ABSTRACT
Examining descending cystograms in 357 patients with renal colic caused by calculi in the ureteral prevesical portion revealed that 34 (9.5%) had the asymmetric bladder filling defect which was ipsilateral to the calculus. In 11 patients with the calculi strangulating in the ureteral ostium, the outlines of filling defect took the form of a rim around the calculus. Echography provides direct ultrasonic evidence for a calculus in 186 (52%) patients and the asymmetric shape of the bladder only in 1 patient. The described symptom caused by urinary detrusor spasm and, in some cases, by perifocal tissue edema at the site of the ureteral ostium with its strangulated calculus may serve as indirect evidence for a lower ureteral calculus.
Subject(s)
Colic/diagnostic imaging , Ureteral Calculi/diagnostic imaging , Urography/methods , Adult , Aged , Colic/etiology , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Ultrasonography , Ureteral Calculi/complications , Urinary Bladder/diagnostic imagingABSTRACT
Extracorporeal shock-wave lithotripsy (ESWL) is the treatment of choice in the majority of urinary calculi. In experimental and clinical research it has been shown that the method has short-term deleterious effects on renal function. Several factors, such as urinary tract infection (UTI), the site of the stone, pre-existing renal abnormalities, the number and intensity of the shock waves may influence the extent of the damage. The aim of this study was to measure the excretion of the renal microsomal enzyme, leucinaminopeptidase (MLAP) as expression of renal damage following ESWL. Our study shows that there was a significant elevation in urinary excretion of MLAP immediately after ESWL, especially in patients with UTI. These results indicate that UTI may be one of the risk factors for aggravation of renal damage after ESWL. However, these changes are transient and expressed less than in patients with light renal trauma arising because of other external influence.
