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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Wire problems in bladder for access sheath insertion. If considering leaving a stent, good preoperative counselling of the patient is vital.


Ureteroscopy with and without safety guide wire: Published online Nov The use of disposable laser fibres is increasing, and they have been shown to be cost-effective and reduce ureteroscope damage urolithiasiw 6 ].

In this paper we provide a summary of placing ureteric access sheath, flexible ureteroscopy, intra renal stone fragmentation and retrieval, maintaining visual clarity and biopsy of ureteric and pelvicalyceal tumours. If this is unsuccessful, one makalan consider using a stiff wire, rather than the standard guide wire, to aid sheath placement. Improving vision in the kidney Vision is key to achieving good fragmentation and stone-free rates, particularly in the kidney.

Ureteric and renal tumors Diagnostic ureterorenoscopy maaklah biopsy has been recommended for cases of upper tract tumors [ 310 urollithiasis. One biopsy technique is by performing a cold cup technique biopsy, utilising a tip-less stone basket. This will help reduce unnecessary readmissions for stent related symptoms.

Basket relocation of lower pole stone. A pre-instrumented ureteric sample is preferable. The ureterorenoscope is directed to the upper medial calyx as the starting point for an anti-clockwise tour of the collecting system. However, urolithiwsis noted above, it is important to note that larger access sheaths can potentially cause ureteric ischaemia and even direct ureteric trauma including perforation.

Improved optical characteristics translate to improved clinical outcomes with significant improvements in mean operative time, flexible ureterorenoscopy time and efficiency of stone fragmentation [ 89 ]. Inglis1 and Daron Smith Then, try repeating access sheath placement with both the sheath and inner component. Laser fragmentation and basket technique Before performing laser utolithiasis in the kidney, consider repositioning the stone into a more favourable position upper calyx or even upper ureter if feasible.


Makalah Urolithiasis Documents –

The indications for endoluminal surgery continue to widen, mainly through technological advances, such that this branch of urological practice continues urolihtiasis increase year on year. 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. As with most forms of surgery, meticulous preoperative planning ueolithiasis lead to a more successful outcome.

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The use of routine access sheaths for biopsies and laser fragmentation of tumours is discouraged, as any minor trauma of the ureter may theoretically result in tumor seeding, but this might be necessary in selected cases where multiple passes need to be made for biopsy from the pelvicalyceal system. Pass the sheath slowly, feeling for resistance when placing over the wire. Please review our privacy policy.

Do not forget to check that your assistant is maintaining adequate stiffness of the wire whilst the stent is being inserted. The use of ureteric access sheaths prior to flexible ureterorenoscopy can be both a surgical preference and case-specific.

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.

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

It is helpful to liaise with the anaesthetist to control urolothiasis patient’s respiratory movement during stone fragmentation in the kidney. The stone has been successfully broken into small pieces.

Cent European J Urol. National Center for Biotechnology InformationU.

Corresponding author Bhaskar K. Aspiration of the collecting system may result in further bleeding; therefore, be patient and wait for the vision to improve.

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

Blood will affect vision and may result in a premature end to the procedure. 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 urolithiaasis compromised views under low irrigation flow rates. These can migrate into the ureter and be tricky to reposition.


Do ureteric stent extraction strings affect stent-related quality of life or complications after ureteroscopy for urolithiasis: If the access sheath progresses up the ureter makalh, consider placing it just below the PUJ, allowing the flexible scope to be fully deflectable. For safety reasons, one may prefer to use a guidewire in diagnostic cases. The working guide wire has been withdrawn slightly, such that the coiled loop is of smaller diameter.

The stone is then released from the basket, which is withdrawn from the scope, and replaced with an appropriate laser fibre for stone fragmentation. Although these might be an option in very particular circumstances, in most cases makkalah an unfavourable ureter, it is usually preferable to place a stent and return for the definitive operation at a later date.

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.

We do not advocate the use of ureteric balloons to dilate the ureter to aid sheath placement nor the use of other ureteric dilators.

It is best to visualise and ensure its position in the bladder before sending the patient to recovery — if there is any doubt from the final fluoroscopic image, it is best to be sure by passing the cystoscope and having a look!