Ureteric stones are generally solitary and less than 2 cm long. Exceptionally, ureteric stones can be longer than 5 cm and/or weigh more than 50 grams, and are referred to as giant ureteric stones. In the light of two personal cases and a review of the literature, the authors review the epidemiological, aetiopathogenic, clinical and therapeutic aspects of this disease with particular emphasis on the importance of the aetiological work-up. These two cases concerned two boys, aged 10 years and 4 and a half years, respectively, with no particular medical history, who presented an acute episode of pyelonephritis. The KUB plain film, renal ultrasound and IVU demonstrated a huge stone filling the right ureter in one case and the left ureter in the other case. The stones were treated surgically in both cases. The aetiopathogenesis of these large ureteric stones remains unclear. A urinary tract malformation (megaureter, ureterocele, stricture, etc.), either alone or associated with a metabolic predisposition plays an important role in the pathogenesis of these large stones. The aetiological work-up of these large stones is essential. Morpho-constitutional stone analysis provides extremely useful and even decisive information in some cases for the aetiological diagnosis. Despite the development of extracorporeal lithotripsy and endourological techniques, the treatment of giant ureteric stones often remains surgical.
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BMC Urol
January 2025
Urology and Nephrology Research Center (UNRC), Research Institute for Urology and Nephrology, Center of Excellence in Urology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.
Background: Medical Expulsive Therapy (MET) has been recommended as an established modality for the treatment of distal ureteral stones due to its clearance rate, pain control, and patient satisfaction while having minimal morbidity in comparison to other urologic interventions. In some studies, a combination of medications has been used, which we assessed in this network meta-analysis (NMA).
Methods: We conducted systematic searches in PubMed, Scopus, and Web of Science to identify relevant trials published between 2001 and 2024.
Front Med (Lausanne)
January 2025
Department of Urology, Second People's Hospital of Yichang, Second People's Hospital of China Three Gorges University, Yichang, China.
Emphysematous pyelonephritis (EPN) is a rare but severe necrotizing infection often associated with diabetes, ureteral obstruction, and gas production in the renal parenchyma and perinephric area. This report describes a 54-year-old man with type 2 diabetes who presented with right lumbar pain and was diagnosed with EPN complicated by right ureteral calculi and perinephric gas accumulation. Despite initial improvement with fluid resuscitation, antibiotics, and drainage, inadequate blood glucose control led to a worsening of the infection, eventually involving the psoas major muscle and iliac vessels.
View Article and Find Full Text PDFJ Endourol
January 2025
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Several diagnostic and therapeutic endoscopic urological procedures, such as stent placement, ureteroscopy, and bladder stone lithotripsy, can be performed in a hospital, an ambulatory surgery center, in the office with IV sedation, or in the office using only topical anesthesia. The potential benefits of performing procedures in the office setting using topical anesthesia include efficiency and cost reduction. The potential harms are failure to achieve the desired outcome and patient pain.
View Article and Find Full Text PDFDiseases
January 2025
Department of Urology, Kanazawa Medical University, Uchinada 920-0293, Ishikawa, Japan.
Urinary stones (urolithiasis) have been categorized as kidney stones (renal calculus), ureteric stones (ureteral calculus and ureterolith), bladder stones (bladder calculus), and urethral stones (urethral calculus); however, the mechanisms underlying their promotion and related injuries in glomerular and tubular cells remain unclear. Although lifestyle-related diseases (LSRDs) such as hyperglycemia, type 2 diabetic mellitus, non-alcoholic fatty liver disease/non-alcoholic steatohepatitis, and cardiovascular disease are risk factors for urolithiasis, the underlying mechanisms remain unclear. Recently, heat shock protein 90 (HSP90) on the membrane of HK-2 human proximal tubular epithelium cells has been associated with the adhesion of urinary stones and cytotoxicity.
View Article and Find Full Text PDFBJU Int
January 2025
Department of Urology, University of Alabama, Birmingham, AL, USA.
Objectives: To identify associations between 24-h urine abnormalities and clinical risk factors for recurrent stone formers.
Patients And Methods: The Registry for Stones of the Kidney and Ureter was queried for all patients who underwent 24-h urine studies. Patients were categorised by the number of clinical risk factors for recurrent stone disease.
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