The life of Lord Moynihan is briefly reviewed. Incidence of stones in Peninsular Malaysia appears to show the same trend as in other industrialised countries. Management of urinary calculi both prior to and after the introduction of ESWL in a personal series is discussed. More than 90% of urinary stones are now treated by ESWL threatening the place of surgery in Urology. The pattern of incorporating renal transplantation into the urological training programme as practised in the Institute of Urology and Nephrology in Malaysia is suggested as a way to assure a place for surgery in Urology.
A study into the incidence of urinary calculi over a 15-year period from 1962-1976 in the states of mainland Malaysia is presented. Figures from the Ministry of Health Returns are the only source for such information. The incidence from the various states over each five year period from 1962-1972 is tabulated and its significance especially, the pattern of incidence, and its relation to industrialisation is discussed. Malaysia is beginning to show the same pattern of incidence in the upper and lower urinary tract as that of other industrialised countries. A plea is made for the establishment of a central register at the Institute of Urology and Nephrology to carry out a national survey of urinary calculi so that a study into the epidemiology, and if possible, preventive aspects of urolithiasis can be undertaken.
Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968-May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V-Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed.