Abstract:
INTRODUCTION:Drugs and their metabolites are known factors in 1% to 2% of all kidney stones. Certain antiepileptic drugs are known to cause stone formation. Phenytoin is used as a first line antiepileptic therapy for many seizure disorders. We present what we believe to be the first report of a phenytoin metabolite urinary stone. METHODS:A 79-year-old woman with a fever and seizure disorder was found to have a right pelvic kidney with hydronephrosis and multiple large calcifications. She had been taking the antiepileptic medication phenytoin for the past 10 years. Average total serum phenytoin level from the year prior was in the normal range. Free phenytoin levels were not routinely monitored, but the one value available was elevated at 5.1 ng/dL. The patient underwent a percutaneous nephrolitomy, ultimately expiring from medical complications after the procedure. Final stone analysis revealed a composition of 35% phenytoin metabolite (5-(para-hydroxyphenyl)-5-phenylhydantoin) and 65% proteinaceous material. An extensive review of literature including PubMed, MedLine, and various internet search engines was performed, searching for any prior reports of urinary calculi formed from phenytoin or its metabolite. RESULTS:No previous reports of phenytoin or phenytoin metabolite urinary stones were found in the medical literature. Phenytoin has many known ill effects on the genitourinary system including acute interstitial nephritis, nephrotic syndrome, acute renal failure, and priapism. Now we can add urinary lithiasis to the list of its potential adverse effects. This article represents the first report of a phenytoin metabolite urinary stone. CONCLUSION:A metabolite of the commonly used antiepileptic medication phenytoin can cause clinically relevant urolithiasis leading to significant morbidity and even mortality. Clinicians should have an increased level of suspicion for metabolite stone formation in symptomatic patients taking antiepileptic medications. Further studies on phenytoin metabolism and its potential for inducing urinary lithiasis should be performed.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Kalorin CM,Bauer R,White MDdoi
10.1089/end.2007.0410subject
Has Abstractpub_date
2008-08-01 00:00:00pages
1665-8issue
8eissn
0892-7790issn
1557-900Xjournal_volume
22pub_type
杂志文章abstract::In the last three decades, minimally invasive techniques have progressed significantly, replacing traditional open surgery as the mainstay of stone disease surgical treatment. The challenge for the next millennium remains medical prevention of calcium urolithiasis, a field where less dramatic progress has been achieve...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.1999.13.669
更新日期:1999-11-01 00:00:00
abstract:PURPOSE:We aimed to understand the characteristics of patients who are less likely to submit adequate urine collections at metabolic stone evaluation. METHODS:Inadequate urine collection was defined using two definitions: (1) Reference ranges for 24-hour creatinine/kilogram (Cr/24) and (2) discrepancy in total 24-hour...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0544
更新日期:2015-06-01 00:00:00
abstract:: Objective: To evaluate whether reducing the dose of fluoroscopy to ¼ of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, ...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2018.0722
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Ascertaining the optimal depth of dilator progression is a crucial factor during tract dilation in percutaneous nephrolithotomy. Dilation is generally guided under fluoroscopy, ultrasonography, or combination of both techniques, and it is still difficult to prevent overdilation causing perforatio...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0710
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:The current experimental study aimed at evaluating the temperature raise of the irrigation fluid caused by the use of the thulium (Tm:YAG) and holmium laser (Ho:YAG) in the upper urinary tract (UT) of pigs. MATERIALS AND METHODS:An experimental setting was designed for the investigation of differences in ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0768
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:To analyze the early outcome after single tract vs multiple tracts percutaneous nephrolithotomy (PCNL) in the management of staghorn calculi. PATIENTS AND METHODS:The records of 413 patients with staghorn calculi (223 [54%] had complete and 190 [46%] had partial) who underwent PCNL were reviewed retrospectivel...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0456
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Transurethral resection of the bladder (TURB), the first step in treatment of patients with urothelial bladder cancers, is limited by technicalities, surgeon skill, and random chance. When high-risk superficial diseases are discovered, a repeated TURB is indicated. We reviewed current literature ...
journal_title:Journal of endourology
pub_type: 杂志文章,meta分析,评审
doi:10.1089/end.2011.0081
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients who are undergoing laparoscopic ablative therapy (LAT) are often older with more comorbidities in comparison with patients who are undergoing laparoscopic partial nephrectomy (LPN). A matched control study was performed to compare the surgical and functional outcomes of LPN and LAT. PAT...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0087
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Kidney stone disease (KSD) affects millions of people worldwide and has an increasing incidence. Social media (SoMe) and search engines are both gaining in usage, while also being used by patients to research their conditions and aid in managing them. With this in mind, many authors have expressed the beli...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0319
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:Safe insertion of the first port during laparoscopic surgery has always been problematic, from the early use of the Veress needle to the open Hasson technique. We describe a novel, safe, and well-illuminated technique of port entry using the Killian nasal speculum. This technique has been used successfully in t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0142
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:A unilateral paravertebral (PVB) block with catheter can provide extendable analgesia without physiological changes. The objective of this study was to assess the efficacy of PVB bupivacaine for providing perioperative pain relief in adults undergoing percutaneous nephrolithotomy (PCNL) under gen...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2014.0179
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Urinary-tract fistulas present unique clinical challenges that often necessitate open surgical excision with interposition of healthy tissue. Advances in retrograde instrumentation have enabled endourologists to employ more minimally invasive approaches to urologic disease, including fistulas. We...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.419
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:To evaluate in vitro and in vivo effects of Moses technology in Holmium laser and to compare it with the Regular mode in terms of lithotripsy efficiency and laser-tissue interactions. METHODS:The Lumenis® Pulse™ P120H holmium laser system together with Moses D/F/L fibers were used to compare the Regular mode...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0050
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Benign prostatic hyperplasia (BPH) affects more than 50% of men by the age of 60 and 90% by age 85. Many of these men are not candidates for surgical procedures such as transurethral resection of the prostate (TURP), stimulating the development of less-invasive forms of therapy. We studied the ut...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.159
更新日期:2005-03-01 00:00:00
abstract:INTRODUCTION:Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-cente...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0271
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:We evaluated the feasibility and effectiveness of percutaneous urinary diversion in patients with obstructive uropathy. PATIENTS AND METHODS:A total of 206 percutaneous nephrostomies (PCNs) (right-sided in 54, left in 56, and bilateral in 48) were performed in 102 male and 57 female patients 18 to 94 years ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.401
更新日期:2000-06-01 00:00:00
abstract::Large bladder calculi are often outside the range of treatment with conventional endoscopic lithotrites because of either anatomic factors or the mechanical limits of available instruments. Alternative methods of cystolithotripsy: ultrasonic, electrohydraulic, or laser, can prove time-consuming or even hazardous, so t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.183
更新日期:1994-06-01 00:00:00
abstract::Five patients with major (Grade IV) renal trauma required ureteral stent placement to facilitate urinary drainage. Three of these patients had stents placed for recurrent gross hematuria with flank pain. All three had obstructing blood clots present at the time of stent placement. The fourth patient had a stent placed...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1998.12.545
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Holmium:YAG lithotripsy of uric acid calculi produces cyanide. The laser and stone parameters required to produce cyanide are poorly defined. In this study, we tested the hypotheses that cyanide production: (1) varies with holmium:YAG power settings; (2) varies among holmium:YAG, pulsed-dye, and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.169
更新日期:2000-03-01 00:00:00
abstract::A new tip design of a 3.3F electrohydraulic probe for endoureteral lithotripsy was evaluated in comparison to a regular probe. The peak pressure, as well as the slope of the shock front, depend solely on the voltage. Increasing the capacity leads merely to broader pulses. A laser-like short high-pressure pulse has a g...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1993.7.35
更新日期:1993-02-01 00:00:00
abstract::Laparoscopic living-donor nephrectomy has decreased the disincentives to live renal donation with a risk of complications similar to that of open donor nephrectomy. We report a patient who developed chylous ascites after an otherwise-uneventful laparoscopic donor nephrectomy. On MEDLINE search, we could find only two ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.839
更新日期:2005-09-01 00:00:00
abstract:PURPOSE:To compare the morbidity of percutaneous nephrolithotomy (PCNL) requiring multiple percutaneous tracts with that of procedures requiring a single tract for calculus clearance. PATIENTS AND METHODS:Data from 20 patients undergoing PCNL through two or more percutaneous renal tracts over a 1-year period were comp...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.753
更新日期:2006-10-01 00:00:00
abstract:PURPOSE:To assess factors that affect prostate biopsy results following salvage whole gland cryoablation. PATIENTS AND METHODS:One hundred seventy-four patients underwent prostate biopsy following salvage whole gland cryoablation of the prostate in the Cryo-OnLine Database registry. Wilcoxon rank-sum and χ2 tests and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0715
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:To investigate prospectively the benefits of three-dimensional stereolithographic biomodeling produced from CT data as an aid to achieving optimal access for percutaneous nephrolithotripsy (PCNL). PATIENTS AND METHODS:Eight patients with complex urinary calculi were selected. Multislice CT scans of the kidney ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.92
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Nephroureterectomy (NU) with bladder cuff excision is the gold standard treatment for patients with upper urinary tract urothelial cancer. We report our initial experience with laparoendoscopic single-site plus one port (LESS POP) technique for NU and bladder cuff excision. PATIENTS AND METHODS:...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0735
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:The use of a ureteral access sheath (UAS) may provide significant advantages, particularly, in the treatment of a large renal stone burden. However, in some patients, the passage of a UAS up the ureter is impossible. We prospectively evaluated the ability to insert a 14F UAS and analyzed the possible predi...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0215
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal cysts are common in the adult population. Symptomatic cysts traditionally have been treated by percutaneous aspiration with injection of sclerosant agents. Our aim was to compare the efficacy and side effects of ethanol and sodium tetradecyl sulfate (STDS) as sclerosants for symptomatic sim...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.0462
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal Fine Needle Aspiration Cytology (FNAC) has gained popularity due to increasing options in management of renal lesions such as energy ablation and active surveillance. The diagnostic yield of renal FNAC varies between 40-90%. We hypothesized that adequate and diagnostic FNA samples would be ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.9724
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. METHODS:Nationwide Emergency Department Sample was analyzed from 2006 to 2009. All patients presenting t...
journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
doi:10.1089/end.2013.0205
更新日期:2013-12-01 00:00:00
abstract:: Purpose: Transparently reported, high-quality randomized controlled trials (RCTs) play a critical role in guiding evidence based clinical practice and informing evidence-based guidelines in patients with nephrolithiasis. Prior studies have found reporting quality to be low...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0649
更新日期:2020-04-01 00:00:00