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

Endometriosis affecting the urinary tract is very rare disease. The ureteral endometriosis is mostly asymptomatic for a long time, and associated with nonspecific symptoms such as abdominal or flank pain, renal colic, voiding difficulty and gross hematuria. Radiologic and laboratory findings show nonspecific findings, and the diagnosis is difficult. We report a case of obstructive ureteral endometriosis associated with right hydronephorsis. This case is operated under the impression of direct compression of ureter by uterine myoma. Total abdominal hysterectomy and ureteroureterostomy were performed. Final diagnosis of ureteral endometriosis is documented by pathologic findings.
Diagnosis ; Endometriosis* ; Female ; Flank Pain ; Hematuria ; Hydronephrosis* ; Hysterectomy ; Leiomyoma ; Rare Diseases ; Renal Colic ; Ureter* ; Urinary Tract

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*

BACKGROUND: Ureteral colic due to acute obstruction of urine flow is a frequent and painful condition presenting in the emergency department. Proper control of ureteral colic is important in the management of such a patient. Many drugs, including narcotics, had been used to control ureteral colic, and of them, nonsteroidal anti-inflammatory drugs are most commonly used. This study was carried out to compare the analgesic effect of diclofenac with that of caroverine which is used empirically in ureteral colic. METHODS: We carried out a randomized, prospective clinical trial in the emergency department of a university hospital. Sixty patients in whom ureteral colic had been diagnosed on the basis of physical signs and symptoms were included in this study. Each patients received an IM dose of diclofenac 75 mg, a IV bolus dose of caroverine 20 mg, or a continuous infusion of caroverine 60 mg. An additional dose of medication was added 20 min after the initial medication if needed. RESULTS: The main outcome was measured by using both the visual analogue scale(VAS), four-point categorial pain scale at times of 20, 40, and 60 min after initial medication. The requirement for supplemental medication was also measured. At 40 min, diclofenac was more effective than the other two treatments according to its pain- relieving capacity(p<0.05) and the categorial pain scale. By 60 min, caroverine continuous infusion was less effective than the other two treatments according to visual analogue scale(VAS) and the categorial pain scale(p<0.05). There were no significant differences between the diclofenac group and the caroverine bolus injection group at this time. The diclofenac group needed significantly less rescue medication for pain control(p<0.05). CONCLUSION: IM diclofenac, a non-steroidal antiinflammatory drug, was superior to the spasmolytics, single bolus or continuous intravenous infused, in treatment of ureteral colic.
Diclofenac* ; Emergency Service, Hospital ; Humans ; Narcotics ; Parasympatholytics ; Prospective Studies ; Renal Colic* ; Ureter*

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: Renal colic is a common disorder with a high rate of recurrence, resulting in a large number of emergency department visits. The aim of this study was to investigate the seasonal variation in renal colic attacks and the association with climatic parameters. METHODS: The time of onset, monthly incidence, and effects of climatic parameters of renal colic were evaluated. Data on climatic parameters were obtained from the Korea Meteorological Administration. Correlation between the number of monthly episodes and climatic parameters was assessed using Pearson's correlation coefficient. RESULTS: A total of 5060 renal colic episodes were retrieved during a period of 84 months (from May 2006 to April 2013). Episodes of renal colic were more common in men (67.4%) than in women(32.6%). The incidence of renal colic showed a circadian variation, with a morning peak (500~1000 h) and an afternoon dip (1500~1900 h). Findings of the current study showed a higher number of renal colic episodes during summer compared with other seasons. Significant positive correlations were observed between the mean monthly temperature and the monthly incidence of renal colic, but not between other climatic parameters (relative humidity, rainfall, sunshine hours, and atmospheric pressure) and incidence of renal colic. CONCLUSION: We conclude that the incidence of renal colic has significant seasonal variation, and only mean monthly temperature showed any consistent association with monthly attack rates.
Climate ; Emergency Service, Hospital* ; Humans ; Humidity ; Incidence ; Korea ; Male ; Recurrence ; Renal Colic* ; Seasons* ; Sunlight ; Urolithiasis

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

Extracorporeal shock wave lithotripsy (ESWL) is a non-contact, non-invasive technique for disintegrating urinary tract calculi into sand-sized particles which can be passed spontaneously by a patient during normal urine flow. ESWL with an Edap lithotriptor which uses piezoelectric elements, was performed in 465 cases with urinary calculi from May 1987 to October 1988. The overall success rate of ESWL in 465 cases was 92.7% and renal stones were more successfully (95.9%) treated than ureteral stone (86.7%) main complications of ESWL for urinary calculi were hematuria (70.8%), hypertension(8.0 %). renal colic (2.6%), ileus (2.5%) and fever (1.2%) and then they were controlled without specific treatment. ESWL using ultrasonic localization was effective for treatment of the urinary stones.
Calculi ; Fever ; Hematuria ; Humans ; Ileus ; Lithotripsy* ; Renal Colic ; Shock* ; Ultrasonics ; Ureter ; Urinary Calculi* ; Urinary Tract