Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy
Objectives. To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percut...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2002-09, Vol.60 (3), p.383-387 |
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| container_title | Urology (Ridgewood, N.J.) |
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| creator | Watterson, James D Girvan, Andrew R Beiko, Darren T Nott, Linda Wollin, Timothy A Razvi, Hassan Denstedt, John D |
| description | Objectives. To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy. Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy.
Methods. A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6).
Results. Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered.
Conclusions. Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes. |
| doi_str_mv | 10.1016/S0090-4295(02)01751-X |
| format | Article |
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Methods. A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6).
Results. Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered.
Conclusions. Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/S0090-4295(02)01751-X</identifier><identifier>PMID: 12350466</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Diseases of the urinary system ; Female ; Fluoroscopy - methods ; Gestational Age ; Holmium ; Humans ; Lithotripsy, Laser - methods ; Medical sciences ; Pregnancy ; Pregnancy Complications - diagnostic imaging ; Pregnancy Complications - etiology ; Pregnancy Complications - therapy ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Retrospective Studies ; Stents - adverse effects ; Treatment Outcome ; Ultrasonography ; Ureteral Calculi - diagnostic imaging ; Ureteral Calculi - etiology ; Ureteral Calculi - therapy ; Ureteroscopy - methods</subject><ispartof>Urology (Ridgewood, N.J.), 2002-09, Vol.60 (3), p.383-387</ispartof><rights>2002 Elsevier Science Inc.</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-f371614e323852a3be04f4285da6d7942b5c90e10d3a51b762ded013dbe0de5d3</citedby><cites>FETCH-LOGICAL-c391t-f371614e323852a3be04f4285da6d7942b5c90e10d3a51b762ded013dbe0de5d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S009042950201751X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13913502$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12350466$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watterson, James D</creatorcontrib><creatorcontrib>Girvan, Andrew R</creatorcontrib><creatorcontrib>Beiko, Darren T</creatorcontrib><creatorcontrib>Nott, Linda</creatorcontrib><creatorcontrib>Wollin, Timothy A</creatorcontrib><creatorcontrib>Razvi, Hassan</creatorcontrib><creatorcontrib>Denstedt, John D</creatorcontrib><title>Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives. To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy. Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy.
Methods. A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6).
Results. Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered.
Conclusions. Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Diseases of the urinary system</subject><subject>Female</subject><subject>Fluoroscopy - methods</subject><subject>Gestational Age</subject><subject>Holmium</subject><subject>Humans</subject><subject>Lithotripsy, Laser - methods</subject><subject>Medical sciences</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnostic imaging</subject><subject>Pregnancy Complications - etiology</subject><subject>Pregnancy Complications - therapy</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Retrospective Studies</subject><subject>Stents - adverse effects</subject><subject>Treatment Outcome</subject><subject>Ultrasonography</subject><subject>Ureteral Calculi - diagnostic imaging</subject><subject>Ureteral Calculi - etiology</subject><subject>Ureteral Calculi - therapy</subject><subject>Ureteroscopy - methods</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0c1u1DAQB3ALgei28AggX0DlEPBHnDS9oKqCglSJA1QqJ8trT1IjfwTbqZQ34LFxd1f0yMkH_8bj-Q9Cryh5TwntPnwnZCBNywZxStg7QntBm9snaEMF65thGMRTtPlHjtBxzr8IIV3X9c_REWVckLbrNujPTYICKWYd5xWrYPBddN4u_vznxRV2KkPCzpa7WJKd83peCQYPabJhwgZGG2yx94C9CmqqF6HgXJIqMK14jAnn1c8lelWsxsuulXJYK6cXZ7ENeE4wBRX0-gI9G5XL8PJwnqCbz59-XH5prr9dfb28uG40H2hpRt7TjrbAGT8TTPEtkHZs2ZkwqjP90LKt0AMBSgxXgm77jhkwhHJToQFh-Al6u393TvH3ArlIb7MG51SAuGTZM8qr5xWKPdQ1nZxglHOyXqVVUiIfViB3K5AP-UrC5G4F8rbWvT40WLYezGPVIfMK3hyAyjWJMdXxbX50dc4qWXUf9w5qHPcWkszaQtBgbAJdpIn2P1_5C1sipog</recordid><startdate>20020901</startdate><enddate>20020901</enddate><creator>Watterson, James D</creator><creator>Girvan, Andrew R</creator><creator>Beiko, Darren T</creator><creator>Nott, Linda</creator><creator>Wollin, Timothy A</creator><creator>Razvi, Hassan</creator><creator>Denstedt, John D</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><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>20020901</creationdate><title>Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy</title><author>Watterson, James D ; Girvan, Andrew R ; Beiko, Darren T ; Nott, Linda ; Wollin, Timothy A ; Razvi, Hassan ; Denstedt, John D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-f371614e323852a3be04f4285da6d7942b5c90e10d3a51b762ded013dbe0de5d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Diseases of the urinary system</topic><topic>Female</topic><topic>Fluoroscopy - methods</topic><topic>Gestational Age</topic><topic>Holmium</topic><topic>Humans</topic><topic>Lithotripsy, Laser - methods</topic><topic>Medical sciences</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnostic imaging</topic><topic>Pregnancy Complications - etiology</topic><topic>Pregnancy Complications - therapy</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Retrospective Studies</topic><topic>Stents - adverse effects</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><topic>Ureteral Calculi - diagnostic imaging</topic><topic>Ureteral Calculi - etiology</topic><topic>Ureteral Calculi - therapy</topic><topic>Ureteroscopy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watterson, James D</creatorcontrib><creatorcontrib>Girvan, Andrew R</creatorcontrib><creatorcontrib>Beiko, Darren T</creatorcontrib><creatorcontrib>Nott, Linda</creatorcontrib><creatorcontrib>Wollin, Timothy A</creatorcontrib><creatorcontrib>Razvi, Hassan</creatorcontrib><creatorcontrib>Denstedt, John D</creatorcontrib><collection>Pascal-Francis</collection><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>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watterson, James D</au><au>Girvan, Andrew R</au><au>Beiko, Darren T</au><au>Nott, Linda</au><au>Wollin, Timothy A</au><au>Razvi, Hassan</au><au>Denstedt, John D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2002-09-01</date><risdate>2002</risdate><volume>60</volume><issue>3</issue><spage>383</spage><epage>387</epage><pages>383-387</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives. To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy. Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy.
Methods. A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6).
Results. Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered.
Conclusions. Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12350466</pmid><doi>10.1016/S0090-4295(02)01751-X</doi><tpages>5</tpages></addata></record> |
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| ispartof | Urology (Ridgewood, N.J.), 2002-09, Vol.60 (3), p.383-387 |
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| subjects | Adult Biological and medical sciences Diseases of the urinary system Female Fluoroscopy - methods Gestational Age Holmium Humans Lithotripsy, Laser - methods Medical sciences Pregnancy Pregnancy Complications - diagnostic imaging Pregnancy Complications - etiology Pregnancy Complications - therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Stents - adverse effects Treatment Outcome Ultrasonography Ureteral Calculi - diagnostic imaging Ureteral Calculi - etiology Ureteral Calculi - therapy Ureteroscopy - methods |
| title | Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy |
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