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Id: lil-796892
Autor: Galal, Ehab Mohamad; Anwar, Ahmad Zaki; El-Bab, Tarek Khalaf Fath; Abdelhamid, Amr Mohamad.
Título: Retrospective comparative study of rigid and flexible ureteroscopy for treatment of proximal ureteral stones
Fonte: Int. braz. j. urol;42(5):967-972, Sept.-Oct. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Background: We analyzed the outcome and complications of rigid (R-URS) and flexible (F-URS) ureteroscopic lithotripsy for treatment of proximal ureteric stone (PUS). Subjects and methods: Retrospective data of 135 patients (93 males and 42 females) submitted to R-URS and F-URS for treatment of PUS in the period between July 2013 and January 2015 were investigated. (R-URS, group 1) was performed in 72 patients while 63 patients underwent (F-URS, group 2).We compared the 2 groups for success, stone characteristics, operative time, intraoperative and postoperative complications. Results: The overall stone free rate (SFRs) was 49/72 (68%) in group 1 and 57/63 (91%) patients in group 2, (P=0.005). The operative time was shorter in group 1 in comparison to group 2 with statistically significant difference (P=0.005). There was not any statistically significant difference between 2 groups in complication rate (P=0.2). Conclusıon: Both R-URS and F-URS could be a feasible option for treatment of PUS. R-URS is less successful for treatment of PUS and should be used cautiously and with availability of F-URS.
Descritores: Litotripsia/métodos
Cálculos Ureterais/terapia
Ureteroscopia/métodos
-Complicações Pós-Operatórias
Litotripsia/efeitos adversos
Litotripsia/instrumentação
Estudos Retrospectivos
Resultado do Tratamento
Ureteroscopia/efeitos adversos
Ureteroscopia/instrumentação
Intervalo Livre de Doença
Duração da Cirurgia
Complicações Intraoperatórias
Tempo de Internação
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Tipo de Publ: Estudo Comparativo
Responsável: BR1.1 - BIREME


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Id: lil-794679
Autor: Zhang, Long; Li, Junping; Pan, Minjie; Han, Weiwei; Liu, Shucheng; Xiao, Yajun.
Título: Doxazosin oral intake therapy to relieve stent - related urinary symptoms and pain: a prospective, randomized, controlled study
Fonte: Int. braz. j. urol;42(4):727-733, July-Aug. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Objective: To assess the impact of Doxazosin Oral Intake Therapy on urinary symptoms and pain in patients with indwelling ureteral stents Patients and Methods: A total of 239 patients with ureteral stone-related hydronephrosis who underwent a double-J stent insertion after ureteroscopic lithotripsy were enrolled. Patients were randomized to receive doxazosin cotrolled release 4 mg once daily for 4 weeks or matching placebo. Patients completed the brief-form Chinese version Ureteric Stent Symptom Questionnaire (USSQ) and quality of life (QoL) score 2 weeks and 4 weeks after stent placement and 4 weeks after stent withdrawal. The analgesic use was also recorded during the stenting period. Results: Patients in Doxazosin Oral Intake Therapy group, in the first 2 weeks and second 2 weeks with the stent in situ, expressed significant lower daytime frequency (p=0.028 and p=0.038), nocturia (p=0.021 and p=0.008) and urgency (p=0.012 and p=0.014), respectively. Similarly, flank pain score, QoL score and analgesic use were also significant less in the stenting period. There was no significant difference in scores of urinary symptoms, pain and QoL during the post-stent period between two cohorts. Conclusions: Doxazosin Oral Intake Therapy reduced stent-related urinary symptoms, pain and the negative impact on QoL.
Descritores: Dor/tratamento farmacológico
Qualidade de Vida
Stents/efeitos adversos
Doxazossina/administração & dosagem
Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem
Sintomas do Trato Urinário Inferior/tratamento farmacológico
-Período Pós-Operatório
Litotripsia/métodos
Administração Oral
Estudos Prospectivos
Inquéritos e Questionários
Resultado do Tratamento
Ureteroscopia/efeitos adversos
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Srougi, Miguel
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Id: lil-794680
Autor: Torricelli, Fabio C. M; Monga, Manoj; Marchini, Giovanni S; Srougi, Miguel; Nahas, William C; Mazzucchi, Eduardo.
Título: Semi-rigid ureteroscopic lithotripsy versus laparoscopic ureterolithotomy for large upper ureteral stones: a meta - analysis of randomized controlled trials
Fonte: Int. braz. j. urol;42(4):645-654, July-Aug. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Introduction: To provide a systematic review and meta-analysis of randomized controlled trials (RCT) comparing semi-rigid ureteroscopic lithotripsy (URS) with laparoscopic ureterolithotomy (LU) for the treatment of the large proximal ureteral stone. Materials and methods: A systematic literature review was performed in June 2015 using the PubMed, Scopus, and Web of Science databases to identify relevant studies. Article selection proceeded according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria. Results: Six RCT including 646 patients were analyzed, 325 URS cases (50.3%) and 321 LU cases (49.7%). URS provided a significantly shorter operative time (weighted mean difference [WMD] = −31.26 min; 95%CI −46.88 to −15.64; p<0.0001) and length of hospital stay (WMD = −1.48 days; 95%CI −2.78 to −0.18; p=0.03) than LU. There were no significant differences in terms of overall complications (OR = 0.78; 95%CI 0.21-2.92; p=0.71) and major complications – Clavien ≥3 – (OR = 1.79; 95%CI 0.59-5.42; p=0.30). LU led to a significantly higher initial stone-free rate (OR = 8.65; 95%CI 4.18-17.91; p<0.00001) and final stone-free rate (OR = 6.41; 95%CI 2.24-18.32; p=0.0005) than URS. There was a significantly higher need for auxiliary procedures in URS cases (OR = 6.58; 95%CI 3.42-12.68; p<0.00001). Conclusions: Outcomes with LU for larger proximal ureteral calculi are favorable compared to semi-rigid URS and should be considered as a first-line alternative if flexible ureteroscopy is not available. Utilization of flexible ureteroscopy in conjunction with semi-rigid ureteroscopy may impact these outcomes, and deserves further systematic evaluation.
Descritores: Litotripsia/métodos
Cálculos Ureterais/cirurgia
Laparoscopia/métodos
Ureteroscopia/métodos
-Fatores de Tempo
Ureter/cirurgia
Cálculos Ureterais/patologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
Medicina Baseada em Evidências/classificação
Limites: Humanos
Tipo de Publ: Revisão
Metanálise
Revisão Sistemática
Responsável: BR1.1 - BIREME


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Id: lil-794690
Autor: Gul, Zeynep; Alazem, Kareem; Li, Ina; Monga, Manoj.
Título: Predicting procedural pain after ureteroscopy: does hydrodistention play a role?
Fonte: Int. braz. j. urol;42(4):734-739, July-Aug. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: To identify perioperative predictors of immediate pain after ureteroscopy, specifically evaluating the impact of hydrodistention from irrigation on pain. Materials and Methods: We retrospectively identified patients who underwent ureteroscopy for the treatment of calculi. Data recorded for these patients included their maximum pain score in the post-anesthesia care unit (PACU), average flow rate of irrigant used during the procedure, patient and stone characteristics, operative procedure, and details of patients' immediate, post-operative course. Spearman's rho was used to determine the relationship between non-parametric, continuous variables. Then, a linear regression was performed to assess which variables could predict the peak pain score. Results: A total of 131 patients were included in the study. A non-parametric correlation analysis revealed that maximum pain score was negatively correlated with being male (r = −0.18, p=0.04), age (r = −0.34, p<0.001), and post-op foley placement (r = −0.20, p=0.02) but positively correlated with the preoperative pain score (r = 0.41, p<0.001), time in the PACU (r = 0.19, p = 0.03), and the morphine equivalent dose (MED) of narcotics administered in the PACU (r = 0.67, p<0.001). On linear regression, the significant variables were age, preoperative pain score, and stent placement. For every ten-year increase in age post-operative pain score decreased by 4/10 of a point (p = 0.03). For every 1 point increase in preoperative pain score there was a 3/10 of a point increase in the maximum pain score (p = 0.01), and leaving a stent in place post-operatively was associated with a 1.6 point increase in the maximum pain score. Conclusions: Hydrodistention does not play a role in post-ureteroscopy pain. Patients who are younger, have higher preoperative pain scores, or who are stented will experience more post-operative pain after ureteroscopy.
Descritores: Dor Pós-Operatória/etiologia
Cálculos Renais/cirurgia
Cálculos Ureterais/cirurgia
Ureteroscopia/efeitos adversos
-Modelos Lineares
Estudos Retrospectivos
Enfermagem em Pós-Anestésico
Período Pré-Operatório
Irrigação Terapêutica
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Responsável: BR1.1 - BIREME


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Id: lil-794696
Autor: Kadihasanoglu, Mustafa; Özbek, Emin.
Título: RE: Evaluation of sexual function in patients submitted to ureteroscopic procedures
Fonte: Int. braz. j. urol;42(4):859-860, July-Aug. 2016.
Idioma: en.
Descritores: Cálculos Ureterais
Ureteroscopia
Limites: Humanos
Tipo de Publ: Comentário
Responsável: BR1.1 - BIREME


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Id: lil-785730
Autor: Taşkinlar, Hakan; Avlan, Dincer; Bahadir, Gokhan Berktug; Delibaş, Ali; Nayci, Ali.
Título: The outcomes of two different bulking agents (dextranomer hyaluronic acid copolymer and polyacrylate-polyalcohol copolymer) in the treatment of primary vesico-ureteral reflux
Fonte: Int. braz. j. urol;42(3):514-520tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose Subureteral injection of bulking agents in the endoscopic treatment of vesicoureteral reflux is widely accepted therapy with high success rates. Although the grade of vesicoureteric reflux and experience of surgeon is the mainstay of this success, the characteristics of augmenting substances may have an effect particularly in the long term. In this retrospective study, we aimed to evaluate the clinical outcomes of the endoscopic treatment of vesicoureteric reflux (VUR) with two different bulking agents: Dextranomer/hyaluronic acid copolymer (Dx/HA) and Polyacrylate polyalcohol copolymer (PPC). Materials and Methods A total 80 patients (49 girls and 31 boys) aged 1-12 years (mean age 5.3 years) underwent endoscopic subureteral injection for correction of VUR last six years. The patients were assigned to two groups: subureteral injections of Dx/HA (45 patients and 57 ureters) and PPC (35 patients and 45 ureters). VUR was grade II in 27 ureters, grade III in 35, grade IV in 22 and grade V in 18 ureters. Results VUR was resolved in 38 (66.6%) of 57 ureters and this equates to VUR correction in 33 (73.3%) of the 45 patients in Dx/HA group. In PPC group, overall success rate was 88.8% (of 40 in 45 ureters). Thus, Thus, this equates to VUR correction in 31 (88.5%) of the 35 patients. Conclusions Our short term data show that two different bulking agent injections provide a high level of reflux resolution and this study revealed that success rate of PPC was significantly higher than Dx/HA with less material.
Descritores: Polímeros/uso terapêutico
Refluxo Vesicoureteral/terapia
Materiais Biocompatíveis/uso terapêutico
Acrilatos/uso terapêutico
Resinas Acrílicas/uso terapêutico
Dextranos/uso terapêutico
Ácido Hialurônico/uso terapêutico
-Próteses e Implantes
Ureter
Reprodutibilidade dos Testes
Estudos Retrospectivos
Seguimentos
Resultado do Tratamento
Ureteroscopia/métodos
Injeções/métodos
Limites: Humanos
Masculino
Feminino
Lactente
Pré-Escolar
Criança
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: lil-785743
Autor: Berardinelli, Francesco; Proietti, Silvia; Cindolo, Luca; Pellegrini, Fabrizio; Peschechera, Roberto; Derek, Hennessey; Dalpiaz, Orietta; Schips, Luigi; Giusti, Guido.
Título: A prospective multicenter European study on flexible ureterorenoscopy for the management of renal stone
Fonte: Int. braz. j. urol;42(3):479-486tab.
Idioma: en.
Resumo: ABSTRACT Purpose The aim of this study was to describe the outcomes and the complications of retrograde intrarenal surgery (RIRS) for renal stones in a multi-institutional working group. Materials and Methods From 2012 to 2014, we conducted a prospective study including all RIRS performed for kidney stones in 4 European centers. Demographic information, disease characteristics, and perioperative and postoperative data were gathered. Patients and stone data, procedure characteristics, results and safety outcomes were analyzed and compared by descriptive statistics. Complications were reported using the standardized Clavien system. Results Three hundred and fifty-six patients underwent 377 RIRS with holmium laser lithotripsy for renal stones. The RIRS was completed in all patients with a mean operative time of 63.5 min. The stone-free status was confirmed endoscopically and through fluoroscopic imaging after the first procedure in 73.6%. The second procedure was performed in twenty patients (5.6%) achieving an overall stone free rate of 78.9%. The overall complication rate was 15.1%. Intra-operative and post-operative complications were seen in 24 (6.7%) and 30 (8.4%) cases, respectively. Conclusions RIRS is a minimally invasive procedure with good results in terms of stone-free and complications rate.
Descritores: Cálculos Renais/cirurgia
Litotripsia a Laser/métodos
Ureteroscopia/instrumentação
Ureteroscopia/métodos
Ureteroscópios
-Complicações Pós-Operatórias
Fluoroscopia/métodos
Estudos Prospectivos
Reprodutibilidade dos Testes
Resultado do Tratamento
Litotripsia a Laser/instrumentação
Ureteroscopia/efeitos adversos
Desenho de Equipamento
Europa (Continente)
Duração da Cirurgia
Tempo de Internação
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Tipo de Publ: Estudo Multicêntrico
Responsável: BR1.1 - BIREME


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Id: biblio-828925
Autor: Liu, Pei; Su, Xiao-hong; Xiong, Geng-Yan; Li, Xue-Song; Zhou, Li-Qun.
Título: Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
Fonte: Int. braz. j. urol;42(6):1129-1135, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). Materials and Methods: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent diagnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multivariate analyses were used to determine the independent risk factors. Results: The median follow-up time was 48 months (interquartile range (IQR): 31-77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR: 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who underwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN0 stage tumor (p=0.045) were independent predictors of IVR. Conclusions: Diagnostic ureteroscopy is independently associated with intravesical recurrence after radical nephroureterectomy.
Descritores: Neoplasias Ureterais/patologia
Neoplasias da Bexiga Urinária/patologia
Neoplasias Urológicas/patologia
Ureteroscopia/métodos
Recidiva Local de Neoplasia/patologia
Nefrectomia/métodos
-Ureter/patologia
Neoplasias Ureterais/cirurgia
Neoplasias da Bexiga Urinária/cirurgia
Carcinoma de Células de Transição/cirurgia
Carcinoma de Células de Transição/secundário
Seguimentos
Neoplasias Urológicas/cirurgia
Intervalo Livre de Doença
Gradação de Tumores
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-828929
Autor: Ozgor, Faruk; Kucuktopcu, Onur; Ucpinar, Burak; Gurbuz, Zafer Gokhan; Sarilar, Omer; Berberoglu, Ahmet Yalcin; Baykal, Murat; Binbay, Murat.
Título: Is There A Difference Between Presence of Single Stone And Multiple Stones in Flexible Ureterorenoscopy And Laser Lithotripsy For Renal Stone Burden < 300mm2 ?
Fonte: Int. braz. j. urol;42(6):1168-1177, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT In this study, we aim to evaluate and compare the effectiveness of flexible ureterorenoscopy (f-URS) for solitary and multiple renal stones with <300 mm2 stone burden. Patients' charts who treated with f-URS for kidney stone between January 2010 and June 2015 were reviewed, retrospectively. Patients with solitary kidney stones (n:111) were enrolled in group 1. We selected 111 patients with multiple kidney stones to serve as the control group and the patients were matched at a 1:1 ratio with respect to the patient's age, gender, body mass index and stone burden. Additionally, patients with multiple stones were divided into two groups according to the presence or abscence of lower pole stones. Stone free status was accepted as complete stone clearence and presence of residual fragments < 2 mm. According to the study design; age, stone burden, body mass index were comparable between groups. The mean operation time was longer in group 2 (p= 0.229). However, the mean fluoroscopy screening time in group 1 and in group 2 was 2.1±1.7 and 2.6±1.5 min, respectively and significantly longer in patients with multiple renal stones (P=0.043). The stone-free status was significantly higher in patients with solitary renal stones after a single session procedure (p=0.02). After third month follow up, overall success rate was 92.7% in Group 1 and 86.4% in Group 2. Our study revealed that F-URS achieved better stone free status in solitary renal stones <300 mm2. However, outcomes of F-URS were acceptable in patients with multiple stones.
Descritores: Cálculos Renais/terapia
Litotripsia a Laser/métodos
Ureteroscopia/métodos
-Período Pós-Operatório
Cuidados Pré-Operatórios
Cálculos Renais/cirurgia
Índice de Massa Corporal
Fatores Sexuais
Estudos Retrospectivos
Resultado do Tratamento
Ureteroscópios
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Responsável: BR1.1 - BIREME


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Id: lil-777316
Autor: Zhu, Jianguo; Liang, Yuxiang; Chen, Weihong; Xu, Shuxiong; Wang, Yuanlin; Hu, Jianxing; He, Hui-chan; Zhong, Wei-de; Sun, Zhaolin.
Título: Effect of alpha1-blockers on stentless ureteroscopic lithotripsy
Fonte: Int. braz. j. urol;42(1):101-106, Jan.-Feb. 2016. tab.
Idioma: en.
Projeto: NationalNatural Science Foundation of China.
Resumo: ABSTRACT Objective To evaluate the clinical efficiency of alpha1-adrenergic antagonists on stentless ureteroscopic lithotripsy treating uncomplicated lower ureteral stones. Materials and Methods From January 2007 to January 2013, 84 patients who have uncomplicated lower ureteral stones treated by ureteroscopic intracorporeal lithotripsy with the holmium laser were analyzed. The patients were divided into two groups, group A (44 patients received indwelled double-J stents) and group B (40 patients were treated by alpha1-adrenergic antagonists without stents). All cases of group B were treated with alpha1 blocker for 1 week. Results The mean operative time of group A was significantly longer than group B. The incidences of hematuria, flank/abdominal pain, frequency/urgency after surgery were statistically different between both groups. The stone-free rate of each group was 100%. Conclusions The effect of alpha1-adrenergic antagonists is more significant than indwelling stent after ureteroscopic lithotripsy in treating uncomplicated lower ureteral stones.
Descritores: Sulfonamidas/uso terapêutico
Litotripsia/métodos
Cálculos Ureterais/cirurgia
Ureteroscopia/métodos
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico
-Complicações Pós-Operatórias
Período Pós-Operatório
Medição da Dor
Estudos Prospectivos
Reprodutibilidade dos Testes
Resultado do Tratamento
Estatísticas não Paramétricas
Lasers de Estado Sólido/uso terapêutico
Duração da Cirurgia
Tansulosina
Tempo de Internação
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Adulto Jovem
Tipo de Publ: Estudo de Validação
Responsável: BR1.1 - BIREME



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