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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...
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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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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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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)...
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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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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...
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Bilateral same session renal stone surgery tolerance and complications.

Abdulmalik Addar1, Ahmed Aljuhayman2, Yahya Ghazwani3,4,5

  • 1Department of Urology, McGill University Health Center, McGill University, Montreal, QC, Canada.

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Bilateral same-session ureterorenoscopy (BSS-URS) is a safe and effective treatment for patients with bilateral kidney stones. This procedure achieved a high stone-free rate, demonstrating its efficacy in managing complex stone burdens.

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Area of Science:

  • Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Upper urinary tract calculi present a significant health challenge in Saudi Arabia, with high global prevalence.
  • Management of bilateral renal stones remains a subject of clinical debate and requires effective therapeutic strategies.

Purpose of the Study:

  • To evaluate the safety and efficacy of bilateral same-session ureterorenoscopy (BSS-URS) for managing bilateral renal and ureteric stones.
  • To assess key outcomes including operative time, hospital stay, and stone-free rates following BSS-URS.

Main Methods:

  • A retrospective study involving 31 patients with bilateral renal or ureteric stones.
  • Data collected included patient demographics, stone characteristics, operative details, anesthesia type, stenting, and complications.
  • Stone-free status was determined by computed tomography (CT) Kidney, Ureter and Bladder (KUB) 3 months post-surgery.

Main Results:

  • The majority of the 31 patients (80.6%) were male, with a mean age of 41.6 years.
  • The mean operative time per renal unit was 46.53 minutes, and the mean hospital stay was 17.87 hours.
  • A high stone-free rate of 90.3% was achieved at 3-month follow-up, with minimal complications reported.

Conclusions:

  • Bilateral same-session ureterorenoscopy (BSS-URS) is a safe and highly effective treatment option for bilateral renal stones.
  • The procedure demonstrates significant success in achieving stone clearance and warrants consideration in clinical practice.