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A 32 year old with pain and urinary frequency
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Although ESWL is frequently used to disintegrate small renal calculi as an elective procedure, it can also be used for lower ureteric stones. Most hospitals do not have a lithotripter, but can rent a mobile lithotripter, which is transported on a lorry for a planned session.
Urolithiasis
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Thomas Johnston, James Armitage, Oliver Wiseman
The following are true of extracorporeal shock wave lithotriptors, except:The Dornier HM1 lithotriptor, developed in 1980, was the first lithotripter to be used to treat renal calculi in vivo.The Stortz Modulith® is an example of a electromagnetic lithotripter, where magnetic energy is applied to crystals to generate the shockwave.Electrohydraulic lithotriptors often incorporate an angulated hemispherical dish to focus shock waves created by an underwater spark gap.Piezoelectric lithotriptors utilise multiple ceramic crystals arranged around a hemispherical dish.The Dornier HM3 lithotriptor, the first commercial device, required immersion of the fully anaesthetised patient in a water bath.
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Urinary stones are often treated only symptomatically with analgesics until they are passed through the urethra, but large stones in the bladder are usually removed surgically (lithotomy) or crushed into smaller pieces by sound waves and washed out using a lithotriptor through a procedure known either as lithotripsy (from the Greek words for "stone" and "to rub") or litholapaxy (lapaxis = evacuation).
Novel elbow basket mechanical lithotripter for large common bile duct stone removal
Published in Postgraduate Medicine, 2022
Huahui Zhang, Ying Fang, Jian Huang, Fengdong Li, Xiangrong Qin, Jin Huang
Riemann et al. first reported mechanical lithotripsy (ML) for CBD stones in 1982 [8]. ML is the easiest method for fragmenting large CBD stones. It consists of trapping the stone in a basket and then closing the basket to crush the stone. Basket mechanical lithotripter is widely used in treating large CBD stones because of its simple operation, few complications, effectiveness, and low mortality [9,10]. The key point for successful stone removal for large stones depends on whether the basket can enter the bile duct. However, access to the bile duct was difficult with conventional basket mechanical lithotripter (CBML) in many patients. We introduced a novel elbow basket mechanical lithotripter for large CBD stones and evaluated the safety and feasibility of the novel elbow basket mechanical lithotripter in the treatment of large CBD stones.
The effect of stone size on the results of extracorporeal shockwave lithotripsy versus semi-rigid ureteroscopic lithotripsy in the management of upper ureteric stones
Published in Arab Journal of Urology, 2022
Ahmed S. El-Abd, Ahmed M. Tawfeek, Shawky A. El-Abd, Tarik A. Gameel, Hasan H. El-Tatawy, Magdy A. El-Sabaa, Mohamed G. Soliman
The URSL was done under spinal or general anaesthesia using 8.5-F semi-rigid ureteroscope (Richard Wolf, Knittlingen, Germany), and disintegration was done under direct vision. Dilatation of ureteric orifice when needed was done using a balloon catheter or double lumen ureteric dilator. Intracorporeal lithotripsy was done using an ultrasound lithotripter, using a stone cone as an ante-retropulsion tool. All fragments were extracted using URS forceps and the cone was released inside the urinary bladder. After completion of the procedure guided by both direct vision and fluoroscopic control, a 6-F ureteric catheter was placed for 2 days. If extensive manipulation or mucosal injury had occurred, or incomplete disintegration and in cases with solitary renal unit, a 6-F JJ was placed for 4 weeks.
Percutaneous nephrolithotomy is safe and effective in aging male patients: a single center experience
Published in The Aging Male, 2020
Huseyin Besiroglu, Erkan Merder, Galip Dedekarginoglu
All procedures were carried out under general anesthesia. Preoperative antibiotics were administered to patients with positive urine culture result according to the antibiotic susceptibility tests. First, a five or six French ureteral catheter was inserted into the affected kidney under direct vision of cystoscopy. Then, the patient was turned into a prone position. Access to the targeted calix was punctured with an 18-gauge needle, a guidewire was inserted, and then the urinary tract was dilated with a balloon dilatator (Nephromax, Microvasive Boston Scientific Corporation, Natick, MA) and a 30-F Amplatz sheath was replaced. A rigid, 26-F nephroscope was used for nephroscopy. The stones were fragmented by a pneumatic lithotripter (Vibrolith, Elmed, Ankara, Turkey) or an ultrasonic lithotripter (Swiss Lithoclast, EMS Electro Medical Systems, Nyon, Switzerland) and stone fragments were removed by the forceps. Upon the detection of no residual fragments, the operation was completed. A 16 F reentry or malecot nephrostomy was inserted in all patients. In selected solitary kidney patients, a DJ stent was inserted along with a malecot nephrostomy. A plain X-ray of the kidneys, ureters, and bladder (KUB) was obtained 24 h after the operation. In patients with stone-free and/or clinically insignificant residual fragments, the nephrostomy tube was removed on the postoperative second day after demonstrating no urinary leakage by antegrade nephrostogram.