MyMedR

Ureteroscopy: the first line treatment for distal located ureteral stones smaller than 10 mm

Kamarulzaman MN

Urol J, 2014 Nov 01;11(5):1914.

Matched MeSH terms: Ureteral Calculi/therapy*

Comparison of the Efficacy and Safety of Laparoendoscopic Single-Site Surgery with Conventional Laparoscopic Surgery for Upper Ureter or Renal Pelvis Stones in a Single Institution: A Randomized Controlled Study

Park J, Lee SB, Cho SY, Jeong CW, Son H, Park YH, et al.

Urol J, 2016 Aug 25;13(4):2759-64.

PMID: 27576882

PURPOSE: To evaluate the utility and safety of laparoendoscopic single-site surgery (LESS) in comparison with conventional laparoscopic (CL) surgery for the treatment of upper urinary tract stones.

MATERIAL AND METHODS: Between June 2011 and May 2012, 20 patients with upper urinary tract stones were included in this prospective randomized study. The patients were assigned into the LESS group or CL group in a one-on-one manner using a random table. The clinical parameters were evaluated in the immediate postoperative period, and the stone clearance rate was evaluated via non-contrast computer tomography at one month postoperatively.

RESULTS: There were no significant differences in patient demographics or preoperative stone sizes between the two groups. The perioperative parameters, including operative time, estimated blood loss, postoperative pain scores, length of hospital stay, and changes in renal function, were comparable. No transfusions or open conversions were required in either group. The incidence of residual stones was lower in the LESS group (1 case) than in the CL group (2 cases). However, this difference was not statistically significant.

CONCLUSIONS: For large and impacted upper ureteral stones, the effectiveness and safety of LESS were equivalent to those of CL. Further randomized control trials with larger sample sizes are needed to strengthen the conclusions of this study.&nbsp.

Matched MeSH terms: Kidney Calculi/surgery*; Ureteral Calculi/surgery*

Fulltext Endogenous endophthalmitis as a septic complication postureteroscope candiduria

Inn FX, Md Noh UK, Jasman MH

Urol Ann, 2017 2 22;9(1):83-85.

PMID: 28216938 DOI: 10.4103/0974-7796.198902

Ureteroscopy (URS) is commonly used by urologists to treat ureteral stones. It is a relatively low-risk procedure. Both urinary tract obstruction and contamination of instrument can cause candiduria post-URS, and this infection can be treated with an antifungal medication. Candidemia is known as hematogenous dissemination, and ocular tissue is a common invasion. However, endogenous endophthalmitis, due to postureteroscope candiduria, has not been reported up to date. This is a devastating complication that may lead to visual loss. Here, we describe a case of endogenous endophthalmitis as a consequence of candiduria after URS.

Matched MeSH terms: Ureteral Calculi

Does simultaneous inversion during extracorporeal shock wave lithotripsy improve stone clearance: a long-term, prospective, single-blind, randomized controlled study

Leong WS, Liong ML, Liong YV, Wu DB, Lee SW

Urology, 2014 Jan;83(1):40-4.

PMID: 24044912 DOI: 10.1016/j.urology.2013.08.004

To determine the efficacy of a combination of simultaneous shock wave lithotripsy (SWL), hydration with controlled inversion therapy compared with SWL with hydration alone in patients with lower pole calyx stones.

Matched MeSH terms: Kidney Calculi/therapy*

Urinary metabolic evaluation of stone formers-a Malaysian perspective

Hong YH, Dublin N, Razack AH, Mohd MA, Husain R

Urology, 2012 Sep;80(3):529-34.

PMID: 22578827 DOI: 10.1016/j.urology.2012.02.053

To investigate the urinary metabolic excretion pattern among local stone formers given the great differences in the intrinsic and extrinsic risk factors as well as the urinary metabolic excretions compared with other populations.

Matched MeSH terms: Urinary Calculi/metabolism; Urinary Calculi/urine*

Twenty-four hour and spot urine metabolic evaluations: correlations versus agreements

Hong YH, Dublin N, Razack AH, Mohd MA, Husain R

Urology, 2010 Jun;75(6):1294-8.

PMID: 19914693 DOI: 10.1016/j.urology.2009.08.061

OBJECTIVES: To investigate the correlations and agreements between the solute/creatinine ratios from the 24-hour and early morning spot urine samples for metabolic evaluation in stone-formers given the various pitfalls with the 24-hour urinary metabolic evaluation in stone-formers.
METHODS: 30 urinary stone-formers out of an initial 62 recruited provided a complete 24-hour urine and early morning spot urine samples for metabolic evaluation. Pearson correlation and Bland and Altman Test were used to assess the correlations and agreements.
RESULTS: Significant correlations were established between the 24-hour urinary solute excretions and the corresponding early morning spot urine solute/creatinine ratios for calcium, magnesium, urate, potassium, oxalate, citrate, and the Differential Gibb's free energy value of calcium oxalate DG(CaOx) values. However, all these solute/creatinine measurements between the 24-hour and early morning spot urine samples were judged to be not within the acceptable limits based on the estimated "limit of agreement" by the Bland and Altman Test of Agreement. Diurnal circadian rhythm and postprandial excretion surge are thought to be responsible for the disagreements.
CONCLUSIONS: Thus, the early morning spot urine is not suitable to be used interchangeably to replace the 24-hour urine collection in the evaluation of urinary metabolic abnormalities in stone-formers. A good correlation does not translate to an agreement between the 2 measurements.

Matched MeSH terms: Urinary Calculi/diagnosis; Urinary Calculi/urine*

Fulltext Studies on Leaf Venation in Selected Taxa of the Genus Ficus L. (Moraceae) in Peninsular Malaysia

Badron UH, Talip N, Mohamad AL, Affenddi AE, Juhari AA

Trop Life Sci Res, 2014 Dec;25(2):111-25.

PMID: 27073603 MyJurnal

A study on the variation of leaf venation patterns was conducted on 21 taxa of the genus Ficus in Peninsular Malaysia. The results showed the existence of eight leaf venation patterns based on veinlets, the ultimate marginal and areolar venation. The majority of species, such as F. annulata, F. benghalensis, F. benjamina, F. deltoidea var. angustifolia, F. deltoidea var. kunstleri, F. depressa, F. elastica, F. hispida, F. microcarpa, F. religiosa, F. tinctoria, F. ucinata and F. vasculosa, show tri-veinlets. The others exhibit the following: bi-veinlets in F. aurata and F. heteropleura; uni-veinlets in F. lepicarpa, F. schwarzii and F. superba; and simple veinlets in F. aurantiacea and F. fulva. F. sagittata presents no veinlets for areolar venation. The presence of tracheid or swollen veins at the centre of the lamina and the presence of cystolith cells and trichomes are common anatomical characteristics that could assist in group classification of the studied species. Variations in leaf venation patterns are not only valuable in identifying a taxon group, but can also be used to differentiate between species in the genus Ficus.

Matched MeSH terms: Urinary Bladder Calculi

Uterine inversion with massive uterovaginal prolapse and multiple bladder stones

Naidu A, Nusee Z, Tayib S

J Obstet Gynaecol Res, 2011 Jun;37(6):633-5.

PMID: 21349130 DOI: 10.1111/j.1447-0756.2010.01401.x

A non-puerperal uterine inversion in advanced uterovaginal prolapse is a rare occurrence. Even more unusual is the presence of bladder calculi in these two conditions, which has not been documented before. We report a case of acute urinary retention secondary to severe uterovaginal prolapse associated with uterine inversion and multiple bladder calculi.

Matched MeSH terms: Urinary Bladder Calculi/complications*; Urinary Bladder Calculi/physiopathology

Fulltext Renal stones in Kelantan, Malaysia--has the pattern changed?

Nazmi N, Zainal D, Hashim M

Southeast Asian J. Trop. Med. Public Health, 1997 Sep;28(3):641-4.

PMID: 9561623

Records of 183 patients with renal stones managed at Hospital Universiti Sains Malaysia between 1985 and 1995 were retrospectively evaluated. The commonest symptom was lumbar pain which may be associated with either frequency, blood stained urine or dysuria. One hundred and sixty-one patients (88%) had upper tract stones while the remainder had lower tract stones. Positive urine cultures were seen in 33 patients. The commonest organism isolated was Escherichia coli followed by Klebsiella aeruginosa and Staphylococcus aureus. Almost all of our patients had renal impairment at presentation and 70% of them progressed to chronic renal failure. In contrast to previous findings, the pattern of renal stone in this region is similar to that described in Western society. Its effect on renal function is serious and hence warrant special attention.

Matched MeSH terms: Urinary Calculi/diagnosis*; Urinary Calculi/etiology*; Urinary Calculi/therapy

Fulltext Submandibular intraductal calculi removal as an office procedure with radiofrequency device

Revadi G, Rahmat O, Shailendra S

Med J Malaysia, 2010 Mar;65(1):80-2.

PMID: 21265259 MyJurnal

Salivary duct obstruction secondary to calculi is a common disorder of the submandibular gland and often manifesting as painful episodic swelling of the gland during meals. Complications may arise in unresolved obstruction leading to infections, abscess formation and a hypofunctioning gland. Treatment of this disorder has evolved from the traditional sialadenectomy to organ preserving procedures done under general or local anaesthesia. Our technique using Ellman Surgitron radiofrequency device, is another alternative technique for transoral removal of extraglandular calculi. It is a simple, quick an easy technique to learn that can be done in the office setting under local anaesthesia.

Matched MeSH terms: Salivary Gland Calculi/surgery*

Fulltext Comparing extracorporeal shock wave lithotripsy and ureteroscopy for treatment of proximal ureteric calculi: a cost-effectiveness study

Izamin I, Aniza I, Rizal AM, Aljunid SM

Med J Malaysia, 2009 Mar;64(1):12-21.

PMID: 19852314

Extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) are two main methods of treating proximal ureteric stones. Success rates and cost-effectiveness of the two methods were compared. A total of 67 patients who underwent treatment between January 2007 and July 2007 at a state general hospital were included in the study. The success rate for ESWL group was 81.8% and for URS group was 84.6%. ESWL technique produced a significant higher overall cost per patient than URS (RM930.02 versus RM621.95 respectively). There was no significant difference in quality of patient's life. Cost-effectiveness ratio was lower for URS. The analysis suggested that URS was more cost-effective than ESWL.

Matched MeSH terms: Ureteral Calculi/therapy*

Fulltext Emphysematous pyelonephritis in a diabetic patient with pelvic-ureteric stone

Chan AC, Rohan MJ, Hamid A, Azam A

Med J Malaysia, 2007 Jun;62(2):166-7.

PMID: 18705456 MyJurnal

Emphysematous pyelonephritis is a rare but life threatening infection of kidney that is characterized by gas formation within or around the kidney. We describe a case of emphysematous pyelonephritis as a consequence of inadequately treated pelvic-ureteric stone in a diabetic man and complement this with a brief review of the literature pertaining in particular to the management of this condition.

Matched MeSH terms: Kidney Calculi/complications*; Ureteral Calculi/complications*

Fulltext Twisted fate of bladder catheters

Sithasanan N, Kihne M, Naidu RR, Ramanujam TM

Med J Malaysia, 2006 Aug;61(3):369-70.

PMID: 17240594 MyJurnal

Catheter knotting is a rare complication of bladder catheterisation. Retention of catheter parts resulting in calculus formation is even rarer. We report a case of a vesical calculus formed over a broken and retained supra-pubic catheter which to the best of our knowledge has yet to be reported, along with three other cases of bladder catheter knotting.

Matched MeSH terms: Urinary Calculi/etiology

Fulltext A review of day care ureteroscopy of a teaching hospital in Malaysia

Chan KY, Zulkifli MZ, Nazri MJ, Rashid MO

Med J Malaysia, 2005 Mar;60(1):5-9.

PMID: 16250273 MyJurnal

This is a retrospective review of 200 day-care ureteroscopies performed between April 1998 and October 2002. The aim was to determine the feasibility and safety of this procedure. The mean age was 38.8 years and 75% of them were male. Eighty-three percent were ASA 1 and the remainders were ASA 2. The side of procedure were 48.5% right, 2.5% left and 6% both sides. Fentanyl and proprofol were used during induction. Calculi were found in 82.5% of cases. Rigid and flexible scope were used in 91.5% and 10.5% of cases. There were 33% upper, 23% mid and 44% distal ureteric stones. The mean stone size was 9.37 X 6.93mm. Seventy-four percent required a ureteric stent insertion. The mean operative time was 58.3 minutes. Four percent of patients experienced pain post-operatively relieved by NSAID injection. Repeat ureteroscopy performed in 30% of patients. There were zero admission rates. This study suggests day-care ureteroscopy is effective, safe and well tolerated by patients.

Matched MeSH terms: Ureteral Calculi/surgery*

Fulltext Accuracy of ultrasound versus computed tomography urogram in detecting urinary tract calculi

Salinawati B, Hing EY, Fam XI, Zulfiqar MA

Med J Malaysia, 2015 Aug;70(4):238-42.

PMID: 26358021 MyJurnal

AIM: To determine the (i) sensitivity and specificity of ultrasound (USG) in the detection of urinary tract calculi, (ii) size of renal calculi detected on USG, and (iii) size of renal calculi not seen on USG but detected on computed tomography urogram (CTU).
METHODS: A total of 201 patients' USG and CTU were compared retrospectively for the presence of calculi. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of USG were calculated with CTU as the gold standard.
RESULTS: From the 201 sets of data collected, 59 calculi were detected on both USG and CTU. The sensitivity and specificity of renal calculi detection on USG were 53% and 85% respectively. The mean size of the renal calculus detected on USG was 7.6 mm ± 4.1 mm and the mean size of the renal calculus not visualised on USG but detected on CTU was 4 mm ± 2.4 mm. The sensitivity and specificity of ureteric calculi detection on USG were 12% and 97% respectively. The sensitivity and specificity of urinary bladder calculi detection on USG were 20% and 100% respectively.
CONCLUSION: This study showed that the accuracy of US in detecting renal, ureteric and urinary bladder calculi were 67%, 80% and 98% respectively.
Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur

Matched MeSH terms: Kidney Calculi*

Fulltext Day care percutaneous renal surgery--is this viable?

Chong WL, Murali S, Sahabudin RM, Khairullah A

Med J Malaysia, 2002 Mar;57(1):108-10.

PMID: 14569727

Pros and cons of Percutaneous Nephrolithotripsy (PCNL) versus Extracorporeal Shockwave Lithotripsy (ESWL) have often been highlighted when one discusses on the management of renal stones. An oft quoted point is that PCNL entails a prolonged hospital stay whereas ESWL sessions are day surgical in nature. However, PCNL has superior stone clearance rate as compared to ESWL especially for lower pole stones. In addition, PCNL is more suitable for large bulk stones and when ancillary procedures are required e.g. endopyelotomy. The first 50 cases of successful tubeless PCNL were reported by Bellman et al in 1997. The remarkable recovery of patients in their series encouraged them to employ this technique as their technique of choice for the majority of their cases. A similar technique was employed on endopyelotomy by Liang et al and they concluded that this was a safe, less morbid and effective technique. We report our first case of tubeless PCNL.

Matched MeSH terms: Kidney Calculi/therapy*

Fulltext Multimodal approach in the management of 1163 ureteric stone cases

Tan HM, Liew RP, Chan CC, Wong AT, Ngun KW

Med J Malaysia, 1995 Mar;50(1):87-92.

PMID: 7752983

One thousand one hundred and sixty three patients (male-852, female-311) with ureteric calculi requiring intervention were treated between April 1988 to July 1992. Four hundred and eleven cases were treated by ESWL Monotherapy, 414 by stone manipulation plus ESWL, 301 by retrograde ureteroscopic lithotripsy, 36 by percutaneous antegrade ureteroscopic lithotripsy and 1 case by open ureterolithotomy. There were 25 failures of the initial procedures. Only three cases that failed primary procedures required open surgery. Other complications include minor ureteric mucosal perforation (3%), infection (3%), transient moderate to gross haematuria (20%), loin ache (26.4%), irritative urination (34.4%) and low grade fever (30.1%). Current modalities used in the treatment of ureteric calculi produce good results and there is generally no primary role for any open surgery.

Matched MeSH terms: Ureteral Calculi/therapy*

Fulltext Bilateral stones and renal failure

Suleiman AB, Awang H, Proehoeman F

Med J Malaysia, 1981 Mar;36(1):14-6.

PMID: 7321931

The clinical presentation of patients with bilateral stones is discussed. The majority of patients presenting to the Nephrology Unit were in renal failure. Aggressive medical treatment allowed
diagnostic procedures and definitive surgery to be performed in uraemic patients. Most patients presenting in uraemia benefitted from treatment.
Study Site: Urology Unit, General Hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Kidney Calculi/complications*; Kidney Calculi/therapy

Fulltext Endourology new vistas in the management of urinary tract disease

Mahamooth Z

Med J Malaysia, 1987 Sep;42(3):191-5.

PMID: 3506643

Retrograde ureteroscopy, using the 12.5 French Storsz Perez-Castro Ellendt operating ureteroscope provides excellent visual access to the whole of the ureteric lumen in most instances. A total of 41 ureteroscopies were performed on a similar number of patients over a period of 12 months since April 1986. Majority of them were for ureteric calculi. Success rate for patients with ureteric calculi below the pelvic brim was 77.4%. A lower success was noted for calculi above the pelvic brim (50%). Retrograde ureteroscopy will eventually make blind basketing of lower ureteric stones an unnecessarily risky procedure and perhaps even obsolete. Ureterolithotomy nevertheless will still have a place in the management of stones that cannot be extracted either due to acute bullous oedema of the ureteric mucosa or in previously explored rigid non-yielding ureters not suitable for ureteroscopy.

Matched MeSH terms: Ureteral Calculi/diagnosis; Ureteral Calculi/therapy*

Fulltext Urinary calculi in Limbang District

Lau LK, Ong AT

Med J Malaysia, 1980 Sep;35(1):38-40.

PMID: 7253996

74 cases of radiologically proven urinary calculi between 1975 and 1979 were analysed by race, sex and age. The relative frequency of single and multiple stones was also studied. The disease was found in all the ethnic groups present in Limbang except for the Punans. Possible reasons for this observation of their apparent absence were given. The absence of patients from one of the Malay Kampongs in Limbang town was also noted.

Matched MeSH terms: Urinary Calculi/epidemiology*

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