Handbook of Urology

Drug Therapy of Urinary Calculi and Prevention of Recurrence.- I. Introduction.- II. General Preventive Measures.- III. Special Preventive and Therapeutic Measures.- 1. Calcium Oxalate Calculi (Mono- and Dihydrates).- a) Diet and Fluid Intake: Quantity and Choice of Drinks.- b) Drug Therapy of Calcium Oxalate Lithiasis.- c) Calcium Oxalate Stones: Drug Therapy and Recurrence Prevention.- 2. Infective Calculi.- 3. Uric Acid Stones: Treatment, Recurrence Prevention, Oral Chemolysis.- a) Diet, Fluid Intake and Choice of Drinks in Uric Acid Lithiasis.- b) Preventive Drug Treatment of Uric Acid Lithiasis.- 4. Urate Calculi.- a) Sodium Hydrogenurate Monohydrate.- b) Ammonium Hydrogenurate.- 5. The Treatment of Cystine Calculi.- a) Cystinuria Diets and Associated Problems.- b) Fluid Intake, Volume, and Composition.- c) Drug Treatment of Cystine Stones.- d) Chemical Conversion of Cystine to Cysteine.- 6. The Treatment of Rare Stones.- a) Xanthine Lithiasis.- IV. Childhood Urolithiasis.- 1. Dietary and Medical Treatment of Oxalosis and Hyperoxaluria.- 2. Dietary and Medical Treatment of Cystinuria.- a) Disorders of Purine Metabolism.- b) Renal Tubular Acidosis.- 3. General Comments on the Drug Treatment of Juvenile Urolithiasis.- V. Conclusion.- References.- The Treatment of Ureteric Colic and Promotion of Spontaneous Passage.- I. Introduction.- II. Pathophysiology.- 1. Innervation of the Ureter.- 2. Urodynamics of Obstruction.- III. The Treatment of Colic (Initial Analgesia).- 1. Metamizole (Novaminsulfone).- 2. Pentazocine.- 3. Morphine.- IV. Passage of the Stone.- 1. Spasmoanalgesia.- 2. Extended Spasmoanalgesia.- 3. Herbal Remedies.- 4. Adjuvant Therapy.- a) Anti-Edematous Drugs.- b) Increased Diuresis.- c) Physical Activity.- V. Complications of Conservative Treatment.- 1. Urinary Obstruction.- 2. Infection.- References.- Surgical Treatment of Renal Calculi.- I. Introduction.- II. The Classification of Kidney Stones.- III. The Indication for Surgery.- IV. Preoperative Investigations and Patient Preparation.- V. Surgical Access to the Kidney.- 1. The Modified Posterior Lumbotomy Incision.- 2. The Supracostal Approach.- 3. The Anterior Approach.- 4. Access for Recurrent Disease.- VI. Pyelolithotomy.- 1. Simple Pyelolithotomy.- 2. Coagulum Pyelolithotomy.- 3. Extended Pyelolithotomy (Intrasinusal Pyeloinfundibulotomy).- References.- Ischemia and Regional Hypothermia in Renal Stone Surgery.- I. Introduction.- II. Renal Ischemia.- III. Drug-Mediated Prolongation of Renal Ischemia Tolerance.- IV. Increasing Ischemia Tolerance by Hypothermia.- References.- Radial Nephrolithotomy Under Ultrasound and Doppler Probe Control.- I. Introduction.- II. Preoperative Investigation.- III. Apparatus.- 1. Doppler Probe.- 2. The B-Scanner.- IV. Practical Application.- 1. Sterilization.- 2. Exposing the Kidney.- 3. Intraoperative Ultrasonography.- 4. Limitations of B-Scanning.- a) Stone Surface and Density.- b) Air.- c) Scars.- d) Urine, Clots.- e) Vasculature.- 5. Doppler Ultrasonography.- a) Limitations of Doppler Ultrasonography.- 6. Siting the Nephrotomy.- 7. Making the Nephrotomy.- V. Results.- References.- Intraoperative Pyeloscopy.- I. Introduction.- II. Rigid Nephroscopes.- III. Flexible Nephroscopes.- 1. Equipment.- 2. Technique.- a)Inspection.- b) Stone Extraction.- c) Indication of a Nephrotomy Site.- IV. Results.- V. Complications.- References.- Intraoperative Radiology.- I. Introduction.- II. X-Ray Equipment.- 1. Stationary or Mobile X-Ray Sets.- 2. Renodor.- 3. The C-Arm Image Intensifier.- 4. Film Stock and Intensifying Screens.- 5. Polaroid Film.- a) Packing and Sterilizing Film Material.- III. Aids to Intraoperative Radiology.- IV. Alternative Techniques.- References.- Percutaneous Manipulation of Renal Calculi.- I. Introduction.- II. Anatomical Considerations.- III. Percutaneous Access.- 1. Patient Preparation.- 2. Patient Positioning.- 3. Imaging Guidance.- 4. Puncturing the Kidney.- 5. Tract Dilatation.- 6. Nephrostomy Tubes.- IV. Nephroscopy.- 1. Rigid Nephroscopes.- 2. Flexible Nephroscopes.- V. Mechanical Stone Extraction.- VI. Intrarenal Stone Disintegration.- 1. Mechanical Disintegration.- 2. Ultrasonic Lithotripsy.- 3. Electrohydraulic Lithotripsy.- 4. Microexplosion Lithotripsy.- 5. Stone Disintegration by Laser Irradiation.- VII. Percutaneous Chemolysis.- VIII. Results and Complications.- IX. The Choice of Treatment.- References.- The Instrumentation and Surgery of Ureteric Calculi.- I. Introduction.- II. History.- III. Significance of Symptoms.- IV. Investigations.- V. Spontaneous Passage and Size of Stone.- VI. Stone Removal.- 1. Retrograde Techniques Under X-Ray Control.- a) Indications.- b) Technique.- c) Other Techniques.- d) Ureteric Stone Disintegration Under Radiologie Control.- 2. Ureterorenoscopy.- a) Technique.- b) Endoscopy.- c) Eliminating the Stone.- d) Aftercare.- e) Complications.- f) Results.- 3. Antegrade Removal.- 4. Shockwave Lithotripsy.- 5. Open Surgery.- References.- Treatment of Bladder Stones.- I. Surgical Removal of Bladder Stones.- 1. Historical Perspective.- a) Perineal Lithotomy.- b) Suprapubic Lithotomy.- c) Transurethral Lithotresis.- d) Litholapaxy.- 2. Indications.- a) Patient Selection.- b) Anesthesia.- c) Prerequisites.- d) Contraindications.- e) Conclusion.- II. Techniques of Litholapaxy.- 1. The Ultrasonic Lithotrite.- a) Definition of Ultrasound.- b) The Effect of Ultrasound on Urinary Calculi.- c) The Instrument.- d) The Technique of Ultrasound Litholapaxy.- e) Technical Reliability of the Lithotrite.- f) The Complications of Ultrasonic Litholapaxy.- g) Conclusion.- 2. Electrohydraulic Litholapaxy.- a) Definition of Electrohydraulic Shockwaves.- b) Principle of the Operation.- c) Instrumentation.- d) Technique of Electrohydraulic Lithotresis.- e) Reliability.- f) Complications.- g) Contraindications.- h) Conclusion.- 3. Microexplosion Cystolithotresis.- a) Definition and Physical Principles of Microexplosion Cystolithotresis.- b) Experimental Studies.- c) Instrumentation.- d) Clinical Experience and Complications.- e) Conclusion.- 4. Viewing Litholapaxy.- 5. Blind Litholapaxy.- 6. Combined Transurethral and Suprapubic Litholapaxy.- 7. Unusual Transurethral Techniques.- a) The Stone Basket.- b) The Proctoscope.- 8. Suprapubic Cystotomy.- 9. Pregnancy and Litholapaxy for Bladder Calculi.- 10. Conservative Treatment.- 11. Drug Therapy for Bladder Calculi (Cystolitholysis).- 12. Stones in Conduits.- References.- Treatment of Urethral Stones.- I. Prevalence.- II. Pathogenesis.- III. Symptomatology and Diagnosis.- IV. Treatment.- References.- Extracorporeal Shockwave Lithotripsy (ESWL) in the Treatment of Kidney and Ureter Stones.- I. Introduction.- 1. Method.- 2. Fundamentals.- 3. Shockwaves - Ultrasonic Waves.- II. Shockwave Generation and Focussing.- 1. Equipment.- 2. Stone Localization.- 3. Respiratory Mobility.- 4. Procedure.- 5. Trial Runs.- 6. Anesthesia.- 7. Shockwave Exposure.- 8. ECG Triggering.- 9. Readjustment During Treatment.- III. Subsequent Treatment After ESWL.- 1. Results.- 2. Auxiliary Procedures.- 3. Renal Function.- IV. Indications.- l.Infected Stones.- 2. Stone Size.- 3. High-Risk Patients.- 4. Ureteric-Stone Patients.- 5. Obstruction and Noncontrastive Stones.- V. Conclusion.- References.- Preventive Measures.- I. The Role of Prevention in the Management of Urolithiasis.- II. Risk Factors and Persons at Risk.- 1. Nutrition.- 2. Metabolic Disorders.- 3. Drugs.- 4. Infection and Outflow Obstruction.- 5. Occupation and Environment.- 6. Calculating the Risk of Stone Formation.- III. Health Education and Behavior Patterns.- References.