time. As the emerging of endourology and laparoscopy, urologists have been trying to manage this therapeutic dilemma in minimally invasive approach.