Abstract:
INTRODUCTION:The treatment of large complete staghorn calculi requires a sandwich combination of percutaneous nephrolithotomy (PCNL) and shockwave lithotripsy (SWL) or sometimes open surgery. Many urologists hesitate to place more than 2-3 tracts during PCNL because of the belief that this may increase complications. We present data to support multi-tract PCNL for large (surface area >3,000 mm(2)) complete staghorn calculi. PATIENTS AND METHODS:From July 1998 to October 2003, 121 renal units (103 patients) with large complete staghorn renal calculi were treated with PCNL. All procedures were performed in the prone position after retrograde ureteral catheterization. Fluoroscopy-guided punctures were made by the urologist followed by track dilation to 34 french. When multiple tracts were anticipated all punctures were usually made at the outset and preplaced wires were put into the collecting system or down the ureter. Stones were fragmented and removed using a combination of pneumatic lithotripsy and suction. Postoperative stone clearance was documented on X-ray KUB. RESULTS:121 renal units of 103 patients (15 women and 88 men, mean age 43 years) were treated. Six patients had associated bladder calculi that were treated simultaneously. The stone surface area was 3,089-6,012 (mean 4,800) mm(2). 10 patients (9.7%) had renal insufficiency with a mean (range) serum creatinine of 3.0 (1.5-5.5) mg/dl. The number of tracts required per patient were 2 tracts in 11, 3 tracts in 68, 4 tracts in 39, and 5 tracts in 3, giving a total of 397 tracts in 121 renal units, over a total of 140 procedures (including second-look procedures in 19 renal units). The points of entry of these tracts were 121 upper calyx (30.4%), 178 middle calyx (44.8%), and 98 lower calyx (24.6%). All 121 units had one upper polar access tract of which 92 (76%) were supracostal. Complications were blood transfusion (n = 18), pseudoaneurysm (n = 2), fever (n = 22), septic shock (n = 1) and hydrothorax (n = 3). PCNL monotherapy achieved an 84% complete clearance rate that improved to 94% with SWL in 8 renal units with small residual fragments. Stone compositions were calcium oxalate (91%), uric acid (2%) and mixed (7%). CONCLUSION:Aggressive PCNL monotherapy using multiple tracts is safe and effective, and should be the first option for massive renal staghorn calculi.
journal_name
Urol Intjournal_title
Urologia internationalisauthors
Aron M,Yadav R,Goel R,Kolla SB,Gautam G,Hemal AK,Gupta NPdoi
10.1159/000089168subject
Has Abstractpub_date
2005-01-01 00:00:00pages
327-32issue
4eissn
0042-1138issn
1423-0399pii
89168journal_volume
75pub_type
杂志文章,多中心研究abstract::To evaluate the possible effect of urinary tract infection (UTI) on the fragility of calcium-containing stones (calcium-oxalate, calcium-phosphate), the results of extracorporeal shock wave lithotripsy (ESWL) therapy in 81 patients with UTI and 30 patients with no sign of UTI were comparatively evaluated. ESWL paramet...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282908
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:Multiparametric MRI (mpMRI) and MRI targeted biopsies (MRtb) are a new standard in prostate cancer (PCa) screening and diagnosis. Guidelines already include this approach for patients at risk. We aimed to gather information from German urologists about their knowledge, routine use, and attitude toward mpMR...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000508755
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:To demonstrate the relationship between testicular microlithiasis and testicular tumor development. PATIENTS AND METHODS:Between January 1996 and March 2004, bilateral testicular microlithiasis was found in 40 of the 5,263 patients who underwent scrotal ultrasonography yielding a prevalence of 0.76%. Of t...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000083279
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:The percentage of positive prostate biopsy cores (%PBC) has been shown to be a prognostic factor in localized prostate cancer. We hypothesized that it would predict time to hormonal independence and survival in prostate cancer patients treated with androgen deprivation therapy (ADT). PATIENTS AND METHODS:...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000230017
更新日期:2009-01-01 00:00:00
abstract::Negotiating a tortuous or obstructed ureter with a wire can be time-consuming and sometimes tiring. The principle of using a slippery floppy wire and then replacing it with a stiff wire through a 5-french open-ended ureteral catheter yields a high success rate. The ureteral catheter can be used for a radiocontrast stu...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282713
更新日期:1995-01-01 00:00:00
abstract::We report an unusual case of unilateral ureteral obstruction with secondary urinary extravasation by forniceal rupture as a complication of the Burch colposuspension procedure. Surprisingly, this complication has never been described before. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281485
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:The study aimed to evaluate the predictive value of ureteral wall thickness (UWT) and stone-related parameters for medical expulsive therapy (MET) success with an alpha blocker in pediatric upper ureteral stones. PATIENTS AND METHODS:A total of 35 children receiving MET ureteral stones (<10 mm) were evaluate...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000453668
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To report conservative and surgical strategies for treatment of mesh erosion after pelvic organ prolapse (POP) repair. METHODS:Between 1998 and 2008, 179 patients underwent integral pelvic floor reconstruction for advanced POP in our tertiary urogynecological unit. Patients' charts and follow-up data were en...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000324243
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:This study aims to examine the relationship between chronic prostatic inflammation and prostatic calculi, and clinical parameters of benign prostatic hyperplasia (BPH). MATERIALS AND METHODS:This study was based on 225 patients who underwent transurethral resection of the prostate for BPH. Chronic inflammati...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000342643
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:We report our experience with the use of povidone iodine instillation into the renal pelvis for the treatment of chyluria. MATERIALS AND METHODS:From August 2006 to November 2008, 26 patients with chyluria were treated. There were 18 males and 8 females ranging from 24-55 years of age. Cystoscopic localization...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000288233
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Intravesical epirubicin is a widely used agent for the treatment of superficial bladder cancer. A direct relationship between dose and activity has been reported: unfortunately the dose increase also increased the frequency and the intensity of treatment-related side effects. MATERIALS AND METHODS:A phase...
journal_title:Urologia internationalis
pub_type: 临床试验,杂志文章
doi:10.1159/000058438
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:β-HCG has been the only tumor marker evaluated in testicular vein (VT) blood until now. OBJECTIVE:To evaluate the correlation between the tumor markers β-HCG, AFP, PLAP, and LDH from the VT and peripheral blood as well as their significance in predicting tumor recurrence and tumor stage. METHODS:Patients...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000511649
更新日期:2020-12-17 00:00:00
abstract:INTRODUCTION:The aim of this study is to evaluate the effect of the gonadal biopsy procedure on fertility and histology of the experimentally created undescended testis. MATERIALS AND METHODS:Thirty Wistar-Albino rat litters were divided into three groups. In the first two groups, undescended testes were obtained by d...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000087799
更新日期:2005-01-01 00:00:00
abstract::Interstitial cystitis is a chronic benign disease of the bladder that causes bothersome and debilitating symptoms and mainly affects women. Since interstitial cystitis (IC) might result from a defective glycosaminoglycan layer of the bladder epithelium, we conducted a trial of hyaluronic acid (HA), used intravesically...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000283012
更新日期:1997-01-01 00:00:00
abstract::Human infestation with Dioctophyma renale is presented. Clinical signs and diagnostic findings are unspecific. They are discussed and a conservative therapeutic approach is suggested. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000067695
更新日期:2003-01-01 00:00:00
abstract::Bladder tumors were staged preoperatively before and/or after M-VEC poly-chemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%. Using thi...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282472
更新日期:1993-01-01 00:00:00
abstract::Two cases of ureteral endometriosis and 1 case of vesical endometriosis are reported and a short review of the literature is presented. The diagnostic problems, despite modern image procedures, and therapeutic modalities are discussed. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281099
更新日期:1985-01-01 00:00:00
abstract::The functional activity of the sphincter muscle of the urethra is known to be controlled largely by the hypogastric and pudendal nerves. It remains unknown, however, whether innervation of the muscle by these peripheral nerves is ipsi- or bilateral. In an attempt to answer this question urethral closure pressure was d...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281328
更新日期:1988-01-01 00:00:00
abstract::It has been well established that erectile dysfunction (ED) is a common incident in patients with benign prostate hyperplasia. Animal models have been described to investigate the relationship between bladder obstruction and ED. In this study, we aimed to investigate whether partial bladder outlet obstruction (PBOO) i...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000137649
更新日期:2008-01-01 00:00:00
abstract::From April 1978 to September 1993, the Department of Urology of Giessen Medical School used laser urethrotomy as standard endoscopic treatment in benign urethral strictures. In this period, 900 urethrotomies were performed in 450 patients. The majority of strictures treated were iatrogenic (65%), located in the poster...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282774
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To describe our surgical experience and clinical outcome in laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) with level 1 renal vein tumor thrombus. PATIENTS AND METHODS:11 patients with RCC level 1 renal vein tumor thrombus were treated by LRN plus thrombectomy. The mean age was 66.8 ye...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000363580
更新日期:2015-01-01 00:00:00
abstract::Myelolipomas are rare benign neoplasms of the adrenal glands, characterized by the presence of adipose tissue and elements of bone marrow in various degrees of differentiation. Usually asymptomatic, they are discovered incidentally or at autopsy; sometimes larger masses may cause local symptoms. We report clinical, ra...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282612
更新日期:1994-01-01 00:00:00
abstract::A rare case of abscess of the corpus cavernosum is described. Culture of the abscess yielded beta-hemolytic streptococcus. Ultrasound scan and cavernosography confirmed the physical examination findings of involvement of the corpus cavernosum. The patient was treated successfully by percutaneous ultrasound-guided aspi...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282373
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:The aim of this study is to modify and validate a novel screening tool to determine the necessity of bone scans in Chinese PCa patients at the time of diagnosis. METHODS:Five-hundred-and-one patients diagnosed with PCa between 2010 and 2013 at Zhongshan Hospital, Fudan University, were included in the study...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000368912
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Partial unilateral ureteral obstruction (PUUO) is the type of obstruction that is most often encountered in pediatric clinical practice. The majority of our knowledge on PUUO has been derived from experimental studies and the effects of PUUO on the kidney have still been a source of continual investigation...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000111736
更新日期:2008-01-01 00:00:00
abstract::A case of spontaneous, partial, unilateral thrombosis of the corpus cavernosum is described. A 35-year-old white male presented with a painful mass in the perineum without priapism. Diagnostic evaluation with sonography and magnetic resonance imaging revealed a thrombosis in the left posterior corporal body. Treatment...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000030246
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:To present our experience and results with the transvesical laparoscopic diverticulectomy, developed by Pansadoro et al. [BJU Int. 2009;103(3):412-24], as treatment of symptomatic bladder diverticula, with a medium-term follow-up. METHODS:Between June 2010 and July 2018, we successfully operated 15 patients...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000510242
更新日期:2020-01-01 00:00:00
abstract::We report a case of clitoral hypertrophy of unknown origin. A 3-year-old girl showed clitoral hypertrophy at birth. Biochemical analysis of peripheral blood and endocrinological examinations were normal. Other virilizing symptoms were not recognized. Clitoroplasty was carried out, and the clitoris has not enlarged 20 ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000030385
更新日期:1999-01-01 00:00:00
abstract::Of 211 incontinent women the answer to each item of a questionnaire is correlated with the urodynamical data and the discriminative value for the type of incontinence is calculated. The relevant questions are discussed. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281355
更新日期:1988-01-01 00:00:00
abstract::Urethral diverticula are pouches opening into the urethral canal that may be either acquired or congenital. Diverticula of the female urethra are fairly common. However, diverticula of the male urethra are relatively uncommon abnormalities. Clinical manifestation is frequently described with irritative and/or obstruct...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000346321
更新日期:2013-01-01 00:00:00