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Zhang X, Zhang Y, Li F, He W, Cao X. Total tubeless percutaneous nephrolithotomy without artificial hydronephrosis in preschool children: Three case reports. Medicine (Baltimore) 2023; 102:e33415. [PMID: 37000074 PMCID: PMC10063253 DOI: 10.1097/md.0000000000033415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/21/2023] [Accepted: 03/10/2023] [Indexed: 04/01/2023] Open
Abstract
RATIONALE Indwelling ureteral catheter, double J tube, or nephrostomy tube are routine procedures for percutaneous nephrolithotomy (PCNL) in children. There are a few cases in which PCNL has been performed in children without any additional instruments being left in place. PATIENT CONCERNS In this study, 3 children were treated for hematuria and complicated with different degrees of urinary tract infection. All of them were diagnosed as upper urinary tract calculi by abdominal computed tomography. DIAGNOSIS Three preschoolers were diagnosed with upper urinary tract calculi before surgery, one with no hydronephrosis and the other 2 with different degrees of hydronephrosis. INTERVENTIONS After preoperative evaluation, all the children successfully completed PCNL without indwelling ureteral catheter, double J tube, or nephrostomy tube. OUTCOMES The operation was successful and there were no residual stones observed during postoperative review. The operating times for the children were 33 minutes, 17 minutes, and 20 minutes, and the intraoperative bleeding volumes were 1 mL, 2 mL, and 2 mL. The catheter was removed on the second day after the operation, the postoperative review of the abdominal computed tomography or ultrasound did not indicate any stone residue, and there were no fever, bleeding, and other related complications after the operation. LESSONS We believe that total tubeless PCNL without artificial hydronephrosis can be achieved in the preschool population.
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Affiliation(s)
- Xicai Zhang
- School of Clinical Medicine of Jining Medical University, Jining, China
| | - Yonghe Zhang
- School of Clinical Medicine of Jining Medical University, Jining, China
| | - Fengyue Li
- Department of Urology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Wenbo He
- Department of Pediatric Surgery, Affiliated Hospital of Jining Medical University, Jining, China
| | - Xiande Cao
- Department of Urology, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China
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Yang YR, Chen SJ, Yen PY, Huang CP, Chiu LT, Lin WC, Chen HY, Chen YH, Chen WC. Hydronephrosis in patients with cervical cancer is an indicator of poor outcome: A nationwide population-based retrospective cohort study. Medicine (Baltimore) 2021; 100:e24182. [PMID: 33578522 PMCID: PMC7886411 DOI: 10.1097/md.0000000000024182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/13/2020] [Indexed: 01/05/2023] Open
Abstract
Cervical cancer is a common malignancy in women. The presence of hydronephrosis in patients with cervical cancer can be a challenging clinical problem. The appropriate management of these patients and the prediction of their outcomes are concerns among gynecologists, urologists, medical oncologists, radiation oncologists, and nephrologists. We enrolled a total of 2225 patients with cervical cancer over a 12-year period from the nationwide database of Taiwan's National Health Insurance Bureau. Among them, 445 patients had concomitant hydronephrosis. The remaining 1780 patients without hydronephrosis were randomly enrolled as a control group for the analysis of associated factors. The results indicated that the proportions of patients with hypertension, chronic kidney disease, and diabetes were significantly higher in the hydronephrosis group. The hydronephrosis group showed a higher all-cause mortality than the non-hydronephrosis group (adjusted hazard ratio 3.05, 95% confidence interval 2.24-4.15, P < .001). The rates of nephrectomy and stone disease were also significantly higher in the hydronephrosis group. A higher percentage of other cancers was also observed in the hydronephrosis group than in the non-hydronephrosis group (12.36% vs 8.99%, respectively). This study shows that cervical cancer with hydronephrosis may have a higher morbidity and mortality than cervical cancer without hydronephrosis. Other factors such as human papilloma virus vaccination, smoking, and cancer staging need to be further studied.
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Affiliation(s)
- You-Rong Yang
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
| | - Szu-Ju Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital
| | - Pin-Yeh Yen
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
| | - Chi-Ping Huang
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
| | - Lu-Ting Chiu
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
| | - Wu-Chou Lin
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
| | - Huey-Yi Chen
- Department of Urology, Department of Obstetrics & Gynecology, Management Office for Health Data, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Kuo J, Rabley A, Domino P, Otto B, Moy ML, Bird VG. Evaluation of Patient Factors That Influence Predictive Formulas for Determining Ureteral Stent Length When Compared to Direct Measurement. J Endourol 2020; 34:805-810. [PMID: 32316762 DOI: 10.1089/end.2020.0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: To compare direct ureteral length measurements with predictive formulas used for the preoperative assessment of ureteral length, and to evaluate patient factors that impact the accuracy of these predictive formulas. Methods: Patients undergoing ureteral stenting for benign and malignant indications were included. Clinical factors analyzed were gender, race, height, weight, prior abdominal or pelvic surgery, radiation therapy, pelvic organ prolapse (POP), laterality, hydronephrosis, and pre-existing ureteral stent. Three predictive formulas and a common height-based formula were used. Direct ureteral measurements were obtained with a ruled 5F ureteral catheter. Predictive formulas were compared with direct ureteral measurements using scatterplot and Spearman's correlation coefficient. Univariate and multivariate logistic regressions were used to evaluate patient factors associated with ≥2 cm deviation from direct ureteral measurements. Results: A total of 108 patients (134 ureters) were analyzed. All predictive formulas correlated poorly with direct ureteral measurements, although as much as 60% of ureteral stent lengths were accurately predicted. Several patient factors significantly impacted accuracy of formulas: male gender (p = 0.04), POP (p = 0.05), body mass index (BMI) ≥25 (p = 0.03), and pre-existing ureteral stent (p = 0.05). Conclusion: Our study suggests that predictive formulas for ureteral stent length have poor accuracy when compared to direct measurement, especially for patients with elevated BMI and POP. Our institution considers direct ureteral measurement the gold standard for determining ureteral stent length-a method that is universally applicable and independent of patient factors.
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Affiliation(s)
- Jennifer Kuo
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Andrew Rabley
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Paula Domino
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Brandon Otto
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Meredith Louis Moy
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Vincent G Bird
- Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA
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Dowd KE, Muse TO, Lowry PS, Essani R. Prophylactic ureteral catheter placement for minimally invasive colorectal surgery. Proc (Bayl Univ Med Cent) 2020; 33:103-104. [PMID: 32063789 DOI: 10.1080/08998280.2019.1673876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 09/08/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022] Open
Abstract
Ureteral catheter placement for identification of ureters during colorectal surgery has been a controversial subject with ill-defined indications. We present a case of ureteral catheter placement wherein the patient required readmission for renal failure with intervention under local anesthesia. This case highlights the importance of patient selection for catheter placement and clinical follow-up, as well as the need for prospective studies to determine the risk-benefit ratio of preoperative catheters.
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Affiliation(s)
| | - Tommy O Muse
- Department of Surgery, Baylor Scott and White HealthTempleTexas
| | - Patrick S Lowry
- Department of Surgery, Baylor Scott and White HealthTempleTexas
| | - Rahila Essani
- Department of Surgery, Baylor Scott and White HealthTempleTexas
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Kotaskova I, Obrucova H, Malisova B, Videnska P, Zwinsova B, Peroutkova T, Dvorackova M, Kumstat P, Trojan P, Ruzicka F, Hola V, Freiberger T. Molecular Techniques Complement Culture-Based Assessment of Bacteria Composition in Mixed Biofilms of Urinary Tract Catheter-Related Samples. Front Microbiol 2019; 10:462. [PMID: 30949137 PMCID: PMC6435596 DOI: 10.3389/fmicb.2019.00462] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/21/2019] [Indexed: 11/26/2022] Open
Abstract
Urinary or ureteral catheter insertion remains one of the most common urological procedures, yet is considered a predisposing factor for urinary tract infection. Diverse bacterial consortia adhere to foreign body surfaces and create various difficult to treat biofilm structures. We analyzed 347 urinary catheter- and stent-related samples, treated with sonication, using both routine culture and broad-range 16S rDNA PCR followed by Denaturing Gradient Gel Electrophoresis and Sanger sequencing (PCR-DGGE-S). In 29 selected samples, 16S rRNA amplicon Illumina sequencing was performed. The results of all methods were compared. In 338 positive samples, from which 86.1% were polybacterial, 1,295 representatives of 153 unique OTUs were detected. Gram-positive microbes were found in 46.5 and 59.1% of catheter- and stent-related samples, respectively. PCR-DGGE-S was shown as a feasible method with higher overall specificity (95 vs. 85%, p < 0.01) though lower sensitivity (50 vs. 69%, p < 0.01) in comparison to standard culture. Molecular methods considerably widened a spectrum of microbes detected in biofilms, including the very prevalent emerging opportunistic pathogen Actinotignum schaalii. Using massive parallel sequencing as a reference method in selected specimens, culture combined with PCR-DGGE was shown to be an efficient and reliable tool for determining the composition of urinary catheter-related biofilms. This might be applicable particularly to immunocompromised patients, in whom catheter-colonizing bacteria may lead to severe infectious complications. For the first time, broad-range molecular detection sensitivity and specificity were evaluated in this setting. This study extends the knowledge of biofilm consortia composition by analyzing large urinary catheter and stent sample sets using both molecular and culture techniques, including the widest dataset of catheter-related samples characterized by 16S rRNA amplicon Illumina sequencing.
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Affiliation(s)
- Iva Kotaskova
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, Brno, Czechia.,Medical Genomics Research Group, CEITEC, Masaryk University, Brno, Czechia.,Department of Clinical Immunology and Allergology, Medical Faculty, Masaryk University, Brno, Czechia
| | - Hana Obrucova
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, Brno, Czechia
| | - Barbora Malisova
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, Brno, Czechia
| | - Petra Videnska
- Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czechia
| | - Barbora Zwinsova
- Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czechia
| | - Tereza Peroutkova
- Institute of Microbiology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Milada Dvorackova
- Institute of Microbiology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Petr Kumstat
- Department of Urology, St. Anne's University Hospital, Brno, Czechia
| | - Pavel Trojan
- Department of Urology, St. Anne's University Hospital, Brno, Czechia
| | - Filip Ruzicka
- Institute of Microbiology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Veronika Hola
- Institute of Microbiology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czechia
| | - Tomas Freiberger
- Molecular Genetics Laboratory, Centre for Cardiovascular Surgery and Transplantation, Brno, Czechia.,Medical Genomics Research Group, CEITEC, Masaryk University, Brno, Czechia.,Department of Clinical Immunology and Allergology, Medical Faculty, Masaryk University, Brno, Czechia
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Gönen M, Arslan ÖE, Dönmez Mİ, Halat AÖ, Sezgin T. Ureteral Catheter Versus Nephrostomy Tube for Patients Undergoing Percutaneous Nephrolithotomy Under Spinal Anesthesia: A Prospectively Randomized Trial. J Endourol 2019; 33:291-294. [PMID: 30793924 DOI: 10.1089/end.2018.0875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate overnight ureteral catheterization vs nephrostomy tube for urinary diversion in patients undergoing percutaneous nephrolithotomy (PNL) under spinal anesthesia. MATERIALS AND METHODS Patients were enrolled using block randomization between February 2016 and July 2016. Patients with renal stones >2 cm confirmed via noncontrast-enhanced CT were included. All patients underwent PNL under spinal anesthesia. Group 1 refers to patients who had a nephrostomy tube following PNL, whereas group 2 refers to overnight ureteral catheterization. Those who refuse spinal anesthesia, <18 years of age, >70 years of age, and anomalous kidneys (ectopic pelvic kidney, horseshoe kidney, etc.) were excluded. In group 1, nephrostomy tube (14F) was removed 48 hours after surgery, whereas the ureteral catheter (6F) was removed at postoperative 12th hour in group 2. Visual analogue scores (VASs) at 24th hour and mean narcotic analgesic (tramadol) amounts were compared. RESULTS There were 30 patients in both groups. Mean age, mean body mass index, and stone area were not significant between groups (p > 0.05, for all). With regard to operative measures, mean duration of surgery, mean number of accesses, and mean drop in Hb levels were comparable. Besides, mean hospitalization period in group 1 was 68.8 ± 12 hours, whereas it was 54.5 ± 10 hours in group 2 (p < 0.001). No patients in either group needed transfusion. Stone-free rates were similar in both groups (83% vs 90%, p = 0.391). Mean 24th hour VAS was 6.17 ± 1.4 in group 1 and 3.37 ± 1.4 in group 2 (p < 0.001). Also, there was a statistically significant difference in mean tramadol requirements between groups (181.67 ± 56.45 vs 86.67 ± 57.13, groups 1 and 2, respectively). CONCLUSION In patients undergoing PNL under spinal anesthesia, using an open-ended ureteral catheter to be removed at early postoperative period reduces analgesic requirement and duration of hospital stay without compromising surgical outcomes and complication rates.
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Affiliation(s)
- Murat Gönen
- 1 Department of Urology, Konya Training and Research Hospital, Konya, Turkey
| | - Ömer Erkam Arslan
- 1 Department of Urology, Konya Training and Research Hospital, Konya, Turkey
| | - M İrfan Dönmez
- 2 Department of Pediatric Urology, Konya Training and Research Hospital, Konya, Turkey
| | - Ahmed Ömer Halat
- 1 Department of Urology, Konya Training and Research Hospital, Konya, Turkey
| | - Tezcan Sezgin
- 1 Department of Urology, Konya Training and Research Hospital, Konya, Turkey
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Hu CY, Shang ZJ, Qin X, Shao LN. Application of Delayed Surgical Managements in Patients with Stensen's Duct Injury. Curr Med Sci 2018; 38:519-523. [PMID: 30074221 DOI: 10.1007/s11596-018-1909-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/20/2018] [Indexed: 10/28/2022]
Abstract
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with 1- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen's duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
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Affiliation(s)
- Chuan-Yu Hu
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.,Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng-Jun Shang
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.
| | - Xu Qin
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Le-Nan Shao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Alyaev JG, Grigoriev NA, Sorokin NI, Diakonov IV, Ali SH. [Choosing a method of draining the upper urinary tract following percutaneous nephrolithotripsy]. Urologiia 2016:38-43. [PMID: 28247628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE to compare various methods of upper urinary tract drainage in patients with urolithiasis. PATIENTS AND METHODS 60 patients were included into a prospective study which ran from March 2013 through December 2014. All patients underwent PCNL with a nephrostomy tract diameter of (28-30 Ch.) at the I.M. Sechenov First Moscow State Medical University urology clinic. Patients were divided into 2 groups. Group 1 30 (patients) underwent nephrostomy after PCNL with nephrostomy tract placement, in group 2 (29 patients) internal drainage was performed. One patient withdrew from the study due to residual stone. Adequacy of urinary tract draining was assessed by operative time and blood loss. A comparative analysis was performed to outline difference in both groups by length of hospital stay, severity of flank pain in early postoperative period and 5 days after the procedure, day of drain removal. RESULTS the average operative time in group No1 was 104 minutes (+/-17 min.), and 71 minutes (+/- 19 minutes) in group No2 . The average hemoglobin level before surgery in both groups was roughly comparable and amounted to: 141.5g / l (+/-13) in group No1, in group No 2 143.6 g / l (+/-18). At the same time, hemoglobin level in the early postoperative period varied in both groups and was as follows: 121g / l (+/-13) in group No1, and 128g / l (+/-14) in group 2. Evaluation of pain severity by VAS score showed that severity of pain in an early postoperative period was roughly comparable in both groups and amounted to 6.29 and 6.05 points, respectively, but from the second day, and since the activation of the patients, the values of the intensity of pain in both groups became differ. Group No1: - 5.33 (+/-1.5) on day 2, 3.25 (+/-1.8) on day 3, - 2.5 (+/-1.6) on day 5. A more thorough elucidation of the cause of pain showed that in 56 (88%) patients the pain was due to the nephrostomy and pain in the nephrostomy stroke while driving and only 7 (11%) patients complained of a pain in the operated kidney. Group No2: - 3.5 (+/-1.2) on day 2, - 2.9 (+/-1.4) on day 3, 1.22 (+/-0.8) on day 5. CONCLUSION A detailed and thorough history, taking together with multislice computed tomography and multiplanar 3D modeling allows for better preoperative assessment regarding a size, a number and location of stones, vascular architecture of the kidney. This enebles an experienced endoscopic surgeon to plan an operation, and avoid the possible difficulties associated with lithotripsy and choose a more suitable method of pyelocaliceal system draining after the operation. In turn, tubeless PCNL, with proper intraoperative managamant and careful selection of patients appears to be safe and effective. Drainage of the upper urinary tract with internal drainage reduces intensity of postoperative pain, which improves the quality of life of patients in the postoperative period, and reduces the length of postoperative stay.
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Affiliation(s)
- Ju G Alyaev
- Sechenov First Moscow State Medical University, Moscow, Research Institute of Uronephrology and Human Reproductive Health
| | - N A Grigoriev
- Sechenov First Moscow State Medical University, Moscow, Research Institute of Uronephrology and Human Reproductive Health
| | - N I Sorokin
- Sechenov First Moscow State Medical University, Moscow, Research Institute of Uronephrology and Human Reproductive Health
| | - I V Diakonov
- Sechenov First Moscow State Medical University, Moscow, Research Institute of Uronephrology and Human Reproductive Health
| | - S H Ali
- Sechenov First Moscow State Medical University, Moscow, Research Institute of Uronephrology and Human Reproductive Health
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Park KK, Kim MU, Chung MS, Lee DH, Hong CH. Easily removable ureteral catheters for internal drainage in children: a preliminary report. Yonsei Med J 2013; 54:464-8. [PMID: 23364982 PMCID: PMC3575964 DOI: 10.3349/ymj.2013.54.2.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE We review our experience using a new and easily removable ureteral catheter in patients who underwent complicated ureteral reimplantation. Our goal was to shorten hospital stay and lower anxiety during catheter removal without fear of postoperative ureteral obstruction. MATERIALS AND METHODS Between April 2009 and September 2010, nine patients who underwent our new method of catheter removal after ureteral reimplantation were enrolled. Patients who underwent simple ureteral reimplantation were excluded from the study. Following ureteral reimplantation, a combined drainage system consisting of a suprapubic cystostomy catheter and a ureteral catheter was installed. Proximal external tubing was clamped with a Hem-o-lok clamp and the rest of the external tubing was eliminated. Data concerning the age and sex of each patient, reason for operation, method of ureteral reimplantation, and postoperative parameters such as length of hospital stay and complications were recorded. RESULTS Of the nine patients, four had refluxing megaureter, four had a solitary or non-functional contralateral kidney and one had ureteral stricture due to a previous anti-reflux operation. The catheter was removed at postoperative week one. The mean postoperative hospital stay was 2.4 days (range 1-4 days), and the mean follow-up was 9.8 months. None of the patients had postoperative ureteral obstructions, and there were no cases of migration or dislodgement of the catheter. CONCLUSION Our new method for removing the ureteral catheter would shorten hospital stays and lower levels of anxiety when removing ureteral catheters in patients with a high risk of postoperative ureteral obstruction.
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Affiliation(s)
- Kyung Kgi Park
- Department of Urology, Jeju National University College of Medicine, Jeju, Korea
| | - Myung Up Kim
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mun Su Chung
- Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Dong Hoon Lee
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Hee Hong
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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