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Vesicoureteric reflux: Open and minimally invasive treatment
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Aurelien Scalabre, Delphine Demède, Pierre Mouriquand
The child is usually hospitalized for 5 days. The ureteric stent is removed after 2 days (or 10 days if the ureter has been remodeled). The bladder catheter is removed on the fifth postoperative day. Both suction drains are usually removed on the second day. Bladder spasms are common, and administration of oxybutinin can be useful to reduce the discomfort. Antibiotic prophylaxis is a possible option with trimethoprim with or without sulfamethoxazole (co-trimoxazole).
Urinary system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Generally ureteral stents are placed by a urologist in the operating theatre. Fluoroscopy is needed to verify accurate stent positioning. Simple stent placement is often performed without general anaesthesia. Under fluoroscopic guidance the ureteral orifice to be cannulated is identified and a guidewire advanced up the ureter to the renal pelvis. A 5F catheter is placed over the guidewire to the renal pelvis, the wire is removed and a nephrostogram is often performed. The guidewire is then replaced and the catheter removed. The chosen ureteral stent is placed over the wire and advanced up the ureter with a stent pusher. Radio-opaque markings on the stent indicate the length of the stent that has passed up the ureter. Once the proximal curl of the stent is within the renal pelvis, observed by the markings on the stent, and the distal end of the stent visualised at the neck of the bladder, the wire is removed deploying the stent.
Nephrolithiasis: surgical treatment and metabolic evaluation
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Ureteral stent: Will not improve fragmentationUsed for relief of symptoms/obstructionDisplacement of stone into renal pelvis may potentially improve results.
Inner surface modification of ureteral stent polyurethane tubes based by plasma-enhanced chemical vapor deposition to reduce encrustation and biofilm formation
Published in Biofouling, 2022
Hyuna Lim, Jae Hoon Chung, Yoonsoo Park, Namwuk Baek, Youngsik Seo, Heonyong Park, Yong Ki Cho, Donggeun Jung, Deok Hyun Han
Plasma treatment and coating were performed on the inner surface of the ureteral stent PU tube with an inner diameter of 1.2 mm and a length of 300 mm by applying a specialized PECVD technology for millimeter-scale fine processing. Ar and O2 plasma treatments were shown to accelerate EBF due to the hydrophilic and chemically active properties of the treated surface, while the C2H2-based coating inhibited EBF in urine. Ar and O2 treatment increased the risk of EBF due to the -OH rich surface formed by the plasma treatment. The amorphous carbon surface of the C2H2-based coated PU tube is chemically inert and stable, comprising mostly carbon bonds with fewer hydrogen bonds. Therefore, it is considered that the C2H2-based coated surface minimizes the physical and/or chemical sites where EBFs such as calcium salt can attach. As a result of the 15-day urine immersion experiment, the C2H2-based coating exhibited an increased EBF resistance time, from 72 h for bare PU to 360 h, i.e. five times longer. This can provide a stepping stone for the development of a ureteral stent with increased stability and lifetime.
Emergency vs elective ureteroscopy for a single ureteric stone
Published in Arab Journal of Urology, 2021
Abdullatif Al-Terki, Majd Alkabbani, Talal A. Alenezi, Tariq F. Al-Shaiji, Shabir Al-Mousawi, Ahmed R. El-Nahas
All patients received intravenous ceftriaxone with induction of anaesthesia. Retrograde pyelography was not routinely done. The technique of URS was the same for both groups. Under general anaesthesia, a long semi-rigid ureteroscope (Richard Wolf, Knittingen, Germany) was used. A flexible ureteroscope (FlexX2, Karl Storz Endoskope, Tuttlingen, Germany) was available in the operating room in case the rigid ureteroscope could not reach the upper ureteric stone or stone fragments migrated to the kidney during laser disintegration. No anti-retropulsion devices were used. A small ureteric stone was extracted using a tipless nitinol basket (Dormia No-Tip 2.2 F, Coloplast, Humlebaek, Denmark). Large ureteric stones were fragmented with holmium laser (Calculase®; Karl Storz Endoskope) then fragments were retrieved with the basket. Lithotripsy was used if the surgeon judged that the stone could not be extracted safely as one piece. Laser power was adjusted to 0.8–1 J and 6–10 Hz. At the end of the procedure, an externally draining ureteric catheter was placed for 24–48 h, unless there was stone impaction or ureteric injury where a ureteric stent was placed for 2–4 weeks.
Indwelling ureteric stents: Patterns of use and nomenclature
Published in Arab Journal of Urology, 2020
Joon Yau Leong, James E. Steward, Kelly A. Healy, Scott G. Hubosky, Demetrius H. Bagley
Ureteric stent placement is a common urological procedure. Indications for stent placement include relief of obstruction, post-ureteroscopy placement for obstruction prevention, ureteric identification/designation, and as a splint after ureteric repair or operation. Associated risks and complications of ureteric stenting include stent migration, encrustation, injury to the ureter, loss of patency, infection, and retained stent. The objectives of the present study were to explore trends of ureteric stenting amongst a diverse group of urologists. We also aimed to investigate the specific terminology used to describe ureteric stents amongst urologists, as well as within the current literature. Finally, we propose the use of the generic term ‘indwelling ureteric stent’ (IUS) unless describing the specific stent design.