Background: Ureteral obstruction is a common surgical problem and managed by stent insertion or percutaneous nephrostomy. However, there is still confusion that which procedure is better in terms of the complications. Objective: To compare the efficacy of double J stenting and percutaneous nephrostomy for ureteral obstruction in terms of post-operative complications. Study Design: Randomized Clinical Trial. Settings: Urology Department, Shaikh Zayed Hospital, Rahim Yar Khan-Pakistan. Duration: One years from January through December 2016. Methodology: Male/female patients (aged: 19-63 years) presenting in the OPD of the hospital with ureteral obstruction were registered during study period. Either of the groups i.e. A (double J stenting, n = 55) or B (percutaneous nephrostomy, n = 55) was allotted to the subjects, randomly. The procedures and subsequent complications were addressed as per hospital protocols. Results: Most of the patients i.e., 75 (68.2% of 110) were male whereas age statistics were, as: M = 49.47, SD = 8.2 (range 19-62) years. Ureteral stone(s) was found as the most prevalent cause of ureteral obstruction in group A (49.1%, n = 27) and B (40.0%, n = 22). Hematuria was seen as a common complication: 33.3 (n = 5) and 42.9% (n = 3) in group A and B, respectively. The rate of complications was significantly lower in group B than A [12.7% (n = 7) vs. 27.3% (n = 15), respectively] (p = .04). Conclusion: Percutaneous nephrostomy is a better procedure (in terms of post-operative complications) than double J stenting in management of ureteral obstruction.
Keywords: Ureteral obstruction, Percutaneous nephrostomy, Stents, Postoperative complication.

https://www.apmcfmu.com/index.php/apmc/article/download/1108/701

Double-J Stenting Versus Percutaneous Nephrostomy; Postoperative Complications in Management of Ureteral Obstruction

A case report of upper tibial gout stones resulting in bone destruction

Urolithiasis is a common disease in urology. The incidence of urolithiasis in China is 1% ~ 5%. With the development of economy and the change of diet structure, the incidence of urolithiasis in China is increasing year by year. The treatment methods for urolithiasis include row of stones, dissolving stones, extracorporeal shock wave lithotripsy (SWL), ureteroscopy lithotripsy (URS), percutaneous nephrolithotomy (PCNL), laparoscopic or open lithotripsy. In recent years, retrograde intrarenal surgery (RIRS) (also termed flexible ureterorenoscopy, F-URS) is an emerging minimally invasive measure for managing the upper urinary calculi. Due to the advantages of easy operation, little trauma, fast recovery, and few contraindications, RIRS has been widely used in the treatment of upper urinary calculi [1]. In RIRS surgery, the operator usually routinely indwells the ureteral stent (the Double J ureteral catheter). The ureteral stent has the functions of draining urine, preventing the formation of stone streets, facilitating stone discharge and preventing ureteral stenosis. However, different complications may occur with the shortor long-term use of the ureteral stent. These complications vary from minor side effects such as hematuria, dysuria, frequency and flank, to major complications such as stent migration, encrustation, urinary infection, stent fracture and ureteral fistula. Among all the complications, the most serious complication is the formation of adherent stones on ureteral stent, which makes it difficult to remove the ureteral stent [2]. Therefore, in recent years, how to avoid the formation of adherent stones on ureteral stent has become a research hotspot. Potassium sodium hydrogen citrate granules is commonly used in the treatment of urolithiasis. Relevant clinical studies suggest that it can inhibit the formation of calculus. This medicine can dissolve some small calculus by adjusting the pH of urine [3]. The purpose of this study was to explore the effect of using potassium sodium hydrogen citrate granules to prevent the formation of adherent stones on ureteral stent after RIRS. The report is as follows: From September 2017 to September 2019, 120 patients with unilateral ureteral stent who underwent RIRS in the Urology Department of our hospital were selected as the study subjects. According to the time of admission, the patients were randomly divided into observation group and control group, 60 cases each. All patients provided written informed consent. This study was conducted in accordance with the Declaration of Helsinki. There was no significant difference in gender, age, stone size, drinking water, concomitant disease and other general characteristics between the two groups, which was comparable (P > 0.05). Patients in the control group received routine postoperative treatment and nursing, including disease publicity and education, favorable eating habits, drinking more water and moderate activity. The observation group received medication of potassium sodium hydrogen citrate granules on the basis of the control group routine postoperative treatment and nursing. The potassium sodium hydrogen citrate granules wear purchased from Wuhan Weiao Pharmaceutical Co., Ltd. (Wuhan, China). Medicine usage: after breakfast and lunch: 2.5 g, po; after dinner: 5.0 g, po. Zixiang Li, Yifan Sheng and Shiyi Wang have contributed equally to this work.

Shiyi Wang

Papers

Effect of potassium sodium hydrogen citrate granules on preventing adherent stones on ureteral stent after retrograde intrarenal surgery.

Au/SiNCA-based SERS analysis coupled with machine learning for the early-stage diagnosis of cisplatin-induced liver injury.