Extra corporeal shock wave lithotripsy in the management of calyceal stones

Renal stones are a life long disease characterized by formation of solid concretions within the kidney or its drainage system. The extra corporeal shock wave lithotripsy is widely used in the treatment of calyceal stones, for any given location within the calyceal system.stone, free rate varies with increasing stone size, stone composition and site of the stotne. This study was conducted to evaluate the eftectivenoss, stone free rate and complications of ESWLin the treatment of calyceal stones, also to evaluate the eftect of urinary tract infection on success rate.This study included 25 patients schoduled for ESWL for calyceal calculi exclusion crileria were body weight more than 120 Kg and stone diameter more than 2.5 cm. ESWL was done with the lithostar lithotripter. [SIEMENS LITHOSTAR II] Post ESWL assessment by plain x-ray [KUB] one day and 2 weeks after. Follow up was done by KUB monthly until patient is stone free or ESWL terminated it was found that in patients with upper calyceal stones, the success rate was 83.3%, in lower calyceal stones and in combined stones, it was 57.1%. Middle calyceal stones were all in combind cases lower calyceal stones have high success rate for the obtuse infundibulopelvic angle, wide calyceal neck and short calyx. According to number of stones, the success rate for multiple stones was 60%, while, in single stones, it was 86.6%. According to the stone burden the success rate for stones less than 1 cm was 84.6% but for stones more than 1 cm, it was 66.6%. According to the number of sessions, the mean number of sessions was 2.6 which is higher than other studies as the mean of loading voltage was 16.4 bkilovolt which is relatively low. According to stone composition, the best results were for uric acid dihydrate and calcium phosphate, the next result was for calcium oxalate dihydrate, the worst was for calcium oxalate monohydrate. According to urine culture and urosepsis, it was found that 8% of sterile cases become Infected post ESWL. Inspite of its few complications, ESWL, when properly done and when correctly indicated still provides a marvelous alternative way to solve the problem of urinary stones

Genitourinary mycoplasma. Mycoplasma prostatitis

Nineteen patients with the initial diagnosis of chronic nonbacterial prostatitis were screened for mycoplasma infection. Expressed prostatic secretion was examined by the "Mycofast" technique. Positive mycoplasma assays were obtained in 68% of patients. Treatment based on an identibiogram provided in the "Mycofast" produced clinical cure in all patients and bacteriological cure was documented in 5 of them. Search for mycoplasma was warranted in all patients with chronic nonbacterial prostatitis. The "Mycofast" is an inexpensive, fast and reliable technique to detect mycoplasma in genitourinary specimens