Search

Introduction: To assess the efficacy and morbidity of percutaneous nephrolithotomy (PNLT) in the treatment of renal stones in patients with neurogenic lower urinary tract dysfunction (NLUTD)., Methods: Retrospective, monocentric study including all patients with NLUTD who had undergone PNLT between 2005 and 2017. Pre-operative clinical data (neurological condition, voiding mode, preoperative urine culture…), peri-operative and post-operative data (success and morbidity) were collected from the patients' charts. Success was defined by the absence of residual fragment (RF), on imaging or intraoperative endoscopy. Partial efficacy was defined by the presence of RF lower than 4mm. Early complications were reported according to the Clavien-Dindo classification., Results: In all, 53 PNLTs were performed, in 35 patients, mostly with spinal cord injury. The success and partial efficacy rates were 66.0% and 71.7% respectively. The failure rate was correlated with increased stone burden (P=0.03), increased size of the largest stone (P=0.02), and the presence of complex stones (P<0.02). The rate of early complications was 41.5%, with 27.3% major, mostly septic, and bleeding. The retreatment rate within 3 years was 41.5%., Conclusion: In patients with NLUTD, PNLT allows a high success rate, but with a significant rate of retreatment and infectious complications. However, NLPC remains the gold standard in this population, especially for renal stones larger 20mm, allowing a higher success rate than ureteroscopy and a lower retreatment rate., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

The purpose of our study is to compare the status of vitamin A and E enters a group of male patients aged 30–40 years and having idiopathic lithiasis in the other whose origin of the lithiasis is awarded to a hypercalciuria and/or hypercalciuria and/or hyperoxaluria. Reference values were established from a normal subjects aged 30–40 years and having no history of nephrolithiasis. Our results showed that the mean levels of vitamin A was significantly lower in idiopathic renal stone-formers than metabolic stone-formers (p < 0.001). Compared to control group, the status of vitamin A was found lower only in idiopathic renal stone patients (p < 0.05). On the contrary, the mean levels of vitamin E were found similar in the two patient groups, but significantly lower compared to control group. These results suggested that idiopathic renal stone genesis could be generated by vitamin A deficiency. [Copyright &y& Elsevier]

Résumé Introduction Le laser pulsé Holmium:YAG est la principale source laser en endo-urologie. L’optimisation des paramètres du laser est certainement le facteur non-opérateur dépendant qui est le plus important pour garantir le succès d’une intervention d’endo-urologie. Paramètres du laser Trois paramètres déterminent l’efficacité biologique d’un faisceau laser : la fréquence d’impulsion, la durée d’impulsion et l’énergie par impulsion. On définit 4 principaux profils de paramétrages du laser pour l’endo-urologie du haut appareil urinaire : le dusting et la fragmentation pour le traitement des calculs, la section pour les sténoses urétérales et la coagulation/ablation pour les tumeurs de la voie excrétrice. Pour le calcul, le dusting a l’avantage d’éviter la formation de fragments résiduels. La fragmentation est plus adaptée aux calculs denses. Diamètre de la fibre Une fibre de petit diamètre (200–270 μm) a une efficacité équivalente à une fibre de diamètre supérieur, et permet une meilleure irrigation et une meilleure manœuvrabilité. Summary Introduction The pulsed Holmium:YAG laser is the main laser source in endo-urology. The optimization of the laser parameters is certainly the most important independent-operator factor for the success of an endo-urological procedure. Laser parameters Three parameters determine the biological effectiveness of a laser: the pulse frequency, the pulse duration and the energy per pulse. Four main laser profiles are defined for the endo-urology of the upper urinary tract: the dusting and fragmentation for the treatment of stones, the section for ureteral strictures and coagulation/ablation for tumors of the urinary tract. For renal stones, the dusting has the advantage of avoiding the formation of residual fragments, but fragmentation is more suited for very hard stones. Diameter of the fiber The use of a small diameter fiber (200–270 microns) is recommended as it is as effective as a larger fiber, allows a better irrigation and a better maneuverability. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the efficacy and tolerance of renal stone fragmentation by flexible ureterorenoscopy (URS), compared to percutaneous nephrolithotomy (PCNL)., Material and Methods: Patients treated between 1998 and 2010 by URS and PCNL for intrarenal stone were reviewed. Patients' and stones' characteristics were analyzed. The preoperative parameters were reported as well as the procedure's efficiency and its complications. Success was defined by the absence of residual lithiasis visualized on renal imaging at 6 months of follow-up., Results: Among 531 patients included, there were 159 PCNL and 372 URS. The mean duration of hospitalization after PCNL was 8±4.6 days and 3±1.7 days after URS. The mean stones' size was higher in the PCNL group (19.9±7.5mm) than for the URS group (9.7±5.6mm; P<0.0001). The stone-free rate was significantly better in the PCNL group for stones measuring between 10 and 20mm (P<0.0001) and for stones of more than 20mm (P=0.017). Postoperative complications were significantly more frequent (27 %) and more severe (8.8 % vs Clavien III and IV) in the PCNL, than in the URS group, respectively (P=0.0001)., Conclusion: PCNL is a successful technique for renal stone fragmentation. However, URS seemed more tolerated despite a lower stone-free rate., Level of Evidence: 4., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)