PURPOSE: To determine the efficacy and outcome of extracorporeal shock-wave lithotripsy (SWL) compared with ureteroscopy (URS) in the treatment of lower ureteric calculi. MATERIALS AND METHODS: The records of patients treated primarily by SWL and URS were analysed retrospectively. Treatment with SWL included 198 patients (103 men and 95 women). All patients received 2500-3000 shocks waves at a mean energy setting of 16-20kV. URS was used in 194 patients (91 men and 103 women), with 7Fr, 8Fr, 9.5Fr rigid Storz ureteroscope. All ureteroscopies were performed with the patient under general or spinal anesthesia. The outcome was assessed by stone-free rates, retreatment rates, auxiliary treatment, Efficiency quotient (EQ), complications. RESULTS: SWL and URS for lower ureteric calculi resulted in a success rate 75.3% and 95.8%, respectively. Including the number of auxiliary procedures, we calculated the Efficiency Quotient (EQ) as 66.6 for SWL and 72.3 for URS. The mean treatment time for SWL was 30 minutes and for URS 38.1 minutes. General anesthesia was more frequently needed in URS patients. Complications occurred more often in the URS group. These were mostly mild, and all could be treated with a double-J stent, antibiotics, or analgesics. A lower stone-free rate was achieved in patients with larger(> OR = 10mm) stones (56.9% vs 82.9%) for smaller stones (<10mm) in the SWL group and 90.0% vs 97.9% for smaller stones in the URS group. Compared with SWL, URS was more time consuming; entailed placement of a ureteral stent and more often led to hospitalization. On the other hand, stone clearance was rapid after URS. CONCLUSIONS: The stone-free rate after URS is much higher than after SWL. Our study demonstrates that URS is highly effective treatment option for lower ureteral stones.
Analgesics ; Anesthesia, General ; Anesthesia, Spinal ; Anti-Bacterial Agents ; Calculi ; Hand ; Hospitalization ; Humans ; Lithotripsy* ; Male ; Retreatment ; Retrospective Studies ; Shock ; Stents ; Ureter* ; Ureteroscopes ; Ureteroscopy*

The three major scrotal anomalies are bifid scrotum, penoscrotal transposition, and ectopic or accessory scrotum. Bifid scrotum occurs if the genital swellings fail to fuse at the scrotal septum. Penoscrotal transposition results from abnormal genital tubercle development. This is associated with delay in the midline fusion of the urethral folds. Ectopic and accessory scrotum result from cleavage or abnormal migration of the genital swellings. Ectopic scrotum is extremely rare. His right scrotum was normal in position and size, and contained a normal palpable testis. The penis was showed externally normal appearance. At operation it was possible to excise the scrotal wall, preserving the vas deferens and the testicular vessels. Accessory scrotum has not been recorded in Korea. We experienced a case of unilateral ectopic scrotum and a case of accessory scrotum.
Korea ; Male ; Penis ; Scrotum* ; Testis ; Vas Deferens

The idiopathic calcinosis of the scrotum is multiple and asymptomatic nodules of scrotal skin which can onset either in childhood or early adulthood. It increases in size and number, while breakingdown to discharge chalky contents on occasions. We report a case of a 68-year-old-man who was effectively treated with a simple excision of the affected skin with an idiopathic scrotal calcinosis. There is no family history of scrotal calcification. Histopathologically, multiple nodules showed the epidermal cyst with partially degenerated wall and calcium deposits with a foreign body reaction in the dermis in this case. In most reported cases, some intact epidermal cysts are also present, and dystrophic calcification, and possible inflammation and rupture of epidermal cysts regarded as be the main pathogenetic mechanism of the disease.
Calcinosis* ; Calcium ; Dermis ; Epidermal Cyst ; Foreign-Body Reaction ; Humans ; Inflammation ; Rupture ; Scrotum* ; Skin