Background and Purpose:
Microperc using all-seeing needle is associated with reduce tract-related morbidity. The purpose of this study was to examine the effectiveness and safety of microperc in children.
Patients and Methods:
From July 2010 to August 2014, a total of 17 patients with renal stones underwent microperc at our institution. Renal access was achieved through 4.85-Fr (16 gauge) all-seeing needle under direct vision and fragmentation with 200 µm holmium:YAG laser fiber. The patient’s demographic data, operating time, hemoglobin drop, complications (Clavien-Dindo), and length of hospital stay were prospectively studied. A complete stone-free status or CIRF at 1 month was accepted as the criterion for final clinical success.
A total of 17 patients with a median age of 9 years were studied. The stone size ranged from 5.3mm to 24.9mm. The median operative time was 40 minutes. The median decrease in hemoglobin was 1.2 mg/dl. The stone-free rate at postoperative day 1 and 1st month was 82.4% and 88.2% respectively. The mean hospital stay was 56.4 …show more content…
The patient was monitored for postoperative complications. Ureteric catheter was removed along with Foley catheter in first post-operative day. DJ stent was removed after 4weeks. The patients were re-evaluated with KUB to assess the stone free rate at day 1 and 1-month follow up. Clearance was defined as no residual stone on KUB and ultrasound. All fragments less than 4 mm were considered clinically insignificant residual fragments (CIRF).
The patient’s demographic data, stone characteristics, stone fragmentation method, intraoperative assessment of stone fragmentation, complications (Clavien-Dindo), operating time, hemoglobin drop and length of hospital stay were prospectively studied. A complete stone-free status or CIRF at 1 month was accepted as the criterion for final clinical success.
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Justina Toland- Tennant Unit 4 Assignment Chapter 4 Exercises and Review Chapter 4: Exercise 4.26 #4 49521 Hernia repair, inguinal, incarcerated Chapter 4: Exercise 4.31 #4 50920 Fistula, closure, ureter cutaneous Chapter 4: Exercise 4.34 #10 54322 Hypospadias, repair, one stage, meatal advancement Chapter 4: Exercise 4.37 #8 58956 Hysterectomy, abdominal, total Chapter 4: Exercise 4.41 #4 61312 Craniotomy, evacuation of hematoma Chapter 4: Exercise 4.43 #8 67700-RT Incision and drainage, abscess, eyelid Chapter 4: Review: Coding for Facility # 12 11305-LT Shaving, skin lesion Appendix C: Case Number #9 52630 Prostatectomy, transurethral 9. 52601 Prostate, excision, transurethral; or Prostatectomy,
During my clinical preceptorship at New York Presbyterian Hospital, many patients that came into the hospital with urinary retention a catheter was inserted to determine the amount of urine in their bladder or post-void residual (PVR). Many patients later developed pain and a urinary tract infection or Community Acquired Infection secondary to frequent cauterization. Therefore, the gap identified was related to a knowledge deficit of the current practice that inserting a
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I write on behalf of my patient, Phil Robins, who is a sixty-five-year-old male facing acute urinary retention. Phil Robins shows several medical symptoms, including an inability to urinate, severe pain and discomfort in the lower abdomen, and bloating of the lower abdomen. My patient has been previously diagnosed with benign prostatic hyperplasia which has been obstructing his urinary tract. Because of this, he frequently has to use a catheter to empty his bladder. My main concern for Mr. Robins is the prevention of infections commonly associated with catheter use.
we discussed using a green stone and flatten bitting surface. During FB she was using the cotton pliers to retrieve wire clippings. Demonstrated how to keep the wire on the distal end cutter and explained why we want to refrain from using cotton pliers in mouth so we always have them to get into our drawers. After demonstrating to the patient how to wear rbs Discussed using
On assessment of his abdomen I noticed his lower pubic area was bulging outward, which looked very abnormal. I started to insert the Indwelling catheter and noticed that when it was fully inserted there was no urine return, but I was
Your Name Diane Burns Your Discipline Family Trainee (Spina Bifida Coalition of Cincinnati Program Manager) Name of Clinic/Type of Clinic Fetal Care Center Provider(s) Observed Beatrix Wong, MS, LGC, Erin E. Hillman, MSW, LSW, Jody Petru, BSN, RN, Sammy M. Tabbah, MD, Jamie K. Capal, MD, Howard M. Saal, MD, FACMG, DonnaMaria E. Cortezzo, MD Observed Provider(s) Discipline Genetic Counselor, Social Work, Nursing, Maternal Fetal Medicine, Neurosurgery, Geneticist, Neonatology/Palliative Care Date/Time Observation 2/6/2018 9:45 AM – 12:30 PM, 3:30 PM – 5:00 PM team meeting My observation in the Fetal Care Center was intended to follow one family (Family A) through their day of appointments, starting with the Genetic Counselor, Social Worker,
The hospital has been remarkably successful because of its ability to provide its patients a low cost, quality and quick surgery while administering an unforgettable experience and a comfortable environment to all. From the surgery techniques to the warm environment, the hospital’s success is due to a range of factors. It is physiologically attractive to patients, receiving surgery; they are also able to discuss about the receiving procedure with the previous patients to ultimately alleviate the level of anxieties. Additionally, Shouldice hospital has
These drains can be removed within one to several days. The incision may or may not have a dressing. If a dressing is used, most doctors will remove it within one to two days. There will be moderate pain with this operation, but it should be readily controlled with oral pain medication. Swelling and bruising around the operative site is common, but this resolves fairly quickly.
At Toledo Hospital I noticed that the male extern catheters have been completely changed to a new design. Upon further investigation, I found that they have done so by observing and collecting evidence that the old model was doing more harm than good. The old models were very frequently leaking and causing discomfort and skin breakdown from the adhesive as well as the leaking urine that was constantly getting on the patient’s skin. To fix the issue they completely changed the design for external catheters for men and it has been found that application is easy and there is less discomfort and urine leakage from the catheters. From even my own experience this was a great change for the patient and
Intermittent catheterization, allowing the patient to be involved in the insertion and removal of a catheter, and educating patients on the use of indwelling catheters can increase human dignity and decrease catheter associated urinary tract infections. Intermittent catheterization is when a catheter is inserted to drain the bladder and is immediately taken out once the bladder is emptied. The use of intermittent catheterization over indwelling catheterization can increase human dignity, especially in home settings, by allowing patients to have more independence in their self-care (Woodward, Steggal, & Tinhunu, 2013). Indwelling catheters contain drainage systems that can be embarrassing and inconvenient for patient’s. Intermittent catheterization gets rid of the drainage systems, allowing
This is a tough decision to make for a family member with the existing medical conditions like that of Mary's. Apparently, Mary was a very active person and self reliant in her younger days of life. However, as she aged, so did her vitality to recover from such an extensive procedure. Careful thought must be given to the fact that she has had a heart attack in the past and that she is diabetic before making this type of decision. Diabetic patients have an increased risk for problems during or after their surgery such as: infections, healing slower, and increased risk for heart
Follow-up results after 6 weeks showed no statistically significant difference in the overall stone free rate for stones sized ≤ 1cm (P=0.856) but the Mean clearance time was higher in the placebo group than tamsulosin group (P =0.523). The clearance rate for stones sized 1-2cm within 2weeks was higher in the tamsulosin group than the control group (91.7% versus 60%, respectively) it was statistically significant difference (P=0.049) but in 4 and 6 weeks shows no statistically significant difference (P =0.745), and there was no statistically significant difference as regard colic attacks, the need for analgesic , the occurrence of Steinstrasse and the need for