PMID: 22555043May 5, 2012Paper

Ureteroscopy in patients with coagulopathies is associated with lower stone-free rate and increased risk of clinically significant hematuria

International Braz J Urol : Official Journal of the Brazilian Society of Urology
Mohamed A ElkoushySero Andonian

Abstract

Patients with coagulopathy are at increased risk of peri-operative hemorrhage. The aim of the present study was to compare ureteroscopy (URS) in these high risk patients to those with normal bleeding profile. Twelve patients with coagulopathies (Group I) undergoing 17 URS were included in the study [3 for biopsy of ureteral lesions and 9 for Holmium Laser Lithotripsy (HLL)]. A patient had Child B (MELD 11) cirrhosis, 6 patients were on warfarin, 3 patients on ASA, 1 patient on ASA and clopidogrel, and the last patient was on heparin. URS in Group I was performed without correction of coagulopathy. Group II consisted of 32 patients with normal bleeding profile who underwent 34 URS concurrently. Group I included 4 ureteral biopsies in 3 patients with suspicious ureteral lesions and 13 URS for HLL in 9 patients with nephrolithiasis. There were no significant differences between the two groups in terms of patient age, sex, percent of renal stones, median operative and fluoroscopy times. When compared with Group II, Group I had significantly larger median stone size (9.2 vs. 14.0 mm, p = 0.01) and significantly lower stone-free rate after fi rst URS (94.1% vs. 69.2%, p=0.04). However, after second URS, stone-free rates were comparab...Continue Reading

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Citations

Jun 26, 2014·World Journal of Urology·Guido GiustiPierpaolo Graziotti
Dec 13, 2012·Journal of Endourology·Ahmet TefekiJean de la Rosette
Sep 6, 2012·Journal of Endourology·Jean de la RosetteStavros Gravas
Sep 13, 2012·Angiology·Jolanta MalyszkoMaciej Banach
Sep 12, 2012·Expert Opinion on Pharmacotherapy·J Seth Hawkins, Deborah A Wing
Jul 16, 2013·Bioengineered·Kerry Joan O'ConnellDouwe van Sinderen
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May 13, 2014·RSC Advances·Megan E GodseyKam W Leong
Aug 8, 2014·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Richard Hellman

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