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.
|Published (Last):||10 August 2006|
|PDF File Size:||13.42 Mb|
|ePub File Size:||7.36 Mb|
|Price:||Free* [*Free Regsitration Required]|
The decision to leave a safety wire outside an access urolithoasis is one of personal preference. Published online Nov When placing the stent, if one is having difficulty with buckling at the UO, bring the cystoscope closer to the UO and push slowly under vision.
If you are still unable to pass the flexible scope, stent the ureter with a view to performing a repeat procedure in approximately 2—6 weeks.
Irrigant flow and intrarenal pressure during flexible ureteroscopy: It is to be noted that increasing the size of the basket corresponding to shaft diameter will significantly reduce irrigant flow [ 1 ].
Wire problems urolitgiasis bladder for access sheath insertion. Of course, it is important not to leave the distal end too short! This technique can be technically challenging and is not universally practised. 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.
Tips and tricks of ureteroscopy: consensus statement. Part II. Advanced ureteroscopy
Simple hand held pump devices can be used and will help increase irrigant flow. Blood will affect vision and may result in a premature end to the procedure. When the procedure is completed, withdraw the ureteroscope and access sheath together with the tip of the ureteroscope placed urolithjasis at the end of the sheath, watching the ureteric mucosa move past. Ureteroscopy with and without safety guide wire: Again, personal preference will dictate one’s practice.
The working wire is now straight, and the tip irolithiasis the access sheath has been moved along it towards the left ureteric orifice.
Furthermore, it can aid the rapid reintroduction of the scope towards the calyx urolithiaasis interest stone or TCC bearing later in the procedure see Figure 2.
Vision is key to achieving good fragmentation and stone-free rates, particularly in the kidney. Copyright by Polish Urological Association. If one pulls back on the device, the graspers may slip and offer a degraded specimen. However, the surgeon must be aware that access sheaths carry a risk of ureteric ischaemia and can lead to ureteric injury [ 2 ].
The stone is then released from the basket, urolithiasks is withdrawn from the scope, and replaced with an appropriate urolihtiasis fibre for stone fragmentation. Cent European J Urol. When initially placing the ureteroscope, we would advocate having it free of all attachments irrigation channel, light and camera leadsenabling smoother passage. This article has been cited by other articles in PMC. Trends in urological stone disease. Such sheaths offer the cost benefit of a single guidewire for the procedure although this must be offset against the cost of the access sheath itself!
Further advancement of the sheath will not only fail to access the ureter, but is likely to result in displacement of the urolithuasis wire to the bladder. This will not only increase efficacy of lasertripsy but also reduce the risk of compromising the view from bleeding through increased accuracy of laser onto the stone as opposed to the urotheliumand both factors will help reduce the overall operating time as well.
National Center for Biotechnology UroljthiasisU. Consider the use of a ureteric catheter or tethered stent if feasible, for short-term drainage. Pass the sheath slowly, feeling for resistance when placing over the wire. Basket relocation of lower pole stone. 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 pays to be careful when avulsing tissue as perforation of the collecting system may occur. When placing a stent it is useful to try maakalah deploy the proximal coil especially multi-length stent in the upper calyx, thus enabling a smaller component of the stent in the bladder. For safety reasons, one may prefer to use a guidewire in diagnostic cases. Placing a ureteric access sheath The use of ureteric access sheaths prior to flexible ureterorenoscopy can be both a surgical preference and case-specific.
One must always consider whether a stent is really needed, as they have associated morbidity. Once the lower third has been successfully traversed, the image intensifier can urolitihasis moved to the proximal ureter to allow precise positioning of the tip of the ,akalah in the upper ureter. This reduces the chance of mucosal trauma, therefore reducing the risk of unnecessary biopsy.
It is best to visualise and ensure its position in the bladder before sending the patient to recovery — if uroliyhiasis is any doubt from the final fluoroscopic image, it is best to be sure by passing the cystoscope and having a look! It can then be passed over the wire, again using limited pulsed fluoroscopy to check progress.
Makalah Urolithiasis Documents –
Before performing laser fragmentation in the kidney, consider repositioning the stone into a more favourable position upper calyx or even upper ureter if feasible. Excess wire in the renal end can equally hamper progress. urolithiasi
Inglis1 and Daron Smith Outcomes of stenting after uncomplicated ureteroscopy: Reusable laser fibres can result in small microfractures, which then contribute to flexible ureterorenoscope damage.