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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...
Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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)...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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...

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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Upper urinary tract transitional cell carcinoma. A 10-year experience.

Athanasios G Papatsoris1, Michael Chrisofos, Andreas Skolarikos

  • 1Second Department of Urology School of Medicine, University of Athens, Sismanoglio Hospital, Athens, Greece. agpapatsoris@yahoo.gr

Tumori
|May 13, 2008
PubMed
Summary

This study analyzed 264 patients with upper urinary tract transitional cell carcinoma, finding tumor stage is the key predictor of recurrence and survival. Other factors like male gender and older age also impact outcomes.

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Area of Science:

  • Urology
  • Oncology
  • Surgical Pathology

Background:

  • Upper urinary tract transitional cell carcinoma (UT-TCC) is a rare malignancy.
  • Surgical management is the primary treatment modality for localized UT-TCC.

Purpose of the Study:

  • To evaluate the 10-year surgical treatment outcomes for upper urinary tract transitional cell carcinoma.
  • To identify prognostic factors influencing recurrence and survival in surgically treated UT-TCC patients.

Main Methods:

  • Retrospective review of 264 patients treated surgically for UT-TCC between 1996 and 2005.
  • Analysis of patient demographics, tumor characteristics, surgical approach, and follow-up data.

Main Results:

  • Local recurrence occurred in 14% of patients, with a mean time to recurrence of 13 months.
  • Overall mortality was 14%, with a mean survival of 109 months.
  • Significant predictors of survival included male gender, age >80 years, tumor location (pelviocaliceal system and ureter), two-incision surgery, high tumor grade (grade III), and advanced stage (T3/T4).

Conclusions:

  • Tumor stage is the most critical determinant for predicting recurrence and survival in UT-TCC.
  • Male gender, advanced age, specific tumor locations, surgical approach, and high tumor grade are also significant prognostic factors for survival.