ABSTRACT
Bladder lithiasis is common in developing countries. It has become rare in industrialized countries and exceptional in the absence of associated lower tract pathology. usually caused by urinary tract infections, urethral obstruction or the presence of intravesical foreign bodies. Open cystolithotomy was performed on a 45-year-old patient with lower abdominal pain, moderate dysuria, pollakiuria, nocturia, and hematuria for a long time. A stone of 12 × 8cm in size and approximately 620 grams in weight was removed. The cystoscopy was performed without any infravesical obstruction during the operation. The stone analysis showed 21% struvite and 79% carbonate apatite. Bladder lithiasis is common in Morocco. However, giant lithiasis is rare and is the consequence of neglected voiding disorders. Open cystolithotomy remains the most treatment in the management of giant stones.
ABSTRACT
The extracorporeal shockwave lithotripsy (ESWL) is a minimally invasive therapeutic approach which has been widely used through the last years. The aim of this study was to evaluate the effectiveness of ESWL in the treatment of nephrolithiasis in Gharb Chrarda Bni Hssen area (North of Morocco). A retrospective study of 590 patients with urinary stone was conducted between February 2009 and January 2013 in the Centre of Lithotripsy Anoual Clinic Kenitra. The treatment consisted in one or several sessions of ESWL. Evaluation of efficiency was based on radiological examinations using abdominal echography during the consultation with the urologist after the last session. There were 306 males and 184 females aged 17-79 years. The medium size of stone was 12.3 ± 5 mm. The average number of sessions and shock waves were 4 and 2490, respectively. The shockwave session was continued until stone fragmentation was observed when 4000 shocks were given. Failure of stone fragmentation or the presence of fragments larger than 4 mm were indications of repeat ESWL sessions. 92% of patient stones were completely cleared (p < 0,05%). The majority of patients were asymptomatic. This data show that the ESWL is extremely successful in treating human kidney stone. It is the first line of choice as a treatment modality for this pathology by the population of this area.
