Choong Hee Noh

Efficacy and safety of emergency ureteroscopic management of ureteral calculi.

Purpose To evaluate the efficacy and safety of the ureteroscopic management of ureteral stones immediately after a first colic attack. Materials and Methods We retrospectively analyzed the data of 226 patients with obstructive ureteral stones who underwent ureteroscopy with stone retrieval. The 67 patients in group A underwent ureteroscopy within 48 hours of admission to our emergency department, whereas the 159 patients in group B underwent ureteroscopy more than 48 hours after admission. The chi-square test was used to evaluate and compare stone-free status, auxiliary procedures, and complications and the Kruskal-Wallis and Fishers exact tests were used to analyze qualitative data. Results Mean stone sizes in groups A and B were 2.41±1.62 mm and 4.11±2.64 mm, respectively. No patient experienced a major complication during or after the procedure. Stone-free rates were 89.55% and 89.93%, respectively. Conclusions Emergency ureteroscopy in cases of obstructive ureteral stones is both safe and effective and offers the advantages of immediate stone fragmentation and the relief of acute-onset colic pain.

Percutaneous Nephrolithotomy: Comparison of the Efficacies and Feasibilities of Regional and General Anesthesia

Purpose To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. Materials and Methods One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. Results The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9±3.2 days vs. 11.5±6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). Conclusions Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.

THE RESULTS OF SPARC PROCEDURE FOR FEMALE STRESS URINARY INCONTINENCE STRATIFIED BY PREOPERATIVE VALSALVA LEAK POINT PRESSURE

Study design, materials and methods 246 women with SUI underwent SPARC procedure between January 2000 and June 2006. The patients were divided into 2 groups by VLPP: group A (VLPP<60cmH2O) and group B (VLPP≥60cmH2O) and then the objective success rate and subjective success rate were assessed. Before surgery, the patients were evaluated with history taking, physical examination, and urodynamic studies. The objective outcome was evaluated with an 1-hour pad test in 6 month postoperatively and the subjective satisfaction rate was assessed using questionnaires for the patients’ satisfaction and evaluating by recommendation rates of SPARC to other patients. The objective success rate included cure and improvement, the subjective success rate satisfaction and fair.

PREDICTORS OF THE THERAPEUTIC EFFECTS OF THE PRIMARY ENDOSCOPIC URETHRAL REALIGNMENT IN MALE URETHRAL INJURY

Hypothesis / aims of study Primary urethral realignment has been tried by some investigators as an alternative means of treatment, in an effort to avoid longterm suprapubic drainage, as well as to simplify future reconstructiveefforts. Therefore early primary endoscopic urethral realignment is considered as a promising primary treatment method for the male urethral injury. We retrospectively evaluated variable factors affecting the effectiveness of the primary endoscopic urethral realignment in male urethral injury to identi fy the significant risk factors.