ENDOUROLOGY

In this article we present our experience and analysis of periand postoperative complications after percutaneous nephrolithtomy (PCNL) in patients with large and staghorn kidney stones. In period from 2009 up to 2013 we have performed 1649 PCNLs with a growth tendency of 36% pro year.

Benign prostatic hyperplasia (BPH) is one of the commonest diseases in older men. Operation is the most effective treatment modality. Monopolar surgery is slowly retracting itself, giving the way to the bipolar surgery. Bipolar transurethral vaporesection of prostate (TUVRB) is similar to the standard TURis with regard to the mechanism of action, but has some constructive peculiarities in the form of the loop electrode.

In spite of significant success in treatment of the urolithiasis, extraction of the staghorn stones in obese patients is a major clinical problem. Role of the laparoscopic approach in operative treatment of these patients is not clear. The aim of this work was to analyze retrospectively our first experience in treatment of obese patients with staghorn kidney stones using the laparoscopic pyelolithotomy. The analysis was performed in 15 patients. No intraoperative complications were registered. There was no need in blood transfusion.

Ureteral peristalsis and pelvic pressure were studied in the patients with kidney stones, which were treated by means of percutaneous nephrolithotripsy (PCNL). Besides the common urological investigations the peristalsis status of the upper, middle and lower thirds of the ureter was evaluated with the use of the multichannel impedance uretrography in 12 patients immediately before the PCNL.

Operative treatment in patients with large and staghorn urinary stones of anatomically or functional solitary kidney is one of the complicated problems in urology. Literature review shows that extracorporeal shockwave lithotripsy (ESWL) as monotherapy has low efficacy in patients with this form of urolithiasis and its role could be described as amplification of other modalities, for example, in the combination treatment with transurethral and percutaneous manipulations.

Objective. A rational division of the upper urinary tract stones by their complexity from position of endoscopic surgery. Materials & methods. We retrospectively reviewed medical records of 1027 patients, with stones located in upper urinary tract (597 males – 58.1% and 430 females – 41.9%), with mean age 38,9 ± 15,6 (from 4 to 84) years. The age of 46 (4,5%) patients ranged from 4 to 15 years. The mean stone size was 30,3 ± 0,6 (3 to 150) mm. All endoscopic interventions were performed by three experienced surgeons.

Aim of the study was to compare the efficacy of the artificial stone desintegration between new nanosecond electroimpulse lithotripter (NSEIL) standard electrohydraulic lithotripter (EGL). Two types of “stones” were used, which simulated hard and soft urinary stones and were made of dental ultrastrong gypsum BegoStone. EGL was performed using sounds of 3 diameters: 3.0 Fr, 4.5 Fr and 7.0 Fr; NSEIL – using sounds 2.7 Fr, 4.5 Fr and 6.0 Fr.

Introduction. Three-dimensional modeling of the retroperitoneal cavity could be used for the pre-operative planning of the surgery. An optimal method, which could let to coordinate the 3D model with the patient’s body, is still lacking, though it could be perspective for the minimally-invasive surgery, for example, in case of the retroperitoneal endoscopic ureterolithotomy (REULT).

Aim: to estimate efficacy and safety of the retrograde contact electroimpulse ureterolithotripsy (RECULT) depending on the stone size and location.

Percutaneous nephrolithotripsy (PCNL) became a standard for the large and staghorn stones of the kidney, forcing out the open surgery. Today the standard PCNL is being compared in terms of efficacy to the technique using the instrument with smaller diameter. The desire to use the smallest possible access stems from the necessity to reduce the intra- and postoperative complications.