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Flexible ureteroscopy and holmium:YAG laser lithotripsy for stone disease in patients with bleeding diathesis: a systematic review of the literature

Flexible ureteroscopy and holmium:YAG laser lithotripsy for stone disease in patients with bleeding diathesis: a systematic review of the literature
Flexible ureteroscopy and holmium:YAG laser lithotripsy for stone disease in patients with bleeding diathesis: a systematic review of the literature

Introduction and objectives: the management of urolithiasis in patients on anticoagulants presents a challenge to the endourologist. Due to multiple comorbidities, it may be impossible to safely discontinue the anticoagulant treatment. Other modalities such as shock wave lithotripsy and PCNL are contraindicated in these patients, so ureteroscopic treatment may be the only option. We conducted a systematic review of the literature to look at the safety and efficacy of ureteroscopic management in these patients.

Methods: systematic review and quantitative meta-analysis was performed using studies identified by a systematic electronic literature search from January 1990 to August 2011. All articles reporting on treatment for stones in patients with a bleeding diathesis using ureteroscopy and a Holmium:YAG laser were included. Two reviewers independently extracted the data from each study. The data was included into a meta-analysis and discussed.

Results: three studies were identified reporting on 70 patients (73 procedures). All patients had stone fragmentation using Holmium laser. The mean stone size was 13.2mm with a range of 5-35 mm. The quality of the included studies was modest. Stone free status was achieved in sixty-four patients (87.7%). There were no major complications and only 11% of the patients developed minor complications with only 4% rate of minor bleeding.

Conclusions: retrograde stone treatment using ureteroscopy and holmium laser lithotripsy can be safely performed in patients with bleeding diathesis with a low complication rate.

Anticoagulants, Disease Susceptibility, Hemorrhagic Disorders, Humans, Lasers, Solid-State, Lithotripsy, Laser, Treatment Outcome, Ureteroscopy, Urinary Calculi, Journal Article, Meta-Analysis, Review
1677-5538
298-305; discussion 306
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Monga, Manoj
9ab0c2b2-1eb2-41e5-8559-37427097dc00
Aboumarzouk, Omar M
3c7e2433-638d-4378-9931-902fdc68acce
Somani, Bhaskar K
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Monga, Manoj
9ab0c2b2-1eb2-41e5-8559-37427097dc00

Aboumarzouk, Omar M, Somani, Bhaskar K and Monga, Manoj (2012) Flexible ureteroscopy and holmium:YAG laser lithotripsy for stone disease in patients with bleeding diathesis: a systematic review of the literature. International Brazilian Journal of Urology, 38 (3), 298-305; discussion 306.

Record type: Review

Abstract

Introduction and objectives: the management of urolithiasis in patients on anticoagulants presents a challenge to the endourologist. Due to multiple comorbidities, it may be impossible to safely discontinue the anticoagulant treatment. Other modalities such as shock wave lithotripsy and PCNL are contraindicated in these patients, so ureteroscopic treatment may be the only option. We conducted a systematic review of the literature to look at the safety and efficacy of ureteroscopic management in these patients.

Methods: systematic review and quantitative meta-analysis was performed using studies identified by a systematic electronic literature search from January 1990 to August 2011. All articles reporting on treatment for stones in patients with a bleeding diathesis using ureteroscopy and a Holmium:YAG laser were included. Two reviewers independently extracted the data from each study. The data was included into a meta-analysis and discussed.

Results: three studies were identified reporting on 70 patients (73 procedures). All patients had stone fragmentation using Holmium laser. The mean stone size was 13.2mm with a range of 5-35 mm. The quality of the included studies was modest. Stone free status was achieved in sixty-four patients (87.7%). There were no major complications and only 11% of the patients developed minor complications with only 4% rate of minor bleeding.

Conclusions: retrograde stone treatment using ureteroscopy and holmium laser lithotripsy can be safely performed in patients with bleeding diathesis with a low complication rate.

Full text not available from this repository.

More information

Published date: 7 July 2012
Keywords: Anticoagulants, Disease Susceptibility, Hemorrhagic Disorders, Humans, Lasers, Solid-State, Lithotripsy, Laser, Treatment Outcome, Ureteroscopy, Urinary Calculi, Journal Article, Meta-Analysis, Review

Identifiers

Local EPrints ID: 419088
URI: https://eprints.soton.ac.uk/id/eprint/419088
ISSN: 1677-5538
PURE UUID: f411736c-d4b4-424b-95e7-e6bc29e25ef3

Catalogue record

Date deposited: 29 Mar 2018 16:30
Last modified: 13 Mar 2019 18:44

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