Multi-institutional assessment of ureteroscopic laser papillotomy for chronic flank pain associated with papillary calcifications

Yehoshua Gdor, Stephen Faddegon, Amy Krambeck, William W. Roberts, Gary J. Faerber, Joel M H Teichman, James E. Lingeman, J. Stuart Wolf

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose We evaluated the long-term safety, efficacy and durability of ureteroscopic laser papillotomy for chronic flank pain associated with renal papillary calcifications. Materials and Methods We reviewed the medical records of all patients who underwent ureteroscopic laser papillotomy in the absence of free urinary calculi at our institutions from 1998 through 2008. Success was defined as patient report of significant pain relief. The duration of response was considered the time from papillotomy to repeat papillotomy in the same renal unit, patient report of recurrent pain or final followup. Results Ureteroscopic Ho:YAG laser papillotomy was done a total of 176 times in 65 patients, including 147 unilateral and 29 bilateral procedures. Of the patients 39 underwent multiple procedures (2 to 12). Symptomatic followup was available in 50 patients (146 procedures) during a mean of 38 months. Significantly less pain was reported after 121 procedures (83%). The mean duration of response per procedure was 26 months and 30 patients (60%) had a mean remission duration of greater than 1 year. Postoperatively hospital admission was required after 14 procedures (8%). There was no significant change in the mean estimated glomerular filtration rate during a mean 41.3-month followup. Seven of the 65 patients (11%) had hypertension before papillotomy. In 3 of the 49 patients (6.1%) with adequate followup new hypertension developed during a mean of 38 months. Conclusions Ureteroscopic laser papillotomy is safe and effective. In patients with papillary calcifications and characteristic chronic, noncolicky pain this procedure provides significant, moderately durable symptom relief.

Original languageEnglish (US)
Pages (from-to)192-197
Number of pages6
JournalJournal of Urology
Volume185
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Flank Pain
Chronic Pain
Lasers
Pain
Hypertension
Kidney
Urinary Calculi
Solid-State Lasers
Glomerular Filtration Rate
Medical Records

Keywords

  • Kidney
  • Lasers
  • Pain
  • Solid state
  • Ureter
  • Urinary calculi

ASJC Scopus subject areas

  • Urology

Cite this

Multi-institutional assessment of ureteroscopic laser papillotomy for chronic flank pain associated with papillary calcifications. / Gdor, Yehoshua; Faddegon, Stephen; Krambeck, Amy; Roberts, William W.; Faerber, Gary J.; Teichman, Joel M H; Lingeman, James E.; Wolf, J. Stuart.

In: Journal of Urology, Vol. 185, No. 1, 01.2011, p. 192-197.

Research output: Contribution to journalArticle

Gdor, Yehoshua ; Faddegon, Stephen ; Krambeck, Amy ; Roberts, William W. ; Faerber, Gary J. ; Teichman, Joel M H ; Lingeman, James E. ; Wolf, J. Stuart. / Multi-institutional assessment of ureteroscopic laser papillotomy for chronic flank pain associated with papillary calcifications. In: Journal of Urology. 2011 ; Vol. 185, No. 1. pp. 192-197.
@article{83359795a6ae491aac015954f4064492,
title = "Multi-institutional assessment of ureteroscopic laser papillotomy for chronic flank pain associated with papillary calcifications",
abstract = "Purpose We evaluated the long-term safety, efficacy and durability of ureteroscopic laser papillotomy for chronic flank pain associated with renal papillary calcifications. Materials and Methods We reviewed the medical records of all patients who underwent ureteroscopic laser papillotomy in the absence of free urinary calculi at our institutions from 1998 through 2008. Success was defined as patient report of significant pain relief. The duration of response was considered the time from papillotomy to repeat papillotomy in the same renal unit, patient report of recurrent pain or final followup. Results Ureteroscopic Ho:YAG laser papillotomy was done a total of 176 times in 65 patients, including 147 unilateral and 29 bilateral procedures. Of the patients 39 underwent multiple procedures (2 to 12). Symptomatic followup was available in 50 patients (146 procedures) during a mean of 38 months. Significantly less pain was reported after 121 procedures (83{\%}). The mean duration of response per procedure was 26 months and 30 patients (60{\%}) had a mean remission duration of greater than 1 year. Postoperatively hospital admission was required after 14 procedures (8{\%}). There was no significant change in the mean estimated glomerular filtration rate during a mean 41.3-month followup. Seven of the 65 patients (11{\%}) had hypertension before papillotomy. In 3 of the 49 patients (6.1{\%}) with adequate followup new hypertension developed during a mean of 38 months. Conclusions Ureteroscopic laser papillotomy is safe and effective. In patients with papillary calcifications and characteristic chronic, noncolicky pain this procedure provides significant, moderately durable symptom relief.",
keywords = "Kidney, Lasers, Pain, Solid state, Ureter, Urinary calculi",
author = "Yehoshua Gdor and Stephen Faddegon and Amy Krambeck and Roberts, {William W.} and Faerber, {Gary J.} and Teichman, {Joel M H} and Lingeman, {James E.} and Wolf, {J. Stuart}",
year = "2011",
month = "1",
doi = "10.1016/j.juro.2010.08.081",
language = "English (US)",
volume = "185",
pages = "192--197",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Multi-institutional assessment of ureteroscopic laser papillotomy for chronic flank pain associated with papillary calcifications

AU - Gdor, Yehoshua

AU - Faddegon, Stephen

AU - Krambeck, Amy

AU - Roberts, William W.

AU - Faerber, Gary J.

AU - Teichman, Joel M H

AU - Lingeman, James E.

AU - Wolf, J. Stuart

PY - 2011/1

Y1 - 2011/1

N2 - Purpose We evaluated the long-term safety, efficacy and durability of ureteroscopic laser papillotomy for chronic flank pain associated with renal papillary calcifications. Materials and Methods We reviewed the medical records of all patients who underwent ureteroscopic laser papillotomy in the absence of free urinary calculi at our institutions from 1998 through 2008. Success was defined as patient report of significant pain relief. The duration of response was considered the time from papillotomy to repeat papillotomy in the same renal unit, patient report of recurrent pain or final followup. Results Ureteroscopic Ho:YAG laser papillotomy was done a total of 176 times in 65 patients, including 147 unilateral and 29 bilateral procedures. Of the patients 39 underwent multiple procedures (2 to 12). Symptomatic followup was available in 50 patients (146 procedures) during a mean of 38 months. Significantly less pain was reported after 121 procedures (83%). The mean duration of response per procedure was 26 months and 30 patients (60%) had a mean remission duration of greater than 1 year. Postoperatively hospital admission was required after 14 procedures (8%). There was no significant change in the mean estimated glomerular filtration rate during a mean 41.3-month followup. Seven of the 65 patients (11%) had hypertension before papillotomy. In 3 of the 49 patients (6.1%) with adequate followup new hypertension developed during a mean of 38 months. Conclusions Ureteroscopic laser papillotomy is safe and effective. In patients with papillary calcifications and characteristic chronic, noncolicky pain this procedure provides significant, moderately durable symptom relief.

AB - Purpose We evaluated the long-term safety, efficacy and durability of ureteroscopic laser papillotomy for chronic flank pain associated with renal papillary calcifications. Materials and Methods We reviewed the medical records of all patients who underwent ureteroscopic laser papillotomy in the absence of free urinary calculi at our institutions from 1998 through 2008. Success was defined as patient report of significant pain relief. The duration of response was considered the time from papillotomy to repeat papillotomy in the same renal unit, patient report of recurrent pain or final followup. Results Ureteroscopic Ho:YAG laser papillotomy was done a total of 176 times in 65 patients, including 147 unilateral and 29 bilateral procedures. Of the patients 39 underwent multiple procedures (2 to 12). Symptomatic followup was available in 50 patients (146 procedures) during a mean of 38 months. Significantly less pain was reported after 121 procedures (83%). The mean duration of response per procedure was 26 months and 30 patients (60%) had a mean remission duration of greater than 1 year. Postoperatively hospital admission was required after 14 procedures (8%). There was no significant change in the mean estimated glomerular filtration rate during a mean 41.3-month followup. Seven of the 65 patients (11%) had hypertension before papillotomy. In 3 of the 49 patients (6.1%) with adequate followup new hypertension developed during a mean of 38 months. Conclusions Ureteroscopic laser papillotomy is safe and effective. In patients with papillary calcifications and characteristic chronic, noncolicky pain this procedure provides significant, moderately durable symptom relief.

KW - Kidney

KW - Lasers

KW - Pain

KW - Solid state

KW - Ureter

KW - Urinary calculi

UR - http://www.scopus.com/inward/record.url?scp=78650024475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650024475&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2010.08.081

DO - 10.1016/j.juro.2010.08.081

M3 - Article

C2 - 21074798

AN - SCOPUS:78650024475

VL - 185

SP - 192

EP - 197

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -