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A contemporary step-by-step guide to performing flexible ureterorenoscopy for renal calculi

Current Urology 2024年第4期18卷 265-267页

作者： Thomas Fonseka Alberto Melchionna Nicolo De Luyk Vimoshan Arumuham Simon Choong stone and endourology unit Institute of UrologyUniversity College London Hospitals NHS Foundation TrustLondonUK

With advancements in laser technology and urological techniques, flexible ureterorenoscopy has emerged as a vital surgical approach for managing stone disease. Various techniques can be employed to customize endourological stone treatments. Despite the continuous evolution of equipment, it remains crucial to comprehend the fundamental steps of the procedure. This paper offers a comprehensive step-by-step guide that integrates the latest advancements in both scopes and lasers. Additionally, it outlines potential pitfalls and strategies to circumvent them, aiming to achieve optimal stone clearance and deliver individualized patient care safely and efficiently.

关键词： Flexible ureterorenoscopy technique Tailored endourological stone treatment Minimally invasive stone treatment

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Extracorporeal shockwave lithotripsy in the management of urinary stones: New concepts and techniques to improve outcomes

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Asian Journal of Urology 2024年第2期11卷 143-148页

作者： Pilar Bahilo-Mateu Alberto Budia-Alba Lithotripsy and endourology unit La Fe University and Polytechnic HospitalValenciaSpain Lithotripsy and endourology unit Urology DepartmentLa Fe University and Polytechnic HospitalValenciaSpain

Objective: Extracorporeal shockwave lithotripsy (SWL) currently plays an important role in the treatment of urinary tract lithiasis. The purpose of this article was to describe new concepts and procedural strategies that would improve results using SWL as a treatment for urolithiasis, thereby achieving better clinical ***: A systematic review process was carried in PubMed/PMC from January 2003 to March 2023. A narrative synthesis of the most important aspects has been ***: The important recommendations for the adequate selection of the candidate patient for treatment with SWL are summarized, as well as the new strategies for a better application of the technique. Aspects about intraoperative position, stone localization and monitoring, analgesic control, machine and energy settings, and measures aiming at reduced risk of complications are ***: To achieve the therapeutic goal of efficient stone disintegration without increasing the risk of complications, it is necessary to make an adequate selection of patients and to pay special attention to several important factors in the application of treatment. Technological development in later generation devices will help to improve current SWL results.

关键词： Lithotripsy Extracorporeal shockwave stone disease Treatment Urinary stone

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Forgotten Ureteral Stents in a Tertiary Hospital in Accra and a Review of Endourological Management of Upper Urinary Tract Pathologies in the West Africa Sub-Region

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Open Journal of Urology 2016年第6期6卷 102-108页

作者： Lemuel Davies Bray Mathew Yamoah Kyei James Edward Mensah Kwadwo Ntiamoah Ampadu Isaac Obeng Asiedu Bernard Toboh Evans Akpakli Foli Ashiagbor Joseph Awuku-Asabre Mawuenyo Oyortey Department of Surgery and Urology School of Medicine and Dentistry College of Health Sciences University of Ghana Accra Ghana Ureteral Stent Encrustation Endourology West Africa

Background: Forgotten ureteral stent is defined as prolong indwelling ureteral stent whose function is no longer desired. Ureteral stents are used in the management of upper urinary tract pathologies. Prolonged indwelling ureteral stents may be complicated by urosepsis or renal failure, encrustation, stone formation, spontaneous fracture which may either be retained or voided in the urine (stenturia). Hitherto, these complications were managed by open procedures alone in our center. We report our recent experience in endourology with the management of three cases of forgotten ureteral stents with durations of ten years and two years (two cases) and review endourological practice in West Africa. Conclusion: Although encrusted stents can be managed successfully by minimally invasive approaches in the majority of cases, the best treatment is prevention. Urology units should have preferably an electronic stent register such that when the time for removal is due, the patient's name and details are flagged red. If electronic register is not available, then a hard paper/book register should be made to prevent situations of forgotten stents. Also, efforts must be made to improve endourological services in the West Africa subregion to allow patients to have the benefit of endourology in the management of upper urinary tract pathologies including that of stones originating from an encrusted or fractured forgotten ureteral stent.

关键词： Ureteral Stent Encrustation endourology West Africa

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Radiation protection measures during endourological therapies

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Asian Journal of Urology 2023年第3期10卷 215-225页

作者： Lazaros Tzelves Patrick Juliebø-Jones Ioannis Manolitsis Themistoklis Bellos Ioannis Mykoniatis Marinos Berdempes Titos Markopoulosa Michael Lardas Belthangady M.Zeeshan Hameed Panagiotis Angelopoulos Amelia Pietropaolo Bhaskar Somani Ioannis Varkarakis Andreas Skolarikos nd Department of Urology National and Kapodistrian University of AthensSismanogleion HospitalAthensGreece Young Academic Urologists(YAU) Urolithiasis&Endourology Working Party6846 Arnhemthe Netherlands Department of Urology Haukeland University HospitalN-5021 BergenNorway Department of Urology Faculty of Health SciencesSchool of MedicineAristotle University of Thessaloniki54124 ThessalonikiGreece Department of Urology Kasturba Medical College ManipalManipal Academy of Higher EducationManipal 576104India Department of Urology University Hospital Southampton NHS TrustSouthamptonUK

Objective The objective of this narrative review was to search the existing literature for studies reporting measures to minimize radiation use during endoscopic management of stone disease and present ways of reducing the exposure of both patients and operating room *** A literature review in PubMed was performed to identify studies describing protocols or measures to reduce radiation received during endourological procedures from January 1970 to August *** studies were those that reported outcomes for ureteroscopy or percutaneous nephrolithotripsy regarding measures to minimize radiation doses used intraoperatively,performed either in real-life theatres or using *** comparative and non-comparative studies were deemed *** Protection can be achieved initially at the level of diagnosis and follow-up of patients,which should be done following an algorithm and choice of more conservative imaging *** protocols,which follow principles for minimized fluoroscopy use should be implemented and urologists as well as operating room staff should be continuously trained regarding radiation damage and protection *** protective lead equipment remains a cornerstone for personnel protection,while configuration of the operating room and adjusting X-ray machine settings can also significantly reduce radiation *** There are specific measures,which can be implemented to reduce radiation *** include avoiding excessive use of computed tomography scans and X-rays during diagnosis and follow-up of urolithiasis *** protocols with minimal fluoroscopy use can be *** training regarding dangers of radiation plays also a major *** and maintenance of protective equipment and setting up the operating room properly also serve towards this *** settings can be customized appropriately and finally continuously monitoring of exposure with dosimeters can be adopted.

关键词： endourology Radiation Fluoroless ureteroscopy Percutaneous nephrolithotripsy As low as reasonably achievable

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