Advanced Endourology by Stephen Y. Nakada, Margaret S. Pearle

By Stephen Y. Nakada, Margaret S. Pearle

Top nationwide and overseas urologists within the box of endourology describe normal and complex endoscopic tactics for treating upper-tract pathology. The authors supply step by step directions for the newest endoscopic tactics, starting from higher urinary tract calculi and strictures to urothelial melanoma. An accompanying DVD comprises video clips that essentially illustrate serious elements of the suggestions and supply suggestions and tips from the specialists. complex Endourology: the whole medical advisor deals training urologists and urology citizens not just a accomplished, illustrated consultant to endourological techniques-particularly the extra complicated procedures-but additionally a realistic capacity to extend the variety and scope of the methods they practice.

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038-in. floppy-tipped wire, b) hydrophilic coated wire straight or angled 3. Open-ended retrograde catheters, angled catheters 4. 8/10-Fr coaxial dilators 5. Radiocontrast and syringe 6. Ureteral access sheath 7. Balloon dilator 8. Amplatz dilators Ureteral Access: Step 2—Advancing a Guidewire Into the Ureter Table 3 lists the equipment necessary for ureteral access. Cystoscopy is initially carried out to identify the ureteral orifices. Either a flexible or rigid cystoscope may be used, but flexible cystoscopes are less traumatic, offer more patient comfort, and provide the surgeon with greater range of motion, particularly in patients with an enlarged prostate gland.

Hendricks SK, Ross SO, Krieger JN. An algorithm for diagnosis and therapy of management and complications of urolithiasis during pregnancy. Surg, Gynecol Obstet 1991; 172(1): 49–54. 43. Stothers L, Lee LM. Renal colic in pregnancy. J Urol 1992; 148(5): 1383–1387. 44. Evans HJ, Wollin TA. The management of urinary calculi in pregnancy. Curr Opin Urol 2001; 11(4): 379–384. 45. Goldfarb RA, Neerhut GJ, Lederer E. Management of acute hydronephrosis of pregnancy by ureteral stenting: risk of stone formation.

Fig. 2. Double-J stent. (Curl magnified) Sideholes aid in drainage and the black mark on either end of the stent facilitate visualization of the curl when placing a stent visually through the cystoscope. ureteral aperistalsis, vesicoureteric reflux, increased pressure and hydronephrosis proximal to the area of dilation, and diminished ureteral contractility (77,78). Only after 6 to 7 weeks of dilatation did the ureteral physiology and histology return to normal in these animals (77–79). The safety and efficacy of balloon dilators in ureteroscopy have been confirmed in humans and are in routine use (80,81).

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