PURPOSE: The objective of this study were to evaluate the location of ureteral stones and the diameter of the ureter in patients with renal colic. MATERIALS AND METHODS: We retrospectively reviewed the records of 95 consecutive patients who presented to the emergency department with renal colic in whom urinary stones were diagnosed by computed tomography between January 2009 and August 2009. The size and location of the stones were investigated. The length and diameter of unaffected ureters were also measured. RESULTS: The mean size of the stones was 4.87+/-3.49 mm (range, 0.9-22 mm). Stones were located at ureterovesical junction (UVJ) in 44 cases (46.3%), proximal ureter in 29 (30.5%), distal ureter in 16 (16.8%), ureteropelvic junction (UPJ) in 5 (5.2%), and the ureter crossing external iliac vessel (UEIV) in 1 case (1%). The mean length of the ureter was 226.8+/-20.8 mm (range, 175-286 mm). The mean diameter of the ureter was 3.40+/-0.61 mm (range, 1.9-5.3 mm). The mean diameter of the UEIV was 3.28+/-0.59 mm (range, 2.2-5.3 mm). CONCLUSIONS: The UPJ and UEIV were not common sites of ureteral stones. The smaller the stones, the closer to the UVJ that the stones were located. Spontaneous passage of the stones was most frequently observed for stones in the UVJ. The UEIV was not significantly narrower than the other parts of the ureter.
Colic ; Emergencies ; Glycosaminoglycans ; Humans ; Renal Colic ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Urinary Calculi

PURPOSE: The aim of this study was to evaluate the effect of tamsulosin on expulsion of ureteral stones after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Seventy-six patients(39 with upper ureteral stones and 37 with lower ureteral stones) treated with ESWL for stones <10mm were randomly divided into two groups. Tamsulosin(0.2mg orally once daily) was administered to group 1; group 2 received no medications. All patients were evaluated with respect to the number of episodes of ureteral colic, the expulsion rates of stones after ESWL, and the mean number of sessions of ESWL until complete expulsion of stones. RESULTS: The complete expulsion rates of upper and lower ureteral stones did not differ significantly between groups 1 and 2 during each session of ESWL; however, the mean session of ESWL was lower in group 1 than in group 2. For upper ureteral stones, 1.8 sessions were necessary per patient in group 1, while 2.3 sessions were required for the patients in group 2(p=0.039). For lower ureteral stones, 2.0 sessions were necessary per patient in group 1, while 2.9 sessions were required for the patients in group 2(p=0.032). There were significant decreases in the number of episodes of pain in group 1 with lower ureteral stones(p=0.014). There were no side effects associated with tamsulosin. CONCLUSIONS: The use of tamsulosin in the treatment of upper and lower ureteral stones after ESWL can decrease the mean number of sessions of ESWL and the number of episodes of pain, but cannot improve the expulsion rate. Further research regarding the cost-effectiveness of tamsulosin after ESWL is needed.
Calculi ; Humans ; Lithotripsy ; Renal Colic ; Shock ; Sulfonamides ; 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

PURPOSE: The most important step for patients who come to the emergency department with ureter stones is acute pain management. There have been insufficient studies on what factors affect acute pain management for ureteral colic the most. In this study, patients with ureteral colic were divided into two groups: one group, in which the pain was first managed with an analgesic, and another group with unmanaged pain, to find factors that most affect additive analgesics administration for ureter stones. METHODS: There were 121 patients, eventually confirmed for the presence of ureter stones through a computed tomography CT scan, included in this study. When ureter stones were suspected after the initial patient evaluation, initial pain was assessed through numerical rating scale (NRS) and the first analgesic was administered once. Pain was reassessed through NRS after 30 minutes. At that time, if the pain was managed, the patient was assigned to Group 1. If the pain persisted, another analgesic was administered for the second and third time, and the patient was assigned to Group 2. Finally, ureter stones were identified through CT scan. RESULTS: There were 58 patients (47.9%) in Group 1 and 63 patients (52.1%) in Group 2. There were no statistically significant differences in average age, serum creatinine, size of ureter stone, and severity of hematuria between the two groups. The differences in NRS measured initially and after 30 minutes were statistically significant (7.6+/-1.4 vs. 8.6+/-1.2, p<0.001; 1.4+/-1.3 vs. 6.6+/-1.9, p<0.001, respectively). The presence of hydronephrosis and perirenal edema were also statistically significant (p<0.001, p=0.007). The affecting factor for the administration of additive analgesics was hydronephrosis (odds ratio 7.213, p<0.001). CONCLUSION: Hydronephrosis is an important factor in the treatment of patients with additive analgesics. It can also be used as a predictive index to assess the severity of pain in patients with ureter stones.
Acute Pain ; Analgesics ; Creatinine ; Edema ; Emergencies ; Hematuria ; Humans ; Hydronephrosis ; Renal Colic ; Ureter ; Urolithiasis

During 5 years, from January 1976 to December 1980, clinical observation on management of ureteral stones was made on 169 admitted patients with ureter stones. Following results were obtained. 1) Among total 1054 in-patients, 169 cases (16.0%) had ureteral stones, and male to female ratio was 2 : 1. 2) Patients with 20-40 of his age was half. 3) On seasonal distribution, it was most prevalent on Summer. 4) 113 cases were located on lower ureter, and laterality was even. 5) Most common symptoms were renal colic and hematuria (91.8%) 6) Ureterolithotomy was done in 127 cases. In 86 cases of lower ureter stones, less than 1cm in size. conservative fluid therapy and cystoscopic extraction was successful in 44 cases. 7) Post-operative complications were urinary leaking (16 cages), wound infection(12 cases), hematuria (3 cases), ureteral stricture (1 case), and pyelonephritis (1 case).
Constriction, Pathologic ; Female ; Fluid Therapy ; Hematuria ; Humans ; Male ; Pyelonephritis ; Renal Colic ; Seasons ; Ureter* ; Wounds and Injuries

PURPOSE: The authors evaluated of the efficacy of Genestone 190 lithotriptor (Genemed company) for the treatment of the patients with urinary calculi. MATERIALS AND METHOD: From August, 1995 to February, 1997, Seventy patients with venal stones and 103 patients with ureteral stones underwent SWL using fluoroscopy targeting, under intramuscular analgesics. Characteristics of site and size of stones, number of SWL sessions according to the size of stones, success rate according to site or size of stones, and their complications were analysed. RESULTS: The cumulative stone-free rates of first, second, and third SWL session of renal stones were 47%, 74%, and 86% and the cumulative stone-free rates of ureter stones were 65%, 79%, and 87% respectively. As the size of urinary calculi increased, the numbers of SWL sessions increased, but, the success rates were reduced. Success rate of calyx stone was lower than that of pelvis and multiple stone. Post-SWL complications were transient gross hematuria in 161 cases, steinstrasse in 18 cases, renal colic in 15 cases, and fever in one case. CONCLUSIONS: SWL monotherapy with Genestone 190 lithotriptor is a effective, safe and useful treatment modality which can resolve almost all cases of urinary calculi without any clinically significant complications.
Analgesics ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Lithotripsy* ; Pelvis ; Renal Colic ; Shock* ; Ureter ; Urinary Calculi

PURPOSE: This study was performed to evaluate the success rate, failure causes, complications, safety and effectiveness of extracorporeal shock wave lithotripsy(SWL) with domestic SDS-5000 lithotriptor for the treatment of urinary calculi. MATERIALS AND METHODS: SWL monotherapy using the Domestic SDS-5000 lithotripter was performed in 195 urinary stones from 173 patients between 9 years and 74 years old from March 1998 to February 1999. Distribution of stones, location and size of stones, session, success rate, causes of failure and complications of SWL were reviewed. RESULTS: Of 195 cases, 88(45.1%) had renal, and 107(54.9%) ureteral stones. Of these cases 44.6% had stones smaller than 0.9cm, 33.3% from 1 to 1.9cm, 15.9% from 2 to 2.9cm, and 4% larger than 3cm. The overall success rate of complete SWL was 91.3% with 90.1% in 5-9mm, 96.9% in 10-19mm, 90.3% in 20-29mm and 62.5% over 30mm stone size. There were no significant complications. The cases of transient gross hematuria were developed in 11.3%, renal colic in 8.7%, steinstrasse in 2.0% and fever in 1.0%. These complications were controlled with conservative treatment or repeated session of shock wave lithotripsy, Double - J stent insertion. CONCLUSIONS: SWL with Domestic SDS-5000 lithotriptor is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stone.
Aged ; Fever ; Hematuria ; Humans ; Lithotripsy* ; Outpatients ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*

PURPOSE: We studied to evaluate the safety and effectiveness of the domestic SDS-3000(R) extracorporeal shock wave lithotriptor (SWL). MATERIALS AND METHODS: Between October 1995 and April 2000, 440 patients, 16 to 79 years old, were treated with the domestic SDS-3000(R) lithotriptor using C-arm fluoroscopy without regional or general anesthesia. Distribution of stones, location and size of stones, session, success rate, causes of failure and complications of SWL were retrospectively reviewed. RESULTS: Of 440 patients, renal stones were 133 (30.2%) and ureteral stones 307 (69.8%). The overall success rate (stone free rate) of SDS-3000(R) lithotriptor in 440 patients was 89.8% (81.4%) with 94.9% (91.0%) in 5-9mm, 87.2% (75.8%) in 10-19mm, 66.7% (42.8%) in 20-29mm and 57.1% (35.7%) over 30mm of stone size. The success rate was 94.9% for stones between 5-9mm in diameters and 82.6% for stones more than 10mm (p<0.05). As compaired with success rate for stones less then 20mm, stones more then 20mm had significently higher success rate (92.1% Vs 62.8%) (p<0.05). Ureter stones were more successfully treated than renal stones (93.2% Vs 82.0%) (p<0.05). Main complications of SWL were renal colic in 10.0%, steinstrasse in 4.3%, transient gross hematuria in 1.8% and fever in 1.1%. All of complications were controlled with conservative treatment. CONCLUSIONS: The domestic SDS-3000(R) lithotriptor monotherapy is considered to be a safe and efficient outpatient procedure for the initial treatment of urinary stones.
Aged ; Anesthesia, General ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Outpatients ; Renal Colic ; Retrospective Studies ; Shock ; Ureter ; Urinary Calculi*

Primary localized amyloidosis is a rare disease. A 75-year-old woman with a history of intermittent right-sided renal colic and hematuria had a stricture of lower ureter which was suspected to be caused by tumor or fibrosis. Intraoperative frozen biopsy of the ureter showed no evidence of malignancy. So we report a case of primary amyloidosis of the ureter which was treated successfully with segmental resection and end to end anastomosis.
Aged ; Amyloidosis* ; Biopsy ; Constriction, Pathologic ; Female ; Fibrosis ; Hematuria ; Humans ; Rare Diseases ; Renal Colic ; Ureter*

Extracorporeal shock wave lithotripsy monotheraphy was performed in 315 urinary stones from 278 patients with the Domestic SDS-2 lithotriptor using C-arm fluoroscopy between December 1991 and December 1994. Of 315 cases, renal stones were 150 cases(47.6%) and ureteral stones 165 cases(36.1%). No regional or general anesthesia was required but parenteral or oral analgesics were required in some patients. Among 315 cases who completed extracorporeal shock wave lithotripsy, the overall success rate of treatment was 90.5% with 92.4% in 5-9 mm, 94.8% in 10-19 mm, 89.7% in 20-29 mm and 61.5% over 30 mm or staghorn stones. Post lithotripsy complications were transient gross hematuria in 17.1%, renal colic in 11.4%, steinstrasse in 4.8%, petechia in 2.9% and fever in 1.9% and these complications were controlled with conservative treatment or repeated session of extracorporeal shock wave lothotropsy, percutaneous nephrodtomy, Double-J stent insertion or ureterolithotomy. We suggest that extracorporeal shock wave lithotripsy monotheraphy with the Domestic SDS-2 lithotriptor was considered to be effective and safe procedure for the initial treatment of urinary stones.
Analgesics ; Anesthesia, General ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Lithotripsy ; Renal Colic ; Shock* ; Stents ; Ureter ; Urinary Calculi*