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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...

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Retrograde intra-renal surgery for stone extraction.

Dorit E Zilberman1, Yoram Mor, Mordechai Duvdevani

  • 1Section of Endourology, Department of Urology, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. dorit1e@yahoo.com

Scandinavian Journal of Urology and Nephrology
|May 1, 2007
PubMed
Summary

Retrograde intra-renal surgery (RIRS) is effective for kidney stones. However, large stones (>20mm) or prior drainage increase infection risk and may reduce stone-free rates.

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Area of Science:

  • Urology
  • Endourology

Background:

  • Retrograde intra-renal surgery (RIRS) is a standard endoscopic procedure for treating renal calculi.
  • Assessing factors influencing RIRS efficacy and safety is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate clinical parameters affecting the efficacy and safety of RIRS for kidney stone extraction.
  • To identify patient subgroups at higher risk for complications after RIRS.

Main Methods:

  • A retrospective analysis of 63 patients who underwent RIRS for renal calculi between 2001 and 2003.
  • Specific focus on 25 patients with stones greater than or equal to 20mm.

Main Results:

  • Postoperative infectious complications occurred in 19 (30%) patients.
  • A trend indicated higher infection rates in patients with large stones (>/=20mm) and those with preoperative drainage.

Conclusions:

  • While RIRS is generally safe, patients with large stones (>20mm) or multiple calculi, especially with prior drainage or urinary tract infections, face increased infectious complication risks.
  • These high-risk subgroups may also experience lower stone-free rates following RIRS.