Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital
Objectives: The aim is to evaluate the safety and efficacy of retrograde ureteral catheterization under local anesthesia in patients with urinary tract infections complicated by hydronephrosis caused by ureteral stone obstruction. Materials and Methods: From October 2020 to September 2021, a retrosp...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Tzu-Chi Medical Journal |
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| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=4;spage=317;epage=321;aulast=Hsu |
| _version_ | 1797221318787072000 |
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| author | Chun-Kai Hsu Wan-Ling Young Shu-Yu Wu |
| author_facet | Chun-Kai Hsu Wan-Ling Young Shu-Yu Wu |
| author_sort | Chun-Kai Hsu |
| collection | DOAJ |
| description | Objectives: The aim is to evaluate the safety and efficacy of retrograde ureteral catheterization under local anesthesia in patients with urinary tract infections complicated by hydronephrosis caused by ureteral stone obstruction. Materials and Methods: From October 2020 to September 2021, a retrospective analysis of patients' medical records was performed. Records of past history, physical examination, laboratory tests, and imaging investigations were reviewed. Retrograde ureteric stent (RUS) was performed under local anesthesia using cystoscopes and guided by portable fluoroscopy. Real-time fluoroscopy was used to verify the double-J stent position and confirm a smooth process. The postoperative recovery and length of admission were also recorded. Results: A total of 14 patients with ureteral stone obstruction with infective hydronephrosis received 15 total emergency RUS procedures (one bilateral). Intraoperative findings, operation times, and infection signs were recorded and analyzed. All patients met systemic infection criteria, with a mean body temperature of 38.7°C ± 1.7°C. Leukocytosis was noted in 8 (57.1%) patients. Elevated C-reactive protein (8.5 ± 6.3 mg/L) and procalcitonin (24.1 ± 22.0 ng/mL) were found in 13 (92.9%) and 9 (64.3%) patients, respectively. Mean stone size was 8.5 ± 6.3 mm, mostly localized to the upper ureter (upper: 12; middle: 0; lower: 3). Mean operation time was 14.1 ± 4.3 min. After emergency drainage, all patients improved and were discharged after infection was controlled. The average length of admission was 6.2 ± 2.2 days. Conclusion: RUS under local anesthesia is safe and effective for treating infective hydronephrosis due to ureteral stone obstruction. A randomized controlled trial with a large sample remains necessary to validate these findings. |
| first_indexed | 2024-04-24T13:03:32Z |
| format | Article |
| id | doaj.art-ec699739234548348ead24e4df959070 |
| institution | Directory Open Access Journal |
| issn | 1016-3190 2223-8956 |
| language | English |
| last_indexed | 2024-04-24T13:03:32Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu-Chi Medical Journal |
| spelling | doaj.art-ec699739234548348ead24e4df9590702024-04-05T10:08:18ZengWolters Kluwer Medknow PublicationsTzu-Chi Medical Journal1016-31902223-89562023-01-0135431732110.4103/tcmj.tcmj_11_23Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospitalChun-Kai HsuWan-Ling YoungShu-Yu WuObjectives: The aim is to evaluate the safety and efficacy of retrograde ureteral catheterization under local anesthesia in patients with urinary tract infections complicated by hydronephrosis caused by ureteral stone obstruction. Materials and Methods: From October 2020 to September 2021, a retrospective analysis of patients' medical records was performed. Records of past history, physical examination, laboratory tests, and imaging investigations were reviewed. Retrograde ureteric stent (RUS) was performed under local anesthesia using cystoscopes and guided by portable fluoroscopy. Real-time fluoroscopy was used to verify the double-J stent position and confirm a smooth process. The postoperative recovery and length of admission were also recorded. Results: A total of 14 patients with ureteral stone obstruction with infective hydronephrosis received 15 total emergency RUS procedures (one bilateral). Intraoperative findings, operation times, and infection signs were recorded and analyzed. All patients met systemic infection criteria, with a mean body temperature of 38.7°C ± 1.7°C. Leukocytosis was noted in 8 (57.1%) patients. Elevated C-reactive protein (8.5 ± 6.3 mg/L) and procalcitonin (24.1 ± 22.0 ng/mL) were found in 13 (92.9%) and 9 (64.3%) patients, respectively. Mean stone size was 8.5 ± 6.3 mm, mostly localized to the upper ureter (upper: 12; middle: 0; lower: 3). Mean operation time was 14.1 ± 4.3 min. After emergency drainage, all patients improved and were discharged after infection was controlled. The average length of admission was 6.2 ± 2.2 days. Conclusion: RUS under local anesthesia is safe and effective for treating infective hydronephrosis due to ureteral stone obstruction. A randomized controlled trial with a large sample remains necessary to validate these findings.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=4;spage=317;epage=321;aulast=Hsuretrograde ureteral catheterizationureteral stenturolithiasis |
| spellingShingle | Chun-Kai Hsu Wan-Ling Young Shu-Yu Wu Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital Tzu-Chi Medical Journal retrograde ureteral catheterization ureteral stent urolithiasis |
| title | Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital |
| title_full | Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital |
| title_fullStr | Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital |
| title_full_unstemmed | Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital |
| title_short | Retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi: Experience from a tertiary care hospital |
| title_sort | retrograde ureteral catheterization under local anesthesia for emergency drainage in patients with infection and hydronephrosis secondary to ureteral calculi experience from a tertiary care hospital |
| topic | retrograde ureteral catheterization ureteral stent urolithiasis |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=4;spage=317;epage=321;aulast=Hsu |
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