Clinical Experience of Extracorporeal Shock Wave Lithotripsy with Modulith SL-20 in 750 Urinary Calculi / 대한비뇨기과학회지

PURPOSE: Extracorporeal shock wave lithotripsy(ESWL) has been established as the first line procedure of urinary stone treatment. We studied retrospectively to evaluate the effectiveness of ESWL. MATERIALS AND METHODS: ESWL was performed in 750 cases with Modulith SL-20 electromagnetic lithotriptor from January, 1994 to June, 1997 in our Department of Urology. RESULTS: Most patients were distributed between the fourth and sixth decades 72.5%), and male to female ratio was 1.47:1. There were 750 cases of urinary stones: 172 cases of renal stone(23.0%), 529 cases of ureteral stone(70.4%), 14 cases of renal and ureteral stone(1.9%), 35 cases(4.7%) of bladder stone, and range of size was 5mm-60mm in diameter The success rate according to stone location was 76.2% In renal stone, 98.1% in ureter stone, 84.3% in renal and ureteral stone, and 71.4% In bladder stone. The success rate according to stone size measured on the KUB and sonography was 98.0% in 5-10mm, 82.0% in 11-20mm, 46.4% in 21-30mm and 40.0% over 31mm. The average number of sessions was 2.8 sessions. Of 59 cases of staghorn calculi, 16 were treated without preoperative silicone ureteral stenting, while 43 were treated with preoperative silicone ureteral stunting. The complications were gross hematuria(69.6%), flank pain(13.4%), nausea & vomiting(8.4%), fever(1.9%), steinstrasse(1.2%), perirenal hematoma(0.7%) and uremia(0.1%). The failure rate was 8.8%. The causes of failure were large stone(2.67%), difficulty in eliminating lower caliceal stones(1.33%), bladder stone(1.33%), impact stone(1.07%), caliceal diverticulum(0.93%), infundibular stenosis(0.67%), steinstrasse(0.53%), ureterocele(0.13%), and patient's desire for operation(0.13%). CONCLUSIONS: ESWL is considered to be a safe and non-invasive treatment method. ESWL therapy is less effective for stones larger than 2cm(43.4%), staghorn calculi(52.5%) or the presence of anatomical obstructions.

A Case of Xanthogranulomatous Pyelonephritis in Children / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is an uncommon form of chronic pyelonephritis occurring usually in middle-aged women. This disease is characterized by destruction of the renal parenchyma which is then replaced by granulomatous tissue containing lipid-laden macrophages (foam cells). But this disease is hard to diagnose preoperatively since it resembles renal abscess, renal cell carcinoma, renal tuberculosis and so forth. Xanthogranulomatous pyelonephritis in children is rare. We report a case in a 30 month-old boy.