In the study of 43 cases of urinary stones in aldults in Thuy Van commune, Huong Thuy district, Thua Thien Hue province showed that: Hydronephrosis was 27.3%, level III examined by renal ultrasound was the highest rate of 23.3%, three cases of urinary stones had the complication of Hydronephrosis III grade. Urinary tract infection with nitrite and white blood cell (+) in urine was 18.6%. Chronic renal failure was 16.3% with the most was level I (9.3%). Hematuria was 18.6% and red blood cell in urine was the highest (25.6%).
Urinary Calculi/complications ; Epidemiology ; Aduld

From 1992 to 1997, 982 calculus in the upper urinary tract (UUT) was removed. There were 10 acute renal failure and 75 chronic renal failures. The study deserves special commentaries. Renal failure occurred in both groups patients bilateral calculi (group I) and calculus in the single kidney (group II). The members of chronic renal failure were much higher than that of acute renal failure. Renal failure in group II was 2.24 time higher than in group I. The risk was equal for both sex. In group I, the rate of renal failure increased with long history of disease and patients in very short time. Among high - risk factors for renal failure we noted: calculus in many location, bilateral Staghorn calculus multiple bilateral calculi or calculi with calculi in the single kidney, calculi urinary tract infection. Roentgenography, ultrasound, and radioisotope examinations were used as non-invasive techniques for those patients
Urinary Calculi ; Kidney Failure ; diagnosis ; complications

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: 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

A clinical observation was made on 90 consecutive cases of urologic in-patients with renal stones in the Department of Urology, Yonsei University College of Medicine, from January, 1975 to December, 1979. 1) This disease occurred most frequently in the fourth decade, showing 29 cases of total urologic in-patients with renal stones and the ratio of male to female was 2:1. 2) 57 cases showed acidic urine, compared with alkaline urine in 25 cases. 3) Pyuria was observed in 57,3% and microscopic hematuria in 59.8%. 4) In 35.4%, cultures of urine were positive for bacteria and the common invaders were staphylococci and E. coli. 5) In 20.7%, of all cases there were urinary stones of other sites. 6) Pyelolithotomy in 47 cases (54.4%), nephrolithotomy in 16 cases (17.8%), partial nephrectomy in 7 cases (7.8%), nephrectomy in 12 cases (13.3%) and bivalve nephrolithotomy in 8 cases (8.9%) were performed. 7) In pyelolithotomy, single stone was 70.2%, and single stone and staghorn stone in nephrolithotomy were 43.8% respectively which were fixed to the renal calyx. In bivalve nephrolithotomy, staghorn stone was 75% and multiple stone in partial nephrectomy was 85.7% and staghorn stone in nephrectomy was 41.7%. 8) Transfusion was performed in bivalve nephrolithotomy, partial nephrectomy, nephrolithotomy, pyelolithotomy and nephrectomy in decreased order, operation times were longer in order of partial nephrectomy, bivalve nephrolithotomy, nephrolithotomy, nephrectomy and pyelolithotomy, and post-operative day was longer in partial nephrectomy with 11.3 days. 9) Postoperative complications were observed in 9 cases (10%). There were in differences in operative technique and secondary operation by postoperative complication was performed in 2 cases.
Bacteria ; Bivalvia ; Female ; Hematuria ; Humans ; Male ; Nephrectomy ; Postoperative Complications ; Pyuria ; Urinary Calculi ; Urology

A clinical observation was made on 97 patients of renal calculi who were admitted to the Department of Urology, Chonam University Medical School during the 5 years period from January, 1976 to December, 1980. The following results were obtained. 1) The incidence of renal calculi in 97 patients was 38.0% of urolithiasis in 255 patients and 6.8% of 1430 inpatients. The was an increasing tendency of incidence of renal calculi with annual increasing number of inpatients. 2) There were 51 male and 46 female, a ratio of 1.1:1. The age of two thirds patients of renal calculi ranged from 31 to 50 years, with peak age incidence in the fifth decade. 3) Definite past history of urinary calculi was found in 23 cases (23.7%). 4) The clinical symptoms on admission were flank pain in 92.8%, hematuria in 15.4%, frequency in 5.1% and suprapubic pain in 4.1%. 5) Urinalysis revealed hematuria in 77.3%, proteinuria in 54.1%, pyuria in 42.3%, bacteriuria in 28.9% crystalluria in 9.3% and normal in 8.2% 6) There were 42 renal units of right renal stone and 39 renal units of left renal stone with a ratio of 1.1:1. Unilateral renal calculi were found in 81 patients (83.5%). 7) Treatment consisted of pyelolithotomy in 51 patients (52.6%), pyelonephrolithotomy in 11 patients (11.3%), nephrectomy in 4 patients (4.1%) and nephrolithotomy in 3 patients (3.1%) in order. 8) The incidence of stone ranged from 1.1 to 4.0 gm in weight was 50.6%. The mean weight of removed renal calculi was 25.8 gm in nephrectomy, 19.0 gm in pyelonephrolithotomy, 5.7 gm in nephrolithotomy and 4.9 gm in pyelolithotomy. 9) A nephrostomy tube extended into the upper ureter was located in 30 cases (30.9%) and there was no difference in duration of nephrostomy tube inlaying between pyelolithotomy and pyelonephrolithotomy. 10) Postoperative complications were observed in 22 cases (26.2%) and the most common one was remnant stones in 6 cases (27.4%), of which 5 cases had multiple stones overweighed 10.0 gm. 11) The chemical analysis of 43 renal calculi showed calcium oxalate in 14 cases (32.6%), calcium phosphate in 78 cases (16.3%), the mixed type of calcium oxalate and calcium phosphate in 6 cases (14.0%) and the mixed type of calcium oxalate and magnesium phosphate in 5 cases (11.6%). There were 24 single chemical component of stones. As a result, oxalate stone (67.5%) and phosphate stone (55.9%) were prevalent.
Bacteriuria ; Calcium ; Calcium Oxalate ; Female ; Flank Pain ; Hematuria ; Humans ; Incidence ; Inpatients ; Kidney Calculi* ; Magnesium ; Male ; Nephrectomy ; Postoperative Complications ; Proteinuria ; Pyuria ; Schools, Medical ; Ureter ; Urinalysis ; Urinary Calculi ; Urolithiasis ; Urology

Twenty-four anatrophic nephrolithotomies under hypothermia were performed between June, 1980, and July, 1982, to remove staghorn and multiple renal calculi. 1. There were no operative deaths, and eight transient postoperative complications occurred. These complications resolved during their initial hospitalization, and no nephrectomies were required. 2. The average time of the operation was 4.17 hours, and the mean cold renal ischemic time was 51 minutes. The patient required an average of 1.9 pints of blood intraoperatively and no transfusion postoperatively. The average length of postoperative hospitalization was 10.3 days in all patients and 17.4 days in complicated cases. 3. Magnesium ammonium phosphate calculi were present in the major of patients (62.5%) in staghorn calculi and calcium oxalate (62.5%) in multiple renal calculi. 4. Postoperative evaluation was done in 16 of 24 patients. Seven patients (43.8%) has residual calculi. This high residual stone rate was due to lack of intraoperative roentgenography. 5. Among 16 patients, 9 had preoperative urinary tract infection. In 4 patients who had residual stone, 2 patients had perpetuated urinary tract infection and in 5 patients who had no residual stone, postoperative urine culture were sterile. 6. Intravenous pyelography was performed 3 months after the operation in 6 patients. Of these 6 patients 5 revealed stable or improved renal function. In 1 patient it revealed non-functioning kidney. We suppose it may be due to vascular spasm or injury.
Ammonium Compounds ; Calcium Oxalate ; Calculi ; Hospitalization ; Humans ; Hypothermia* ; Kidney ; Kidney Calculi ; Magnesium ; Nephrectomy ; Postoperative Complications ; Radiography ; Spasm ; Urinary Tract Infections ; Urography

Continent urinary diversion or neobladder has been attempted more and more recently. However, ileal conduit urinary diversion is still the most common diversion technique applied after cystectomy, because it is much simpler than other techniques and also because it has reportedly produced less postoperative complications. But there have not been enough long term follow-up reports on this procedure in Korea. Therefore, the authors followed 90 ileal conduit urinary diversion cases which were performed at the Korea Cancer Center Hospital(KCCH) between 1985 and 1994. Upon these 90 cases, the authors analyzed the occurrence of early complications and late complications in percentage. For the early complications, wound complications comprised 16%, early intestinal obstruction 2%, necrosis of ileal segment .1%, leakage of ureteroileal anastomosis 2% and acute pyelonephritis comprised 4%. These statistics show similar result with other reports. For the late complications, stromal stenosis comprised 1% and the formation of calculi 3%. These number are lower occurrence compared to other reports. Also, the late postoperative ileus comprised 10% and renal deterioration 12%. These reflect similar occurrences with other reports. In conclusion, reviewing long term follow-up on ileal conduit urinary diversion by means of analyzing the early and late complications, the ileal conduit urinary diversion is still considered good diversion technique which has acceptable ratio of renal deterioration and postoperative complications.
Calculi ; Constriction, Pathologic ; Cystectomy ; Follow-Up Studies ; Ileus ; Intestinal Obstruction ; Korea ; Necrosis ; Postoperative Complications* ; Pyelonephritis ; Urinary Diversion* ; Wounds and Injuries

OBJECTIVETo investigate the surgical treatment of benign prostate hyperplasia (BPH) and its concomitant diseases at the same time.

METHODSOne hundred and fourteen operations were performed for BPH patients, including transurethral resection/vapor of the prostate (TURP/TUVP), inguinal herniorrhaphy, internal urethrotomy, transurethral resection of bladder tumor (TURBt) or vesical litholapaxy, and the data were reviewed.

RESULTSThe procedures were successful in all cases. A follow-up of 3 to 60 months found a good outcome of TURP. There was no recurrence in 30 cases of inguinal hernia and 39 cases of vesical calculus. Of the 25 cases of urethral stricture, 1 had an obvious hypotension during the operation and 4 needed urethral dilatation after operation. Six of the 20 cases of bladder tumor underwent a second TURBt due to the recurring tumor which was far from prostatic urethra.

CONCLUSIONInguinal hernia, urethral stricture, bladder tumor or vesical calculus can be treated simultaneously during TURP.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Hernia, Inguinal ; complications ; surgery ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; surgery ; Transurethral Resection of Prostate ; Urethral Stricture ; complications ; surgery ; Urinary Bladder Calculi ; complications ; surgery ; Urinary Bladder Neoplasms ; complications ; surgery

PURPOSE: Most stones in the urinary tract can be managed by SWL, percutaneous nephrolithotomy and ureteroscopic lithotripsy, however in some patients whose calculi were not managed by these methods, open surgery must be considered. We performed ureterolithotomy using laparoscopy assisted small incision in upper ureter stone and compared their efficacy with conventional ureterolithotomy. MATERIALS AND METHODS: 10 patients whose stones were not fragmented by SWL or who showed intractable pain were managed by laparoscopy assisted small flank incision of 5cm without insufflation of gas(group I). We compared the efficacy of this procedure with 10 patients who underwent conventional ureterolithotomy(group II) in operating time, the number of analgesics required for the management of postoperative pain control, hospital stay, immediate complication and medical expenses. RESULTS: The stones were successfully removed in all patients. The operating times ranged 40 to 150 min(mean 98.5) in group I and 60 to 190 min(mean 83.0) in group II. The mean requirement of analgesics and hospital stay after surgery were 2.4 times and 3.4 days in group I, and 8.4 times and 6.8 days in group II respectively. The mean medical expenses were 803,000 won in group I and 956,000 won in group II. No intra-operative complication was noted in group II, but 1 patient showed urine leakage in group I, which was managed by placement of ureteral catheter. In immediate postoperative complications, 1 patient complained wound pain persisted over 1 month in group I but 6 patients in group II. CONCLUSIONS: Ureterolithotomy using laparoscopy assisted small incision is another modality in the management of upper ureter stone which was not managed by SWL, percutaneous nephrolithotomy and ureteroscopic lithotripsy. Furthermore, this procedure is safe and effective, and offers significant advantages in hospital stay, requirement of analgesics, and medical expense.
Analgesics ; Calculi ; Humans ; Insufflation ; Laparoscopy* ; Length of Stay ; Lithotripsy ; Nephrostomy, Percutaneous ; Pain, Intractable ; Pain, Postoperative ; Postoperative Complications ; Ureter* ; Urinary Catheters ; Urinary Tract ; Wounds and Injuries