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Ureteroscopic management of renal calculi in anomalous kidneys.
Urology. 2005 Feb; 65(2):265-9.U

Abstract

OBJECTIVES

To review our experience with ureteroscopy in treating patients with renal calculi in anomalous kidneys and to evaluate the efficacy of this approach.

METHODS

Eight patients with renal calculi in anomalous kidneys who were managed by ureteroscopic procedures were identified. Demographic information, preoperative stone burden, operative information (ureteroscope size, lithotrite used, instruments used, duration of surgery, complications, stenting), follow-up imaging, and complications were obtained from the medical record. This information was analyzed to determine the most frequently used instruments and stone-free rates.

RESULTS

Our cohort consisted of 4 patients with horseshoe kidneys (HSK) and 4 patients with pelvic kidneys (PK) (6 male, 2 female, mean age, 50.6 years). The average preoperative stone burden of the 11 treated calculi was 1.4 cm, with 5 stones located in the renal pelvis, 2 in the upper pole, and 4 in lower pole calyces. A 7.5F flexible ureteroscope, holmium laser lithotripsy, and nitinol baskets and graspers were used in all patients. Six patients had complete clearance of the stone on postoperative imaging (75% HSK, 75% PK), with 88% of patients asymptomatic after their procedure. No patients required additional surgical intervention.

CONCLUSIONS

Flexible ureteroscopy with holmium laser lithotripsy and the use of nitinol baskets and graspers provides a reasonable alternative to shock wave lithotripsy in the management of patients harboring renal calculi in anomalous kidneys. In addition, ureteroscopy can be considered a primary option for managing select patients with symptomatic stones in PKs before a percutaneous surgical approach.

Authors+Show Affiliations

The Comprehensive Kidney Stone Center, The Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15708035

Citation

Weizer, Alon Z., et al. "Ureteroscopic Management of Renal Calculi in Anomalous Kidneys." Urology, vol. 65, no. 2, 2005, pp. 265-9.
Weizer AZ, Springhart WP, Ekeruo WO, et al. Ureteroscopic management of renal calculi in anomalous kidneys. Urology. 2005;65(2):265-9.
Weizer, A. Z., Springhart, W. P., Ekeruo, W. O., Matlaga, B. R., Tan, Y. H., Assimos, D. G., & Preminger, G. M. (2005). Ureteroscopic management of renal calculi in anomalous kidneys. Urology, 65(2), 265-9.
Weizer AZ, et al. Ureteroscopic Management of Renal Calculi in Anomalous Kidneys. Urology. 2005;65(2):265-9. PubMed PMID: 15708035.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ureteroscopic management of renal calculi in anomalous kidneys. AU - Weizer,Alon Z, AU - Springhart,W Patrick, AU - Ekeruo,Wesley O, AU - Matlaga,Brian R, AU - Tan,Yeh H, AU - Assimos,Dean G, AU - Preminger,Glenn M, PY - 2004/02/13/received PY - 2004/09/02/accepted PY - 2005/2/15/pubmed PY - 2005/10/6/medline PY - 2005/2/15/entrez SP - 265 EP - 9 JF - Urology JO - Urology VL - 65 IS - 2 N2 - OBJECTIVES: To review our experience with ureteroscopy in treating patients with renal calculi in anomalous kidneys and to evaluate the efficacy of this approach. METHODS: Eight patients with renal calculi in anomalous kidneys who were managed by ureteroscopic procedures were identified. Demographic information, preoperative stone burden, operative information (ureteroscope size, lithotrite used, instruments used, duration of surgery, complications, stenting), follow-up imaging, and complications were obtained from the medical record. This information was analyzed to determine the most frequently used instruments and stone-free rates. RESULTS: Our cohort consisted of 4 patients with horseshoe kidneys (HSK) and 4 patients with pelvic kidneys (PK) (6 male, 2 female, mean age, 50.6 years). The average preoperative stone burden of the 11 treated calculi was 1.4 cm, with 5 stones located in the renal pelvis, 2 in the upper pole, and 4 in lower pole calyces. A 7.5F flexible ureteroscope, holmium laser lithotripsy, and nitinol baskets and graspers were used in all patients. Six patients had complete clearance of the stone on postoperative imaging (75% HSK, 75% PK), with 88% of patients asymptomatic after their procedure. No patients required additional surgical intervention. CONCLUSIONS: Flexible ureteroscopy with holmium laser lithotripsy and the use of nitinol baskets and graspers provides a reasonable alternative to shock wave lithotripsy in the management of patients harboring renal calculi in anomalous kidneys. In addition, ureteroscopy can be considered a primary option for managing select patients with symptomatic stones in PKs before a percutaneous surgical approach. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15708035/Ureteroscopic_management_of_renal_calculi_in_anomalous_kidneys_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01124-0 DB - PRIME DP - Unbound Medicine ER -