REPLY TO THE AUTHORS: Re: Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion

To the editor,

We appreciated the valuable comments on our recent published article in the International Braz J Urol (¹, ²). We agree with the commentary, to our knowledge, these studies have shown that the complicated patients with lower tract stone were treated by endoscopic management.

In patients with reservoir stone after urinary diversion, stone management present unique challenges. In our research, 3 patients with reservoir stones following urinary diversion were treated by transurethral neo-bladder lithotripsy, and one patient had 6 mm residual stone postoperatively and received subsequently conservative watching treatment (²). Recently, percutaneous pouch access and laparoscopic techniques to facilitate the treatment of lower tract stones has become popular (³,⁴).

With the advancement of equipments and increasing experience, the surgical management of urolithiasis in patients with urinary diversion are varied, individualized consideration and comprehensive evaluation must be taken into account, which depending upon diversion type, patient fitness, stone size, stone location, available resource and surgeon experience (⁵,⁶).

• Published as Ahead of Print: April 10, 2018

REFERENCES

• ¹
  Pina IM, Floyd MS Jr, Stubington SR. Re: Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion. Int Braz J Urol. 2018;44(2):[Ahead of Print].
• ²
  Zhong F, Alberto G, Chen G, Zhu W, Tang F, Zeng G, Lei M. Endourologic strategies for a minimally invasive management of urinary tract stones in patients with urinary diversion. Int Braz J Urol. 2018;44:75-80.
• ³
  L'Esperance JO, Sung J, Marguet C, L'Esperance A, Albala DM. The surgical management of stones in patients with urinary diversions. Curr Opin Urol. 2004;14:129-34.
• ⁴
  Okhunov Z, Duty B, Smith AD, Okeke Z. Management of urolithiasis in patients after urinary diversions. BJU Int. 2011;108:330-6.
• ⁵
  Seth JH, Promponas J, Hadjipavlou M, Anjum F, Sriprasad S. Urolithiasis following urinary diversion. Urolithiasis. 2016;44:383-8.
• ⁶
  Zhong W, Yang B, He F, Wang L, Swami S, Zeng G. Surgical management of urolithiasis in patients after urinary diversion. PLoS One. 2014;9(10):e111371.

Publication Dates

• Publication in this collection
  Jul-Aug 2018

History

• Received
  29 Mar 2018
• Accepted
  30 Mar 2018