A Novel Semirigid Ureterorenoscope with Vacuum Suctioning System for Management of Single Proximal Ureteral and Renal Pelvic Stones: An Initial Experience.

INTRODUCTION: A novel semirigid ureterorenoscope, named the Sotn ureterorenoscope, was designed with a vacuum suction system. The present study aimed to evaluate the feasibility and safety of using the Sotn ureterorenoscope to manage single proximal ureteral or renal pelvic stones. PATIENTS AND METHODS: Data were retrospectively collected from consecutive patients treated with a Sotn ureterorenoscope between February 2010 and August 2015 at Sun Yat-sen Memorial Hospital of Sun Yat-sen University and Jiangmen Wuyi Traditional Chinese Medicine Hospital in China. The primary outcome was the primary stone-free rate (SFR) in 1 month. The secondary outcomes were the final SFR and the perioperative complication rate. RESULTS: A total of 386 patients were evaluated, including 240 males and 146 females. The median (interquartile range [IR]) age was 50 (40-59) years. There were 96 and 290 stones located in the renal pelvis and proximal ureter, respectively. The median (IR) operative time and console time for all patients were 40 (30-70) and 20 (12-38) minutes, respectively. The primary overall SFR was 86.5%, whereas the SFRs for stones with a diameter of ≤1, 1 to 2, and 2 to 3 cm were 95.7%, 86.9%, and 69.0%, respectively. Complications occurred in 90 patients (23.3%); these complications were classified as Clavien-Dindo grades 1 to 2 (minor) in 79 (20.5%) patients, and grades 3 to 4 (major) in 11 (2.8%). CONCLUSIONS: The novel semirigid Sotn ureterorenoscope featuring a vacuum suction system is effective and safe for managing proximal ureteral and renal pelvic stones.

Estimation of renal pelvic volume in free urinary flow and in ureteral stasis. An experimental study in the rabbit.

At urography the radiopacity of the pelvis increases with the product of iodine concentration of the urine and its layer thickness. The layer thickness is proportional to the third root of the volume. Using this knowledge, we estimated the volume of the renal pelvis in rabbits and found it to be proportional to the diuresis up to a level of approximately 0.8 ml per min, after which a maximal dilatation seemed to be reached. By this means, the estimated density of the renal pelvis can be calculated. This model of evaluating urographic contrast agents is thought to be more appropriate than and complementary to the mere determination of urinary iodine concentration.

Sequential changes in the CT numbers of the normal canine kidney following intravenous contrast administration. II: The renal medulla.

Following the intravenous administration of sodium and meglumine salts of both diatrizoate and iothalamate (at doses of 310-880 mg I/kg body weight) sequential changes in computed tomographic (CT) numbers of the inner medulla were determined in three dogs, using a 30-second CT scanner. Peak medullary enhancement was greater than, and usually occurred 1-2 minutes after, peak cortical enhancement. The CT number of the medulla increased linearly with increasingly large doses of the contrast agent. At peak enhancement, the meglumine salts produced a significantly lower (p less than 0.025) mean CT attenuation value of the medulla than did the sodium salts. The difference in mean attenuation values between the sodium salts and meglumine salts was maximum (50-60 HU)at peak enhancement. Our data indicate the known difference in renal handling of the meglumine and sodium salts is readily detectable by CT.