Rare Diseases Symptoms Automatic Extraction
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Retrograde transureteral approach: a safe and efficient treatment for recurrent cystine renal stones.
[cystinuria]
Most
patients
presenting
cystinuria
require
multiple
urological
procedures
during
their
lifetime
.
In
this
kind
of
patients
the
availability
of
minimally
invasive
procedure
represents
an
advantage
of
minimizing
the
cumulative
morbidity
of
several
repeated
treatments
.
Herein
we
report
our
experience
using
ureterorenoscopy
(
URS
)
for
the
treatment
of
recurrent
renal
cystine
stones
.
From
2003
to
2007
,
10
patients
(
4
males
and
6
females
)
with
one
or
multiple
recurrent
renal
cystine
stones
underwent
URS
.
Overall
,
21
procedures
have
been
performed
.
Mean
maximum
diameter
of
stones
was
11
.
2
mm
(
range
5
-
30
mm
)
.
Either
8
-
9
.
5
F
semirigid
or
7
.
9
F
flexible
ureteroscopes
were
used
.
In
6
cases
,
stones
were
removed
using
a
basket
;
in
9
procedures
laser
lithotripsy
with
flexible
scope
was
performed
;
in
6
cases
renal
calculi
were
pulled
down
in
the
ureter
using
flexible
instrument
and
then
shattered
with
laser
introduced
by
semirigid
instrument
.
Stone
-free
status
was
defined
as
the
absence
of
any
residual
fragment
.
A
complete
stone
clearance
was
obtained
in
15
out
of
21
procedures
(
71
%
)
.
In
5
cases
(
24
%
)
significant
residual
fragments
occurred
;
in
the
remaining
case
(
5
%
)
URS
was
ineffective
.
In
5
out
of
these
unsuccessful
procedures
,
stone
clearance
was
obtained
with
auxiliary
treatments
.
The
last
patient
has
not
been
treated
yet
.
No
major
complications
occurred
as
a
result
of
the
procedures
.
URS
offers
excellent
advantages
in
case
of
recurrent
hard
calculi
such
as
cystine
stones
.
Minimally
invasive
procedures
allow
satisfactory
outcomes
,
improving
patients
'
quality
of
life
.