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[Primary vaginal lithiasis associated with urethrovaginal fistula. Report of a case and review of the literature].

Vaginal stones are rare. We can classify them as primary or secondary, depending on the presence or the absencse of a foreign body nidus. Various cases can led to stone formation. Most of them developed in women with a vesicovaginal or urethrovaginal fistula, as well as in patients with congenital anomalies of the genitourinary tract, previous pelvic radiotherapy, neuropathic bladder and other different causes of vaginal outlet obstruction. Secondary vaginal stones, formed around foreign bodies, are not so frequent. Radiological examination and urethro-vaginoscopy make easy the right diagnosis. Sometimes the stone may be fragmented by lithotripsy before the extraction. The associated etiology should be treated concomitantly in order to prevent recurrence. We report a case of primary vaginal stone associated with an urethrovaginal fistula in a 25 years old women and a review of the related literature.

Adult↗

[Surgery of renoureteral lithiasis. Current indications].

INTRODUCTION: Today, the issue about kidney and ureteral stone and their management is based on ESWL (Extracorporeal Shock Wave Lithotripsy) like singly or as a part of combination therapy. In some cases, endoscopic procedures (URS, PNL) with contact lithotripsy, is the first-line treatment. Retroperitoneoscopic is a therapeutical option in some hospitals. Open stone surgery is now drastically reducing and the endoscopic and extracorporeal methods are increasing, overcoat ESWL in those hospitals who has an own lithotripter. The optimal results of non-invasive procedures, and the ESWL advantages for the patients (outpatient and anesthesia-free treatment, decreased morbidity,...), has caused limited annual indications of open surgery for stone disease even a complete disappearance in many center. MATERIALS AND METHODS: The Stone and Lithotripsy Unit of "Jiménez Díaz" Foundation (FJD) (Madrid), who has an own lithotipter (Modulith SL 20, STORZ) make an evaluation of 54 patients treated with open surgery (1990-2000) in order to reflect on the indications. Nephrectomy for serious paremquimal lithiasic lesions (complicated pyelonefhritis, xantogranulomatosis....) is not included. RESULTS: The open surgery techniques for stone diseases were the classic according to every case: pielolithotomy (simple or extended +/- infundibulolithotomy), anatrophic nephrotomy, ureterolithotomy,.... At the same time it should be resolved those anomalous structures or obstruction associated to the stone disease (congenital hydroneprosis, ureterocele,...). DISCUSSION: Now days are difficult cases of stone diseases to be managed for any methods included open surgery. It's the renal complex stone. Of course, surgery is the best option, the more effectively choice. When endoscopic procedures (URS, NPL) fall and the stone is synthomatic must be operated. When they are serious situation (septic shock, complications derived from the others methods,...). It's necessary an urgent and effectively treatment and it's the open surgery. CONCLUSION: Open surgery is actually indicated for the complex renal stone and the complicated ureteral stone. So, the training on open surgery should be at the same time on the endoscopic, laparoscopic or extracorporeal. Open surgery will be the first-line treatment in some case. Open surgery should be considered in those urgent situation and will be done with skill and precision.

Adult↗

[The Somovillas: a family of lithiasis surgeons from Rioja. Chronology of their trajectory in Arnedillo, 16th Century].

In the second middle of the XVI century lived in Arnedillo Juan and Francisco Somovilla, booths "maesse". The names of his wives were Anna Garcia and Iomar de Oña. The brothers of Juan and Anna were Mardia, Diego baptised on 20 of june of 1566, and Iñigo. Juan Somovilla passes away on 22 of December of 1574. His brother made the testament. We think that Juan was the surgeon that we contracted by Felipe II, instead of Francisco. Francisco Díaz talked about Arnedillo, as an important thermal baths in the treatment of the kidney diseases, in his text. If Arnedillo was a centre of treatment of urinary disease, the Somovilla family could learn here the surgery of bladder litiasis.

History, 16th Century↗

[Vesico-urethral lithiasis secondary to foreign body].

We report a case of vesico-urethral litiasis secondary to foreign body (gauze) calcificated, left in prostatic cell during prostate open surgery of performed twelve years ago. In the related literature we observe that most of foreign urinals bodies are secondary to the introduction through the urethra of objects with autoerotic finality in normal patients or more often with psychiatric disorders, and only a small proportion are of iatrogenic origin, mainly in the last ten years.

Aged↗

[Multiple urinary lithiasis and nephrocalcinosis secondary to primary Sjögren syndrome].

A 39 year old women with a primary Sjögren syndrome (pSS) had bilateral and multiple nephrolithiasis and nephrocalcinosis due to distal renal tubular acidosis (dRTA), hypercalciuria and hypocitraturia. She had in serum positive antinuclear antibodies with mottled pattern 1/320, totals ENA, Anti-SSA/Ro 52, Anti-SSA/Ro 60 and Anti-SSB-La antibodies. Stones were removed with extracorporeal shock wave lithotripsy satisfactory and were composed of calcium phosphate and calcium oxalate. Metabolic abnormalities were resolved with potassium citrate and hydrochlorothiazide. At two years of follow-up, the patient hadn't stone recurrence and had normal 24-hour urinary levels of citrate and calcium.

Adult↗

[Indinavir and renal lithiasis].

Indinavir is a new specific and potent drug that inhibits, like other antiretroviral agents, the protease of immune deficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), an enzyme necessary to maduration and replication of the virus. Indinavir has the capacity to bind the active site causing a decrease in plasma of HIV1-RNA and an increase of T-CD4 helper lymphocytes. The aim of this work is to study in HIV and/or AIDS patients treated with indinavir the crystalluria and the formation of renal calculi due to the clearance of this drug. Two out of nine patients studied in this work presented abundant crystalluria and one of them presented spontaneously passed renal stone. Urinary crystals were studied under polarized-light microscopy and renal stone was analyzed by infrared spectroscopy.

HIV Infections↗

[Brief history of vesical lithiasis management].

Stones of the bladder are one of the oldest illness that we know. History of its treatment has been cause of discussion in different moments. Since first treatments in Egypt or India, until our extracorporeal shock waves lithotritia (ESWL), there have been many intermediate treatments. The objective of this work is to know a little about some of these advances and their authors, as well as the instruments that have made it possible.

History, 15th Century↗

[Anuric renal insufficiency caused by bilateral ureteral lithiasis].

A 73-year-old man was admitted to the ICU for anuria. He reported no history of urinary disease. The abdominal roentgenography and two echographies showed an empty urinary bladder, a right ureteral calculus without dilatation of the urinary tract. Computed tomography demonstrated the presence of a left ureteral stone. Bilateral retrograde ureteroscopy and drainage allowed a rapid recovery. When the abdominal roentgenography and echography cannot explain the occurrence of anuria, the computed tomography, or better the helical CT, can demonstrate the presence of otherwise unrecognized calculi.

Acute Kidney Injury↗

Campylobacter jejuni: unusual cause of cholecystitis with lithiasis. Case report and literature review.

A 51-year-old man presented with acute cholecystitis and the routine intraoperative culture of the bile grew Campylobacter jejuni. The patient was cured by laparoscopic cholecystectomy without specific antimicrobial treatment. Cholecystitis owing to Campylobacter spp. could be missed because a culture for Campylobacter is not routinely requested nor is it cost effective to look for it in bile or gallbladder specimens. Moreover, the fastidious nature of these bacteria dictates against their recovery in routine culture. Because this is a rare infection at this site, a review of the literature on this infection is included.

Campylobacter Infections↗

Recurrence of biliary drug lithiasis due to dipyridamole.

The occurrence of drug-containing gallstones is not often observed. To our knowledge, three drugs have so far been incriminated-ceftriaxone, glaphenine, and dipyridamole. This report presents the case of an 85-year-old woman who developed a recurrent drug-containing gallstone caused by dipyridamole eighteen months after a previous stone had been removed endoscopically.

Aged↗