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A 2013 meta-analysis found LL can treat larger stones (> 2 cm) with good stone-free and complication rates. [5] Holmium laser lithotripsy had superior initial success and re-treatment rate compared to extracorporeal shock wave lithotripsy (ESWL) in a 2013 trial. [6]
This means an anteroposterior diameter of less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [18] In adults, cutoff values for renal pelvic dilation have been defined differently by different sources, with anteroposterior diameters ranging between 10 and 20 mm. [ 19 ] About 13% of normal healthy adults have a ...
The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones [3] (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. It is also reported to be used for salivary stones [4] and pancreatic stones. [5]
These advantages are especially apparent with stones greater than 10 mm (0.4 in) in diameter. However, because ureteroscopy of the upper ureter is much more challenging than ESWL, many urologists still prefer to use ESWL as a first-line treatment for stones of less than 10 mm, and ureteroscopy for those greater than 10 mm in diameter. [85]
Many stone types can be detected by ultrasound; Factors contributing to stone formation (as in #Etiology) are often tested: Laboratory testing can give levels of relevant substances in blood or urine; Some stones can be directly recovered (at surgery, or when they leave the body spontaneously) and sent to a laboratory for analysis of content
The Boari flap technique reshapes part of the bladder wall into a tube to replace a damaged ureter segment, while appendiceal ureter interposition uses the appendix as a substitute for the ureter. For more extensive reconstruction, the ileal ureter approach repurposes a segment of the small intestine (ileum) to create a new channel for urine ...
Lithotomy differs from lithotripsy, where the stones are crushed either by a minimally invasive probe inserted through the exit canal, or by an acoustic pulse (extracorporeal shock wave lithotripsy), which is a non-invasive procedure. Because of these less invasive procedures, the use of lithotomy has decreased significantly in the modern era.
Ureteroscopy is an examination of the upper urinary tract, usually performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. [1] The procedure is useful in the diagnosis and treatment of disorders such as kidney stones and urothelial carcinoma of the upper urinary tract. [1]