During 5 years (1994-1998), 28 patients with renal and ureteral stones in solitary kidney were operated at the surgical department of §µ N½ng hospital, including congenital solitary kidney: 3 patients (10.7%). Acquired solitary kidney: 1 patient (3.5%). Functional solitary kidney: 24 patients (85.7%). Among them: renal stone: 27 patients (96.4%), Staghorn stone: 14 patients (50%). Pyelotomy and nephrostomy account for 68% of cases, associated with positive drainage of pelvis giving favourable results: No need for blood transfusion: 24 patients (86%). Residual stones: 1 patient (3.5%). Post-operative bleeding: 2 patients (7.0%). Short-term follow up: Good (78.6%), medium (14.0%), Bad (7.0%)
Kidney Calculi ; Ureteral Calculi ; surgery

OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic. METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People's Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient's level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis. RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96). CONCLUSION Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
Humans ; Quality of Life ; Pandemics ; COVID-19/epidemiology* ; Ureter/surgery* ; Urinary Calculi ; Pain ; Ureteral Diseases ; Stents ; Surveys and Questionnaires ; Ureteral Calculi

OBJECTIVETo evaluate the feasibility of retroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis for treatment of renal and ureteral calculi.

METHODSIn February 2010, 2 patients with renal and ureteral calculi underwent retroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis.

RESULTSThe operation time in these two cases was 70 and 80 min, and the volume of intraoperative blood loss was about 20 ml. The exposure was excellent, and the patient recovered rapidly without complications or residual calculi.

CONCLUSIONRetroperitoneal laparoscopic surgery combined with ureteroscopic lithotomy through the pelvis is feasible for treatment of renal and ureteral calculi.

Aged ; Female ; Humans ; Kidney Calculi ; complications ; surgery ; Kidney Pelvis ; Laparoscopy ; Male ; Treatment Outcome ; Ureteral Calculi ; complications ; surgery

A 55-year-old woman suffered from right flank pain and had a right giant ureteral stone with hydronephrosis. Ureterolithotomy was performed. The ureteral stone was 11cm long and weighed 45gm.
Case Report ; Female ; Human ; Hydronephrosis/surgery ; Middle Age ; Ureteral Calculi/pathology/*surgery

BACKGROUND: The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm. METHODS: A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed. RESULTS: Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242). CONCLUSIONS MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.
Humans ; Laparoscopy ; Length of Stay ; Nephrolithotomy, Percutaneous/adverse effects* ; Retroperitoneal Space/surgery* ; Treatment Outcome ; Ureteral Calculi/surgery*

Aged ; Female ; Humans ; Kidney Pelvis ; pathology ; surgery ; Rupture, Spontaneous ; diagnosis ; etiology ; surgery ; Ureteral Calculi ; complications ; diagnosis ; surgery ; Ureteral Obstruction ; complications ; diagnosis ; surgery

OBJECTIVETo compare the surgical effect of three-dimensional (3D) versus 2D laparoscopic surgery in ureter lithotomy.

METHODSFrom January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to undergo ureter lithotomy under 3D laparoscopy (25 cases) and 2D laparoscopy (20 cases). The time used for each surgical process (including the exposure, D-J tube discharge, suture and other surgical procedures) was recorded and compared between the two groups.

RESULTSThe operation was completed smoothly in all the 45 patients. In this cohort, the wound drainage tube was removed in a mean of 3.0mnplus;0.8 days after the operation, the catheter was removed after a week, and the double J tube was removed at 1 month. Follow-up intravenous pyelography at 3 months after the operation reveal ureteral stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was significantly shorter in the 3D group than in the 2D group (P<0.05). 3D laparoscopic surgery allowed more precise operation by providing a good sense of depth as in an open surgery to reduce the operation time.

CONCLUSIONSAs a minimally invasive surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in ureter lithotomy.

Humans ; Imaging, Three-Dimensional ; Kidney Pelvis ; Laparoscopy ; methods ; Operative Time ; Retroperitoneal Space ; Ureter ; Ureteral Calculi ; surgery

OBJECTIVETo compare the efficacy and complication of ureteroscopic lithotripsy and ureteroscopic management for ureteral calculi after failed extracorporeal shock wave lithotripsy (ESWL).

METHODSOne hundred and thirty-six cases with ureteral calculi after failed ESWL and 189 cases with ureteral calculi were treated with ureteroscopic lithotripsy (URSL). Clinical data of two groups were analyzed retrospectively.

RESULTSThe mean operating time and therapeutic time in ESWL-URSL group was longer than that in URSL group, while the rate of polypi hyperplasia and open-surgery in ESWL-URSL group was 34.6%, 5.88% versus 28.3%, 1.59% in URSL group. There is no significant statistical difference in stone-free rate between two groups.

CONCLUSIONUreteroscopic management can be preferred for the patients with disadvantage of ESWL in some condition.

Adult ; Female ; Humans ; Lithotripsy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi ; surgery ; therapy ; Ureteroscopy

BACKGROUNDLaparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to evaluate the outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral calculi.

METHODSBetween November 2011 and July 2013, retroperitoneal LESS ureterolithotomy was performed in 12 patients using a homemade single-port device comprising a surgical glove and several strips of tape. Another 16 patients underwent conventional retroperitoneal laparoscopic ureterolithotomy. We compared the operative time, complications, and surgical outcomes, retrospectively.

RESULTSAll patients were completed without conversion to conventional laparoscopic or open surgery. The operative time of the LESS group and of the conventional laparoscopic group were (125.3 ± 12.8) minutes and (116.9 ± 14.4) minutes, respectively (P = 0.119). The intraoperative blood loss was (42.9 ± 8.9) and (43.4 ± 14.7) ml, respectively (P = 0.914). Postoperative radiologic evaluation revealed that the stones had been removed completely. Cosmetic results were superior in the LESS group (P = 0.001).

CONCLUSIONRetroperitoneal LESS ureterolithotomy using a homemade single-port device can be considered a feasible and safe alternative to conventional laparoscopic ureterolithotomy.

Adult ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Retroperitoneal Space ; surgery ; Ureteral Calculi ; surgery ; Urologic Surgical Procedures ; methods

BACKGROUNDUrolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years.

METHODSWe reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6-36 months), and the mean maximum stone diameter was 19.2 mm (range 10-35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.

RESULTSFifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8-5.0 min), the mean operative time was 36.5 min (range 20-88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2-15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3-13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.

CONCLUSIONSThis study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.

Child, Preschool ; China ; Female ; Humans ; Infant ; Kidney Calculi ; diagnostic imaging ; surgery ; Male ; Nephrostomy, Percutaneous ; methods ; Retrospective Studies ; Treatment Outcome ; Ultrasonography ; methods ; Ureteral Calculi ; diagnostic imaging ; surgery