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Related Concept Videos

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...
Anatomical Positions01:11

Anatomical Positions

In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
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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...
Imaging Studies I: Kidney, Ureter, and Bladder Studies01:28

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Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
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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...
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...

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Prone versus modified supine position in percutaneous nephrolithotomy: a prospective randomized study.

Yanbo Wang1, Yan Wang, Yunming Yao

  • 11. Department of Urology, First Hospital of Jilin University, 130021, Changchun, China.

International Journal of Medical Sciences
|September 19, 2013
PubMed
Summary

The prone position is more effective for percutaneous nephrolithotomy (PCNL) than the modified supine position, requiring less operative time and fewer repeat procedures for kidney stones. This comparison highlights key differences in outcomes for PCNL stone removal.

Keywords:
modified supine positionpercutaneous nephrolithotomyprone positionprospective randomized trial

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Area of Science:

  • Urology
  • Surgical Techniques
  • Nephrolithiasis Management

Background:

  • Percutaneous nephrolithotomy (PCNL) is a primary treatment for kidney stones.
  • Patient positioning during PCNL, specifically prone versus supine, impacts procedure outcomes.
  • Optimizing PCNL positioning is crucial for surgical efficacy and patient safety.

Purpose of the Study:

  • To compare the efficacy and safety of PCNL in prone versus modified supine positions.
  • To evaluate operative time, stone-free rates, and complication rates between the two positions.
  • To determine the optimal patient position for successful PCNL.

Main Methods:

  • A prospective randomized trial involving 122 patients with renal and ureteral calculi.
  • Patients were randomized to undergo fluoroscopy and ultrasound-guided PCNL in either the prone or modified supine position.
  • Key outcomes including stone-free rate, operative time, blood loss, and hospital stay were compared.

Main Results:

  • No significant differences in baseline characteristics or complications like blood loss and hospital stay were observed.
  • The prone position demonstrated a significantly higher stone clearance rate and a lower rate of requiring a second PCNL procedure.
  • Mean operative time was significantly shorter in the prone group (78 min) compared to the modified supine group (88 min).

Conclusions:

  • Both prone and modified supine positions are safe and effective for PCNL.
  • The prone position offers advantages in terms of reduced operative time and improved stone clearance.
  • The modified supine position was associated with a higher need for repeat procedures due to lower stone clearance rates.