A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar

Objective: The fluoroscopic image from the second plan (oblique) tube of an upper ureteral stone close to the crista iliaca may be superimposed on the pelvic bones during SWL using the Siemens Lithostar 1 Siemens Medizinische Technik, Erlangen, Germany. 1 with the patient in the prone position. This...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:European urology 2004-03, Vol.45 (3), p.352-355
Hauptverfasser: Tansu, Nejat, Öbek, Can, Önal, Bülent, Yalçın, Veli, Öner, Armağan, Solok, Vural
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 355
container_issue 3
container_start_page 352
container_title European urology
container_volume 45
creator Tansu, Nejat
Öbek, Can
Önal, Bülent
Yalçın, Veli
Öner, Armağan
Solok, Vural
description Objective: The fluoroscopic image from the second plan (oblique) tube of an upper ureteral stone close to the crista iliaca may be superimposed on the pelvic bones during SWL using the Siemens Lithostar 1 Siemens Medizinische Technik, Erlangen, Germany. 1 with the patient in the prone position. This creates difficulty in imaging and targeting of the stone and can necessitate using ureteral catheters before treatment and/or intravenous contrast injection during SWL. We describe a very simple, yet effective method for easier visualization of the stone under this circumstance. Methods: Between March 1992 and February 2003, we treated 1561 patients with ureteral stones by SWL with the Siemens Lithostar. The stones were localized in the upper ureter in 841. The image of the stone from the second plan (oblique) tube was superimposed on the pelvic bones in 221 in whom visualization of the stone was hardly possible with the standard prone position. By simply rotating the patient 180 degrees on the table, the superimposition of the image of the stone on the pelvic bone was obviated. This resulted in easier and better imaging of the stone during SWL. It also allowed for a clear and superior image to the treating physician during SWL. The energy and shock waves, utilization of anesthesia, number of treatment sessions, auxiliary measures, and complications were noted. Stone load was recorded in square centimeters (cm 2). Patients were evaluated by intravenous urogram or KUB and ultrasonography when stone-free or CIRF (nonobstructive and noninfectious insignificant fragments ≤4 mm) status was noted at the fluoroscopic control 2 to 4 weeks after the last session. Final CIRF decision was made 10–12 weeks after the last session. SWL was regarded as failure if no fragmentation was noted after the 3rd session. Therapy was continued if fragmentation was noted. Results: The median age was 40 (range 5–85). The mean stone burden was 0.8 (range 0.24–2.9) cm 2. No indwelling ureteral stents were placed in any patients before and during treatment. The mean number of shock waves and energy used for the entire patient population was 2007 and 17.5 kV, respectively. The median and average treatment session was 1 and 1.7, respectively. A total of 196 patients (89%) were rendered stone-free. Clinically insignificant residual fragments were present in 18 (8%). SWL was unsuccessful in 7 (3%) patients. These stones were removed by ureterorenoscopy. Intravenous contrast administration was n
doi_str_mv 10.1016/j.eururo.2003.10.012
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71753010</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0302283803005360</els_id><sourcerecordid>71753010</sourcerecordid><originalsourceid>FETCH-LOGICAL-c358t-dd35c0ea4039e616507c94d308adee14ba2b450c66d0e5d60e157100270105093</originalsourceid><addsrcrecordid>eNp9kdGKEzEYhYMobl19A5FceTf1z2SSmd4Ia1m1UHChFi9Dmvzdps5MxiRT3DfyMc0wBe-8Cpx854TwEfKWwZIBkx_OSxzDGPyyBOA5WgIrn5EFa2pe1ELCc7IADmVRNry5Ia9iPEMGxYq_JDdMAJeyKRfkzx3duW5okT746JLzPU2ePgR_cRbpJ0wJA910-tH1j9Qf6X4YcrAPmHPd0l3yPUa6bn3EqZhOSNfBxaTppnXaaGrHMFXvf6egjQ-DDzj1Tt78pD_0BenWpZNPwQ3xie7jxE4jO4cd9nG-zXPhNXlx1G3EN9fzluw_339ffy22375s1nfbwnDRpMJaLgygroCvUDIpoDarynJotEVk1UGXh0qAkdICCisBmagZQFkDAwErfkvez7tD8L9GjEl1LhpsW92jH6OqWS14ZjNYzaAJPsaARzUE1-nwpBioyZA6q9mQmgxNaTaUa--u--OhQ_uvdFWSgY8zgPmXF4dBReOwN2hdQJOU9e7_L_wF-XamHQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71753010</pqid></control><display><type>article</type><title>A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Tansu, Nejat ; Öbek, Can ; Önal, Bülent ; Yalçın, Veli ; Öner, Armağan ; Solok, Vural</creator><creatorcontrib>Tansu, Nejat ; Öbek, Can ; Önal, Bülent ; Yalçın, Veli ; Öner, Armağan ; Solok, Vural</creatorcontrib><description>Objective: The fluoroscopic image from the second plan (oblique) tube of an upper ureteral stone close to the crista iliaca may be superimposed on the pelvic bones during SWL using the Siemens Lithostar 1 Siemens Medizinische Technik, Erlangen, Germany. 1 with the patient in the prone position. This creates difficulty in imaging and targeting of the stone and can necessitate using ureteral catheters before treatment and/or intravenous contrast injection during SWL. We describe a very simple, yet effective method for easier visualization of the stone under this circumstance. Methods: Between March 1992 and February 2003, we treated 1561 patients with ureteral stones by SWL with the Siemens Lithostar. The stones were localized in the upper ureter in 841. The image of the stone from the second plan (oblique) tube was superimposed on the pelvic bones in 221 in whom visualization of the stone was hardly possible with the standard prone position. By simply rotating the patient 180 degrees on the table, the superimposition of the image of the stone on the pelvic bone was obviated. This resulted in easier and better imaging of the stone during SWL. It also allowed for a clear and superior image to the treating physician during SWL. The energy and shock waves, utilization of anesthesia, number of treatment sessions, auxiliary measures, and complications were noted. Stone load was recorded in square centimeters (cm 2). Patients were evaluated by intravenous urogram or KUB and ultrasonography when stone-free or CIRF (nonobstructive and noninfectious insignificant fragments ≤4 mm) status was noted at the fluoroscopic control 2 to 4 weeks after the last session. Final CIRF decision was made 10–12 weeks after the last session. SWL was regarded as failure if no fragmentation was noted after the 3rd session. Therapy was continued if fragmentation was noted. Results: The median age was 40 (range 5–85). The mean stone burden was 0.8 (range 0.24–2.9) cm 2. No indwelling ureteral stents were placed in any patients before and during treatment. The mean number of shock waves and energy used for the entire patient population was 2007 and 17.5 kV, respectively. The median and average treatment session was 1 and 1.7, respectively. A total of 196 patients (89%) were rendered stone-free. Clinically insignificant residual fragments were present in 18 (8%). SWL was unsuccessful in 7 (3%) patients. These stones were removed by ureterorenoscopy. Intravenous contrast administration was not used to facilitate stone targeting during SWL. Anesthesia, in the form of analgesic sedation, was used in 7 (3%) patients. We did not observe any complications and adverse effects. Conclusions: The technique described hereby does not have an affect on coupling; it only provides a superior image of the stone to the treating physician. We advocate its application in all patients with upper ureteral stones close to the crista iliaca when the fluoroscopic image of the stone from the second plan (oblique) tube is superimposed on pelvic bones during SWL in prone position.</description><identifier>ISSN: 0302-2838</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2003.10.012</identifier><identifier>PMID: 15036682</identifier><language>eng</language><publisher>Switzerland: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Fluoroscopy ; Humans ; Lithotripsy - instrumentation ; Lithotripsy - methods ; Male ; Middle Aged ; Pelvic Bones - diagnostic imaging ; Position ; Prone Position ; Shock wave lithotripsy ; Stone ; Treatment Outcome ; Ureter ; Ureteral Calculi - diagnostic imaging ; Ureteral Calculi - therapy</subject><ispartof>European urology, 2004-03, Vol.45 (3), p.352-355</ispartof><rights>2003 Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c358t-dd35c0ea4039e616507c94d308adee14ba2b450c66d0e5d60e157100270105093</citedby><cites>FETCH-LOGICAL-c358t-dd35c0ea4039e616507c94d308adee14ba2b450c66d0e5d60e157100270105093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.eururo.2003.10.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15036682$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tansu, Nejat</creatorcontrib><creatorcontrib>Öbek, Can</creatorcontrib><creatorcontrib>Önal, Bülent</creatorcontrib><creatorcontrib>Yalçın, Veli</creatorcontrib><creatorcontrib>Öner, Armağan</creatorcontrib><creatorcontrib>Solok, Vural</creatorcontrib><title>A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar</title><title>European urology</title><addtitle>Eur Urol</addtitle><description>Objective: The fluoroscopic image from the second plan (oblique) tube of an upper ureteral stone close to the crista iliaca may be superimposed on the pelvic bones during SWL using the Siemens Lithostar 1 Siemens Medizinische Technik, Erlangen, Germany. 1 with the patient in the prone position. This creates difficulty in imaging and targeting of the stone and can necessitate using ureteral catheters before treatment and/or intravenous contrast injection during SWL. We describe a very simple, yet effective method for easier visualization of the stone under this circumstance. Methods: Between March 1992 and February 2003, we treated 1561 patients with ureteral stones by SWL with the Siemens Lithostar. The stones were localized in the upper ureter in 841. The image of the stone from the second plan (oblique) tube was superimposed on the pelvic bones in 221 in whom visualization of the stone was hardly possible with the standard prone position. By simply rotating the patient 180 degrees on the table, the superimposition of the image of the stone on the pelvic bone was obviated. This resulted in easier and better imaging of the stone during SWL. It also allowed for a clear and superior image to the treating physician during SWL. The energy and shock waves, utilization of anesthesia, number of treatment sessions, auxiliary measures, and complications were noted. Stone load was recorded in square centimeters (cm 2). Patients were evaluated by intravenous urogram or KUB and ultrasonography when stone-free or CIRF (nonobstructive and noninfectious insignificant fragments ≤4 mm) status was noted at the fluoroscopic control 2 to 4 weeks after the last session. Final CIRF decision was made 10–12 weeks after the last session. SWL was regarded as failure if no fragmentation was noted after the 3rd session. Therapy was continued if fragmentation was noted. Results: The median age was 40 (range 5–85). The mean stone burden was 0.8 (range 0.24–2.9) cm 2. No indwelling ureteral stents were placed in any patients before and during treatment. The mean number of shock waves and energy used for the entire patient population was 2007 and 17.5 kV, respectively. The median and average treatment session was 1 and 1.7, respectively. A total of 196 patients (89%) were rendered stone-free. Clinically insignificant residual fragments were present in 18 (8%). SWL was unsuccessful in 7 (3%) patients. These stones were removed by ureterorenoscopy. Intravenous contrast administration was not used to facilitate stone targeting during SWL. Anesthesia, in the form of analgesic sedation, was used in 7 (3%) patients. We did not observe any complications and adverse effects. Conclusions: The technique described hereby does not have an affect on coupling; it only provides a superior image of the stone to the treating physician. We advocate its application in all patients with upper ureteral stones close to the crista iliaca when the fluoroscopic image of the stone from the second plan (oblique) tube is superimposed on pelvic bones during SWL in prone position.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Humans</subject><subject>Lithotripsy - instrumentation</subject><subject>Lithotripsy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pelvic Bones - diagnostic imaging</subject><subject>Position</subject><subject>Prone Position</subject><subject>Shock wave lithotripsy</subject><subject>Stone</subject><subject>Treatment Outcome</subject><subject>Ureter</subject><subject>Ureteral Calculi - diagnostic imaging</subject><subject>Ureteral Calculi - therapy</subject><issn>0302-2838</issn><issn>1873-7560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kdGKEzEYhYMobl19A5FceTf1z2SSmd4Ia1m1UHChFi9Dmvzdps5MxiRT3DfyMc0wBe-8Cpx854TwEfKWwZIBkx_OSxzDGPyyBOA5WgIrn5EFa2pe1ELCc7IADmVRNry5Ia9iPEMGxYq_JDdMAJeyKRfkzx3duW5okT746JLzPU2ePgR_cRbpJ0wJA910-tH1j9Qf6X4YcrAPmHPd0l3yPUa6bn3EqZhOSNfBxaTppnXaaGrHMFXvf6egjQ-DDzj1Tt78pD_0BenWpZNPwQ3xie7jxE4jO4cd9nG-zXPhNXlx1G3EN9fzluw_339ffy22375s1nfbwnDRpMJaLgygroCvUDIpoDarynJotEVk1UGXh0qAkdICCisBmagZQFkDAwErfkvez7tD8L9GjEl1LhpsW92jH6OqWS14ZjNYzaAJPsaARzUE1-nwpBioyZA6q9mQmgxNaTaUa--u--OhQ_uvdFWSgY8zgPmXF4dBReOwN2hdQJOU9e7_L_wF-XamHQ</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Tansu, Nejat</creator><creator>Öbek, Can</creator><creator>Önal, Bülent</creator><creator>Yalçın, Veli</creator><creator>Öner, Armağan</creator><creator>Solok, Vural</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar</title><author>Tansu, Nejat ; Öbek, Can ; Önal, Bülent ; Yalçın, Veli ; Öner, Armağan ; Solok, Vural</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c358t-dd35c0ea4039e616507c94d308adee14ba2b450c66d0e5d60e157100270105093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Fluoroscopy</topic><topic>Humans</topic><topic>Lithotripsy - instrumentation</topic><topic>Lithotripsy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pelvic Bones - diagnostic imaging</topic><topic>Position</topic><topic>Prone Position</topic><topic>Shock wave lithotripsy</topic><topic>Stone</topic><topic>Treatment Outcome</topic><topic>Ureter</topic><topic>Ureteral Calculi - diagnostic imaging</topic><topic>Ureteral Calculi - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tansu, Nejat</creatorcontrib><creatorcontrib>Öbek, Can</creatorcontrib><creatorcontrib>Önal, Bülent</creatorcontrib><creatorcontrib>Yalçın, Veli</creatorcontrib><creatorcontrib>Öner, Armağan</creatorcontrib><creatorcontrib>Solok, Vural</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tansu, Nejat</au><au>Öbek, Can</au><au>Önal, Bülent</au><au>Yalçın, Veli</au><au>Öner, Armağan</au><au>Solok, Vural</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar</atitle><jtitle>European urology</jtitle><addtitle>Eur Urol</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>45</volume><issue>3</issue><spage>352</spage><epage>355</epage><pages>352-355</pages><issn>0302-2838</issn><eissn>1873-7560</eissn><abstract>Objective: The fluoroscopic image from the second plan (oblique) tube of an upper ureteral stone close to the crista iliaca may be superimposed on the pelvic bones during SWL using the Siemens Lithostar 1 Siemens Medizinische Technik, Erlangen, Germany. 1 with the patient in the prone position. This creates difficulty in imaging and targeting of the stone and can necessitate using ureteral catheters before treatment and/or intravenous contrast injection during SWL. We describe a very simple, yet effective method for easier visualization of the stone under this circumstance. Methods: Between March 1992 and February 2003, we treated 1561 patients with ureteral stones by SWL with the Siemens Lithostar. The stones were localized in the upper ureter in 841. The image of the stone from the second plan (oblique) tube was superimposed on the pelvic bones in 221 in whom visualization of the stone was hardly possible with the standard prone position. By simply rotating the patient 180 degrees on the table, the superimposition of the image of the stone on the pelvic bone was obviated. This resulted in easier and better imaging of the stone during SWL. It also allowed for a clear and superior image to the treating physician during SWL. The energy and shock waves, utilization of anesthesia, number of treatment sessions, auxiliary measures, and complications were noted. Stone load was recorded in square centimeters (cm 2). Patients were evaluated by intravenous urogram or KUB and ultrasonography when stone-free or CIRF (nonobstructive and noninfectious insignificant fragments ≤4 mm) status was noted at the fluoroscopic control 2 to 4 weeks after the last session. Final CIRF decision was made 10–12 weeks after the last session. SWL was regarded as failure if no fragmentation was noted after the 3rd session. Therapy was continued if fragmentation was noted. Results: The median age was 40 (range 5–85). The mean stone burden was 0.8 (range 0.24–2.9) cm 2. No indwelling ureteral stents were placed in any patients before and during treatment. The mean number of shock waves and energy used for the entire patient population was 2007 and 17.5 kV, respectively. The median and average treatment session was 1 and 1.7, respectively. A total of 196 patients (89%) were rendered stone-free. Clinically insignificant residual fragments were present in 18 (8%). SWL was unsuccessful in 7 (3%) patients. These stones were removed by ureterorenoscopy. Intravenous contrast administration was not used to facilitate stone targeting during SWL. Anesthesia, in the form of analgesic sedation, was used in 7 (3%) patients. We did not observe any complications and adverse effects. Conclusions: The technique described hereby does not have an affect on coupling; it only provides a superior image of the stone to the treating physician. We advocate its application in all patients with upper ureteral stones close to the crista iliaca when the fluoroscopic image of the stone from the second plan (oblique) tube is superimposed on pelvic bones during SWL in prone position.</abstract><cop>Switzerland</cop><pub>Elsevier B.V</pub><pmid>15036682</pmid><doi>10.1016/j.eururo.2003.10.012</doi><tpages>4</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0302-2838
ispartof European urology, 2004-03, Vol.45 (3), p.352-355
issn 0302-2838
1873-7560
language eng
recordid cdi_proquest_miscellaneous_71753010
source MEDLINE; Elsevier ScienceDirect Journals Complete
subjects Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Fluoroscopy
Humans
Lithotripsy - instrumentation
Lithotripsy - methods
Male
Middle Aged
Pelvic Bones - diagnostic imaging
Position
Prone Position
Shock wave lithotripsy
Stone
Treatment Outcome
Ureter
Ureteral Calculi - diagnostic imaging
Ureteral Calculi - therapy
title A Simple Position to Provide Better Imaging of Upper Ureteral Stones Close to the Crista Iliaca during Extracorporeal Shock Wave Lithotripsy Using the Siemens Lithostar
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T15%3A01%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Simple%20Position%20to%20Provide%20Better%20Imaging%20of%20Upper%20Ureteral%20Stones%20Close%20to%20the%20Crista%20Iliaca%20during%20Extracorporeal%20Shock%20Wave%20Lithotripsy%20Using%20the%20Siemens%20Lithostar&rft.jtitle=European%20urology&rft.au=Tansu,%20Nejat&rft.date=2004-03-01&rft.volume=45&rft.issue=3&rft.spage=352&rft.epage=355&rft.pages=352-355&rft.issn=0302-2838&rft.eissn=1873-7560&rft_id=info:doi/10.1016/j.eururo.2003.10.012&rft_dat=%3Cproquest_cross%3E71753010%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71753010&rft_id=info:pmid/15036682&rft_els_id=S0302283803005360&rfr_iscdi=true