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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...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Related Experiment Video

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[Transurethral endopyelotomy using thulium fiber laser].

A G Martov1, M Yu Golubev1, D V Ergakov1

  • 1Department of Urology and Andrology of A.I. Burnazyan SRC FMBC, FMBA of Russia, GBUZ City clinical hospital named after D.D. Pletnev of the Health Department c. Moscow, Moscow, Russia.

Urologiia (Moscow, Russia : 1999)
|June 30, 2020
PubMed
Summary

Transurethral thulium laser endopyelotomy is an effective treatment for ureteropelvic junction (UPJ) obstruction, showing comparable outcomes to traditional surgery with a shorter operation time. This minimally invasive approach offers a promising alternative for UPJ strictures.

Keywords:
endopyelotomyhydronephrosisthulium laser

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Laser Technology

Background:

  • Transurethral endopyelotomy is an established alternative for treating short ureteropelvic junction (UPJ) strictures.
  • UPJ obstruction affects renal function and requires effective management strategies.

Purpose of the Study:

  • To evaluate the efficacy of transurethral thulium fiber laser endopyelotomy for UPJ obstruction.
  • To compare outcomes of thulium laser endopyelotomy with Anderson-Hynes laparoscopic pyeloplasty.

Main Methods:

  • A prospective study of 94 patients with UPJ obstruction from December 2016 to December 2018.
  • Patients were divided into two groups: 48 underwent retrograde thulium fiber laser endopyelotomy (main group) and 46 underwent Anderson-Hynes laparoscopic pyeloplasty (control group).
  • Follow-up included ultrasound and CT-urography, assessing stricture recurrence and renal function over 24 months.

Main Results:

  • The thulium laser group had significantly shorter operation times (24±14 minutes vs. 82±26 minutes).
  • Both groups showed a decrease in pelvic size post-stent removal.
  • Recurrence rates were low and comparable (1 in each group) after 24 months, with no significant impairment in renal function in either group.

Conclusions:

  • Transurethral thulium fiber laser endopyelotomy is effective for UPJ obstruction, particularly for primary or secondary cases with preserved kidney function (up to 40% decrease).
  • Ideal indications include strictures up to 1 cm, absence of crossing vessels, and pelvic dilatation not exceeding 4 cm.
  • This technique offers a minimally invasive and efficient treatment option for selected UPJ obstruction cases.