The Comparison of Efficacy of Ureteroscopic Removal and Shockwave Lithotripsy in Lower Ureteral Stones / 대한비뇨기과학회지

PURPOSE: There still exists controversy as to the most appropriate treatment modality for lower ureteral stone; ureteroscopic removal of stone (URS) versus shockwave lithotripsy (SWL). So we compared clinical results of both procedures to help determine which is more appropriate as initial management for lower ureteral stones. MATERIALS AND METHODS: We retrospectively reviewed 587 patients who had been treated for their lower ureteral stones at our institute. 184 patients were treated under the direct vision of ureteroscope using stone basket or Lithoclast and 403 patients were treated by SWL. We analyzed success rates and complication rates of each procedure. RESULTS: Overall stone free rates were 95.7% with URS and 84.6% with SWL. In SWL group, stone free rate after third session was 88.3% when the stone was smaller than 10mm and 74.0% when the stone was larger than 10mm. But in URS group, the size of stones did not affect to stone free rate. And impaction of stone affected stone free rate. Stone free rates of impacted ureteral stones were 95.2% with URS and 63.8% with SWL. The complications of URS were found in 8.7% but all of them were successfully treated with ureteral stenting for 3 weeks or conservative treatment. While complications in SWL group were minimal. CONCLUSIONS: In our study, URS and SWL were successful and safe treatment modality for lower ureteral stones. And we consider URS as the first line treatment modality when the stone is larger than 10mm or impacted.

Early Experience with Extracorporeal Magnetic Innervation (ExMI) Therapy for Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: The purpose of this study is to assess if extracorporeal magnetic innervation (ExMI) can be successful in treating stress urinary incontinence (SUI). MATERIALS AND METHODS: We studied 38 women with demonstrable stress urinary incontinence. Evaluation before treatment included history, physical examination, voiding diary, perineometer that measures the strength and endurance of pelvic floor muscle contractions, urodynamic study and quality of life questionnaires. Treatments were performed for 20 minutes (10Hz for 10 minutes and 50Hz for 10 minutes), twice a week for 6 weeks. After ExMI therapy, all of the evaluations were repeated at the eighth week. RESULTS: The follow up care was continued on the patients for longer than 2 months. Fourteen out of the 38 patients (36%) were dry after the ExMI treatment. The frequency of leak episodes was reduced from 2.8 to 1.7 in 2 months. Pelvic floor muscle contraction (PMC) pressure was increased from 10.42 4.35 to 17.02 4.04mmHg. CONCLUSIONS: Our early results suggest that ExMI therapy is an effective approach for the treatment of SUI. However, longer follow-up is required to determine how long the benefits of treatment last, whether re-treatment will be necessary, and what the effective treatment strategies are.