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During the past five years, 342 cases of urolithiasis were found among the 3, 821 cases of urological patients who visited the Toho University medical school clinic. Clinical statistical analysis of these 342 cases gave the following results. Thirty-nine cases of them showed double location of stones in the urinary tracts. (1) The occurrence of urolithiasis during the past five years was 8.95 p e r cent of the whole cases. (2) They consisted of 78 cases (20.5%) of renal, 234 (61.4%) of ureteral, 35 (9.2%) of vesical, 13 (3.4%) of urethral and 21 (5.5%) of prostatic calculi. The number of the patients with calculus in the up p er urinary tracts was much more than that of the patients with calculus in lower urinary tracts. So-called "Stone wave" was revealed. (3) As to sex, the condition w as found to occur for more frequently in males (280 cases : 81, 87%) than in females (62 cases : 18, 13%). The ratio was 4.5 to 1. (4) Age distribution of the cases showed 152 occurred in the third decade and 90 in the fourth decade. (5) As to seasonal variation, the results were reported previously. (6) As to occupations of the patients, the results of a nalysis shound higher incidence among office workers. (7) The r ecurrence was 20 cases (5.25%). (8) As the initial symptoms and th e chief complaints pain and haematuria were observed most frequently.(9) Treatment of the upper urinary tract calculi was surgical operation in about a half of cases while the other half received conservative therapy. For cases of vesical and urethral calculi, endosc o pic treatment was commonly used, and for cases of prostatic calculus, the treatment was conservative in all of them. It should be noted that cases of spontaneous discharge or chemical dissolution of stones have been increasing.

A patient with complete obstruction of the ureter for a period of 30 to 50 days and a case of hydronephrosis accompanied by congenital single kidney (related to reno-vascular anomaly) are reported. Observations were made on the process of functional recovery following elimination of the cause of passage disturbance of the ureter in total of 7 patients with hydronephrosis including above 2 cases and 5 additional cases which are attributed to ordinal causes. Results are summerized as follows. 1) An adequate anatom i cal recovery of the renal parenchymal tissue is the most important fact for the renal function after hydronephorsis. In addition, functional recovery of the urinary tracts as transport must be sufficiently restored. 2) For treatment of hydronephrosis, therefor e , not only every causal factors responsible for passage disturbance of urine should be removed, but as much care should be paid as to avoid damage in the urinary transporting system. 3) It was confirmed that the tr e atment of hydronephrosis has to be tried as conservatively as possible.

In vitro tests for antibacterial effect and clinical usefulness for treatment of urinary tract infection were examined on the combined drug of sulfamethnizol and methenamine mandelate. The drug is composed of suflamethizol which is a excellent sulfa drug for urinary fract infection and methenamine mandelate which is anti-inflammatory and antibacterial compound for urinary tract. The drug demonstrated multiplicative effects against Proteus vularis on anti-bacterial test in vitro. The results of clinical use of the d r u g in a total of 40 cases showed 96 % of effective cure rate for acute urinary tract infection and 33 % of effectiveness for complicated chronic urinary tract infection. As the side effects, mild gastrointestinal distress was seen in only 2 patients. It is proved that the drug gives an excellent effectiveness for treatment of urinary tract infection and a safe result even at prolonged use.

Here is a report of huge solitary renal cyst of typical form recently experienced. 91 cases of solitary renal cyst were collected from the Japanese literatures and statistically studied from the clinical point of view. Pathogenesis of this conditions is still obscured. It is said to be basically one of the congenital maldevelopments, but several factors seem to be related to it. In this case, intracystic fluid was biochemically similar to the serum, although it is often reported that the cystic content is just as urine.

Clinical findings of two cases of priapism with hypertension were reported. As a treatment, incision of penile sponge was successfully performe d . One hundred and twenty nine cases of priapism so far repo r t ed in Japan were analysed statistically from the clinical point of view.

Ileocystoplasty was performed in five patients wi t h tuberculous contracted bladder, and the satisfactory clinical results were obtained in increasing the vesical capacity and lessening frequency of urination. Postoperatively, blood chemistry showed no serious unbalance in electrolytes. Serum chloride level, however, somewhat elevated after a considerable period. Because the presence of hydronephrosis and or residual urine tends to impair renal function, voiding must be complete as possible so that no residual urine exists. Ileocystoplasty was thus proved to be one of the most reliable ways of enlarging the vesical capacity.

Two cases of papillary carcinoma of the renal pelvis an d one of the ureter were pathohistologically studied. 1) Malign a ncy of them was graded to be III (according to Tsuji's classification) based on findings of tumor cells and infiltration. 2) Infiltration of neoplasti c cells were noted even at the outmost layer of the pelvic or ureteral wall In one case neoplastic cells were found in the vein. Generally, cells showed striking anaplasia, being different from normal transitional cells of the uroepithelium. 3) In the vicinity of the carcinomatous lesion, uroepithelium demon s trated metaplasia or even neoplastic change. As one of them had an associated tumor in the bladder, multicentric occurrence of uroepithelial tumor was here deeply impressed. By the way, the patient who had the tumor in the bladder had worked, for many years, being contaminated with chemicals of oil derivertives.

This is a case report of torsion of the appendi x testis seen in 25-year-oldm ale while he was skating. Preoperatively, a small tender mass was found to be attached to the caudal portion of the testis on the right side and above diagnosis was presumed. He was successfully treated by open surgery. In previous literatures, there has been no case of this condition occurred at the tail portion of testis. Histologically, the mass was confirmed as appendix testis, therefore, it was recognized that this was the seventh case of the appendix testis in narrow sense in Japan.

A patient with complete obstruction of the ureter for a period of 30 to 50 days and a case of hydronephrosis accompanied by congenital single kidney (related to reno-vascular anomaly) are reported. Observations were made on the process of functional recovery following elimination of the cause of passage disturbance of the ureter in total of 7 patients with hydronephrosis including above 2 cases and 5 additional cases which are attributed to ordinal causes. Results are summerized as follows. 1) An adequate anatom i cal recovery of the renal parenchymal tissue is the most important fact for the renal function after hydronephorsis. In addition, functional recovery of the urinary tracts as transport must be sufficiently restored. 2) For treatment of hydronephrosis, therefor e , not only every causal factors responsible for passage disturbance of urine should be removed, but as much care should be paid as to avoid damage in the urinary transporting system. 3) It was confirmed that the tr e atment of hydronephrosis has to be tried as conservatively as possible.

Here is a report of huge solitary renal cyst of typical form recently experienced. 91 cases of solitary renal cyst were collected from the Japanese literatures and statistically studied from the clinical point of view. Pathogenesis of this conditions is still obscured. It is said to be basically one of the congenital maldevelopments, but several factors seem to be related to it. In this case, intracystic fluid was biochemically similar to the serum, although it is often reported that the cystic content is just as urine.

This is a case report of torsion of the appendi x testis seen in 25-year-oldm ale while he was skating. Preoperatively, a small tender mass was found to be attached to the caudal portion of the testis on the right side and above diagnosis was presumed. He was successfully treated by open surgery. In previous literatures, there has been no case of this condition occurred at the tail portion of testis. Histologically, the mass was confirmed as appendix testis, therefore, it was recognized that this was the seventh case of the appendix testis in narrow sense in Japan.

Two cases of papillary carcinoma of the renal pelvis an d one of the ureter were pathohistologically studied. 1) Malign a ncy of them was graded to be III (according to Tsuji's classification) based on findings of tumor cells and infiltration. 2) Infiltration of neoplasti c cells were noted even at the outmost layer of the pelvic or ureteral wall In one case neoplastic cells were found in the vein. Generally, cells showed striking anaplasia, being different from normal transitional cells of the uroepithelium. 3) In the vicinity of the carcinomatous lesion, uroepithelium demon s trated metaplasia or even neoplastic change. As one of them had an associated tumor in the bladder, multicentric occurrence of uroepithelial tumor was here deeply impressed. By the way, the patient who had the tumor in the bladder had worked, for many years, being contaminated with chemicals of oil derivertives.

In vitro tests for antibacterial effect and clinical usefulness for treatment of urinary tract infection were examined on the combined drug of sulfamethnizol and methenamine mandelate. The drug is composed of suflamethizol which is a excellent sulfa drug for urinary fract infection and methenamine mandelate which is anti-inflammatory and antibacterial compound for urinary tract. The drug demonstrated multiplicative effects against Proteus vularis on anti-bacterial test in vitro. The results of clinical use of the d r u g in a total of 40 cases showed 96 % of effective cure rate for acute urinary tract infection and 33 % of effectiveness for complicated chronic urinary tract infection. As the side effects, mild gastrointestinal distress was seen in only 2 patients. It is proved that the drug gives an excellent effectiveness for treatment of urinary tract infection and a safe result even at prolonged use.

Clinical findings of two cases of priapism with hypertension were reported. As a treatment, incision of penile sponge was successfully performe d . One hundred and twenty nine cases of priapism so far repo r t ed in Japan were analysed statistically from the clinical point of view.

Ileocystoplasty was performed in five patients wi t h tuberculous contracted bladder, and the satisfactory clinical results were obtained in increasing the vesical capacity and lessening frequency of urination. Postoperatively, blood chemistry showed no serious unbalance in electrolytes. Serum chloride level, however, somewhat elevated after a considerable period. Because the presence of hydronephrosis and or residual urine tends to impair renal function, voiding must be complete as possible so that no residual urine exists. Ileocystoplasty was thus proved to be one of the most reliable ways of enlarging the vesical capacity.

During the past five years, 342 cases of urolithiasis were found among the 3, 821 cases of urological patients who visited the Toho University medical school clinic. Clinical statistical analysis of these 342 cases gave the following results. Thirty-nine cases of them showed double location of stones in the urinary tracts. (1) The occurrence of urolithiasis during the past five years was 8.95 p e r cent of the whole cases. (2) They consisted of 78 cases (20.5%) of renal, 234 (61.4%) of ureteral, 35 (9.2%) of vesical, 13 (3.4%) of urethral and 21 (5.5%) of prostatic calculi. The number of the patients with calculus in the up p er urinary tracts was much more than that of the patients with calculus in lower urinary tracts. So-called "Stone wave" was revealed. (3) As to sex, the condition w as found to occur for more frequently in males (280 cases : 81, 87%) than in females (62 cases : 18, 13%). The ratio was 4.5 to 1. (4) Age distribution of the cases showed 152 occurred in the third decade and 90 in the fourth decade. (5) As to seasonal variation, the results were reported previously. (6) As to occupations of the patients, the results of a nalysis shound higher incidence among office workers. (7) The r ecurrence was 20 cases (5.25%). (8) As the initial symptoms and th e chief complaints pain and haematuria were observed most frequently.(9) Treatment of the upper urinary tract calculi was surgical operation in about a half of cases while the other half received conservative therapy. For cases of vesical and urethral calculi, endosc o pic treatment was commonly used, and for cases of prostatic calculus, the treatment was conservative in all of them. It should be noted that cases of spontaneous discharge or chemical dissolution of stones have been increasing.