PubMed Health⌕ Search

Biomedical subjects

P Irby

Publications and source records attributed to P Irby.

8 recordsLinked to original sources
PubMed1996

Outcome assessment of double-J stents during extracorporeal shockwave lithotripsy of small solitary renal calculi.

The utility of indwelling double-J ureteral stents during extracorporeal shockwave lithotripsy (SWL) of renal calculi is ill defined. We evaluated 179 patients treated with SWL for small (< 20 mm in diameter) solitary renal calculi with (N = 27) or without (N = 152) indwelling ureteral stents. There was no significant difference in the stone-free rates at 1 month (both 52%) and 3 months (61% nonstented group v 67% stented group; P = 0.45) or in the retreatment rates (13.3% nonstented group v 14.8% stented group; P = 0.60). The incidence and severity of pain/renal colic were similar for the two treatment groups. There was minimal morbidity associated with SWL in either group. Placement of double-J stents for the purpose of improving stone-free rates, alleviating pain, or preventing ureteral obstruction in conjunction with SWL of solitary renal calculi < 20 mm in diameter is unnecessary.

Evaluation Studies as Topic↗
PubMed1995

[The small urinary calculus: natural course and current treatment concepts].

Depending on size, duration of symptoms and their location in the collecting system urinary calculi may pass spontaneously in 16 to 93% of cases. The rate of infection and increase in size of stones in the renal pelvis or calix reaches 70% within months to years. Ureteral stones, however may lead to complications during a period of days to weeks. New minimally invasive treatment modalities have liberalized the indications for early intervention in cases of small stones.

Endoscopy↗
PubMed1995

The effect of newer generation lithotripsy upon renal function assessed by nuclear scintigraphy.

PURPOSE: We studied the effect of second generation lithotripsy on renal function. MATERIALS AND METHODS: We evaluated 42 patients with unilateral renal calculi by nuclear renography, serum creatinine levels, renal ultrasonography and plain radiographs. RESULTS: There was no significant change in glomerular filtration rate at 1 or 3 months. Split function of the treated kidneys was lower at 1 month (mean 47.2%, p = 0.01) and 3 months (47.3%, p = 0.01) than before treatment (49.1%). A greater than 5% decrease in split function of the treated kidney occurred at 1 month in 6 patients (16.2%) and at 3 months in 3. Of the patients 23 (62.2%) were stone-free and 11 had residual fragments less than 4 mm., with a 19% retreatment rate for an overall success rate of 91.9%. CONCLUSIONS: Newer generation lithotriptors may limit renal damage while permitting satisfactory treatment of renal calculi.

Adult↗
PubMed1994

Inverted Y duplication of the ureter associated with a distal limb ectopic to the seminal vesicle.

Inverted Y duplication of the ureter is a rare anomaly. We report on a 24-year-old man who presented with urolithiasis and azoospermia in a solitary functioning kidney with an inverted Y ureteral duplication. To our knowledge our case represents the first documentation of ectopic emptying of 1 limb of the inverted Y ureter into the seminal vesicle. The embryology and management of this complex case are discussed.

Adult↗
PubMed1994

Fibroepithelial ureteral polyps and urolithiasis.

Fibroepithelial polyps are the most common benign tumor of the ureter. Most of the literature regarding their cause ascribes it to chronic infection. These publications, however, show that the majority of such cases never were associated with a documented urinary tract infection. Fibroepithelial polyps appear with equal frequency in male and female subjects and are found in all age groups including children, in contrast to what would have been expected with an infectious cause. Four histologically confirmed cases of fibroepithelial polyps were associated with chronic inflammation of the upper urinary tract related to the presence of calculi and/or Double J ureteral stents. All patients were managed successfully by endoscopic means, preserving renal function. Fibroepithelial ureteral polyps may be associated with urolithiasis, which serves as a source of chronic inflammation. A review of the literature is presented and supports these observations.

Adult↗
PubMed1993

Laparoscopic pyelocaliceal diverticula ablation.

Pyelocaliceal diverticula are cystic urine collections within the renal parenchyma communicating with the collecting system. They occur in 0.2% to 0.5% of the population and often contain calculi. Flank pain is the most common complaint, and most lesions are diagnosed by intravenous urography. In the past, treatment has required open renal surgery, with potential loss of renal function, or prolonged percutaneous procedures. We propose surgical treatment of caliceal diverticula by laparoscopic unroofing and fulguration. The benefits include renal preservation as well as decreased morbidity and an earlier return to work for the patient.

Aged↗
PubMed1993

Natural history and current concepts for the treatment of small ureteral calculi.

Six studies providing information on 2,704 patients were included into a retrospective analysis. The incidence of spontaneous passage relating both stone size and location was determined from these collated studies. The rate of spontaneous passage for stones smaller than 4 mm was 38% compared to 1.2% for those larger than 6 mm, irrespective of their position in the ureter at the time of presentation. Calculi discovered in the distal third of the ureter had a spontaneous passage rate of 45%, compared with the mid third of 22%, and the proximal third of 12%. Two thirds of all stones which passed did so within 4 weeks after the onset of symptoms. These data from the literature were compared to the treatment modalities applied for the last 100 consecutive patients treated with the diagnosis of ureteral stone at UCSF. 42% of the stones were found in the proximal, 13% in the mid and 45% in the distal third of the ureter. Treatment modalities included ureteroscopic stone extraction (36), ESWL (31) and watchful waiting for stone passage (30). Oral litholysis was performed in 2 cases and percutaneous removal of a proximal stone in 1. No calculus larger than 6 mm passed spontaneously. The passage rate from the proximal ureter was 18%, from the mid ureter 15%, and 38% from the distal ureter disregarding the size of the stones. The rate of complications reached 20% when symptoms exceeded 4 weeks in duration compared to 7% in patients with symptoms lasting less than 4 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗