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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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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...
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Urinary Tract Calculi III: Medical Management01:30

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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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Urinary Tract Calculi V: Nursing Management01:28

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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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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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Imaging Studies II: Ultrasonography01:24

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IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
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Updated: Aug 8, 2025

Vessel-sparing Excision and Primary Anastomosis
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Predicting failed access in unstented ureteroscopy.

Kevin Morgan1, HarLee Possoit2, Zachary Conelly2

  • 1Department of Urology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Knmorgan91@gmail.com.

Urolithiasis
|February 28, 2023
PubMed
Summary
This summary is machine-generated.

Failed access in unstented ureteroscopy occurred in 15.4% of cases. Proximal ureteral stones and prior stone passage were key factors influencing successful ureteroscope access.

Keywords:
AccessStentUreteroscopyUrolithiasis

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Area of Science:

  • Urology
  • Endourology

Background:

  • Failed access (FA) during unstented ureteroscopy presents a significant challenge, with reported rates between 7.7% and 16%.
  • Factors such as patient demographics, ureteral anatomy, and stone characteristics influence the risk of FA.

Approach:

  • This retrospective review analyzed 221 unstented ureteroscopy procedures performed between January 2018 and June 2022.
  • Demographic, clinical, and operative variables were assessed to identify predictors of FA, with the primary endpoint being the rate of failed access.

Key Points:

  • Failed access (FA) occurred in 15.4% of the reviewed unstented ureteroscopy cases.
  • Successful access (SA) was associated with a history of previous stone passage and distal ureteral stone location.
  • Proximal ureteral stone location was significantly associated with failed access (FA).

Conclusions:

  • The rate of failed access in unstented ureteroscopy at this institution was 15.4%.
  • Ureteral stone location and prior stone passage are significant predictors of access success or failure.
  • Further prospective research is necessary to refine the understanding of FA predictors.