[Show abstract][Hide abstract] ABSTRACT: Objective:
To review our experiences with management of symptomatic ureteral calculi complicating pregnancy.
Between January 2001 and December 2011, 57 pregnant women were treated for symptomatic ureteral stones. The medical records of these patients were reviewed retrospectively.
The mean patient age was 24 (range 17-37) years and gestational age at presentation was 26 weeks (range 12-38). Most of the cases (60%) occurred in the third trimester. Flank pain was the most common presenting symptom (90%). Ultrasonography was the initial test confirming diagnosis. With conservative management, spontaneous passing of stones was noted in 13 cases (22.8%). In 10 patients (17.5%), symptomatic relief occurred without spontaneous passing of stones until the end of pregnancy. Invasive management was required in 34 patients (59.6%) because of persistent pain and/or ureteral obstruction. In 29 patients, ureteral calculi were treated successfully by ureteroscopy. Stones were extracted by pneumatic lithotripsy or forceps. In 5 patients, only double-J stent was inserted during ureteroscopy as a result of unreached or migrated stone. The majority of patients (58.8%) had lower ureteric calculi. The mean size of the stones retrieved was 7 mm (range 4-13 mm). Minor complications like ureteric edema, mild ureteric laceration, or bleeding were seen in 5 patients. Three patients had a urinary tract infection and 3 complained of stent-induced bladder irritation; uterine contraction was observed after the procedure in 1 patient, but no serious obstetric or urologic complications were observed in any case.
When conservative treatment fails, ureteroscopy is an effective and safe therapeutic option in symptomatic ureteral calculi complicating pregnancy.
[Show abstract][Hide abstract] ABSTRACT: Although there are various treatment types, majority of women with urinary incontinence
do not seek care for that disorder. We present a case of woman who
used a walnut for the treatment of urinary incontinence by herself.
[Show abstract][Hide abstract] ABSTRACT: Aim
The aim of this study was to evaluate the influence of our spring water
on urinary analytes and stone samples in (patient with) uric acid stone.
Material and Methods
Twenty patients with uric acid stones underwent a nutritional
and metabolic evaluation at baseline and after a controlled diet
including our spring water. Stone samples were also left in the
usual water and in the spring water. The weights of stones were
measured before and 7 days after incubation.
In patients who drank spring water, there was a tendency for
the mean urine pH to increase, the change was significant
statistically. On the other hand, urine citrate excretion
significantly also increased in these patients (p<0.005). The
differences between initial and end-dry weights of stone
examples were significant statistically (p<0.05).
The results of our pilot study may help us to reduce uric acid
stone formation and recurrence with the alkaline spring waters.
[Show abstract][Hide abstract] ABSTRACT: Ureterocele, while not an uncommon pediatric urologic
problem, has been reported only rarely in adults. Adult
bilateral ureteroceles with calculi is an uncommon and
well tolerated, relatively rare clinical entity. Although
ureteroceles in adults are usually asymptomatic, various
symptoms tend to appear in ureteroceles with
stones, such as fl ank pain, urinary tract infections and
bladder irritability. While ureteroceles occur more commonly
in women, stones in ureteroceles tend to be more
common in men. Most ureteroceles can be safely managed
transurethrally endoscopically which is generally
well tolerated by most patients. We present an unusual
clinical presentation of bilateral adult non-obstructing
ureteroceles containing urinary stones.
[Show abstract][Hide abstract] ABSTRACT: Introduction: Vesicouterine fistula without vaginal leakage of urine, cyclic hematuria and amenorrhea is a rare condition, referred to as Youssef's syndrome. It is a rare complication of caesarean section when bladder injury occurs and a fistula develops. Although standard treatment of this syndrome is surgical repair, we suggest that surgical repair is not always necessary, and that recovery even pregnancy may follow conservative management and spontaneous healing. ÖZET Vajinal idrar kaçağı olmadan vezikouterin fistül, siklik hematüri ve amenore birlikteliği Youssef sendromu olarak adlandırılan ender bir durumdur. Sezaryen ameliyatının ender bir istenmeyen yan etkisi olan bu klinik tablo, mesane yaralanmasına bağlı fistül geliştiğinde görülür. Bu durumun standart tedavisi cerrahi onarım olsa da, koruyucu tedavi ve kendiliğinden iyileşmeyle de düzelme ve hatta gebeliğin görülebileceğini bildirmekteyiz. Anahtar kelimeler: Sezaryen, Uterovezikal fistül, Youssef sendromu INTRODUCTION In 1957, Youssef described the classic triad of caesarean section, amenorrhoea, and cyclic haema-turia (menouria) in the absence of urinary inconti-nence as a syndrome, which is characteristic of ve-sicouterine fistula 1 . Youssef syndrome is a rare complication of caesarean section following inad-vertent bladder injury. Vesicouterine fistula is one of the least common types of urogenital fistula, ac-counting for only 1-4% of all cases 2 . Commonly, in modern obstetric practice, vesicouterine fistulas follow the lower segment type of caesarean section which accounts for 83% of cases 2 . Rarely, vesicou-terine fistulas follow long labor, forceps delivery, vaginal birth after caesarean section, abdominal pregnancy for perforation of the anterior wall of the uterus, gynaecological injuries, tuberculosis of the genital tract, or intrauterine contraceptive devi-ces 3-5 . Improved obstetrical and surgical practice is responsible for the decrease in the incidence of these fistulae in comparison with a much more fre-quent occurrence in the 19th century, but the pre-valence worldwide is now increasing because more caesarean sections are being carried out. It is im-portant to be aware of its clinical presentation as well as the potential for non-surgical management.