• Investigative and Clinical Urology
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• 제59권6호
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• pp.371-375
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• 2018

Purpose: To compare patients with sepsis due to obstructive urolithiasis (Sep-OU) and underwent drainage by percutaneous nephrostomy (PCN) or a double-J (DJ)-ureteral stent and to identify predictive risk factors of DJ stent failure in these patients. Materials and Methods: We reviewed our records from January 2013 to July 2018 and identified 286 adult patients with Sep-OU out of which 36 had bilateral involvement, thus total 322 renal units were studied. Urologic residents in training carried out both ureteral stenting and PCN tube placement. Demographic data and stone characteristics were recorded along with Charlson comorbidity index. For predicting risk factors of DJ stent failure, those variables that had a p-value <0.1 in univariate analysis were combined in a multinomial regression analysis model. Results: The patients with PCN placement were significantly older than those with DJ stent placement (p=0.001) and also had significant number of units with multiple calculi (p=0.018). PCN was also placed more frequently in those patients with a upper ureteric calculi (p<0.05). On multinomial regression analysis multiple calculi (p=0.014; odds ratio [OR], 4.878; 95% confidence interval [CI], 1.377-17.276) and larger calculi size (p=0.040; OR, 0.974; 95% CI, 0.950-0.999) were the significant predictors of DJ stent failure. Conclusions: In patients with sepsis from obstructive urolithiasis due to larger and multiple calculi a PCN placement might be better suited although this data requires further prospective randomized studies to be extrapolated.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.71-74
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• 2018

Endoscopic subureteral injection for treatment of vesicoureteral reflux (VUR) is known to be safe and efficient due to its minimal invasive nature. Being non-migratory, non-antigenic, and biocompatible, Macroplastique (Polydimethylsiloxane) is likely to be stable over time. A 5-year-old boy with a past history of subureteral administration of Macroplastique for unilateral Grade V VUR 4 years ago presented with recurrent gross and microscopic hematuria, along with suprapubic pain. On computed tomography (CT) abdomen, calcified material, suspected to be a stone, was visualized in the bladder. On diagnostic cystoscopy, calcification was seen around the orifice site where Macroplastique injection had been performed. We removed the calcific material by Holmium laser. Endoscopic subureteric implantation has several advantages, but nevertheless, vigilance is needed to detect long-term complications, especially in patients with gross or microscopic hematuria.

• Journal of Yeungnam Medical Science
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• 제16권1호
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• pp.85-93
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• 1999

세대 및 특징이 다른 쇄석기종의 치료효과와 안전성을 비교하기 위해 2세대 Northgate사의 SD-3 쇄석기와 3세대 Storz사의 Modulith SLX 쇄석기로 체외충격과 쇄석술을 시행한 단일요로결석 환자 2000례를 분석한 결과, 치료효과를 판정해 볼 수 있는 요로결석의 위치 및 크기에 따른 성공률과 재시행률에서는 큰 차이가 없는 것으로 분석되어, 제 3세대 쇄석기인 Modulith SLX와 Northgate SD-3의 치료효과는 비슷한 것으로 나타났다. 그리고, 두 쇄석기종 모두에서 심각한 합병증의 발생은 없었으나, Northgate SD-3에서 Modulith SLX 보다 합병증으로 인한 입원치료를 받은 환자의 수가 많았다. 이상으로 두 기종 사이의 치료효과에는 큰 차이가 없고, Modulith SLX률 이용한 체외충격파쇄석술이 조금 더 안전한 것으로 나타났지만 두 기종의 장단점을 서로 보완하여 사용한다면 더욱 효과적인 치료방법이 될 것으로 생각된다.