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By Stephen Y. Nakada, Margaret S. Pearle

Top nationwide and overseas urologists within the box of endourology describe average and complicated endoscopic techniques for treating upper-tract pathology. The authors supply step by step directions for the most recent endoscopic strategies, starting from higher urinary tract calculi and strictures to urothelial melanoma. An accompanying DVD comprises movies that in actual fact illustrate severe components of the innovations and supply tips and tips from the specialists. complicated Endourology: the whole medical advisor bargains working towards urologists and urology citizens not just a complete, illustrated advisor to endourological techniques-particularly the extra complicated procedures-but additionally a pragmatic potential to extend the diversity and scope of the approaches they practice.

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42. 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.

An alternative method is to place a ureteral dilating balloon alongside the stent, partially inflate it and deflate it causing the stent to adhere to the deflated balloon. The stent is removed as the deflated balloon is slowly withdrawn under close fluoroscopic observation taking special care to avoid ureteral avulsion or damage to the ureteral orifice (88,89). These maneuvers are best performed with the patient under neuroleptic or general anesthesia. There are also reports that stents may migrate distally or even retrogradely into the kidney (88,90,91).

There is also further evidence in an animal model that a longer duration of stenting results in more ureteral fibrosis and thus, a higher rate of failure (57). These studies demonstrate that 2 and 4 weeks of stenting with a 14/7-Fr endopyelotomy stent result in the same success rates following endopyelotomy. Likewise, the ideal stent diameter is still a matter of debate as sizes from 7- to 27-Fr have been shown to produce equal results. Malignant Ureteric Obstruction Malignant extramural compression of the ureter causing hydronephrosis and renal compromise may be a consequence of many nongenitourinary cancers.

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