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

PURPOSE: We analysed the therapeutic results of 2,585 cases (2,456 patients) of urinary calculi, treated by extracorporeal shock wave lithotripsy (ESWL), using a Dornier MPL 9200X lithotriptor. MATERIALS AND METHODS: The records of all the patients, in whom urinary calculi were treated by ESWL, between October, 1997 and October, 2002, were retrospectively reviewed. The patients were defined as successful if there was no concrement on the X-ray (plain film) or residual fragments renal colic, steinstrasse and fever in 2,158 (83.4%), in 771 (29.8), in 53 (2.1%) and fever in 16 cases (0.6%), respectively, which were successfully controlled by conservative treatment. CONCLUSIONS: We considered ESWL has become a highly effective and minimally invasive treatment modality as the 1st therapeutic option for urinary stones.
Fever ; Hematuria ; Humans ; Kidney ; Lithotripsy* ; Renal Colic ; Retrospective Studies ; Shock* ; Stents ; Ureter ; Urinary Calculi

PURPOSE: We describe our clinical experience of extracorporeal shock wave lithotripsy (SWL) using Modulith SLK in 440 cases of urinary calculi. MATERIALS AND METHODS: The records of 440 cases of urinary stones treated by Modulith SLK lithotriptor, from October, 2002 to June, 2004, were reviewed retrospectively. The size and location of stones, number of sessions, auxiliary procedures, success rate and complications were statistically analysed. RESULTS: The total success rate was 95.7% (421/440 cases), and according to stone location was 98.2% in the kidney and 94.1% in the ureter. The success rate according to stone size was 97.1%, 91.1%, 92.9% and 80% for below 10mm, 11-20mm, 21-30mm and over 30mm, respectively. The success rate within 3 sessions was 82.7%. The average number of treatment session was 2.14. The complications after SWL were gross hematuria in 316 cases (71.8%), renal colic in 83 (18.9%), steinstrasse in 19 (4.3%), and fever in 2 (0.5%). All of the complications were controlled by conservative management only. As an auxiliary procedure, double J stent insertion was done in 22 cases, percutaneous nephrostomy (PCN) in 1, ureteroscopic removal of stone (URS) in 15, percutaneous nephrolithotomy (PNL) in 3, and ureterolithotomy in 1. CONCLUSIONS: Modulith SLK lithotriptor is considered to be an effective and safe tool for the first line treatment of urinary calculi.
Fever ; Hematuria ; Kidney ; Lithotripsy* ; Nephrostomy, Percutaneous ; Renal Colic ; Retrospective Studies ; Shock* ; Stents ; 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*

PURPOSE: The aim of this study was to evaluate the outcome of ureter stones with expectant management and the clinical factors associated with stone passage in Koreans. MATERIALS AND METHODS: We reviewed the charts of patients who visited the emergency room or urological office of our institution with acute renal colic between 2001 and 2008. A total of 656 ureter stone formers were enrolled in this study who had decided to be treated by expectant management. Clinical data such as gender, age, size and location of the stone, body mass index, and previous stone history were analyzed to find the factors related to spontaneous passage of ureter stones. RESULTS: Of the 656 ureter stones, 566 stones (86.3%) were spontaneously expelled. Mean duration of follow-up was 17.5 days (range, 1 to 100 days). Mean time to stone passage was 6.8 days for stones less than 2 mm in size, 12.6 days for stones 2 to 4 mm, 14.8 days for stones 4 to 6 mm, and 21.8 days for stones 6 to 8 mm (p<0.001). The cumulative spontaneous passage rate was 55.3% in 7 days, 73.7% in 14 days, 88.5% in 28 days, and 97.7% in 60 days after the first attack. A total of 90 patients (13.7%) required interventions because of symptom relapse or renal deterioration that was related to the location and size of the stone (each, p<0.001). The more proximal the location and the larger the stone was than 6 mm, the less the chance of spontaneous passage (each, p<0.001). CONCLUSIONS: Size and location of ureter stones are the most important factors for predicting the spontaneous passage of the stone. If a patient has a distal ureter stone of less than 6 mm in size, it is acceptable for the urologist to observe for spontaneous passage for 2 months.
Body Mass Index ; Emergencies ; Follow-Up Studies ; Humans ; Recurrence ; Renal Colic ; Ureter ; Ureteral Calculi ; Watchful Waiting

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*

PURPOSE: This study was designed to correlate the size and position of ureteral stones to their clinical manifestation. METHODS: This study was a retrospective review of medical records of 201 patients who visited the emergency department complaining of renal colic and diagnosed with ureteral stone(s) by use of computed tomography from July to December 2011. The size and position of a stone and the corresponding ipsilateral hydronephrosis, as well as the number and type of administered analgesics, were evaluated. RESULTS: Ureteral stones were located at the ureteropelvic junction in 2.0% of cases, at the proximal ureter between the ureteropelvic junction and the iliac vessels in 41.8% of cases, at the ureter crossing external iliac vessels in 1.0% of cases, at the distal ureter between the iliac vessels and the ureterovesical junction in 12.9% of cases, and at the ureterovesical junction in 42.3% of cases. Where the ureter crossed external iliac vessels, the mean size of stones was significantly larger in the upper ureter, as 5.3+/-2.3 mm, than in the lower ureter, as 4.2+/-1.8 mm. Pain duration and stone size were significant factors associated with hydronephrosis by logistic regression analysis. Ketorolac was selected as the first-line analgesics in 169 patients (94.9%). The factor affecting the response to analgesic treatment was stone size. Patients needing analgesic administration three times or more, had smaller stones. CONCLUSION: Most of the ureteral stones observed were located in the proximal ureter and at the ureterovesical junction. Hydronephrosis occurred more often in patients who had longer periods of pain and larger stones. Patients with smaller stones needed more frequent administration of pain killers.
Analgesics ; Emergencies ; Humans ; Hydronephrosis ; Ketorolac ; Logistic Models ; Medical Records ; Renal Colic ; Retrospective Studies ; Ureter ; Ureteral Calculi

PURPOSE: Our aim was to determine the efficacy of hematuria testing in suspected urinary stone disease using contrast enhanced multidetector computed tomography (MDCT) as the reference standard. METHODS: Records of all patients who presented to the emergency department with suspicion of urinary stone that undergone MDCT during a 2-year period were reviewed. The sensitivity, specificity, positive predictive value, and negative predictive value of the positive hematuria on the urinalysis for renal colic were calculated. The rates of incidence of negative hematuria were obtained. In addition, significant alternative CT findings requiring immediate or deferred treatment were classified. RESULTS: A total of 492 enhanced MDCTs were performed. Urinary stone had been identified in 414(84.1%) of the 492 patients, and 78 patients had a negative stone, including 33 (6.7%) with clinically significant alternative diagnoses in the latter group. Microscopic urinalysis had a sensitivity, specificity, positive predictive value, and negative predictive value of 89.4%, 41.1, 88.9%, and 42.1%, respectively. The combination of microscopic urinalysis and Urine Dipstick test (UDT) yielded a sensitivity, specificity, positive predictive value, and negative predictive value of 96.9%, 28.2%, 87.5%, 62.9%, respectively. The incidence of negative hematuria for microscopic urinalysis, UDT, and the combination were 10.6%, 4.4%, 3.1%, respectively. CONCLUSION: The presence or absence of blood on urinalysis alone cannot be used to reliably determine which patients actually have urinary stone. Therefore, patients presenting with an episode of clinically suspected urinary stone should undergo CT scanning because it enhances diagnostic certainty by identifying alternative significant diagnoses not suspected on clinical grounds alone.
Emergencies ; Hematuria ; Humans ; Incidence ; Multidetector Computed Tomography ; Renal Colic ; Sensitivity and Specificity ; Urinalysis ; Urinary Calculi ; 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