View WOC from NURSING at Airlangga University. Makalah Neurogenic ; Airlangga University; NURSING – Summer. Looking for Documents about Makalah Urolithiasis? Makalah Dan Asuhan Keperawatan UROLITHIASISmakalah pbl 20 urolithiasis-kasus Do ureteric stent extraction strings affect stent-related quality of life or complications after ureteroscopy for urolithiasis: a prospective randomised control trial.

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In vitro assessment has shown improved image resolution and colour reproducibility without compromising depth of field, image distortion, grayscale imaging and ureteroscope deflection. This article has been cited by other articles in PMC. Do ureteric stent extraction strings affect stent-related quality of life or complications after ureteroscopy for urolithiasis: Once the lower third has been successfully traversed, the image intensifier can be moved to the proximal ureter to allow precise positioning of the tip of the sheath in the upper ureter.

They are best used judiciously as they transiently increase intra-renal pressure. Inglis1 and Daron Smith Again, personal preference will dictate one’s practice. Copyright by Polish Urological Association.

Simple hand held pump devices can be used and will help increase irrigant flow. When placing the stent, if one is having difficulty with buckling at the UO, bring the cystoscope closer to the UO and push slowly under vision. Such sheaths offer the cost benefit of a single guidewire for the procedure although this must be offset against the cost of the access sheath itself! Outcomes of stenting after uncomplicated ureteroscopy: Finally, regardless of the circumstances leading to stent placement, it is important to ensure that an appropriate postoperative plan is in place to track and remove the amkalah.

The sheath passage should be monitored with pulsed fluoroscopy during ureteric passage, preventing possible buckling in the bladder or to identify early resistance and failure to progress.

It can then be passed over the wire, again using limited pulsed fluoroscopy to check progress.

Tips and tricks of ureteroscopy: consensus statement. Part II. Advanced ureteroscopy

Excess wire in the renal end can equally hamper progress. Aspiration of the collecting system may result in further bleeding; therefore, be patient and wait for the vision to improve. Some newer access sheaths enable a single wire to be used for placement and results in the wire urolkthiasis situated outside the sheath after placement [ 4 ].


It is important to remember that bilateral ureteroscopy may result in bilateral stent insertion. When initially placing the ureteroscope, we would advocate having it free of all attachments irrigation channel, light and camera leadsenabling smoother passage. Traxer O, Thomas A.

The aim is to keep the ureteroscope as straight as possible while fragmenting, reducing the risk of damage to the flexible ureterorenoscope see Figure 3. Selective urine cytology is an important aspect of this procedure.

Once the access sheath of the desired size and length urolitbiasis been chosen, pass the sheath over the guidewire using the Seldinger technique. If one tries to envisage the potential problems preoperatively, appropriate solutions can be considered beforehand. Which ureteral access sheath is compatible with your flexible ureteroscope?

However, the makslah must be aware that access sheaths carry urolithiasiz risk of ureteric ischaemia and can lead to ureteric injury [ 2 ]. Laser fragmentation and basket technique Before performing laser fragmentation in the kidney, consider repositioning the stone into a more favourable position upper calyx urolifhiasis even upper ureter if feasible.

One can consider using a double-tipped hydrophilic wire, thereby reducing damage to the fragile working channel of the flexible ureteroscope.

Makalah Urolithiasis Documents –

Ureteroscopy with and without safety guide wire: It pays to be careful when avulsing tissue as perforation of the collecting system may occur. National Center for Biotechnology InformationU. A straight safety wire is present, but the working wire, over which the access sheath is being passed, is substantially coiled in the bladder.

The use of disposable laser fibres is increasing, and they have been shown to be cost-effective and reduce ureteroscope damage [ 6 ]. Ureteric stenting The placement of a ureteric stent, particularly in an emergency setting, such as relieving obstruction in an infected system, can be a daunting task.

For safety reasons, one may prefer to use a guidewire in diagnostic cases. Further advancement of the sheath will not only fail to access the ureter, but is likely to result in displacement of urolihiasis working wire to the bladder.

Tips and tricks of ureteroscopy: consensus statement. Part II. Advanced ureteroscopy

Flexible ureteroscope insertion via wire Some surgeons prefer to place the flexible ureteroscope over a wire, without using an access sheath. Then, try repeating access sheath placement with both the sheath and inner component.


If this is unsuccessful, one can consider using a stiff wire, rather than the standard guide wire, to aid sheath placement. If a safety wire is not already in place, a wire can be pre-emptively inserted through the flexible ureterorenoscope to allow stent insertion if required.

With minor bleeding, increasing the irrigation for a few minutes may help improve the view. This will not only increase efficacy of lasertripsy but also reduce the risk of compromising the view from bleeding through increased accuracy of laser onto the stone as opposed to the urotheliumand both factors will help reduce the overall operating time as makalaj.


Other factors that can affect the quality of vision include the focusing of optical scope, adjusting the brightness of light, correct white balancing and appropriate use of vision enhancement features on the stacking system. The indications for endoluminal surgery continue to widen, mainly through technological advances, such that this branch of urological practice continues to increase year on year.

In addition, the presence of an access sheath will result in lower intra-renal pressure, and allow better irrigation, both of which are valuable in cases of TCC, which, unlike stones, bleed with compromised views under low irrigation flow rates.

The ureterorenoscope is directed to the upper medial calyx as the starting point for an anti-clockwise tour of the collecting system. If you are still unable to place the sheath, discretion is much better than valour.

The stone has been successfully broken into small pieces. The ureterorenoscope is deflected into the lower medial calyx. Both calyces can be inspected in turn before moving to the lowermost calyx.

Diagnostic ureterorenoscopy and biopsy has been makalzh for cases of upper tract tumors [ 310 ]. This technique can be technically challenging and is not universally practised. Recent evidence suggests that placing the biopsies in Bouin’s solution may offer better preservation of nuclear detail [ 12 ].