ABSTRACT
PURPOSE: The aim of this study is to compare the shock wave lithotripsy (SWL) with the rigid ureteroscopic stone removal (URS) in order to establish the efficacy in treating upper ureteral stones according to the stone size. MATERIALS AND METHODS: We reviewed 328 patients who have been treated for upper ureteral stones between January 1999 and December 2002. 227 patients were treated with SWL, and 101 patients were treated with URS. We analyzed the success rates of the stone removal, reasons for failure, and complication rates of each procedure. RESULTS: The overall success rate of the URS was 93.1%. In terms of stone size, the success rates were 94.5% (10mm), respectively. With the SWL treatments, the overall success rates after the first, second, and third sessions were 59%, 78%, and 92.5%, respectively. According to the stone size, the success rates were 96.5% (10mm) after third sessions, respectively. The success rate was significantly affected by the size of the stone in the SWL group, but this was not the case with the URS group. The associated complication rates of URS and SWL were 11% and 7%, respectively. CONCLUSIONS: In this study, URS was relatively more efficacious than SWL when the stone was larger than 10 mm. The proper selection of patients for in situ SWL or URS would improve the results of the initial treatment.
Subject(s)
Humans , Lithotripsy , Shock , Ureter , Ureteral Calculi , UreteroscopyABSTRACT
PURPOSE: This study was performed to assess the difference of the continence indices before and after the tension-free vaginal tape procedure (TVT). MATERIALS AND METHODS: We reviewed retrospectively our experience with 30 patients treated with the TVT procedure for stress urinary incontinent women, between January 2002 and December 2003. A comprehensive medical history, physical examination, urinalysis, urine culture, voiding diary, uroflometry and cystourethrogram were performed preoperatively and 3 months after surgery. The positions and mobilities of the bladder neck and the urethra were compared preoperatively and postoperatively by cystourethrograms both at rest and during voiding. The surgical outcomes were evaluated by global satisfaction question, and the definition of success or failure determined by using Stamey's criteria. Multiple parameters, with regard to the uroflometry, and cystourethrogram were analyzed using chi-square tests. RESULTS: In the 30 patients followed up, the TVT procedure was successful in 93.3% (cured 83.3%, improved 10%) 3 months after the procedure. The position and mobility of the bladder neck showed no significant difference before and after surgery, but significant change in the urethral knee angle in cured and improved patients during maximum straining was noted cystourethrographically on cured and improved patients during maximum straining. The preoperative peak flow rates and average flow rates were significantly decreased after surgery, but the residual urine was not. There were no serious complications related to the procedure. CONCLUSIONS: The TVT procedure is an effective surgical procedure for the treatment of female stress urinary incontinence. The procedure seems neither to change the hypermobility nor to elevate the position of the bladder neck. Urinary continence after surgery is most probably achieved by creating a dynamic mid urethral kinking at stress.