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Editorial comment

Editorial comment Management of calcular anuria in adults caused by ureteric stones: By using of ureteroscopy and holmium laser 183 We read with interest this paper on calculus anuria due to This can be applied to the management of obstructing calculi ureteric calculi that were treated successfully with primary in the presence of anuria and renal failure. However, a word ureteroscopy and laser fragmentation of stones. Calculus anur- of caution must be added. These cases are difficult both surgi- ia has been recognised as a true urological emergency and al- cally and anaesthetically, requiring an experienced endourolo- ready decades ago the urgency of surgical decompression of gist and anaesthetist. Therefore, careful consideration should the urinary tract was considered paramount as initial treat- be given as to whether the expertise available allows taking ment. Reports during the 1930s describe and underline the the risks involved. importance of drainage, whether by nephrostomy or ureteric catheterisation [1,2]. A recent series of 66 patients with calculus References anuria reported a 7.5% mortality rate, despite having emer- gency decompression of the urinary tract [3]. For almost a cen- [1] Scott E, Bloemovitch H. Calculus anuria. Br Med J 1932;2:1057. tury now the treatment of calculus anuria has consisted of an [2] Coidan VJH. Calculus anuria. Br Med J 1932;2:1166. [3] Amanullah, Khan G, Lal S, Soomro MI, Jalbani MH. Calculus initially conservative approach either by ureteric stenting or by anuria and its remedy. J Ayub Med Coll Abbottabad 2010;22:112–4. nephrostomy insertion. Definitive stone treatment was usually [4] Sarica K, Tanriverdi O, Aydin M, Koyuncu H, Miroglu C. delayed until after the acute phase had been resolved. Emergency ureteroscopic removal of ureteral calculi after first colic The management of ureteric colic and calculi has seen attack: is there any advantage? Urology 2011;78:516–20. marked advances with the rapid progression of endourological [5] Guercio S, Ambu A, Mangione F, Mari M, Vacca F, Bellina M. technologies, with open surgery now being almost a thing of Randomized prospective trial comparing immediate versus delayed the past. These technological advances have allowed for a ureteroscopy for patients with ureteral calculi and normal renal more definitive initial treatment. This led to a rise in the use function who present to the emergency department. J Endourol of primary ureteroscopy even in emergency settings, and this 2011;25:1137–41. has been shown to be safe and effective [4,5]. There are few re- [6] Jiang H, Wu Z, Ding Q. Ureteroscopy and holmium: YAG laser ports of primary ureteroscopy in calculus anuria. There are lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi. Urology 2008;72:504–7. only two other case series reporting on the use of ureteroscopy [7] Yang S, Qian H, Song C, Xia Y, Cheng F, Zhang C. Emergency with laser fragmentation in calculus anuria [6,7]. Both of these ureteroscopic treatment for upper urinary tract calculi obstruction series describe the successful and safe treatment of impacted associated with acute renal failure: feasible or not? J Endourol stones in the anuric patient, with stone-free rates of up to 90%. 2010;24:1721–4. This article reflects the more technically advanced endouro- logical management available for ureteric stone disease to date. Priyadarshi Kumar Noor Buchholz Endourology & Stone Services, Barts and The Londong NHS Trust, London, UK E-mail: nb@londonurologyconsultant.com (N. Buchholz) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Arab Journal of Urology Taylor & Francis

Editorial comment

Kumar, Priyadarshi; Buchholz, Noor
Arab Journal of Urology , Volume 9 (3): 1 – Sep 1, 2011
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Editorial comment

Abstract

Management of calcular anuria in adults caused by ureteric stones: By using of ureteroscopy and holmium laser 183 We read with interest this paper on calculus anuria due to This can be applied to the management of obstructing calculi ureteric calculi that were treated successfully with primary in the presence of anuria and renal failure. However, a word ureteroscopy and laser fragmentation of stones. Calculus anur- of caution must be added. These cases are difficult both surgi- ia has...
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Publisher
Taylor & Francis
Copyright
© 2011 Arab Association of Urology
ISSN
2090-598X
DOI
10.1016/j.aju.2011.10.001
Publisher site
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Abstract

Management of calcular anuria in adults caused by ureteric stones: By using of ureteroscopy and holmium laser 183 We read with interest this paper on calculus anuria due to This can be applied to the management of obstructing calculi ureteric calculi that were treated successfully with primary in the presence of anuria and renal failure. However, a word ureteroscopy and laser fragmentation of stones. Calculus anur- of caution must be added. These cases are difficult both surgi- ia has been recognised as a true urological emergency and al- cally and anaesthetically, requiring an experienced endourolo- ready decades ago the urgency of surgical decompression of gist and anaesthetist. Therefore, careful consideration should the urinary tract was considered paramount as initial treat- be given as to whether the expertise available allows taking ment. Reports during the 1930s describe and underline the the risks involved. importance of drainage, whether by nephrostomy or ureteric catheterisation [1,2]. A recent series of 66 patients with calculus References anuria reported a 7.5% mortality rate, despite having emer- gency decompression of the urinary tract [3]. For almost a cen- [1] Scott E, Bloemovitch H. Calculus anuria. Br Med J 1932;2:1057. tury now the treatment of calculus anuria has consisted of an [2] Coidan VJH. Calculus anuria. Br Med J 1932;2:1166. [3] Amanullah, Khan G, Lal S, Soomro MI, Jalbani MH. Calculus initially conservative approach either by ureteric stenting or by anuria and its remedy. J Ayub Med Coll Abbottabad 2010;22:112–4. nephrostomy insertion. Definitive stone treatment was usually [4] Sarica K, Tanriverdi O, Aydin M, Koyuncu H, Miroglu C. delayed until after the acute phase had been resolved. Emergency ureteroscopic removal of ureteral calculi after first colic The management of ureteric colic and calculi has seen attack: is there any advantage? Urology 2011;78:516–20. marked advances with the rapid progression of endourological [5] Guercio S, Ambu A, Mangione F, Mari M, Vacca F, Bellina M. technologies, with open surgery now being almost a thing of Randomized prospective trial comparing immediate versus delayed the past. These technological advances have allowed for a ureteroscopy for patients with ureteral calculi and normal renal more definitive initial treatment. This led to a rise in the use function who present to the emergency department. J Endourol of primary ureteroscopy even in emergency settings, and this 2011;25:1137–41. has been shown to be safe and effective [4,5]. There are few re- [6] Jiang H, Wu Z, Ding Q. Ureteroscopy and holmium: YAG laser ports of primary ureteroscopy in calculus anuria. There are lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi. Urology 2008;72:504–7. only two other case series reporting on the use of ureteroscopy [7] Yang S, Qian H, Song C, Xia Y, Cheng F, Zhang C. Emergency with laser fragmentation in calculus anuria [6,7]. Both of these ureteroscopic treatment for upper urinary tract calculi obstruction series describe the successful and safe treatment of impacted associated with acute renal failure: feasible or not? J Endourol stones in the anuric patient, with stone-free rates of up to 90%. 2010;24:1721–4. This article reflects the more technically advanced endouro- logical management available for ureteric stone disease to date. Priyadarshi Kumar Noor Buchholz Endourology & Stone Services, Barts and The Londong NHS Trust, London, UK E-mail: nb@londonurologyconsultant.com (N. Buchholz)

Journal

Arab Journal of Urology – Taylor & Francis

Published: Sep 1, 2011

References

  • Calculus anuria
  • Calculus anuria
  • Calculus anuria and its remedy
  • Emergency ureteroscopic removal of ureteral calculi after first colic attack: is there any advantage?
  • Randomized prospective trial comparing immediate versus delayed ureteroscopy for patients with ureteral calculi and normal renal function who present to the emergency department
  • Ureteroscopy and holmium: YAG laser lithotripsy as emergency treatment for acute renal failure caused by impacted ureteral calculi
  • Emergency ureteroscopic treatment for upper urinary tract calculi obstruction associated with acute renal failure: feasible or not?