Urinary citric acid reduces urinary saturation of calcium oxalate and phosphate salts by forming complexes with calcium and retards crystallization of stone forming salts. Hypocitraturia, important factor in stone formation, has been 19-63% of stone patients in various reports. We measured the 24 hour excretion of citric acid. calcium and calcium/citric acid ratio in 100 renal stone patients and 30 healthy controls. The results were as follows: 1. The 24-hour urinary excretion of citric acid was lower in stone patients than in controls, but statistically insignificant (P>0.05). 2. The 24-trour urinary excretion of calcium was higher in stone patients significantly than in Controls (P<0.05). 3. In stone patients, hypocitraturia showed in 19 patients (19%), hypercalciuria in 22 patients (22%). 4. The 24-hour urinary excretion of citric acid had positive correlation with 24-hour urinary excretion of calcium in stone patients (P<0.05) 5. Urinary calcium/citric acid ratio was significantly higher in stone patients than in controls (P<0.05). As results, urinary calcium/citric acid ratio was more significant than the amount of citric acid in stone patients, furthermore it seems to be a useful measure for stone formation and recurrence.
Calcium ; Calcium Oxalate ; Citric Acid* ; Crystallization ; Humans ; Hypercalciuria ; Recurrence ; Salts

Wilms' tumor is malignant renal tumor, originated from undifferentiated mesonephric blastema. Adult Wilms' tumor, unlike that of childhood, is a rare disease and a total of l67 cases have been reported in the world medical literature until 1980. Diagnosis of adut Wilms` tumor is very difficult preoperatively and the pathologic hallmark is the presence of abortive or embryonal glomerulotubular structure with an immature spindle cell stroma. The therapeutic guidelines and surgical principles that govern childhood Wilms' tumor should be applied to adult Wilms' tumor. We reported a case of Wilms' tumor developed in 34 year-old male patient complaining of right flank pain with gross hematuria for 2 months.
Adult* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Male ; Rare Diseases ; Wilms Tumor*

Stamey endoscopic suspension of bladder neck is a reliable technique among various surgical techniques with high success rate and little morbidity. We treated 8 patients complaining of urinary incontinence with Stamey operation from February 1988 to May 1990 and Follow-up for over 6 months. The results as follows; 1. Patients varied in age from 31 to 63 (mean;45) years. All patients were multiparous average 2.87 (2-4) times of previous deliveries 2. All patients showed frequency and nocturia. Severities of incontinence were Grade I in2 patients, Grade II in 5, Grade III in 1 3. No significant changes were identified between preoperative and postoperative urethral pressure profiles. 4. On preoperative lateral cystourethrograms, bladder base was descended about -2.10+-0.74cm from SCIPP line and elevated about +1.2 cm+/-0.49 cm from SCIPP line on postoperative lateral cystourethrograms. 5. Incontinence was disappeared in 7 patients, but 1 patients was recurred due to rupture of suture material during lifting heavy material.
Female* ; Follow-Up Studies ; Humans ; Lifting ; Neck ; Nocturia ; Rupture ; Sutures ; Urinary Bladder ; Urinary Incontinence*

Early in the experience of ESWL, steinstrasse was recognized as potential complication and suggestions for management were proposed. including retrograde ureteral manipulation. placement of ureteral stent or percutaneous nephrostomy, etc. Recently ESWL has been challenged due to less invasive and safer procedure. We experienced 18 cases (2.1%) of steinstrasse in 850 patients with ESWL (EDAP LT-01) from February, 1989 to February, l99l and treated with ESWL. The results were obtained as follows. 1. The primary stones in 18 cases of steinstrasse were renal stones in l7 cases (complete staghorn calculi; 4 cases. partial staghorn calculi; 5 cases) and upper ureteral stone in 1 case: 2. The sites of steinstrasse were lower ureter in 13 cases and upper ureter in 5 cases. The lengths of steinstrasse were 1.4~8.3cm (mean: 3.19cm). The site and length of steinstrasse were not related with clinical symptoms. 3. Of l8 cases. 13 cases were type 1. 3 cases type II and 2 cases type III. Type of steinstrasse was not related with clinical symptoms. 4. Six cases were asymptomatic and 3 cases of symptomatic steinstrasse required hospitalization. 5. Fifteen cases were treated with ESWL only and 2 cases of solitary kidney were treated with ESWL, after percutaneous nephrostomy. Early experienced 1 case was treated with ureteroscopic removal of stone. 6. Of 17 cases treated with ESWL, stone fragments expelled out within 1 month in 13 cases, 2 months in 3 cases and 4 months in 1 case of solitary kidney. All symptoms of steinstrasse were relieved within 3 days after ESWL.
Calculi ; Hospitalization ; Humans ; Kidney ; Nephrostomy, Percutaneous ; Stents ; Ureter

Ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia is a very rare developmental abnormality. Clinical manifestations consists of dysuria, hematuria, recurrent epididymitis. ejaculatory pain and perineal discomfort and the diagnosis is made by seminal vesiculogram through vas deference. Surgical excision of the seminal vesicle and the ectopic ureter is the best choice or treatment in this entity. We present a case of 34 year old infertile man with ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia and contralateral cryptorchidism.
Adult ; Cryptorchidism ; Diagnosis ; Dysuria ; Epididymitis ; Hematuria ; Humans ; Male ; Seminal Vesicles* ; Ureter*

Caliceal diverticula are eventrations of the upper collecting system lying within the renal parenchyma and communicating with renal pelvis or a calyx through a narrow channel. The incidence on a routine IVP is approximately 0.21 to 0.45 percent and stone formation in a caliceal diverticulum has arised from 9.5 to 50 percent. Traditionally, treatment has included nephrotomy with extraction of the calculi and percutaneous nephrolithotripsy, but more recently ESWL has been challenged due to less invasive and safer procedure. We report the results of 11 patients with calculi in caliceal diverticula treated with EDAP LT-01 lithotriptor. All patients were followed during 2-11 months (average in 6.6) The results were obtained as follows ; 1. The symptoms were included chronic vague flank pain in seven, acute renal colic in two, epigastric discomfort in one and incidentally diagnosed in one. 2. The location of diverticula were upper third in seven, mid third in three and lower third of kidney in one. The stone size showed under 10mm in seven, 11-20mm in three and over 21mm in one. 3. The average numbers of treatment were 2.2 sessions and average storage was 102. 4. The complete success rate in 63.6 % (stone free rate in 45.5 %) and partial success rate in 27.2% were showed. 5. The complete relief of symptom was in eight (72.7% ), partial in one (9.1%) and persistent symptom in two (18.2 9t ). 6. Complication was showed only gross hematuria for 1 day in 63.6 %, but all patients recovered with conservative treatment. Therefore, the possibility of producing a satisfactory result (relief of symptom in 81.1%) and the low morbidity of ESWL suggest that this treatment may be appropriate for calculi in caliceal diverticuli.
Calculi* ; Deception ; Diverticulum* ; Flank Pain ; Hematuria ; Humans ; Incidence ; Kidney ; Kidney Pelvis ; Renal Colic

ESWL is clearly an effective noninvasive treatment for a wide variety of urinary tract calculi. However, numerous clinical and experimental reports present evidence that ESWL can cause acute and chronic complications, especially new onset hypertension. We evaluated that relationship between hypertension and plasma renin activity with follow-up of 1 month after one session ESWL and round that 3.1% of patient showed new onset hypertension. The plasma renin activity was slightly elevated 24 hours after ESWL, but by 1 month after procedure the renin had decreased to near pre-ESWL level. However. these data represented no statistically significant change (p>0.05). Therefore, we believed that at the moment no relation between plasma renin activity and hypertension at least early period of post-ESWL (1 month).
Calculi ; Follow-Up Studies ; Humans ; Hypertension ; Plasma* ; Renin* ; Urinary Tract

The 46, XX male or sex-reversal syndrome is a rare entity, which may be reported first by de la Chapelle and associates in 1964, an additional 135 cases have been recognized, yet only 20 percent of these patients have been diagnosed during childhood. The 46, XX male may be associated with hypogonadism and infertility in adult, and occasionally, sexual ambiguity in the neonate. At least 10% of patients have had hypospadia or ambiguous external genitalia. The 46, XX male was diagnosed with cytogenic study, H-Y antigen, hormonal study testicular biopsy, radiologic study. Here, we report a case of 19 month-old child XX-male with hypospadia and chordee.
46, XX Testicular Disorders of Sex Development* ; Adult ; Biopsy ; Child ; Female ; Genitalia ; H-Y Antigen ; Humans ; Hypogonadism ; Hypospadias ; Infant ; Infant, Newborn ; Infertility ; Male

Seminal vesicle cysts are rare. Since the first case of a seminal vesicle cyst was reported by Zinner in 1914, about 20 cases have been reported in literature up to 1976. They are presented at the age of high sexual activity. They may be asymptomatic and discovered by rectal examination or may manifest with symptoms of bladder irritation, perineal or testicular pain, pain on ejaculation, etc. Here, we report a case of seminal vesicle cyst in a 38 years-old-man who was admitted under the impression of pelvic abscess.
Abscess ; Ejaculation ; Male ; Seminal Vesicles* ; Sexual Behavior ; Urinary Bladder

A total of 17 children with 24 renoureteral units underwent 58 treatment with EDAP LT-01 extracorporeal shock wave lithotripsy for urinary tract stones between January 4, 1989 and January 30, 1993. The patients were followed for over two months. The results were obtained as follows ; 1. The distribution of sex was 9(53%) in male and 8(47%) in female. The average patient age was 7 years with a range of 6 months to 16 years. 2. The location of stones were kidney in l8 cases( 75.0%) ; calyx in 10 (41.7% ) and renal pelvis in 8(33.3% ) and ureter in 6(25.0%) ; upper ureter in 2(8.3%) and lower ureter in 4( 16.7%). There were multiple renal stone in 4 and bilateral renal stone in 2. The average stone length was 9mm with a range of 3 to 10mm. 3. Of the 13 patients whose age was less than 10 years, 11(84.6%) required intravenous Ketamine anesthesia. Two patients whose age was more than 10 years and two patients less than 10 years were treated without any type of anesthesia. 4. The average numbers of treatment were 2.1 session and the average storage required was 19.4 in one session The average treatment time was 39.7 minutes. 5. The total average success rate was 87.5% 6. All of the patients were not the pre- and post- ESWL additional manipulation. ESWL complications did not require admission and surgical management. Therefore, we conclude that EDAP LT-01 is an effective and easy procedure for treatment of urinary stones in children.
Anesthesia ; Child* ; Female ; Humans ; Ketamine ; Kidney ; Kidney Pelvis ; Lithotripsy* ; Male ; Shock* ; Ureter ; Urinary Calculi