Three cases or urethral diverticulum in the female, one of which is complicated by stone formation, were reported. Although these patients were diagnosed by routine physical examination, further postvoiding films and endosopy studies indicated to know accurate size, location, extension and contents of the diverticulum. The transvaginal diverticulectomy was performed and postoperative complications did not arise.
Diverticulum* ; Female* ; Humans ; Physical Examination ; Postoperative Complications

Humans ; Intestinal Obstruction/etiology* ; Meckel Diverticulum/complications*

Cardiomyopathies ; complications ; Diverticulum ; complications ; Hematoma ; complications ; Humans ; Male ; Middle Aged

OBJECTIVETo study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum.

METHODSWe retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus.

RESULTSThe patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream.

CONCLUSIONProstate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.

Adult ; Calculi ; complications ; Diverticulum ; complications ; Humans ; Male ; Prostatic Diseases ; complications ; Urinary Bladder, Neurogenic ; complications

PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has more advantages than conventional common bile duct surgery, but the use of this route for stone removal and biliary drainage remains controversial. The goal of this study was to investigate the usefulness of LCBDE in patients who had been failed in the endoscopic stone extraction. METHODS: From November 2005 to August 2008, 52 patients underwent LCBDE due to failure of endoscopic stone extraction in Chungnam National University Hospital. Clinical data were collected and analyzed retrospectively. RESULTS: Duodenal diverticulum (23 cases, 44.2%) was the most common cause in failure of endoscopic stone extraction and large common bile duct stone 12 cases (23.1%), previous upper gastrointestinal operation 10 cases (19.2%) were followed. Twenty four patients did not have preoperative biliary drainage, such as PTBD, ENBD, PTGBD. Forty-five patients (86.5%) of the 52 participating patients underwent LCBDE successfully, but 7 cases resulted in open surgery for the following reasons: 3 cases of severe intraabdominal adhesions, 3 cases of stone impaction in ampulla portion, and 1 case of a remnant stone. External biliary drainage was performed in 41 cases with T-tube (31 cases, 68.9%), PTBD (7 cases, 15.6%), ENBD (3 cases, 6.7%). The stone clearance of LCBDE was 95.6%. Remnant stone weredetected in 2 cases (4.4%) and removed with choledochoscope via external biliary drain. Postoperative complications happened in 5 cases (9.5%). Procedure related complications happened in 2 cases (3.8%). CONCLUSION: LCBDE is useful technique in patients with failed endoscopic stone extraction, and biliary drainage may be necessary for detection and removal of latent remnant CBD stones.
Common Bile Duct ; Dioxolanes ; Diverticulum ; Drainage ; Fluorocarbons ; Humans ; Postoperative Complications

Aged ; Deglutition Disorders ; etiology ; Humans ; Male ; Zenker Diverticulum ; complications ; pathology

Giant Meckel's diverticulum is a very rare lesion and its association with a congenital diaphragmatic hernia has not been reported previously. We report a case of newborn with a giant Meckel's diverticulum and congenital diaphragmatic hernia. A large round atypical air-filled bowel segment was found by chest radiography preoperatively, and a giant Meckel's diverticulum was located within the left hemithorax during surgery.
Hernia, Diaphragmatic/*complications/congenital/*pathology ; Human ; Infant, Newborn ; Male ; Meckel Diverticulum/*complications/*pathology/surgery

A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Case Report ; Diverticulum/*complications/diagnosis ; Human ; Male ; Rectal Fistula/*complications/diagnosis ; Urethral Diseases/*complications/diagnosis

Choledochoduodenal fistula (CDF) occurring simultaneously with pancreaticoduodenal fistula is extremely rare. CDF has known to be a chronic sequela of cholelithiasis, but it is unknown whether pancreaticoduodenal fistula results from chronic cholelithiasis as well. We report a case of cholelithiasis accompanied with choledochoduodenal and pancreaticoduodenal fistula opening into small suprapapillary diverticulum in a 80-year-old woman.
Aged, 80 and over ; Biliary Fistula/*complications ; Cholelithiasis/complications ; Common Bile Duct Diseases/*complications ; Diverticulum/*complications ; Duodenal Diseases/*complications ; Female ; Humans ; Intestinal Fistula/*complications ; Pancreatic Fistula/*complications

PURPOSE: The developments and advances in extracorporeal shock wave lithotripsy and endourological procedures have greatly diminished the need for open surgery in the treatment of renal and ureteral stones. We reviewed our experience of open stone surgery to determine current indications and efficacy of this treatment modality. MATERIALS AND METHODS: We undertook a review of hospital and office charts, operative records, and pertinent radiographic studies of all patients that had undergone open stone surgery from May 1986 to June 2001 at a single tertiary university hospital. Of 5,533 procedures performed for stone removal, 355 were open surgical procedures (6.4%), these included ureterolithotomy in 215 (60.6%), pyelolithotomy in 50 (14.1%), anatrophic nephrolithotomy in 43 (12.1%), and nephrectomy in 47 (13.2%). RESULTS: The indications for open surgery were complex stone burden (61%), failure of extracorporeal shock wave lithotripsy or endourological treatment (9%), other co- operation (10.4%) and anatomical abnormalities, such as: ureteropelvic junction obstruction, infundibular stenosis and/or renal caliceal diverticulum (6.5%). Stone free rate, following surgery, was 90.7%. All patients had minor postoperative complications that were resolved with appropriate therapy. CONCLUSIONS: Open stone surgery continues to be a reasonable alternative modality for a small proportion of patients with urinary stones. Those patients with large urinary stone, failed less invasive method, anatomical abnormality and serious medical diseases would be recommended for open stone surgical correction.
Constriction, Pathologic ; Diverticulum ; Humans ; Lithotripsy ; Nephrectomy ; Postoperative Complications ; Shock ; Ureter* ; Ureteral Calculi* ; Urinary Calculi