ipl-logo

Calculi Case Studies

3292 Words14 Pages

ABSTRACT
BACKGROUND AND OBJECTIVES
Ureteral calculi has emerged as a global health issue. It is usually described as a loin acute pain radiating to the groin. Almost 20% of urinary stones are found in the ureters with majority (70%) being located in lower third of the ureter. The life time risk of developing urinary calculi is between 5 and 12%, affecting more men compared to women.
Various management options include- medical expulsion therapy (MET), extracorporeal shock wave lithotripsy (ESWL) and invasive therapies (ureteroscopy). Until 1980s, open surgical procedures were the mainstay of treatment of ureteric stone. In the last three decades, the management of urinary stone has undergone revolutionary change. Tamsulosin a selective alpha …show more content…

Patients were followed for 7 to 10 days.
RESULTS:
In the study there were 46 males [24 in Group 1 and 22 in Group 2] and 14 Females [6 in Group 1 and 8 in Group 2]. The mean age of Group 1 was 43.20 ± 13.8 and mean age of group 2 was 40.27 ± 17.7. There was no significant difference in the sex and mean age between two groups.
In the study during the follow up 32 subjects expelled the calculi within 4-5 days, of which 26 were in Tamsulosin group and 6 were in Non Tamsulosin group.
This observation was statistically significant at 0.0001. Hence it can be said that with Tamsulosin treatment expulsion of distal ureteric calculi was higher than when compared to fluids with NSAID.

INTERPRETATION AND CONCLUSION:
Tamsulosin can be used as the first line of management for uncomplicated symptomatic distal ureteric calculi. It is effective and safe. Most of the patients treated with tamsulosin expelled the calculi within short duration. Keywords: Ureteric stones, Alpha 1 blocker, Tamsulosin, …show more content…

The transport of stones from the kidney into the bladder and their movement through the ureter is accompanied by 3 basic factors -- 1) spasm of smooth muscles 2) submucosal edema and 3) Pain
In the transport of stones, the greatest obstacle is usually the terminal part of the ureters, mainly in the intra mural ‘detrusor tunnel’. Stones of size 4 mm or smaller pass spontaneously, although this is not without discomfort and expense to the patient. Ureteral calculi are often associated with renal obstruction conservative or active management should be carefully chosen to prevent irreversible damage to the kidney while choosing.
Interventional treatments comprise - medical expulsive therapy (MET), extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy, ureteroscopy and laparoscopic/open stone removal. Research to a large extent confirmed the ability of medical treatment to facilitate stone expulsion

Show More
Related
168 Words | 1 Pages

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,

Read More
941 Words | 4 Pages

Discussion Post Week ten NURS 6501, N-21 Urinary tract infections (UTIs) are usually caused by bacteria and are common. Symptoms of both upper and lower infections are similar; therefore, it is important for advanced practice nurses (APNs) to be able to determine the pathophysiology of upper and lower UTIs. The purpose of this discussion is to evaluate the similarities and differences between upper and lower UTIs, clinical manifestations, treatments, and factors affecting all of these things. UTIs are infections that may occur anywhere in the urinary tract such as the urethra, bladder, ureters, and kidneys. Typically UTIs are caused by bacteria from the gut flora and are inflammation of the urinary epithelium.

Read More
610 Words | 3 Pages

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

Read More
542 Words | 3 Pages

The next system I dissected was the respiratory system. My first task was to find the trachea as well as the esophagus. My goal was to compare the structure of each. I found the trachea to be wider, stronger, and it had a bumpy surface. The structure of the esophagus is small, but versatile which allows it to move easily.

Read More
460 Words | 2 Pages

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.

Read More
487 Words | 2 Pages

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

Read More
752 Words | 4 Pages

According to ANA, (2014) there are three areas to improve evidence-based clinical care to reduce the rate of CAUTI. Avoidance of inappropriate short term catheter use will assist to reduce foley insertions and utilization. A selection assessment and evidence based management tools used to help nurses manage patients with urinary retention and incontinence. A nurse driven protocol gives emphasis to timely remove urinary catheters. Urinary catheter care during placement is crucial to ensure aseptic technique is not broken during

Read More
1320 Words | 6 Pages

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

Read More
918 Words | 4 Pages

Indwelling catheters are also used in assisting the healing of open sacral or perineal wounds in incontinent patients with a stage III or IV pressure ulcer on the coccyx or sacrum. Prolonged immobilization

Read More
246 Words | 1 Pages

Our patient reported having urinary issues and wetting the bed after taking the diuretic. We suggested he time his doses so he will know roughly around what time he will have to go bathroom. This way he will have enough time to make it to the bathroom and avoid urinating elsewhere. Another positive was explaining the indication for Gabapentin. The patient was not taking Gabapentin and was unsure what it was used for.

Read More
726 Words | 3 Pages

Kidney stones can form anywhere within the urinary tract, within the kidney, within the ureter (the tube draining urine from the kidney), or in the bladder. Kidney stones are crystalline masses that form from minerals and proteins in the urine. Kidney stones form when a change occurs in the normal balance of water, salts, minerals, and other things found in urine. These stones may contain various combination of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate.

Read More
723 Words | 3 Pages

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

Read More
785 Words | 4 Pages

5 Reasons to Wear Compression Sleeves for Recovery Should you wear compression sleeves for recovery? Are they really helpful? What are the main benefits? Come and learn more on the subject.

Read More
627 Words | 3 Pages

Five hours left. The results said that I had a kidney stone. Four hours. Eventually the pain returned. This time worse than ever.

Read More
1582 Words | 7 Pages

Even with being observant and watching for the obvious signs and symptoms of a UTI, it is important we also are aware that UTIs can be symptomatic or asymptomatic (Hälleberg Nyman, Johansson, Persson & Gustafsson, 2011). Signs and symptoms of a UTI can include frequent pain and/or burning during urination, polyuria, increased urgency, nocturia, hematuria, incontinence, and suprapubic, back, or pelvic pain (Paul, Day & Williams, 2016). UTIs need to be treated promptly to prevent renal damage, and/or potential septic shock. We also need to be aware of the different risk factors that

Read More

More about Calculi Case Studies

Related Topics

Open Document