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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)...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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...
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...

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Updated: Jun 22, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
03:56

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Percutaneous nephrolithotomy: Current concepts.

Fabio C Vicentini1, Cristiano Mendes Gomes, Alexandre Danilovic

  • 1Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, SP, Brazil.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|May 27, 2009
PubMed
Summary
This summary is machine-generated.

Percutaneous nephrolithotomy (PNL) for large kidney stones has evolved significantly. Advances improve success rates, with supine PNL showing promise, but ongoing training and technology development are crucial for safe and effective stone removal.

Keywords:
Percutaneous nephrolithotomykidney stonetubeless

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Published on: November 22, 2019

Area of Science:

  • Urology
  • Endourology
  • Nephrolithiasis Management

Background:

  • Percutaneous nephrolithotomy (PNL) is the primary treatment for large renal stones.
  • Significant advancements in PNL techniques and equipment have occurred since its inception in 1976.
  • Continuous evolution aims to enhance procedural success rates and patient outcomes.

Purpose of the Study:

  • To review the evolution of Percutaneous Nephrolithotomy (PNL) techniques and equipment.
  • To evaluate current trends and future directions in PNL for managing large kidney stones.
  • To identify areas for improvement in PNL procedures based on recent literature.

Main Methods:

  • Literature search conducted using Entrez Pubmed database.
  • Time frame for the search: January 2000 to July 2007.
  • Focus on various aspects of PNL, including operative techniques, equipment, and patient positioning.

Main Results:

  • PNL in the supine position is a viable option, though further global experience is needed.
  • Urologist training in renal access is essential for successful outcomes.
  • Mini-PNL requires equipment enhancements; tubeless PNL and tract sealants are gaining traction.
  • Medical stone prevention is effective in reducing recurrence post-PNL.

Conclusions:

  • Despite advancements, continuous improvement in urologist skills and technology is necessary for PNL.
  • PNL remains a safe and effective option for treating large renal stones.
  • Future efforts should focus on refining techniques, optimizing equipment, and integrating preventative strategies.