REFERENCES 1. Hofmann R. Ureteroscopy (URS) for ureteric calculi. Urologe A 2006;45:637-46. 2. Wu CF, Shee JJ, Lin WY, et al. Comparison between extracorporeal shock wave lithotripsy and semi rigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 2004;172:1899-902. 3. Gonen M, Cenker A, Istanbulluoglu O, et al. Efficacy of dretler stone cone in the treatment of ureteral stones with pneumatic lithotripsy. Urol Int 2006;76:159-62. 4. Tepeler A, Resorlu B, Sahin T, et al. Categorization of intraoperative
References 1. Geavlete P. Ureteroscopia. Ed. Univ. „Carol Davila”, 2008, pg. 237-238. 2. EAU Indication for active stone removal and selection of procedure, Guidelines 2013 Edition, pg. 41-43. 3. EAU Perioperative antibacterial prophylaxis in Urology. Guidelines 2014 Edition, pg. 77-92. 4. Geavlete P, Jecu M, Geavlete B, et al: Ureteroscopy - an essential modern approach in upper urinary tract diagnosis and treatment. J Med Life. 2010;3(2):193-199. 5. Geavlete P, Georgescu D, Niţă G, Mirciulescu V, Cauni V. Complications of 2735 Retrograde Semirigid Ureteroscopy
Introduction and objectives: Percutaneous nephrolithotomy represent the main indication for patients with kidney stones, even in the presence of various comorbidities. In our clinic open surgery for this pathology is less than 0.5% of all procedures for renal stones. The objective of this paper is to assess the safety and efficacy of this procedure in patients over 70 years.
Material and methods: A retrospective study was performed for a period of 16 years (1997-2012). A totally of 323 patients entered in this study (162 women, 161 men), aged over 70 and with renal stones They were treated endoscopically by percutaneous nephrolithtomy or anterograde ureteroscopy. 85 patients (26.31%) had comorbidities that were preoperatively diagnosed and treated where necessary.
Results: Overall status of “stone free” at the end of surgery was present in 263 patients (81.42%). 60 patients (18.58%) had residual fragments. Residual stones were solved by a new percutaneuos nephrolithtomy session, spontaneous elimination or extracorporeal shock wave lithotripsy. The most common complications were bleeding and infection. We had no deaths. No hemostasis nephrectomy was necessary.
Conclusions: Recognized preoperative comorbidities do not represent risk factors in elderly patients, but it requires a rigorous evaluation in the preoperative period. The number, size and complexity of stones directly influences the state “stone free” at the end of surgery.
expression of novel tissue markers of kidney injury after ureteroscopy, shockwave lithotripsy, and in normal healthy controls. J Endo. 2013; 27:1455-62. Fahmy N Sener A Sabbisetti V Nott L Lang RM Welk BK et al Urinary expression of novel tissue markers of kidney injury after ureteroscopy, shockwave lithotripsy, and in normal healthy controls J Endo 2013 27 1455 62 21 Horuz R, Goktas C, Cetinel CA, Akca O, Aydin H, Ekici ID, et al. Role of TNF-associated cytokines in renal tubular cell apoptosis induced by hyperoxaluria. Urolithiasis. 2013; 41:197-203. Horuz R Goktas C
A very elegant solution is to extract the mesh fragment endoscopically, by
ureteroscopy or cystoscopy. Frequently, the eroded fragment is sectioned with the
endoscopic scissors and then extracted with the forceps. Some authors proposed the
resection with a loop and of a part of bladder muscle, to remove part of the parietal
inflammatory process (Oh T.H. & Ryu D.S., 2009). Cases requiring multiple procedures to
completely remove the mesh fragment have been described, after each stage, a new portion
enveloping the bladder (Foley C., et al., 2010