Urinary Stones E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 667

Veröffentlichungsjahr: 2014

Beschreibung

Acute urinary stones cause one of the most painful sensations the human body can experience, more painful than childbirth, broken bones, gunshot wounds or burns. Master your patient management with this comprehensive guide to a debilitating medical condition.

Urinary Stones: Medical and Surgical Management provides urologists, nephrologists and surgeons with a practical, accessible guide to the diagnosis, treatment and prevention of urinary stone disease.

Divided into 2 parts – covering both medical and surgical management - leading experts discuss the key issues and examine how to deliver best practice in the clinical care of your patients.

Topics covered include:

• Evaluation and management of stones in children
• Renal colic and medical expulsive therapy
• Imaging in stone disease: sonography, contrast based fluoroscopy, computed tomography and magnetic resonance urography
• Multimodality therapy: mixing and matching techniques to improve outcome
• Complications of stone disease
• Interpretation of 24 hour urine chemistry
• Prevention of recurrent calcium, uric acid, struvite and cystine stones
• The different surgical techniques, including: ureteroscopy, shockwave lithotripsy, ureteroscopic lithotripsy and percutaneous nephrostolithotomy

Packed with high-quality figures, key points, and management algorithms, easy to follow, clear clinical guidance is supported by the very latest in management guidelines from the AUA and EAU.

Brought to you by the best, this is the perfect consultation tool when on the wards or in the office.

Leseprobe

CONTENTS

Cover

Title page

Copyright page

List of Contributors

Preface

PART 1: Types of Urinary Stones and Their Medical Management

CHAPTER 1 : How to Build a Kidney Stone Prevention Clinic

Introduction

Personnel

Evaluation

Treatment

Pharmacological prevention

Conclusion

References

CHAPTER 2: Metabolic Evaluation

Introduction

Serum chemistries

Stone analysis

24-hour urine chemistries

Volume and creatinine

Calcium

Oxalate

Citrate

Uric acid

pH

Sodium and potassium

Phosphorus

Magnesium

Sulfate and urea

Ammonium

Supersaturation of stone-forming salts

References

CHAPTER 3: Uric Acid Stones

Introduction

Epidemiology of uric acid stones

Pathogenesis of uric acid stones

Diagnosis of uric acid stones

Management of uric acid stone formers

Ammonium urate stones

Summary and conclusions

References

CHAPTER 4 : Calcium Stones

Overview

How do stones begin?

Risk factors for calcium stones

Management algorithms

References

CHAPTER 5: Struvite Stones

Introduction

Microbiology

Diagnosis and features

Pathogenicity and pathophysiology

Effects on renal function

Metabolic evaluation and pharmacotherapy

Irrigation chemolysis

Surgical management

Summary

References

CHAPTER 6: Genetic Causes of Kidney Stones

Introduction

When to suspect a genetic cause of kidney stones

Cystinuria

Primary hyperoxaluria

Dent's disease

Adenine phosphoribosyltransferase deficiency (2,8-dihydroxyadeninuria)

References

CHAPTER 7: Evaluation and Management of Pediatric Stones

Summary

References

CHAPTER 8: Primary Hyperparathyroidism and Stones

Introduction

Evaluation

Clinical presentation

Guidelines for surgery

Non-surgical patients

Management of nephrolithiais in primary hyperparathyroidism

Summary

References

CHAPTER 9: Renal Tubular Acidosis, Stones, and Nephrocalcinosis

Historical background

Underlying acid–base physiology

Proximal renal tubular acidosis

Underlying mechanisms in distal RTA

Diagnosis and management of RTA

Summary

References

CHAPTER 10: Drug-Induced Stones

Introduction

Epidemiology

Drug-containing kidney stones

Metabolically induced kidney stones

Management of the patient with drug-induced nephrolithiasis

References

CHAPTER 11: Management of Renal Colic and Medical Expulsive Therapy

Introduction

Etiology

Epidemiology

Pain management

Medical expulsive therapy

References

PART 2: Surgical Management of Urinary Stones

CHAPTER 12: Indications for Conservative and Surgical Management of Urinary Stone Disease

Introduction

Ureteral calculi

Renal calculi

Summary

References

CHAPTER 13: Perioperative Imaging

Introduction

Conventional radiography/abdominal plain film

Ultrasound

Intravenous urography/intravenous pyelography

Computed tomography

Magnetic resonance imaging

Summary

References

CHAPTER 14: Emergency Urinary Drainage Techniques Employed for an Obstructing Upper Urinary Tract Calculus With and Without Associated Sepsis

Introduction

Which procedure should be used for emergency drainage of the obstructed kidney?

Technical aspects

References

CHAPTER 15: Endoscopic Management of Lower Urinary Tract Calculi:

Introduction

Standard endoscopic techniques

Bladder calculi

Prostatic urethral calculi

Anterior urethral calculi

Summary

References

CHAPTER 16 : Ureteroscopy

Equipment

Ureteroscopy technique

Percutaneous nephrolithotomy

Summary

References

CHAPTER 17 : Extracorporeal Shock Wave Lithotripsy in Children

Introduction

Renal functional outcomes after extracorporeal shock wave lithotripsy

Intraoperative monitoring and surgical techniques

Predictors of extracorporeal shock wave lithotripsy success

Outcomes in contemporary large series

Special groups

Summary

Extracorporeal shock wave lithotripsy in children: ureteral stones

Conclusion

References

CHAPTER 18: Extracorporeal Shock Wave Lithotripsy

Introduction

Mechanisms of stone comminution

Shock wave generators

Factors influencing extracorporeal shock wave lithotripsy outcomes

Conclusion

References

CHAPTER 19: Ureteroscopic Lithotripsy

Introduction

Indications

Setting up for surgery

Gaining access to the ureter

Endoscopes

Stone fragmentation and retrieval

After stone extraction

Conclusion

References

CHAPTER 20: Ureteropyeloscopic Management of Upper Urinary Tract Calculi

Introduction

Ureteroscopic lithotripsy: general principles

Choosing an endoscope

Surgical technique

References

CHAPTER 21: Percutaneous Nephrolithomy:

Introduction

Planning access preoperatively

Positioning for access

Access techniques

Instruments

References

CHAPTER 22: Percutaneous Management of Intrarenal Calculi

Introduction

Preoperative antimicrobial prophylaxis

Access

Irrigation fluid

Stone clearance

Exit strategy

Special anatomical considerations

Complications

Follow-up

References

CHAPTER 23: Laparoscopic and Open Surgical Management of Urinary Calculi

Introduction

Renal calculi

Ureteric calculi

Bladder calculi

References

CHAPTER 24: Multimodality Therapy

Introduction

Shock wave lithotripsy with a ureteral stent

Combination of shock wave lithotripsy and percutaneous nephrolithotomy

Laparoscopy combined with endoscopy

Ureteroscopy before renal transplantation

Pre-ureteroscopy ureteral stenting

Combined antegrade and retrograde treatment (Figure 24.2)

References

CHAPTER 25: Management of Complications Associated with Various Lithotripsy Techniques

Introduction

Extracorporeal shock wave lithotripsy

Percutaneous nephrolithotomy

Ureteropyeloscopic lithotripsy

References

Index

Eula

List of Illustrations

Chapter 2

Figure 2.1 Histograms of creatinine/kg body weight ratios for male (n = 24,006) and female (n = 21,924) patients with urolithiasis. The vertical lines identify 1.5 standard deviations from the mean.

Figure 2.2 Plot of urine urea nitrogen excretion versus uric acid excretion in 45,930 patients with urolithiasis. The line is the linear regression, r = 0.76, p < 0.001.

Figure 2.3 Plot of uric acid supersaturation (circles) and calcium phosphate supersaturation (triangles) versus pH. Supersaturation was calculated with Equil 2 software, using fixed urine concentrations of all chemsitries while varying urine pH. The horizontal line indicates the saturation point.

Chapter 3

Figure 3.1 Solubility of uric acid and its sodium and potassium salts in urine according to ambient pH. Source: Data from Pak et al. J Clin Invest 1977; 59: 426–31, and reproduced from Moe et al. 2002 [1]. Reproduced with permission of Elsevier.

Figure 3.2 Evaluation and management of uric acid nephrolithiasis.

Chapter 4

Figure 4.1 Environmental and genetic factors that contribute to calcium nephrolithiasis. Kidney stone risk is dependent on the crystallization potential of urine, which is determined by the net urinary excretion of substances that increase SS, including calcium (Ca), UA, oxalate (Ox), citrate and macromolecular inhibitors. The gap between the upper limit of metastability (ULM) and SS is a quantitative index of crystallization potential, with a lower gap indicating increased chance of crystallization. Environmental modifiers include heat, exercise, and diet. Net GI absorption and renal excretion of urinary substances are under genomic influence. Candidate genes to regulate urinary calcium excretion include, but are not limited to, the vitamin D receptor (VDR), calcium sensing receptor (CaSR), and a recently identified soluble adenylate cyclase (sAC) present in kidney. Candidate genes to regulate other urinary lithogenic factors are less well understood, but include the anion channel SLC26A6 since it promotes intestinal oxalate secretion. Certain individuals may have functional defects in urinary inhibitor function, possibly also under genetic influence. Persons with abnormalities in two or more pathways might have a more severe outcome (i.e. more stones). Source: Copyright of Mayo Clinic, reproduced with permission.

Chapter 6

Figure 6.1 Characteristic urinary crystals. (a) Cystine crystals. The typical hexagonal crystals are diagnostic of cystinuria. (b) 2,8-Dihydroxyadenine crystals. Conventional light microscopy (left panel) shows brown crystals with dark outline and central spicules. When viewed by polarized light microscopy (right panel), the medium-sized cystals appear yellow in colour and produce a central Maltese cross pattern. Original magnification × 400.

Figure 6.2 Schematic overview of adenine metabolism. In APRT deficiency, adenine cannot be converted to adenosine monophosphate and is instead converted by xanthine dehydrogenase to 2,8-dihydroxyadenine. AMP, adenosine monophosphate; APRT, adenine phosphoribosyltransferase; HPRT, hypoxanthine-guanine phosphoribosyltransferase; IMP, inosine monophosphate; XDH, xanthine dehydrogenase. Source: Edvardsson et al. 2013 [3]. Reproduced with kind permission from Springer Science and Business Media.

Chapter 9

Figure 9.1 Simplified cell models of the mechanisms of H+ secretion, bicarbonate absorption, and ammoniagenesis by the proximal tubular cell (orange part of the schematic nephron) and H+ secretion by the α-intercalated cell of the distal tubule and collecting duct cells (blue part of the schematic nephron).

Figure 9.2 Responses to the short oral ammonium chloride and furosemide plus fludrocortisone tests of urinary acidification are compared in normal subjects and patients with known dRTA. Source: Walsh 2007 [12]. Reproduced with permission of John Wiley & Sons Ltd.

Figure 9.3 The pattern of change in the relationship between plasma or serum bicarbonate concentration and urine pH in normal subjects (in black), patients with proximal RTA (pRTA in red) and distal RTA (dRTA in blue); see text for details. Source: Rodriguez-Soriano 1969 [16]. Reproduced with permission of Annual Review Inc.

Figure 9.4 Bone formation in dRTA and the response to alkali therapy. Source: Adapted from Domrongkitchaiporn 2002 [18] and Domrongkitchaiporn 2001 [19].

Figure 9.5 (a) Plain X-ray of a male with a reduced eGFR and autosomal dominant (complete) dRTA showing typical bilateral medullary nephrocalcinosis. (b) Non-contrast CT scan of a young male with autosomal recessive (complete) dRTA with late-onset deafness showing nephrocalcinosis (and dilated ureter – asterisk). Both patients had recurrent calcium phosphate (high urine pH) stones. (c) Young boy with inherited tropical (complete) dRTA and rickets which is rarely seen in the Western form. Source: (c) Khositseth 2012 [10]. Reproduced with permission of Oxford University Press.

Chapter 10

Figure 10.1 (a)Triamterene stones. (b) Cross-section of indinavir stone exhibiting a typical radial loose structure. (c) Indinavir plate-forming crystals in urine as seen by polarizing microscopy. (d) Atazanavir stone of pale yellow-orange color. (e) Atazanavir stone section. (f) Asymmetrical aggregate made of needle-shaped crystals of N-acetylsulfadiazine in urine (polarized light). (g) Small aggregates of crystals made of ceftriaxone calcium salt weakly birefringent in urine. (h) Calculi made of ceftriaxone calcium salt spontaneously passed in a child.

Chapter 11

Figure 11.1 Suggested management algorithm for patient with renal colic.

Chapter 12

Figure 12.1 Treatment selection for renal calculi.

Chapter 14

Figure 14.1 Algorithm for management of obstructive hydronephrosis.

Chapter 15

Figure 15.1 Endoscopic view of a classic “Jack stone” within the bladder (calcium oxalate).

Figure 15.2 Proper endoscopic position of the 1000 µm laser fiber in contrast with the stone. The fiber is properly positioned just outside the scope to prevent scope or lens damage. The green fiber insulation is just visible. Note the lithotripsy has just started.

Figure 15.3 Fragmentation is being performed by laser lithotripsy approaching the stone’s center and protecting the bladder by the outer stone shell.

Chapter 16

Figure 16.1 (a) Anterior view of left renal pelvicalyceal endocast from an injection-corrosion technique. (b) Schematic of left renal endocast with anatomical labels. cc, complex calyx; f, calyceal fornix; i, infundibulum; Mc, major calyx; mc, minor calyx; P, renal pelvis; sc, single calyx. Source: Sampaio FJB, Zanier JFC, Aragao AHM et al. Intrarenal access:3-dimensional anatomical study. J Urol. 1992: 148:1769–73. Reproduced with permission of Elsevier.

Figure 16.2 Proper adjustment of the fluoroscopic image at the start of the procedure is essential. Orientate the picture on the screen so that it corresponds exactly to the way the patient is lying and from the perspective the surgeon is looking at the patient.

Figure 16.3 (a) Puncture technique with the patient in the 30º up prone position. (b) Rotate the fluoroscopic arm from 90º to 30º to provide the target calyx and depth of penetration.

Figure 16.4 (a) Posterior and longitudinal view of right kidney demonstrating an incorrect puncture through the calyceal infundibulum (arrow). This puncture should not be done due to the risk of vascular injury. (b) Superior and transverse view of the right kidney also illustrating the incorrect puncture approach into the right calyceal infundibulum. Source: Smith’s Textbook of Endourology, 3rd edn. Oxford: John Wiley & Sons Ltd, 2012. Reproduced with permission of John Wiley & Sons Ltd.

Figure 16.5 (a) Posterior and longitudinal view of right kidney demonstrating a puncture through the calyceal fornix (arrow). This puncture is safe and provides minimal risk of vascular injury. (b) Superior and transverse view of the right kidney also illustrating a puncture approach into the right calyceal fornix. Source: Smith’s Textbook of Endourology, 3rd edn. Oxford: John Wiley & Sons Ltd, 2012. Reproduced with permission of John Wiley & Sons Ltd.

Figure 16.6 Posterior view of a left renal endocast and intrarenal arteries and veins. A, renal artery; V, renal vein; U, ureter. Source: Sampaio, FJB, Uflanker R, eds. Renal Anatomy Applied to Urology, Endourology and Interventional Radiology. Thieme, 1993. Reproduced with permission of Thieme Publishing Group.

Figure 16.7 A renal diagram depicting the intrarenal structures. aa, arcuate artery; ia, interlobar (infundibular) artery; Ra, renal artery; sa, segmental artery. Source: Sampaio, FJB, Uflanker R, eds. Renal Anatomy Applied to Urology, Endourology and Interventional Radiology. Thieme, 1993. Reproduced with permission of Thieme Publishing Group.

Figure 16.8 Kumpe catheter Source: Cook Urological Inc., Reproduced with permission of Cook Urological Inc, Bloomington, IN, USA.

Figure 16.9 Cobra catheter Source: Cook Urological Inc., Reproduced with permission of Cook Urological Inc, Bloomington, IN, USA.

Figure 16.10 Docimo Mini-PERC

TM

Entry set Source: Cook Urological Inc., Reproduced with permission of Cook Urological Inc, Bloomington, IN, USA.

Figure 16.11 Calyceal anatomy with an upper pole access sheath and ureteral catheter in position.

Chapter 18

Figure 18.1A pressure waveform measured at the focus of an electrohydraulic lithotripter (Dornier HM3). Source: Cleveland 2007 [6]. Reproduced with permission of PMPH- USA.

Figure 18.2 The focusing design of a Dornier HM3 electrohydraulic lithotripter. A spark plug is located at the focus (F1) of an ellipsoidal reflector. Energy from the spark plug is reflected and focused to the second focus of the ellipsoidal reflector (F2). Source: Cleveland 2007 [6]. Reproduced with permission of PMPH- USA.

Figure 18.3 The two focusing mechanisms employed in electromagnetic lithotripters. (a) In a Siemens or Dornier lithotripter, a membrane is driven by a coil to produce a plane wave, which is then focused by an acoustic lens. (b) In a Storz lithotripter, a coil excites a cylindrical membrane, which generates a wave that is focused by a parabolic reflector. Source: Cleveland 2007 [6]. Reproduced with permission of PMPH- USA.

Figure 18.4 Fundamental principles for a piezoelectric lithotripter. Piezoceramic elements are placed onto the surface of a sphere. The wave will focus to the center of the radius of curvature of that sphere. Source: Cleveland 2007 [6]. Reproduced with permission of PMPH- USA.

Chapter 19

Figure 19.1 Indications of URS for the treatment of upper tract stones according to size and location.

Figure 19.2 The ReTrace (Coloplast); the unique side slit in the internal sheath allows easy placement of a safety wire.

Figure 19.3 (a) Hand-held bulb pump irrgiation device (Traxer Flow, Rocamed). (b) Automated pressure and temperature system.

Figure 19.4 Various types of flexible ureteroscopes. URF-V and DUR-D are digital flexible ureteroscopes. Absent from this picture is the Storz Flex XC digital scope.

Figure 19.5 Fiberoptic and digital (bottom three) flexible ureteroscopes.

Figure 19.6 Comparison of the quality of a fiberoptic image (Storz Flex X2) with three digital flexible ureteroscopes.

Figure 19.7 View from a nephroscope of a laser fiber exiting from a flexible ureteroscope. When the fiber is barely visible on the ureteroscope view (top green arrow), the fiber has already safely the working channel exited (bottom green arrow). Visualizing the laser fiber well ensures a safe distance from the ureteroscope (red arrows).

Chapter 20

Figure 20.1  (a) Semi-rigid ureteroscopes (single channel and dual channel). (b) Flexible ureteroscope. Source: Grasso M. 2006 [16]. Reproduced with permission of Karl Storz.

Figure 20.2  (a) Simultaneous placement of laser and basket through a two-channel semi-rigid endoscope. (b) Placement of an accessory device (Passport balloon) into a lower pole system using a flexible ureteroscope

Figure 20.3  Two 60 cc syringes of normal saline irrigant, connected through a three-way stopcock to Luer-Lock extension (i.e. arterial line) tubing.

Figure 20.4  Relocation of lower pole intrarenal calculi to more cephalad location where larger diameter laser fibers can be employed, increasing the efficiency of stone. Source: Grasso M. 2006 [16]. Reproduced with permission of Karl Storz.

Figure 20.5 The obstructing distal ureteral calculus – the two-guidewire technique. (a) Fluoroscopic illustration of impacted distal ureteral stone. (b) Fluoroscopic illustration of two-wire technique. (c) Ureteroscopic view of Zebra wire. (d) Ureteroscopic view of two-wire technique. (e) Ureteroscopic view of impacted ureteral stone ready for lithotripsy.

Figure 20.6 (a) Large upper pole partial staghorn calculus in cystinuric patient. (b) Completion retrograde pyelogram post staged ureteroscopic treatment.

Figure 20.7 (a) Large obstructing lower pole uric acid stone. (b) Placement of two wires. (c) 5 F Cobra catheter positioned with its tip in the lower pole employed for irrigant inflow, and a single pigtail stent (e.g. 6 or 8 F in diameter) positioned centrally used for outflow drainage. (d) Fluoroscopic view of irrigation system.

Chapter 21

Figure 21.1  (a) The ultrasound scan starts posteriorly.The surface marking helps to orient the scanned portion in relation to the surrounding structure. (b) The probe is scanned anteriorly. The first calyx to be seen is the posterior calyx. (c) The ultrasound-guided puncture can be done either with or without a puncture guide. (d) The optimal needle path should follow the dotted line traversing along the cup of the calyx, the infundibulum and thereafter into the renal pelvis.

Figure 21.2  The patient is in prone position. The position of the needle is confirmed on zero position of the C-arm and thereafter in 30º and craniocaudal position of the C-arm.

Figure 21.3  Access needles, two part and three part.

Figure 21.4  (a) Metal serial dilator. These are available from 9 F to 24 F. The assembly resembles a collapsed radio antenna. The rod is 6 F and the knob is 9 F. (b) Amplatz dilators are available up to 30 F. The assembly includes a plastic cannula and a Cobra catheter. (c) The balloon dilators are 53 cm in length and 7.3 F in diameter. (d) The fully inflated dilator.

Figure 21.5  (a,b) The three varieties of graspers: triflange, biflange and alligator. (c) The nephrostomy catheters include re-entry catheter, Nelaton catheter and Council tip Foley catheter.

Chapter 22

Figure 22.1 Percutaneous access through a lower pole calyx with the wire and a catheter manipulated down the ureter.

Figure 22.2 Perc N Circle® Nitinol Tipless Stone Extractor. Source: Cook Medical.

Figure 22.3 Ultrasonic lithotripter with suction attachment.

Figure 22.4 Pediatric nephroscope 17 F. Source: Karl Storz, Tuttlingen, Germany.

Figure 22.5 Installation of sealant at the conclusion of a “tubeless” percutaneous nephrolithotomy.

Figure 22.6 Horseshoe kidney with percutaneous nephrostomy tube in the left midpole calyx.

Figure 22.7 Right upper pole calyceal diverticulum seen on retrograde pyelogram.

Figure 22.8 Miniscope. Source: Karl Storz, Tuttlingen, Germany.

Chapter 23

Figure 23.1 Anatrophic nephrolithotomy. Source: www.netterimages.com. Netter illustration used with permission of Elsevier, Inc. All rights reserved.

Figure 23.2(a) Renal stone in a posterior calyceal diverticulum which makes a PNL approach more favorable. (b) The narrow diverticular neck is visualized by the contrast passively filling the diverticulum, precluding a retrograde access.

Figure 23.3 Algorithm for managing renal stones located in calyceal diverticula.

Figure 23.4 Open ureterolithotomy. Source: www.netterimages.com. Netter illustration used with permission of Elsevier, Inc. All rights reserved.

Chapter 24

Figure 24.1 Stone-free rate in patients with and without stent before ESWL. Source: Shen P, Jiang M, Yang J et al. 2011 [17]. Reproduced with permission of Elsevier.

Figure 24.2 Fluoroscopy demonstrating the simultaneous combination of antegrade and retrograde endoscopy.

List of Tables

Chapter 2

Table 2.1 Analytes to be measured in 24-h urine collections.

Table 2.2 Variability of 24-h urine chemistries between two consecutive collections.

Chapter 7

Table 7.1 Random urine solute-to-creatinine ratio by age

Table 7.2 Normal values for the 24 h excretion of urinary solutes associated with kidney stone formation*

Chapter 8

Table 8.1 Biochemical profile of hypercalcemic and hyperparathyroid conditions

Chapter 10

Table 10.1 Drug-related urolithiasis in our laboratory (1995–2012)

Chapter 11

Table 11.1 Causes of renal colic

Chapter 12

Table 12.1 Results with untreated renal calculi

Chapter 17

Table 17.1 Nomogram table for boys predicting the cumulative probability of stone-free status according to number of treatment sessions

Table 17.2 Nomogram table for girls predicting the cumulative probability of stone-free status according to number of treatment sessions

Table 17.3 Comparison of ESWL and ureteroscopy for treatment of ureteral stones in children

Chapter 20

Table 20.1 Ureteroscopic management of upper urinary tract calculi >2 cm

Table 20.2 Irrigant choice for intrarenal irrigation

Chapter 23

Table 23.1 Summary of open and laparoscopic renal calculi surgeries

Table 23.2 Summary of open and laparoscopic ureteric and bladder calculi surgeries

Chapter 24

Table 24.1 Staghorn calculi treatment – overall outcomes. Modified from AUA guidelines on management of staghorn calculi

Chapter 25

Table 25.1 Complications of ureterorenoscopy

Guide

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Urinary Stones

Medical and Surgical Management

Edited by

Michael Grasso, MD

Professor and Vice Chairman

Department of Urology

New York Medical College

Valhalla, NY, USA

David S. Goldfarb, MD, FASN

Clinical Chief, Nephrology Division

NYU Langone Medical Center;

Professor of Medicine and Physiology

New York University School of Medicine

New York, NY, USA

This edition first published 2014 © 2014 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Urinary stones : medical and surgical management / edited by Michael Grasso III, David S. Goldfarb.p. ; cm.Includes bibliographical references and index.ISBN 978-1-118-40543-7 (cloth)I. Grasso, Michael, III, editor of compilation. II. Goldfarb, David S., editor of compilation. [DNLM: 1. Urinary Calculi–therapy. 2. Urinary Calculi–prevention & control. WJ 140]RC916616.6′22–dc232013041992

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: Courtesy of Dr Michael GrassoCover design by Meaden Creative

List of Contributors

Sachin Abrol, MSResident in UrologyMuljibhai Patel Urological HospitalNadiad, Gujarat, India

Ahmed Alasker, MD, FRCS(C)Endourology, Robotic and Laparoscopy FellowAlbert Einstein College of MedicineMontefiore Medical CenterBronx, NY, USA

Bobby Alexander, MDFellowDivision of EndourologyLenox Hill HospitalNew York, NY, USA

John R. Asplin, MD, FASNMedical Director, Litholink Corporation;Clinical AssociateDepartment of MedicineUniversity of ChicagoChicago, IL, USA

Demetrius H. Bagley, MD, FACSThe Nathan Lewis Hatfield Professor of UrologyProfessor of RadiologyDepartment of UrologyThomas Jefferson UniversityPhiladelphia, PA, USA

Michael S. Borofsky, MDChief Resident in UrologyNew York University Langone Medical CenterNew York, NY, USA

Kai-wen Chuan, MDChief ResidentThe Arthur Smith Institute for UrologyNorth Shore-Long Island Jewish Health SystemNew Hyde Park, NY, USA

Michael J. Conlin, MDAssociate ProfessorPortland VA Medical Center;Department of UrologyOregon Health & Science University/Portland VA Medical CenterPortland, OR, USA

Angela M. Cottrell, FRCS (Urol), MBBS, BSc, Dip Clin EdSpecialist Registrar, UrologyDerriford HospitalPlymouth Hospitals NHS TrustPlymouth, UK

Michel Daudon, PhDChief of the Stone LaboratoryDepartment of Clinical PhysiologyAPHP, Tenon HospitalParis, France

Michael Degen, MDFellowDivision of Endourology and Minimally Invasive UrologyWestchester Medical Center;Department of UrologyNew York Medical College Valhalla, NY, USA

Mahesh R. Desai, MS, FRCSMedical DirectorMuljibhai Patel Urological HospitalNadiad, Gujarat, India

Sameer M. Deshmukh, MDResident in UrologyDepartment of Urologic SciencesStone Centre at Vancouver General HospitalVancouver, BC, Canada

Andrew J. Dickinson, MD, FRCSUrol, FRCSEdConsultant UrologistDerriford HospitalPlymouth Hospitals NHS TrustPlymouth, UK

Christopher M. Dixon, MDAssociateDivision of EndourologyLenox Hill HospitalNew York, NY, USA

Brian D. Duty, MDAssistant ProfessorDepartment of UrologyOregon Health & Science University/PortlandVA Medical CenterPortland, OR, USA

Vidar O. Edvardsson, MDDirector of Pediatric NephrologyChildren's Medical CenterLandspitali – The National University Hospital of Iceland;Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavik, Iceland

Brian H. Eisner, MDCo-Director of Kidney Stone ProgramDepartment of UrologyMassachusetts General HospitalHarvard Medical SchoolBoston, MA, USA

Majid Eshghi, MD, FACSDivision of Endourology and Minimally Invasive UrologyWestchester Medical Center;Department of UrologyNew York Medical CollegeValhalla, NY, USA

Andrew I. Fishman, MDAssistant Professor of UrologyDepartment of UrologyNew York Medical CollegeValhalla, NY, USA

Israel Franco, MDDirector of Pediatric UrologyMaria Fareri Children’s HospitalProfessor of UrologyNew York Medical CollegeValhalla, NY, USA

Sean Fullerton, MDAssistant ProfessorDepartment of UrologyNew York Medical CollegeValhalla, NY, USA

Arvind P. Ganpule, MS, DNBVice-ChairmanDepartment of UrologyMuljibhai Patel Urological HospitalNadiad, Gujarat, India

Reza Ghavamian, MDProfessor of Clinical UrologyChairman of UrologyAlbert Einstein College of MedicineMontefiore Medical CenterBronx, NY, USA

Jordan Gitlin, MDAttending Pediatric UrologistCohen Children’s Medical Center of New York;The Arthur Smith Institute for UrologyNorth Shore-Long Island Jewish Health SystemNew Hyde Park, NY, USA

David S. Goldfarb, MD, FASNClinical Chief, Nephrology DivisionNYU Langone Medical Center;Professor of Medicine and PhysiologyNew York University School of MedicineNew York, NY, USA

Michael Grasso, MDProfessor and Vice ChairmanDepartment of UrologyNew York Medical CollegeValhalla, NY, USA

Kelly A. Healy, MDAssistant ProfessorDepartment of UrologyThomas Jefferson UniversityPhiladelphia, PA, USA

Nicole Hindman, MDAssistant Professor of RadiologyDepartment of RadiologyNew York University Lagone Medical CenterNew York, NY, USA

David Hoenig, MDAssociate Professor of Clinical UrologyAlbert Einstein College of MedicineMontefiore Medical CenterBronx, NY, USA

Paul Jungers, MDEmeritus Professor of NephrologyParis V University;APHP, Department of NephrologyNecker HospitalParis, France

Francis X. Keeley Jr, MD, FRCS(Urol)Consultant UrologistBristol Urological InstituteBristol, UK

Nir Kleinmann, MDAttending UrologistDepartment of UrologySheba Medical CenterTel Hashomer, Israel

Abhishek Laddha, MSResident in UrologyMuljibhai Patel Urological HospitalNadiad, Gujarat, India

Dirk Lange, BSc, PhDAssistant ProfessorDepartment of Urologic SciencesUniversity of British ColumbiaVancouver, BC, Canada

Julien Letendre, MD, FRCSCFellow of EndourologyDepartment of UrologyTenon Hospital, Assistance Publique – Hôpitaux de ParisPierre et Marie Curie UniversityParis, France

John C. Lieske, MDProfessor of MedicineDivision of Nephrology and HypertensionMayo ClinicRochester, MN, USA

James E. Lingeman, MDProfessorDepartment of UrologyIndiana University School of MedicineIndianapolis, IN, USA

Naim M. Maalouf, MDAssistant Professor of MedicineDepartment of Internal Medicine and Charles andJane Pak Center for Mineral Metabolism and Clinical ResearchUniversity of Texas Southwestern Medical CenterDallas, TX, USA

Sunil Mathur, MD, FRCS (Urol)Consultant UrologistGreat Western HospitalSwindon, UK

Lesli Nicolay, MDAssistant ProfessorDivision of Pediatric UrologyLoma Linda University Medical CenterLoma Linda, CA, USA

Runolfur Palsson, MDChief, Division of NephrologyLandspitali – The National University Hospital of Iceland;Associate Professor of MedicineFaculty of Medicine, School of Health SciencesUniversity of IcelandReykjavik, Iceland

Jessica E. Paonessa, MDEndourology FellowDepartment of UrologyIndiana University School of MedicineIndianapolis, IN, USA

Sherry S. Ross, MDDirector of Pediatric Urology Stone ClinicDepartment of SurgeryDivision of UrologySection of Pediatric UrologyDuke University Medical CenterDurham, NC, USA

Ojas Shah, MDAssociate Professor, Director of Endourology and Stone DiseaseNew York University Langone Medical CenterNew York, NY, USA

Shonni J. Silverberg, MDProfessor of MedicineColumbia UniversityCollege of Physicians and SurgeonsNew York, NY, USA

Olivier Traxer, MD, PhDProfessor of UrologyDepartment of UrologyTenon Hospital, Assistance Publique – Hôpitaux de ParisPierre et Marie Curie UniversityParis, France

Robert J. Unwin, PhD, FRCP, FSB, CBiolProfessor of Nephrology and PhysiologyHead of Centre and Research Department of Internal Medicine UCLUCL Centre for NephrologyUniversity College London Medical SchoolLondon, UK

Marcella Donovan Walker, MD, MSAssistant Professor of MedicineColumbia UniversityCollege of Physicians and SurgeonsNew York, NY, USA

Stephen B. Walsh, PhD, MRCPClinical Senior Lecturer in Experimental Medicine/Honorary Consultant NephrologistUCL Centre for NephrologyUniversity College London Medical SchoolLondon, UK

Oliver M. Wrong, DM, FRCPFormer Emeritus Professor of MedicineUCL Centre for NephrologyUniversity College London Medical SchoolLondon, UK

Preface

The natural history of urinary calculi reflects a spectrum of clinical presentations, some with a benign course but many others with the potential for severe and often catastrophic outcomes. Urinary calculi frequently are the sequelae of major underlying metabolic disorders, which if left untreated are regularly associated with recurrent stone events with the ultimate potential for renal parenchymal loss. It is the co-ordination of both surgical intervention to remove obstructing concretions and improve drainage, and the simultaneous application of novel medical therapies employed to alter the underlying hypermetabolic disorder that ultimately changes the natural history of this morbid ailment.

As Editors of this book we represent varied perspectives on stone management, with 18 years of daily collaboration treating the most complex hypermetabolic stone formers. We created the first multimodality stone center in New York and continue to regularly care for patients together. This collaborative spirit of endourology and nephrology has led to a broad spectrum of innovative therapies, many of which will be presented in this text. Our chapter authors reflect international thought leaders in urinary stone management, each offering unique insight into patient evaluation and specific therapies.

We, the editors and authors, are fundamentally committed to improving patient care by developing and employing new treatments, and by encouraging and nurturing the next generation of providers through fellowship training and scholarly efforts. We have always believed and taught that nephrologists need to more fully understand the surgical management of stone disease in order to counsel their patients, and urologists who understand metabolic stone disorders will offer their patients a higher and more attractive level of service.

This text is designed to be a resource for the practitioner when confronted with a challenging clinical presentation. There is an orderly division of chapters: patient assessment, imaging, surgical interventions, and medical therapies. The underlying theme, however, is collaboration of implementation – mixing and matching therapies as required by the presented clinical variables. For example, a patient who presents with urinary tract obstruction and with urosepsis during systemic chemotherapy for acute leukemia requires input from many areas to craft a comprehensive treatment plan. The emergency renal drainage algorithm in the surgical section is promptly applied. Varied interventions as necessary are employed next to clear the stone burden, with subsequent additional medical therapies to treat the underlying hyperuricosuria and minimize future episodes.

It is our intention to offer a user-friendly resource to the clinician. Various treatments are presented with regard to indications, technical nuances, complications, continuity of care, and preventive measures. It is our hope that through efforts like this text, comprehensive collaborative treatment centers will grow, employing many of the tenets described herein.

Michael Grasso

David S. Goldfarb