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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Helens and Knowsley Hospital, St. However, as noted above, it is important to note that larger access sheaths can potentially cause ureteric ischaemia and even direct ureteric trauma including perforation. In vitro assessment has shown improved image resolution and colour reproducibility without compromising depth of field, image distortion, grayscale imaging and ureteroscope deflection.

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

Of course, it is important not to leave the distal end too short! 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.

Some newer access sheaths enable a single wire to be used for placement and results in the wire being situated outside the sheath after placement [ 4 ].

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. Ureteral stenting and urinary stone management: Recent evidence suggests that placing the biopsies in Bouin’s solution may offer better preservation of nuclear detail [ 12 ]. One can consider using a double-tipped hydrophilic wire, thereby reducing damage to the fragile working channel of the flexible ureteroscope.


The stone has been successfully broken into small pieces. When initially placing the ureteroscope, we would advocate having it free of all attachments irrigation channel, light and camera leadsenabling smoother passage. Do ureteric stent extraction strings affect stent-related quality of life or complications after ureteroscopy for urolithiasis: The decision to leave a safety wire outside an access sheath is one of personal preference.

Corresponding author Bhaskar K. Once tumor specimens are taken and still in the grasper, consider pushing the biopsy device forward to gently avulse the biopsy.

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

The second technique utilises single use biopsy devices. Other factors that can affect the quality of vision include the focusing of optical scope, adjusting the brightness of light, correct white balancing and appropriate use of vision enhancement features on the stacking system.

Ureteric and renal tumors Diagnostic ureterorenoscopy and biopsy has been recommended for cases of upper tract tumors [ 310 ]. Author information Article notes Copyright and Maialah information Disclaimer.

Cent European J Urol. Is a safety wire necessary during routine flexible ureteroscopy? This will help reduce unnecessary readmissions for stent related symptoms. Placing a ureteric access sheath The use of ureteric access sheaths prior to flexible ureterorenoscopy can be both a surgical preference and case-specific.

Deliberate, slow movements will get one around the whole collecting system faster than wild, fast movements. After a diagnostic cystoscopy, a previously saline-filled ureteric catheter can be placed in the ureter to collect selective cytology from one or both ureters relatively quickly.


When placing a stent it is useful to try and deploy the proximal coil especially multi-length stent in the upper calyx, thus enabling a smaller component of the stent in the bladder. However, the surgeon must be aware that access sheaths carry a risk of ureteric ischaemia and can lead to ureteric injury [ 2 ].

Maintaining the scope straight as the laser fibre is passed reduces the risk of working channel damage, avoiding costly repairs.

Support Center Support Center. When the procedure is completed, withdraw the ureteroscope and access sheath together with the tip of the ureteroscope placed just at the end of the sheath, watching the ureteric mucosa move past.


Ensure that the wire does not kink, or coil in the bladder, which will make advancement of the sheath impossible. Wire problems in bladder for access sheath insertion. Both calyces can be inspected in turn before moving maklah the lowermost calyx.

The base of the tumor can be snared, and then avulsed with some traction. Although these might be an option in very particular circumstances, in most cases involving an unfavourable ureter, it is usually preferable to place a stent and return for the definitive operation at a later date.