After fragmentation is completed and concretions are extracted, conventional irrigation with saline dissolves the polymer, which is then flushed out.
Materials and Methods: A total of 68
subjects with a single stone in the proximal ureter and an indication for ureteroscopic lithotripsy were enrolled in this prospective, randomized, single-blind, controlled, multisite clinical study. Each subject was randomly assigned to the Back Stop group (34) or the control group (34 with no antiretropulsion device). For subjects in the experimental group Back Stop was dispensed into the ureter above the stone using a 3Fr or 5Fr catheter. Ureteroscopic lithotripsy was performed in all subjects using pneumatic or laser energy. Measured end points included the retropulsion rate, the need for subsequent procedures, the stone-free rate at followup, the occurrence of adverse events and ureteral Nutlin-3 in vivo occlusion, if any, and post-stone fragmentation and extraction.
Results: Subjects randomized to the Back Stop group experienced a statistically significant (p = 0.0002) lower rate of retropulsion (8.8%, 3 of 34) vs the control group (52.9%, 18/34). There were no adverse events in the Back Stop group and Back Stop was successfully dissolved in every subject, resulting in a patent ureter.
Conclusions: Back Stop appears to be a novel, safe
and effective means of preventing stone fragment retropulsion during ureteroscopic Romidepsin supplier lithotripsy for the management of ureteral stones.”
“Purpose: We determined the natural course and compared the deleterious effects in kidneys
of shock wave lithotripsy, percutaneous nephrolithotomy and observation for asymptomatic lower caliceal stones.
Materials and Methods: Between April 2007 and August 2008 patients with asymptomatic lower caliceal calculi were enrolled in the study. To assess stone status noncontrast abdominal helical computerized tomography was done 3 and 12 months after intervention. All patients were evaluated by dimercapto-succinic acid renal scintigraphy 6 weeks and 12 months after find more intervention.
Results: A total of 94 patients were prospectively randomized to percutaneous nephrolithotomy (31), shock wave lithotripsy (31) and observation (32). Mean SD followup was 19.3 +/- 5 months (range 12 to 29). In the percutaneous nephrolithotomy group all patients were stone-free at month 12. Scintigraphy revealed a scar in 1 patient (3.2%) on month 3 followup imaging. In the shock wave lithotripsy group the stone-free rate was 54.8%. Scintigraphy revealed scarring in 5 patients (16.1%). In the observation group 7 patients (18.7%) required intervention during followup. Median time to intervention was 22.5 +/- 3.7 months (range 18 to 26). One patient (3.1%) had spontaneous stone passage.