This paper analyzed the clinical data, diagnosis and treatment of 4 asymptomatic patients with ureteral calculi without hydrops in our hospital from October 2018 to January 2019, and comprehensively discussed the previous literature. The 4 patients in this group had no obvious clinical symptoms, no positive stones were found in the B-ultrasound of the urinary system, and no hydroureter and hydroureter of the affected side was found. Urinary CT scan confirmed ureteral stones. They were all located in the lower ureter, and the stones obstructed the lumen. The stones were round and smooth, and there was no obvious hyperplasia and edema in the surrounding mucosa. The lithotripsy was completed in the first-stage operation, and the DJ catheter was left behind for one month after the operation. Based on the clinical diagnosis and treatment process of the 4 cases of asymptomatic calculi in this group and the analysis of previous studies, these patients were mostly detected by imaging examinations or other systematic imaging examinations during the regular review of urinary calculi. Ureteral stones with obstruction did not necessarily have stone-related symptoms. The onset of renal colic involved an increase in intraluminal pressure, related stimulation of nerve endings, smooth muscle spasms caused by stretching of the ureteral wall, and systemic changes in cytokines and related hormones. Cascade reactions, etc., were associated with the movement of stones down. Ureteral stones without hydrops were mostly located in the lower ureter, which had a certain buffering effect on obstructive pressure. Asymptomatic ureteral calculi could also induce irreversible damage to renal function, and the proportion of damage increased with the diameter of the stone. Patients with a history of urinary calculi, especially those with asymptomatic stones for the first time, should be paid attention to during clinical follow-up. At present, there are few research reports on asymptomatic and non-accumulating ureteral calculi. We analyze the clinical diagnosis and treatment process and characteristics of this group of patients combined with previous literature to provide a reference for the diagnosis and treatment of such patients.
Humans ; Ureteral Calculi/therapy* ; Urinary Calculi/therapy* ; Ureter ; Lithotripsy/methods* ; Edema/therapy* ; Kidney Calculi/therapy*

Calcium Oxalate ; Humans ; Kidney Calculi ; etiology ; therapy

Humans ; Kidney Calculi ; therapy ; Nephrolithotomy, Percutaneous ; Nephrostomy, Percutaneous

Management of urologic patients is being gradually but dramatically altered with new advances in technical innovation and refinements of interventional uroradiology. The broadening of indications for percutaneous nephrostomy became possible only after it was learned that it is a safe and effective means of establishing access to the renal collecting system. Percutaneous stone extraction (Nephrolithotomy) and Endopyelotomy are now well established procedures. These techniques have clear advantages over the surgical treatment for the same conditions and will increase the quality of patient care and reduce health care cost.
Human ; Kidney Calculi/therapy ; Kidney Diseases/diagnosis ; Lithotripsy ; *Nephrostomy, Percutaneous/contraindications ; Urinary Tract Infections/diagnosis/therapy

We report a case of acute kidney injury following extracorporeal shock wave lithotripsy. A 41-year-old man with diabetes mellitus had suffered from urinary difficulty after several treatments of ESWL, bilaterally. It was suspected that fragments of renal stones had caused an obstructive nephropathy with bilateral hydronephrosis. Fortunately, even without renal replacement therapy, renal function gradually returned.
Acute Kidney Injury ; Adult ; Diabetes Mellitus ; Humans ; Hydronephrosis ; Kidney Calculi ; Lithotripsy ; Renal Replacement Therapy ; Shock

Squamous cell carcinoma of the renal pelvis is an uncommon tumor, comprising about 0.5-2% of all primary malignant tumor of the kidney. The patients of this disease usually presented late with extensive local infiltration. In addition, poor response to surgery, radiotherapy and chemotherapy result in a poor prognosis and short survival. We report a patient of squamous cell carcinoma of renal pelvis with staghorn calculi in a 66-year-old woman who had a history of right sided renal colic and palpable abdominal mass.
Aged ; Calculi* ; Carcinoma, Squamous Cell* ; Drug Therapy ; Female ; Humans ; Kidney ; Kidney Pelvis* ; Prognosis ; Radiotherapy ; Renal Colic

We report a case of acute kidney injury following extracorporeal shock wave lithotripsy. A 41-year-old man with diabetes mellitus had suffered from urinary difficulty after several treatments of ESWL, bilaterally. It was suspected that fragments of renal stones had caused an obstructive nephropathy with bilateral hydronephrosis. Fortunately, even without renal replacement therapy, renal function gradually returned.
Acute Kidney Injury ; Adult ; Diabetes Mellitus ; Humans ; Hydronephrosis ; Kidney Calculi ; Lithotripsy ; Renal Replacement Therapy ; Shock

OBJECTIVETo investigate the therapeutics of complex calculi in solitary kidney, and to improve the effect and safety of treatment.

METHODSExperiences in the treatment of 42 patients were summarized. All patients were with mould or multiple calculi, 8 cases were complicated with ureter calculi, and 6 cases were hospitalized because of obstructive anuria. The patients with mould calculi received extracorporal shock wave lithotripsy (ESWL) prior to percutaneous nephrolithotomy (PCNL). While the patients with multiple calculi received PCNL prior to ESWL. Some cases were treated by lithotripsy.

RESULTSThirty-six cases (86%) were cured by ESWL combined with PCNL. Eleven cases received lithotripsy during PCNL. The 6 cases with obstructive anuria recovered in 12 hours after emergent ESWL or lithotripsy; 6 cases (14%) underwent open operation because of deformity or obstruction in renal pelvis and ureter; 2 cases have to keep nephrostomy because of repeated infection. Followed up 6-18 months, 38 cases (86%) keep good kidney function; 5 cases (14%) had renal insufficiency; 4 cases (11%) reoccurred calculi.

CONCLUSIONSThe therapeutics of ESWL combined with PCNL may clear complex calculi of solitary kidney effectively and safe. It is necessary to take emergent ESWL in renal obstructive calculi cases. And the patients with lower ureter obstructive calculi may take lithotripsy first. It is proper to choose open operation on the patients with deformity of renal pelvis or obstruction of ureter.

Adult ; Combined Modality Therapy ; Female ; Humans ; Kidney ; abnormalities ; Kidney Calculi ; therapy ; Lithotripsy ; Male ; Middle Aged ; Nephrostomy, Percutaneous ; methods ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) for renal calculi.

METHODSBetween January, 2004 and January, 2007, 316 patients (212 men and 104 women) with renal stone underwent ESWL. The correlations of the patients' age, gender, body mass index (BMI), disease course, pain, hematuria, stone size, location, side, number and hydronephrosis to the outcome of the treatment was analyzed. The treatment success was defined as complete clearance of the stones or residual stone fragments <0.4 cm, and ESWL was considered unsuccessful with residual stones>0.4 cm.

RESULTSThe overall success rate was 75.3% (238/316) in these patients. Significant difference in stone clearance rates was observed in patients with stone size of 0.5-1.0 cm (90.3%, 167/185), 1.0-2.0 cma(69.6%, 55/79), and >2.0 cm (30.8%, 16/52) (P<0.05). The success rates differed significantly between cases of pelvic stones (83.1%, 118/142) and those of caliceal stones (69.0%, 120/174) (P<0.05). But in cases of caliceal stones, the success rates were comparable between cases with stones at the upper calyx (71.7%, 43/60), middle calyx (68.9%, 31/45), and lower calix (66.7%, 46/69) (P>0.05). Patients with single stones had significantly higher success rate (82.9%,170/205) than those with multiple stones (61.3%, 68/111) (P<0.05). The patients' gender, age, disease course, pain, hematuria, stone side and hydronephrosis did not produce significant impact on the outcome of the treatment (P>0.05).

CONCLUSIONStone size, location and quantity are significant independent factors affecting the outcome of ESWL for renal stones.

Adolescent ; Adult ; Aged ; Female ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus.

METHODSBetween January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients' age, gender, body mass index (BMI), disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established.

RESULTSThe stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients' age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model (Χ(2)=18.144, df=8, P=0.168) with an overall accuracy of 87.4%.

CONCLUSIONDisease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.

Adult ; Female ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; Logistic Models ; Male ; Middle Aged ; Treatment Outcome