Urogenital/from compendium urolith paper except 1st 3 Flashcards
Ho:YAG laser uses an active-medium crystal made of ____,_____,&_____ (YAG) mixed with _________ (chromium and thulium).
yttrium, aluminum, and garnet;
Holmium
The Ho:YAG laser emits light at an infrared wavelength of ______nm.
2100 nm
Fragmentation by a thermal drilling process– the pulse of energy traveling through the fiber creates a microscopic _____ _______ on the surface of the calculus.
Vapor bubble
This microscopic “parting” of the fluid medium by an air bubble (known as the _______ effect). There is a ______ ______ that causes fragmentation
Moses; shock wave
If the fiber tip is __ mm or more away from the stone, the vapor
bubble collapses, the water or saline absorbs the energy, and no energy is transmitted to the urolith
1 mm
EHL: an ______ _______ is generated in a fluid medium, creating a cavitation bubble that generates a hydraulic shock wave.
Electric spark
EHL: The hydraulic shock wave disrupts the crystal lattice structure of the urolith via _________ forces.
Shearing
Complete urolith removal is typically achieved in ___% of dogs with urethroliths, __% to ___ % of female dogs with cystoliths, and __% to __% of male dogs with cystoliths
100-urethra
83 to 96- bladder female
68 to 81- bladder male
“In the literature”-overall
Basket retrieval can be considered in female dogs with stones < __mm, male dogs with stones < __mm, and female cats with stones < __mm
5,4,3
For Lap-assisted cystotomy, Rawlings Compendium 2009 recommended retracting a portion of ____ to suture over the bladder incision w/ the traction sutures.
Omentum
To date, the recommended laser for intracorporeal lithotripsy is the __________ laser.
Ho:YAG laser
Two types of intracorporeal lithotripsy have been described in veterinary patients?
1- Laser lithotripsy and 2- EHL
Electrohydraulic lithotripsy
Grant javma 2010: ___ % calculi remained in the bladder after cystotomy in dogs?
20
Appel javma 2008 study reported that ___% of recurrent stones in dogs were suture induced .
9.4%
complications w/cystotomy, regardless of closure method, were reported in ___% to ___% of cases, with a mean duration of hosp. of __ days. -Thieman javma 2012
37-50%… Really?! Thieman!
4 days hospitalization
List 6 minimally invasive procedures for treatment of uroliths of lower urinary tract
voiding urohydropropulsion (VUH), intracorporeal lithotripsy, extracorporeal shock-wave lithotripsy (ESWL), cystoscopic stone basket retrieval, percutaneous cysto- lithotomy (PCCL), and laparoscopic-assisted cystotomy
Adams javma 2008: Laser lithotripsy for stones in 73 dogs: Complete fragmentation of all uroliths in___% of females and ___% of males
100% females, 86.7% males
Grant JVIM 2008: 25 dogs/ laser lithotripsy for bladder and/or urethral stones. ___% were considered stone free post lith.
80%
Adams et al;complication rate/laser lithotripsy was ___% in female dogs and ____% in male dogs. (lower than those reported for cystotomy (37% to 50%) ugh! Thieman!
In the Adams et al study, the complication rate reported with laser lithotripsy was 17.9% in female dogs and 13.3% in male dogs.
Bevan -javma 2009: compared laser lith to cystotomy; conclusion regarding complication rate
NSD
Bevan javma 2009: conclusion regarding complete urolith removal rate between groups (laser lith vs cystotomy)?
NSD between dogs in the cystotomy group (86%) and
those in the lithotripsy group (89%)
Adams javma 2008:..of 73 dogs with uroliths treated by laser lithotripsy, ___% had stone recurrence after approximately 12 to 24 months of follow-up
19.1%
Defarges JVIM 2008: prospective clinical study of 28 dogs undergoing EHL: was most effective in female dogs with _____ stones and male dogs with ______ stones.
Bladder-female
Urethra- male
Defarges jvim 2008: ____ in dogs appeared to be as safe as laser lithotripsy and was associated with no major complications.
EHL
Defarges: did EHL of urethral stones cause stranguria?
No!
Runge javma 2011: PCCL in 27 dogs and cats:excellent complete stone removal rates (__%) shorter procedure times (total procedure time: __ to __ min)
96%
40-75 min
