[Results of treatment of ureterolithiasis with shock-wave extracorporeal lithotripsy]. / Výsledky lécby ureterolitiázy extrakorporální litotrypsí rázovou vlnou.

At the Urological Clinic, Faculty Hospital Hradec Králové the authors performed extracorporeal lithotripsy in ureterolithiasis in 172 patients, mean age 46.5 years. The patients were divided into two groups. The first group was formed by 114 patients (66.3%) with subrenal ureterolithiasis, the second group by 58 patients (33.7%) with iuxtavesical ureterolithiasis. In 56 patients (32.6%) derivation of urine had to be made by means of a stent or nephrostomic puncture drainage because of an obstruction by a concrement. The general success rate of the method was 96.4% in the subrenal localization and 81% in iuxtavesical ureterolithiasis. In 15 patients an alternate solution had to be sought (URS or extraction of the concrement by a Dormi basket, Zeiss loop).

[Fournier's gangrene]. / Fournierova gangréna.

The authors present their own experiences with diagnostics and treatment of men with necrotising fasciitis of the scrotum (Fournier's gangrene). During 1995-2001 8 men were treated for the above diagnosis at the Clinic of Urology, Faculty Hospital in Hradec Králové. Six cases were patients with diabetes type II, in one patient we found during basic examinations a large tumour of the sigmoid and one patient was 7 days after total scrotal orchiectomy (because of prostatic adenocarcinoma). Repeated open revision under general anaesthesia was performed in all men with necessary necrectomy, testicles were intact (except a patient after orchiectomy). The infection was spread into the hypogastric area in two patients and in one patient spontaneous rupture of bulbar urethra occurred. By a combination of antibiotic therapy and repeated necrectomies, open wound healing and wet compresses we achieved cure of infection and granulations, which made final scrotal plastic surgery possible. From microbiological point of view it was mixed aerobic and anaerobic flora.