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Query: UMLS:C0451641 (urolithiasis)
 3,973 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors submit evaluation of 188 patients operated on during five years (1989-1993). Using the ureterorenoscopic technique (URS), 207 operations have been performed. The average age in the group of patients was 56.1 years. In general anesthesia 151 operations were completed, in spinal anesthesia 54, in neuroleptanalgesia 1 and without any anesthesia 1. The postoperative ureteric intubation was accomplished 128 times (61.8%). The moderate dilatation of the hollow system of the kidney was proved ultrasonographically in only 7 cases. The average postoperative hospitalization reached 5.8 days. Out of 207 operations, we have reached successful result 177 times (85.5%) and 30 times (14.5%) we were not able to accomplish the operation only by means of the URS. 184 operations were performed because of urolithiasis (88.9%) and 23 (11.1%) for other reasons. Out of 184 URS for urolithiasis, 156 (84.8%) were successful and there was no difference found between pelvic (85.4%) and lumbal (83.6%) localization of urolithiasis in the view of success rate. The authors summarize the causes of mishaps and following solutions. The biochemical analyses of 153 concrements are added.
Rozhl Chir 1994 Sep
PMID:[Personal experience with uretero-renoscopy]. 771 55

In 1990 "The classification of urological operations" was introduced to all urological departments in Slovakia. The aim of the classification was to evaluate the quality of work of individual departments in respect of recent trends in surgical therapy. The annual analysis shows the procedures, which are necessary to be replaced by modern ones. The review of the first four-years shows the increase in number of operations almost by one third. Twenty of most common operations represent 73.4% of all urological procedures. The most frequent operation is prostatectomy accounting 11.8% of all operations. During the follow-up period the therapy of urolithiasis has changed principally. The results of surgical activity analysis support the need to extend methods of urinary diversion using intestine and to increase the number of radical cystectomies and prostatectomies.
Rozhl Chir 1994 Sep
PMID:[Surgical activities at urologic departments in Slovakia 1990-1993]. 771 58

A work-up of a child with suspected hematuria should be undertaken once the primary physician has determined that there actually are red blood cells in the urine and that the hematuria is persistent. Evaluation of a child with persistent microscopic hematuria is facilitated with the determination of whether the blood originates from the glomeruli or whether it comes from elsewhere in the urinary tract. Clues to a glomerular origin include the presence of other manifestations of glomerular disease such as significant proteinuria, RBC casts, and dysmorphic erythrocytes in the urinary sediment, hypertension, and renal insufficiency. Clues to the blood originating from the lower urinary tract include blood clots in the urine, normal erythrocyte morphology, and a pertinent history pointing to the lower tract such as that of trauma, urolithiasis, urological or vascular abnormality, or symptoms of bladder inflammation. The initial evaluation should include a detailed patient history and family history as well as a careful physical examination looking for clues to the presence of a familial, hereditary, or chronic kidney disease. A logical, stepwise initial work-up should follow with the goal of ruling out life-threatening and treatable diseases. If there are no indications for immediate further intervention and the cause of the hematuria remains unclear after the initial work-up has been completed, the parents and patient should be reassured that there are no life-threatening conditions and that although the etiology of the blood in the urine is yet unknown, there is time to follow the patient and plan for additional studies if and when they are indicated. The family's concerns (ie, "Is this cancer?," "Will my child require dialysis and transplantation?") should be addressed frankly, and the physician should mention those diagnoses that may lead to renal failure, but have not been absolutely ruled out yet before a kidney biopsy has been performed, such as Alport's syndrome and IgA nephropathy. The child with isolated microhematuria should be evaluated regularly with urinalyses looking for persistence of the hematuria and appearance of proteinuria, blood pressure measurements, and renal function tests. If the microhematuria persists for 6 to 12 months, a kidney biopsy should be considered.(ABSTRACT TRUNCATED AT 400 WORDS)
Pediatr Ann 1994 Sep
PMID:Hematuria in children. 780 Apr 21

The main post uretero-sigmoidostomy complications are stricture of the anastomosis, chronic infection and urolithiasis. In our institution the patients with ureterosigmodostomy undergo a follow-up protocol in which blood chemistry, ultrasonography, intravenous pyelography and C.T. are periodically performed. The aim of the present paper is to compare the accuracy of kidney sonography after diuretic stimulation with intravenous pyelography in the diagnosis of ureteral stenosis. Out of 91 patient with ureterosigmoidostomy 18 patients (34 kidneys) underwent intravenous pyelography, a basal U.S. and then a dynamic one at 5, 10, 15, 30, 45, 60, 90, 120 minutes after administration of furosemide 20 mg i.v. At basal U.S. 27 kidneys were normal and 7 showed a dilations. After diuretic stimulation we observed 16 normal kidneys, 16 dilated units and 2 intermittent hydronephrosis. Out of 16 dilated kidneys 6 became normal in 60 minutes. Out of 10 dilated units 3 were normal in 90 minutes (hipotonic), 2 were normal before 120 minutes (low grade obstruction) and 5 were dilated after 120 minutes (high grade obstruction). With intravenous pyelography we observed 27 normal kidneys and seven dilated units. Dynamic sonography have shown high sensibility (100%), specificity (88.8%) and accuracy (91%) in diagnosis of ureteral obstruction in to I.V.P. in the follow-up of this kind of divesion.
Arch Ital Urol Androl 1994 Sep
PMID:[Dynamic renal echography versus urography in the follow-up of patients who have undergone ureterosigmoidostomy]. 788 45

Inverted Y duplication of the ureter is a rare anomaly. We report on a 24-year-old man who presented with urolithiasis and azoospermia in a solitary functioning kidney with an inverted Y ureteral duplication. To our knowledge our case represents the first documentation of ectopic emptying of 1 limb of the inverted Y ureter into the seminal vesicle. The embryology and management of this complex case are discussed.
J Urol 1994 Sep
PMID:Inverted Y duplication of the ureter associated with a distal limb ectopic to the seminal vesicle. 805 62

Wilson's disease is a rare autosomal recessive disorder that typically presents as hepatic, neurological or psychiatric illness in late adolescence and early adulthood. Although urolithiasis has been documented in as many as 16% of patients with Wilson's disease, only 3 cases have been described that presented with stone disease. We report on a healthy 17-year-old girl who presented with renal colic and a distal ureteral calculus that was subsequently passed. The patient was hospitalized 2 months later with jaundice, ascites, hyperchloremic metabolic acidosis and elevated hepatic enzymes. She was hypophosphatemic and hypouricemic with a low serum ceruloplasmin. Diagnosis was Wilson's disease with Fanconi's syndrome, but despite penicillamine therapy and intensive care support rapidly progressive hepatic failure, coagulopathy and encephalopathy developed. The patient died before emergency liver transplantation. Our case illustrates the role urologists may have in the diagnosis of this rare but potentially treatable disease. Wilson's disease should be considered in the differential diagnosis of any adolescent or young adult with urolithiasis.
J Urol 1994 Sep
PMID:Wilson's disease presenting as symptomatic urolithiasis: a case report and review of the literature. 805 76

Clinical and basic research in the field of urolithiasis has developed rapidly in recent years. Progress in extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) has brought about a revolution in the surgical treatment of urolithiasis and research at the cellular and molecular level is now expanding. In spite of these advances, however, clinical treatment of urolithiasis remains far from satisfactory. Stone recurrence in many patients cannot be predicted and is beyond control of urologists mainly because the mechanisms of stone formation are still not fully understood. It is necessary to study the process of stone-formation more intensely at the cellular and molecular level, and to strengthen the links between basic and clinical research in the field. In this review, the processes involved in the formation of stones are compared with those involved in normal bio-mineralization and a model of urolithiasis is put forward based on modern systems science. Attention is concentrated on: (a) Directions of research based on physico-chemical theories of stone formation; (b) The role of renal tubular defects in urolithiasis; (c) The role of free radical reactions in stone formation; and (d) Macromolecular abnormalities and their correction.
Scanning Microsc 1993 Sep
PMID:A review of new concepts in renal stone research. 814 6

The lack of purine salvage enzyme, adenine phosphoribosyltransferase (APRT), leads to 2,8-dihydroxyadenine stone formation and/or crystalluria because it is insoluble in urine. Urolithiasis composed of 2,8-dihydroxyadenine is not only formed in a complete defect of APRT, but also in a partial deficiency of this enzyme. The defect is inherited as an autosomal recessive trait, the homozygous state is associated with high urinary levels of 2,8-dihydroxyadenine and with crystalluria, calculus formation, and potential nephrotoxicity. Determination of the APRT activity will facilitate quantification of the enzyme deficiency and elucidation of the hereditary history. 2,8-dihydroxyadenine excretion in the 24-hour urine and its circadian rhythm were determined using a new method of high performance liquid chromatography determination. By means of a standard case presentation, we illustrate the analysis of urinary sediments and calculi as well as the scanning electron microscopic images of this kind of stone.
Scanning Microsc 1993 Sep
PMID:Scanning electron microscopy of 2,8-dihydroxyadenine crystals and stones. 814 8

Urolithiasis is generally said to be rare in Africans. Detailed studies of the condition are few in our region. This 2 year prospective study at Muhimbili Medical Centre identified 77 adult patients with urinary stones. Males were affected 3 times more commonly than females and most patients were in the young productive age group. Many patients reached hospital several months or years after the onset of symptoms. However, as in industrial countries, upper urinary tract stones were predominant. Involved kidneys suffered serious damage especially in the presence of obstruction and infection. The only available treatment was outmoded surgery, and long delays were inevitable in the face of overstretched resources, resulting in the sacrifice of kidneys. Urolithiasis is probably not nearly as uncommon as we have been led to believe from impressions and retrospective studies of incomplete records. Therefore, there is a need for more research on the problem in our region.
East Afr Med J 1993 Sep
PMID:Urinary stone disease in Tanzania: an insight into the magnitude of the problem. 818 37

With extracorporeal shock wave lithotripsy, stone fragmentation and the potential creation of residual stones has become an integral part of the treatment strategy. Therefore, true recurrence, regrowth and pseudo-recurrence determine the rate of new stone formation. In nonselected series the overall recurrence rate after ESWL varies between 6% after 1 year and 20% after 4 years. The comparison between recurrence rate after ESWL and the natural recurrence rate reveals that the results of ESWL are better than expected. Lithotripsy has no specific effect on true stone recurrence, and even the pseudo-recurrence is of minor clinical significance. Nevertheless, metaphylaxis keeps its place in treatment of recurrent urolithiasis.
Urologe A 1993 Sep
PMID:[Parameters influencing the incidence of recurrent urinary calculus after ESWL]. 821 30


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