Retrograde intrarenal surgery (RIRS) is being performed for the surgical management of upper urinary tract pathology. With the development of surgical instruments with improved deflection mechanisms, visuality, and durability, the role of RIRS has expanded to the treatment of urinary calculi located in the upper urinary tract, which compensates for the shortcomings of shock wave lithotripsy and percutaneous nephrolithotomy. RIRS can be considered a conservative treatment of upper urinary tract urothelial cancer (UTUC) or for postoperative surveillance after radical treatment of UTUC under an intensive surveillance program. RIRS has a steep learning curve and various surgical techniques can be used. The choice of instruments during RIRS should be based on increased surgical efficiency, decreased complications, and improved cost-benefit ratio.
Carcinoma, Transitional Cell/surgery ; Humans ; Lithotripsy, Laser/methods ; Perioperative Care/methods ; Ureteroscopy/*methods/trends ; Urolithiasis/surgery ; Urologic Neoplasms/surgery

Clinical and statistical observation was made on outpatient inpatients and operations in Urology Department of the Capital Army Hospital during the period from Jan., 1962 to Dec. 1963 and the results (1) Clinical statistics on outpatients. 1) Total outpatient were 2213 cases, 2179 males and U females, and the male to female ratio was 64.1:1. 2) The number of outpatient increased in winter and decreased in summer. 3) According to age distribution, the majority of the patients (96.2%) where between 21 and 40 years of age. 4) The most common diseases were urethritis (35.7%) showing annual increase, while redundant prepuce, urolithiasis, injury of genito-urinary tract, nonspecific epididymitis and hydrocele, showing annual decrease. 5) Renal tuberculosis showed annual decrease and tuberculous epididymitis, annual increase. (II) Clinical statistics on inpatients. 1) The inpatients during 2 years were 241 cases which comprised10.9% of total outpatients. The male inpatients stood for 11% of total outpatient and the female inpatients, 5.9%. 2) The most common disease were renal tuberculosis, hydrocele, non-specific epididymitis, stones of kidney and ureter, tuberculous epididymitis, urethral rupture and scrotal hematoma. (III) Clinical statistics on operations. The number of total operations were 640 during 2 years. Circumcision comprised 34.0% of total operations, vasectomy, 30.6% Nephrectomy, 6.1% ; epididymectomy, 6.1%, hydrocelectomy, 4.1% and plastic surgery of urethra, 2.3%. One case of Bricker's operation was performed.
Age Distribution ; Circumcision, Male ; Epididymitis ; Female ; Hematoma ; Hospitals, Military* ; Humans ; Inpatients* ; Kidney ; Korea* ; Male ; Nephrectomy ; Outpatients* ; Rupture ; Seoul* ; Surgery, Plastic ; Tuberculosis, Renal ; Ureter ; Urethra ; Urethritis ; Urolithiasis ; Urology* ; Vasectomy

PURPOSE: Most cases of urolithiasis are successfully managed with extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopic lithotripsy and percutaneous nephrolithtomy. However, in patients whose calculi are not managed by these methods, an open ureterolithotomy still plays a considerable role. We performed video assisted minilaparo (VAM)-ureterolithotomy in 36 patients with upper ureteral calculi. MATERIALS AND METHODS: Between January 2001 and July 2005, VAM-ureterolithotomy was performed in 36 patients with upper ureteral calculi. We retrospectively analyzed the operating times, postoperative hospital stay, number of postoperative analgesics, incisional size, complications and the degree of improvement in these patients. RESULTS: The stones of all the patients were successfully removed using VAM-ureterolithotomy through a minimal 4cm skin incision. The mean operative time and postoperative hospital stay were 75 minutes and 3.9 days, respectively. The mean analgesic requirement was 69mg of ketorolac. Compared to a conventional ureterolithotomy, the VAM-ureterolithotomy required a similar operating time, but less analgesics and a shorter postoperative hospital stay. There were no significant complications associated with the VAM-ureterolithotomy. CONCLUSIONS: A VAM-ureterolithotomy is a safe and effective minimally invasive procedure, which may be considered as an alternative treatment technique to a conventional ureterolithotomy and laparoscopic ureterolithotomy in cases where first-line treatments have failed or are unlikely to be effective.
Analgesics ; Calculi ; Humans ; Ketorolac ; Laparoscopy ; Length of Stay ; Lithotripsy ; Operative Time ; Retrospective Studies ; Shock ; Skin ; Ureter* ; Ureteral Calculi* ; Urolithiasis ; Video-Assisted Surgery

Clinical and statistical observation was made on outpatients, inpatients and operations in Urology Department of the University of Kyoung Pook during the period from Jan. 1958 to Dec. 1960 and the results obtained were as follows: I) Clincal Statistics on Outpatients: 1) Total out-patients were 1.151 cases of which total. 1,211 were males and 240 were female. and the male to female ratio was 5:1.2) The period of outpatient attendance was peak from May to August.3) According to age grouping, the maximum attendance was from 21-3O years group, next 31-40 group then 11-20 group, and 21-30 years group formed 1/3 of total patients.4) The most frequent diseases were tuberculosis of urinary tract in 9.8% showing annual decrease according to number and percentage, cystitis in 6.5%, urolithiasis, hydrocele and prostatic tumor which showed annual increase.5) Stones of kidney and bladder showed slight increase.6) Neurosis showed annual increase. II) Clincal Statistics on Inpatients: The inpatients during 3 years were 151 cases, and this total comprised 10.6% of total outpatients.1) The patients admitted comprised 9.8% of male and 15% of female to total outpatients, and the male to female ratio was 3.3:1) The most frequent diseases were renal tuberculosis, urolithiasis, tuberculous epididymitis, hydrocele and urethral stricture3) Stones of kidney and bladder showed annual increase but ureteral stones showed no change.4) The patients admitted to hospital comprised the following percentage of the total attending as outpatients with the diseases indicated: stones of kidney and ureter in 82.6%, bladder tumor in 79.2%, kidney tumor in 83.3%, urethral stricture in 80% and renal tuberculosis in 40%.5) The number of admitted patient has gradually increased year by year. III) Clincal Statistics on Operations: The cases of total operation were 115 during 3 years and the cases of operation formed 2/5 of all cases in 1960 and nephrectomy was peak according to number and percentage showing annual decrease while uretero-ileo-cystoplasty. cystolithotomy and plastic surgery of urethra showed annual increase.
Cystitis ; Epididymitis ; Female ; Humans ; Inpatients* ; Kidney ; Male ; Nephrectomy ; Outpatients* ; Surgery, Plastic ; Tuberculosis ; Tuberculosis, Renal ; Ureter ; Urethra ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Tract ; Urolithiasis ; Urology*

Holmium laser lithotripsy (HLL) is one of the common surgical methods for urolithiasis. It causes minor surgical trauma, but complications are not rare. Extracorporeal membrane oxygenation (ECMO) treatment of sepsis is common, but venoarterial (VA)-ECMO treatment of urosepsis has not been reported yet. In this article, we reported a 67-year-old female patient with refractory septic shock caused by HLL under percutaneous nephroscope, involving breathing, heart, kidney and other organs, and organs support treatment was ineffective for the patient. Finally, we successfully treated the patient under VA-ECMO with continuous renal replacement therapy (CRRT). Combined ECMO and CRRT may provide a solution for addressing refractory sepsis. Here we present the case and review relevant literature, so as to provide a treatment strategy for patients with refractory urogenic sepsis and to reduce the mortality rate.
Aged ; Extracorporeal Membrane Oxygenation/methods* ; Female ; Humans ; Lasers, Solid-State/adverse effects* ; Lithotripsy, Laser/methods* ; Postoperative Complications/therapy* ; Renal Replacement Therapy/methods* ; Shock, Septic/therapy* ; Treatment Outcome ; Urinary Tract Infections/therapy* ; Urolithiasis/surgery*