We reviewed 1055 patients with symptomatic urinary calculi treated by extracorporeal shock wave lithotripsy (ESWL) monotherapy to determine the long-term stone regrowth and recurrence rates as correlated with the pre-treatment stone burden, site and multiplicity. Long-term follow-up (mean 75.8 months) was available in 94 patients, representing 106 renal units. The recurrence of stone was defined as reappearance of stone on follow-up plain abdominal radiographs. The regrowth of stone was defined as stone regrowing larger than one-third of the original residual size. A stone-free rate of 53% was achieved. The overall stone regrowth and recurrence rates were 26 and 15% respectively. It was concluded that the stone recurrence rate after ESWL was not influenced significantly by the stone size or the multiplicity, but that the regrowth rate was. Stone recurrence and regrowth rates after ESWL were both influenced by the stone location.

Selective dorsal rhizotomy significantly improved urgency, frequency, incontinence, and urodynamic bladder capacity at first incontinence in a significant proportion of spastic cerebral palsy children.

Objectives: We report our results of an audit on extracorporeal shockwave lithotripsy (ESWL) of renal and ureteric stones using the Dornier Lithotripter S (Dornier MedTech, Wessling, Germany). Materials and Methods:We retrospectively reviewed the outcome of ESWL for patients treated between March and December 2003 (pilot). Prospective collection of data was performed for patients treated between October 2004 and March 2005 (re-audit) after an upgrade to the power unit of our shockwave emitter by the manufacturer in September 2004. Patient demographic data, target stone characteristics and treatment outcome were recorded. Analysis of the results between the two periods was made. Results: ESWL was performed on 232 and 220 target stones in the pilot and re-audit periods, respectively. Patient demographic data and stone characteristics were similar between the two periods. Clinical success (stone fragments less than 4 mm in size after one session of ESWL) was achieved in 31% and 61% (stonefree 19% and 38%) of patients in the pilot and re-audit periods, respectively (P < 0.0001, χ 2 test). Patients requiring re-treatment with ESWL to achieve success and auxiliary procedure reduced to 8% and 5%, respectively, in the re-audit period (pilot: 14% and 14%, respectively). The overall complication rate was reduced from 6.2% (pilot) to 3.3% (re-audit). Obstructive complications significantly reduced from 4.8% to 0.5% (pilot vs re-audit, Fisher's exact test, P = 0.012). Conclusion: Effectiveness of our lithotripter was significantly improved and obstructive complications were significantly reduced after an upgrade to the power unit of the electromagnetic shockwave emitter of our lithotripter.

Aim: To report and analyze the disastrous effects of ketamine abuse on the urinary system seen in young Hong Kong patients. Methods:The hospital records of 80 ketamine abusers who attended the urology clinics of Princess Margaret Hospital and Tuen Mun Hospital were retrospectively reviewed. Their blood creatinine level, cystoscopic and urodynamic findings were analyzed. Results: Up to 30-50% of our patients had either contracted bladder with diminished bladder capacity (< 100 mL) or sonographic evidence of hydronephrosis Conclusion: Ketamine abuse can lead to structural damage of the entire urinary tract, but whether the damage is reversible after quitting ketamine abuse requires further studies.

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