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Introduction: urinary stone is a multifactorial disease characterized by the presence of concretions in the urinary tract. The diagnosis of urinary lithiasis is based on clinical and imaging findings. The objective of this study was to determine the profile of patients suffering from urolithiasis in the city of Yaounde. Methods: this was a descriptive observational cross-sectional study with retrospective data collection. Patients with an age > 15 years and patients diagnosed with lithiasis confirmed by medical imaging were included in our study. The variables studied were sociodemographic, clinical and paraclinical. Results: a total of 120 patients were included in our study. The mean age was 40.46±12.62 years with extremes from 19 to 74 years. Male gender was predominant at 60.8% (n=73). Renal colic was the circumstance found in 67.5% (n=81). Physical examination was normal in 55.8% (n=67). Insufficient hydration was found in 45% (n=61) of cases. Abdominal scanner was the most performed examination in our study in 50.7% (n=61). The median stone density was 731 Hounsfield units [346; 1183.5]. The stones were predominantly located in the upper tract. The left renal topography was predominant in 35% (n=42) of cases. Urine culture revealed Escherichia Coli at 60% (n=15). Blood calcium, phosphorus and uricemia were requested in 15.8% (n=19), 0.8% (n=1) and 12.5% (n=15) of cases, respectively. The results were normal. In the absence of a laboratory specialized in biochemical analysis of calculi, a minority of patients (n=3) benefited from spectrophotometry. Conclusion: urinary lithiasis is a disease of men in their forties. Renal colic is the main revealing sign. The diagnosis is revealed by the abdominal scanner in half of the cases. Metabolic assessment and constitutional analysis of the calculus are still very rarely requested. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the antibacterial activity of four organic extracts: petroleum ether (PE), dichloromethane (DCM), methanol (MeOH), ethanol (EtOH) and aqueous extracts (digestion, decoction, maceration, and infusion), prepared from the leaves of the aromatic plant Myrtus communis. Phytochemical screening revealed a richness of this plant in secondary metabolites such as flavonoids, phenolic acids, anthraquinones, tannins, sterols, and terpenes. The antimicrobial activity of Myrtus communis extracts was evaluated in vitro by the agar diffusion method on two strains of bacteria commonly encountered in urinary tract infections and lithiasis: Staphylococcus aureus ATCC (25923), Proteus mirabilis reference strain ATCC (43862) and Proteus mirabilis clinical strain. All these strains were found to be sensitive to the extracts studied. The minimum inhibitory concentrations (MIC) recorded varied from 3.75 to 15 mg/ml, while the minimum bactericidal concentrations (MBC) were between 7.5 and 30 mg/ml. This activity is essentially bactericidal in nature. The analyses showed the presence of phenolic groups with antibacterial capabilities. The obtained results proved an interesting antibacterial activity of the majority of Myrtus communis extracts, translated by zones of inhibition of important diameter: extracts of methanol (28 mm), petroleum ether (28 mm) and aqueous solution (25 mm) towards Proteus mirabilis reference strain ATCC (43862), Staphylococcus aureus ATCC (25923) and Proteus mirabilis clinical strain, respectively. [ABSTRACT FROM AUTHOR]

Extracorporeal shock wave lithotripsy-related pain is the largest limiting factor in this technique. Our study aimed to compare the effectiveness of different types of analgesics for pain management used during ESWL sessions. We conducted a prospective study of 300 patients with urinary lithiasis justifying ESWL treatment. The patients were randomized to three groups: group I, included 100 patients who received intramuscular injection of 2cc of physiological saline solution (placebo), group II included 100 patients who received intramuscular injection of ketoprofen 100mg while group III included 100 patients who received lidocaine and prilocaine topical cream. Visual Analog Scale (VAS) was used to assess pain 10 minutes after and at the end of the session. Mean VAS score 10 minutes after and at the end of ESWL session was 3.7 and 4.91 respectively. There was no significant difference among the three groups with respect to: epidemiological data (age, sex, BMI, patient's history) and the characteristics of the renal stone (side, size, location, presence or not of double-J ureteral catheter). Eleven patients in the Group I terminated treatment early, with a significant difference compared to the other groups (p=0.003). VAS score 10 minutes after and at the end of ESWL session was statistically higher in Group I compared to Groups II and III (p < 0.001). Moreover, ESWL session was significantly more effective in Groups (II and III) compared to Group I (p<0.001). Pain treatment is necessary during ESWL sessions. Two painkillers molecules were assessed, which showed good pain control as well as an increase in the effectiveness of lithotripsy. [ABSTRACT FROM AUTHOR]

Calyceal diverticulum is acystic cavity in the renal parenchyma, communicating with the collecting system via an infundibulum. In more than 40% of cases it is associated with a stone and in most cases appears as milk of calcium forming a fluid level or multiple small stones. We here report the case of an 82-year old patient with no previous history, presenting with mild and intermittent right flank pain lasting for 8 years. Clinical examination was normal. The patient first underwent X-ray of urinary tree without preparation showing a density of calcium projecting into the upper pole of the right kidney (A). The patient then underwent uroscanner showing giant stone measuring 28mm within a caliciel diverticulum of the upper pole directly communicating with the renal pelvis (B). No associated urinary tract infection or haematuria were detected. Given patient's age and that he was paucisymptomatic and uninfected, therapeutic abstention and monitoring were indicated. In accordance with the recommendations of the experts, only symptomatic intradiverticular stones must be treated. First, extracorporeal shockwave lithotripsy (ESWL) allows improvement to the symptoms in 1 patient out of 2 and no stone fragmentation in 1 patient out of 4. In second intention, flexible uretero-renoscopy should be performed. Percutaneous nephrolithotomy can be performed if the stone is located in the lower pole (rare). Finally, in case of failure, laparoscopic treatment or open surgery may be proposed. [ABSTRACT FROM AUTHOR]

Calyceal diverticulum is acystic cavity in the renal parenchyma, communicating with the collecting system via an infundibulum. In more than 40% of cases it is associated with a stone and in most cases appears as milk of calcium forming a fluid level or multiple small stones. We here report the case of an 82-year old patient with no previous history, presenting with mild and intermittent right flank pain lasting for 8 years. Clinical examination was normal. The patient first underwent X-ray of urinary tree without preparation showing a density of calcium projecting into the upper pole of the right kidney (A). The patient then underwent uroscanner showing giant stone measuring 28mm within a caliciel diverticulum of the upper pole directly communicating with the renal pelvis (B). No associated urinary tract infection or haematuria were detected. Given patient's age and that he was paucisymptomatic and uninfected, therapeutic abstention and monitoring were indicated. In accordance with the recommendations of the experts, only symptomatic intradiverticular stones must be treated. First, extracorporeal shockwave lithotripsy (ESWL) allows improvement to the symptoms in 1 patient out of 2 and no stone fragmentation in 1 patient out of 4. In second intention, flexible uretero-renoscopy should be performed. Percutaneous nephrolithotomy can be performed if the stone is located in the lower pole (rare). Finally, in case of failure, laparoscopic treatment or open surgery may be proposed., (© Mohammed Alae Touzani et al.)

Extracorporeal shock wave lithotripsy-related pain is the largest limiting factor in this technique. Our study aimed to compare the effectiveness of different types of analgesics for pain management used during ESWL sessions. We conducted a prospective study of 300 patients with urinary lithiasis justifying ESWL treatment. The patients were randomized to three groups: group I, included 100 patients who received intramuscular injection of 2cc of physiological saline solution (placebo), group II included 100 patients who received intramuscular injection of ketoprofen 100mg while group III included 100 patients who received lidocaine and prilocaine topical cream. Visual Analog Scale (VAS) was used to assess pain 10 minutes after and at the end of the session. Mean VAS score 10 minutes after and at the end of ESWL session was 3.7 and 4.91 respectively. There was no significant difference among the three groups with respect to: epidemiological data (age, sex, BMI, patient's history) and the characteristics of the renal stone (side, size, location, presence or not of double-J ureteral catheter). Eleven patients in the Group I terminated treatment early, with a significant difference compared to the other groups (p=0.003). VAS score 10 minutes after and at the end of ESWL session was statistically higher in Group I compared to Groups II and III (p < 0.001). Moreover, ESWL session was significantly more effective in Groups (II and III) compared to Group I (p<0.001). Pain treatment is necessary during ESWL sessions. Two painkillers molecules were assessed, which showed good pain control as well as an increase in the effectiveness of lithotripsy., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts.

Aim: To describe the pharmacotherapy of urinary lithiasis., Method: Results of a literature search (PubMed) was summarized by an experts board., Results: The incidence of urolithiasis constantly increases in industrialized countries and its prevalence in France is estimated around 10% in the general population. Due to its high recurrence rate urolithiasis is a public health concern. Significant progresses in both surgery and pharmacotherapy during the last thirty years markedly improve prognostic of high recurrence risk patients., Conclusion: Better understanding of the physiologic disturbances involve in stone formation has allowed to identify at lest one factor in every subset of patient in which diet and pharmacotherapy will reduce the recurrence rate. In this review are discussed treatments of the crisis as well as the metabolic treatment., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Introduction: Urinary lithiasis in children is relatively seldom in France as in industrialized countries. The determination of their etiology based on their composition may lead to a better treatment., Method: One hundred and eight urinary calculi from 6 months through 18-year-old children were analyzed by using spectrophotometry, in order to specify their structure. Six groups were evidenced through a multidimensional analysis based on the presence of components weighing at least 5% of the total., Results: The youngest children affected were mostly boys, and the sex ratio switched after 12.5 years. Above 14 years of age, the number of calculi significantly raised. Their composition varied with the gender, and their localization with the age. Finally a correlation between infection and composition of the calculus was shown in our study., Conclusion: The classification of calculi among six groups according to their composition, along with clinical informations and morphologic studies, has proven its value in determining the etiology of the lithiasis. These data help to better understand the kind of lithiasis that may be observed and the physiopathology of the mechanism explaining it from the gender and age., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)