21/250. Preputial calculi: a case report. The patient was a 92-year-old male whose chief complaint was urinary retention. The x-ray film showed multiple overlapping calcification shadows in the penile region. renal insufficiency was speculated to be due to post-renal obstruction. Under the diagnoses of closure of the preputial orifice by balanoposthitis followed by urinary retention and preputial calculi, an urgent dorsal incision of the prepuce was made. Then, stone removal and indwelling catheter placement were performed. Renal function recovered soon after the operation, and the patient could urinate freely without catheterization. This case reminds us of the significance of surgical treatment for phimosis in elderly patients. ( info) |
22/250. Urethral calculi managed with transurethral holmium laser ablation. In situ holmium laser lithotripsy is a safe, effective procedure for the treatment of impacted urethral stones. This procedure can be performed transurethrally as an outpatient with minimal tissue trauma and render patients stone free. The authors utilized this procedure in 2 patients whose anatomy did not allow the calculi to be manipulated into the urinary bladder in a retrograde manner. Because of its successful use elsewhere in the urinary tract, we believe that holmium laser lithotripsy may be the treatment of choice for impacted urethral stones. ( info) |
23/250. Recurrent urethral hairball and stone in a hypospadiac: management and prevention. A 32-year-old perineal hypospadiac man presented with recurrent urethral hair growth, stone, and stricture with a history of multiple urethroplasties. He was treated by urethrolithotomy, internal urethrotomy, laser epilation of the hair-bearing urethral graft, closure of the fistula, and chemical depilation of the neourethral hair. A dilute solution of thioglycolate was prophylactically instilled into the neourethra at intervals of 3 months to ensure complete tricholysis and to prevent recurrent hair growth in the future. ( info) |
24/250. Ureteral fibroepithelial polyp associated with urolithiasis induced by steroid therapy in a child: a case report. A 14-year-old boy complained of left flank pain. He had been given high-dose corticosteroid therapy for chronic inflammatory demyelinating polyneuropathy (CIDP). Retrograde pyelography revealed irregular defects at the left ureteropelvic junction (UPJ), and ureteroscopy demonstrated ureteral polyp. The polyp was removed and histologically diagnosed as fibroepithelial polyp. hypercalciuria due to the corticosteroids and bedridden was assumed to have been a causative factor in the stone formation. To our knowledge, this is the first report of a ureteral fibroepithelial polyp in children associated with urolithiasis, and associated with CIDP. ( info) |
25/250. A primary vaginal stone in a disabled child. BACKGROUND: Primary vaginal stones in children are extremely rare but important because they are often mistaken for bladder calculi on plain film. CASE: A 13-year-old girl was admitted to the hospital with abdominal pain. Physical and serial radiologic examinations found a hard mass anterior to the rectum. By vaginoscopy, the stone was found at the posterior fornix of the vagina. CONCLUSION: Primary vaginal stones should be suspected, especially in disabled children. ( info) |
26/250. Iatrogenic injuries of renal pelvis and ureter following open surgery for urolithiasis. OBJECTIVE: To study the types of injuries of renal pelvis and ureter following open surgical procedures for urolithiasis and predisposing factors leading to such injuries and discuss various options for the management of iatrogenic injuries of the renal pelvis and ureter. patients AND METHOD: Case files and available radiographs of the patients who were managed for ureteral and renal pelvic injuries were reviewed. Initial procedure, mode of injury and clinical course were noted. RESULTS: The study consisted of 13 patients (9 males and 4 females). Age of the patients ranged from 18 to 65 years. Eight patients had injuries of renal pelvis or ureteropelvic junction and 5 patients got ureteral injuries. Primary management of ureteral and renal pelvic injuries was successful in 9 patients. Four patients required further surgery. Three out of 4 patients underwent nephrectomy and in 1 patient renal function deteriorated despite secondary pyeloplasty. Among 3 patients who had nephrectomy, one died postoperatively due to sepsis and haemorrhage. CONCLUSION: Injuries of the renal pelvis and ureter have significant morbidity and even mortality. Peroperative recognition of these injuries and appropriate management can prevent the late sequele of these injuries such as stricture formation leading to progressive renal damage. ( info) |
27/250. Partial hypoxanthine-guanine phosphoribosyltransferase deficiency as the unsuspected cause of renal disease spanning three generations: a cautionary tale. hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency is an X-linked defect of purine metabolism. Clinical manifestations are usually related to the degree of enzyme deficiency: complete HPRT deficiency (lesch-nyhan syndrome) presenting with severe neurologic or renal symptoms, or partial HPRT deficiency (Kelley-Seegmiller syndrome) manifesting as a gout-urolithiasis syndrome. A 3-generation kindred is described in which the recognition of partial HPRT deficiency in 2 adolescent male siblings presenting with uric acid lithiasis led to the diagnosis in 2 maternal uncles already in renal failure of unknown cause. This report highlights the importance of clinical awareness leading to early diagnosis, appropriate diagnostic methodology, and therapy of a treatable inherited disorder of purine metabolism for the prevention of renal failure. ( info) |
28/250. Laparoscopic management of urolithiasis in a continent urostomy. BACKGROUND: urinary calculi formation is an infrequent but challenging late complication of continent urostomy. Percutaneous endoscopic management of two patients with symptomatic pouch urolithiasis is described. CASES: A 48-year-old woman with a history of cervical squamous cell carcinoma (SCC) treated with primary chemoradiotherapy presented with recurrent pain and urinary tract infections (pouchitis). She had undergone continent urostomy 4 years previously for management of a vesicovaginal fistula. A 59-year-old woman following exenteration with continent diversion for recurrent cervix SCC had a 6-month history of refractory pouchitis. In both women, multiple pouch urinary calculi were identified. Their continent reservoirs were, in part, created using titanium staplers. Percutaneous CO(2) endoscopy afforded identification and removal of their stones and staples without complication. CONCLUSION: Successful treatment of continent urostomy urolithiasis is accomplished by percutaneous endoscopy. ( info) |
29/250. A rare complication of hydrocele. A case of multiple stones complicating a hydrocele is presented. review of the relevant literature has failed to show a similar case. The aetiology of stone formation appears to be obscure. ( info) |
30/250. Iatrogenic bladder stone formation on absorbable suture 3-years after radical prostatectomy. Vesical calculi formation on absorbable sutures is rare. The case of a 68-year-old white man, who had formed a large bladder stone on absorbable suture 3 years after radical prostatectomy, is reported. Endoscopic lithotripsy of the bladder calculi was performed and the suture was removed. ( info) |