Humans ; Lithotripsy ; instrumentation ; methods ; Ureteral Calculi ; therapy

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*

The effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium. YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6% in the upper ureteral calculi, 93.9% in the middle ureteral calculi and 94.4% in the lower ureteral calculi, respectively. The complication rate was 4.8% (8 cases). It was suggested that ureteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Holmium ; *Lithotripsy, Laser/methods ; Ureteral Calculi/*therapy ; *Ureteroscopy

OBJECTIVE: To investigate the efficacy of terpene compound drug (pinene, camphene, borneol, anethole, fenchone and cineol in olive oil) in facilitating spontaneous passage of ureteral calculi

METHODS: Systematic literature search of the MEDLINE, EMBASE, OVID, Science Direct, Proquest, Google scholar, Cochrane Library databases and rference lists of related literature was done without language restriction. Trials on ureterolithiasis medical expulsive therapy (MET) that compare terpene compound drug versus placebo/control group or alpha-blockers were identified. Articles retrieved were critically appraised by two independent reviewers according to Cochrane Collaboration recommendations. Data from included studies were extracted for calculation of risk ratio (RR) and 95% confidence interval (CI). Effect estimates were pooled using Mantel-Haenszel method with random effect model. Inter-study heterogeneity and publication bias were assessed. The PRISMA guidelines for meta-analysis reporting were followed.

RESULTS: Five trials (total of 344 subjects) of adequate methodological quality were included. Pooled effect estimates from homogenous studies showed that compared to placebo/ control group, patients treated with terpene compound drug had significantly higher ureteral calculi expulsion rate (pooled RR: 1.34; 95% CI 1.12, 1.61). Analysis of studies that compare terpene compound drug with alpha-blockers showed no significant difference (pooled RR: 0.79; 95% CI 0.59, 1.06), although significant inter-study heterogeneity was noted. Only minor gastrointestinal adverse effect was reported on terpene compound drug use.

CONCLUSIONS: The results suggest that terpene compound drug as MET is effective in promoting passage of ureterolithiasis. High quality large-scale RCTs comparing alpha-blockers and terpene compound drug are warranted to make a more definitive conclusion.

Human ; Male ; Female ; TERPENES-adverse effects,therapy,TREATMENT OUTCOME ; UROLOGIC DISEASES ; URETERAL DISEASES ; Ureteral Calculi

From April to October, 1988, 34 patients with ureteral calculi more than O.5 cm or smaller but impacted ureteral stone underwent pulsed dye laser lithotripsy under ureteroscopy. The results were as follows : 1. The locations of stone were upper ureter in 9(26.5%), mid ureter in 8(23.5%), lower ureter in 11(32.4%), and UVJ in 6(17.6%). 2. The success rates according to location were 66.7% in upper ureter, 87.5% in mid ureter, 91% in lower ureter, and 100% in UVJ and the average success rate was 85.3%. 3. The success rates according to stone size were 83% in 0.3-0.5 cm, 90% in 0.5-1.0 cm, and 75% in 1.0-2.3 cm. 4. The average procedure time was about 85 minutes, with a range of 30 to 120 minutes and the average hospitalization after laser therapy was about 3 days, with a range of 1 to 6 days. 5. There were 5 cases (14.8%) of failure due to upward migration of stone in 3 cases, ureteral injury in 1 case and ureteral stricture in 1 case. 6. Complications occurred in 10 patients (29.5 %), almost by ureteroscopy but laser induced complication was not found. Therefore, we confirm that laser lithotripsy is a safe and effective method for treatment of ureteral stone.
Constriction, Pathologic ; Hospitalization ; Humans ; Laser Therapy ; Lasers, Dye* ; Lithotripsy ; Lithotripsy, Laser ; Ureter* ; Ureteral Calculi* ; Ureteroscopy* ; Urinary Calculi

OBJECTIVETo evaluate the therapeutic effects of pneumatic lithotripsy on children urethral calculi.

METHODSTwenty-two cases of the male children with urethral calculi were treated with pneumatic lithotripsy under ureteroscopy.

RESULTSAll the patients were treated successfully in a single procedure. The time of lithotripsy was (5.5 +/- 2.2) minutes, and no serious complication such as obvious hematuria, infection and urethral stricture occurred.

CONCLUSIONSIt is suggested that pneumatic lithotripsy under ureteroscopy is an effective and simple way for the treatment of urethral calculi in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Lithotripsy ; methods ; Male ; Ureteral Calculi ; therapy ; Ureteroscopy

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

OBJECTIVETo prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy.

METHODSA total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group (group A), tamsulosin group (group B), and Removing Stasis and Reducing Heat Formula group (group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed.

RESULTSOf the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A (95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B (4.44% and 7.86±4.99 days) and C (2.43% and 6.76±4.37 days) compared with the group A (22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score (all P<0.05).

CONCLUSIONRemoving Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.

Adult ; Female ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Prospective Studies ; Ureteral Calculi ; therapy ; Ureteroscopy ; methods

The effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium. YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6% in the upper ureteral calculi, 93.9% in the middle ureteral calculi and 94.4% in the lower ureteral calculi, respectively. The complication rate was 4.8% (8 cases). It was suggested that ureteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo evaluate the availability of ballistic lithoclast in treatment of ureteral calculi.

METHODSTotally 625 patients with ureteral calculi were treated with ballistic lithoclast by rigid ureteroscopy.

RESULTSTotally 610 patients were treated successfully by ballistic lithoclast with a cure rate of 97.6% (90.3% in upper ureter, 96.8% in middle ureter, 100% in lower ureter). The average time of lithoclast was (5.0 +/- 2.8) minutes and the stone-free rate was 99.2%.

CONCLUSIONBallistic lithoclast combined with rigid ureteroscopy is safe and effective in treating ureteral calculi.

Adult ; Aged ; Female ; Humans ; Lithotripsy ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureteral Calculi ; therapy ; Ureteroscopes