scholarly journals Ureterorenoscopy, a review of first three years of experience for ureteric stone disease.

2019 ◽  
Vol 26 (10) ◽  
pp. 1712-1718
Author(s):  
Saif Ud Din Awan ◽  
Ahmad Nawaz Bhatti ◽  
Ayesha Naureen Awan
Keyword(s):  
Open Surgery ◽  
Stone Disease ◽  
Therapeutic Modality ◽  
Excessive Force ◽  
Distal Ureter ◽  
Medical College ◽  
Ureteric Calculi ◽  
Dj Stent ◽  
Average Size ◽  
Excellent Tool

Objectives: Ureterorenoscopy is a diagnostic and therapeutic modality, used for different ureteral and renal pathologies. It has virtually replaced open surgery for ureteric calculi. Study Design: Observational. Setting: Urology Department of Sargodha Medical College, Sargodha. Period: 2011-2015. Material and Methods: All cases who underwent URS for stone disease during the study period were included in the study. The initial criterion was a bit strict, due to minimum experience, which limited only clinically fit patients with no co-morbid illnesses, with stone size of 1 cm or less, located in middle or preferable in distal ureter, single stone was also preferred, but later the criterion was relaxed with gain confidence. The procedures were performed under general anesthesia using R Wolf Ureterorenoscope. Results: The total number of cases included in the study were 332 of which 189 were males and 143 were females. Average age being 42.82 years. The total number of stones managed were 354 (in 22 cases the stones were bilateral). The average size of stones was 1.2 cm. DJ stent was used in 78 cases. Complications were observed in 14.76 percent cases (2.71% major and 12.05% minor). No deaths occurred in the study group. Conclusion: Uretero renoscopy is an excellent tool for the management of ureteral stone disease so much so that these cases, after sufficient experience, can be managed as day cases. The complication rate can be controlled by careful patient selection. Being intuitive and stopping the procedure on the very first hint of something going wrong like the scope being stuck or requiring excessive force. Strictures should not be traversed without adequate prior dilatation. The operator should have sufficient experience with open surgery.

Study of clinical indication, difficulties and complications of DJ stenting in urological procedure at a tertiary hospital

2021 ◽  
Vol 19 (2) ◽  
pp. 53-57
Author(s):  
Vidyadhar P Kelkar ◽  
Keyword(s):  
Tertiary Hospital ◽  
Stone Disease ◽  
Clinical Indication ◽  
Ureteral Stones ◽  
Stent Insertion ◽  
Stone Size ◽  
Ureteric Calculi ◽  
Dj Stent ◽  
Ureteral Stenting ◽  
Ureteric Stricture

Background: Urolithiasis is one of the major causes of morbidity in our society as our country is located near to equatorial distribution of stone disease Indwelling ureteral stents provide free drainage from the kidney to the bladder, reduce or eliminate urinary leakage and provide ureteral stenting. The present study was designed to observe indications, difficulties and complications of indwelling double J ureteral stenting. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients undergoing DJ stenting URS/ESWL (stone size > 2cm), willing to participate in study. The data collected was entered into Microsoft excel and analyzed. Statistical analysis was done using descriptive statistics. Results: In the present study, we assessed prospectively the effectiveness of DJ stent insertion for treatment of ureteral stones in 100.patients. Gender distribution in the current study was 65% male and 35 % female. 65 % patients were between the age 10 to 40 years; 20 patients have lower ureteric calculi, 37 patient having mid ureteric calculi and 8 patients having upper ureteric calculi. In current study out of 100 patients 32 patients have stone between the range of 6-10 mm, 42 patients have stone size range between 11-16 mm and only 26 patient have stone size more than 16 mm. 32 patients having mid ureteric calculi in which 30 patients DJ stent procedure successfully completed, remaining 2 patients had ureteric stricture treated with URSL. 27 patients having lower ureteric calculi in which 25 patients DJ stent procedure successfully completed, remaining 2 patient had ureteric stricture treated with ESWL followed by cystoscopy removal. 8 patients having bilateral ureteric calculi in which 6 patients DJ stent procedure successfully completed, remaining 2 patient have impacted stone treated with URSL with PCNL. 100% success rate in DJ stent insertion in patients with stone size 11-16mm followed by in 93% with stone size 6-10mm and in 76% with stone size >16mm. Conclusion: Most of the ureteral DJ stent related complications can be managed by surgical procedures hence they should be removed as soon as their purpose solves. The proper follow up from patients can help to early identification of post insertion complications of DJ stent and timely management of them.

scholarly journals COMPARISON OF THE SUCCESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) WITH AND WITHOUT DJ STENTING IN PROXIMAL URETERIC STONE

2020 ◽  
Vol 11 (2) ◽  
pp. 21-24
Author(s):  
Dr. Mudassar Saeed Pansota
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
P Value ◽  
Ureteric Stone ◽  
Extracorporeal Shock Wave ◽  
Dj Stent ◽  
Group A ◽  
Group B ◽  
Average Size

BACKGROUND & OBJECTIVE: There is disagreement in the use of ureteral double-J stent before the extracorporeal shock wave lithotripsy (ESWL), although most of the urologists suggest using stent in shock wave lithotripsy technique for stones bigger than 20mm, for preventing the risk of developing steinstrasse. To compare the success of ESWL with and without DJ stenting in proximal ureteric stone. METHODOLOGY: A total of 60 patients form both genders, between 15 to 55 years of age, with a single proximal ureteric stone, were included. Patients with solitary functioning kidney, multiple stones, pregnancy, pyonephrosis and sepsis were excluded. In Group-A, ESWL without DJ stenting was completed while in Group-B, ESWL with DJ stent placement was done. In all patients, at least 4 sessions were done fortnightly. Patients were followed regularly and final success was noted after one month of completion of ESWL sessions. RESULTS: The mean age was 36.85 ± 8.61 years. From 60 patients, 29 (48.33%) were men and 231 (51.67%) were women.Mean body mass index (BMI) was 28.30±2.20 kg/m . The average size of the stone was 12.47 ± 2.57 mm. Success (according to stone removal) of Group-A (ESWL without DJS) was seen in 26 (86.67%) patients while in Group-B (ESWL with DJS) was seen in 16 (53.33%) patients with P-value of 0.005. CONCLUSION: This study concluded that success (in terms of stone clearance) of extracorporeal shock wave lithotripsy (ESWL) without DJ stenting is higher compared to with DJ stenting in upper ureteric stone.

Transperitoneal Laparoscopic Ureterolithotomy for Large Distal Ureteric Stone: The first Experience in Hasan Sadikin Hospital, Bandung

2014 ◽  
Vol 43 (1) ◽  
pp. 61-64
Author(s):  
Bacilius Agung Priyosantoso ◽  
Sawkar Vijay Pramod
Keyword(s):  
Endoscopic Treatment ◽  
Open Surgery ◽  
Ureteral Stone ◽  
Anatomical Landmarks ◽  
Ureteric Stone ◽  
Transperitoneal Approach ◽  
Distal Ureter ◽  
Distal Ureteral Stone ◽  
Prior Surgery ◽  
Duration Of Operation

Background. Laparoscopic ureterolithotomy has become an alternative to open surgery for removing large stones that is not amenable to endoscopic treatment. In most of the published literature, laparoscopic ap- proach for lower ureteric stone is described to be less successful than middle and upper ureter. Identifica- tion in anatomical landmarks and exposing the distal ureter has been the major boundaries in establishing laparoscopic distal ureteral stone. We hope to provide clarity and feasibility that may increase our knowledge in laparoscopic ureterolithotomy for large distal ureteral stone. Aim. The obbjective is to share our experience in laparoscopic ureterolithotomy for large distal ureteric stone with transperitoneal approach Methods. A 37 years old male has been diagnosed with a right hydronephrosis due to proximal ureterolithiasis and stone at left calyx inferior, first and stone migrated to right distal ureter on 12 hours prior surgery. He underwent laparoscopic ureterolithotomy with transperitoneal approach. Results. We successfully perform laparoscopic ureterolithotomy with transperitoneal approach on a 37 y.o male patient who diagnosed with a a right hydronephrosis due to distal ureterolithiasis and stone at left calyx inferior. Duration of operation was 45 minutes. Patient was discharged at 2nd postoperative day without any complications. Conclusion. A Transperitoneal laparoscopic ureterolithotomy for distal ureteric stone is a safe and feasible technique that should be an options on every patients who plan to undergo distal ureterolithotomy especially large stone

scholarly journals Prevalence of Sub-Clinical Hypothyroidism in Diagnosed Cases of Gallstone Disease

2021 ◽  
pp. 207-212
Author(s):  
C. Kamalakkhannan
Keyword(s):  
Gallstone Disease ◽  
Gall Stone ◽  
Clinical History ◽  
Gallstone Formation ◽  
Stone Disease ◽  
Thyroid Function Tests ◽  
Age Group ◽  
Medical College ◽  
Gall Stone Disease ◽  
A Prospective Study

Thyroid issues have long been debated as a possible cause of gall stone disease. The link between hypothyroidism and gallstone disease could be explained in a variety of ways. The main objective of this study is to determine the prevalence of hypothyroidism in gallstone patients and to rule out hypothyroidism as a probable cause of gallstone formation. A prospective study was conducted in surgical wards of Department of surgery sree balaji medical college from 2016 to 2017. All patients were evaluated using a comprehensive clinical history and examination, as well as suitable investigations such as abdominal USG, thyroid function tests, and lipid profiles. Out of 22 patients 19 patients (86.4%) had normal TSH, 2 patients (9.1%) had increased TSH, 1 patient (4.5%) had decreased TSH. Raised TSH was more in the AGE Group of 61- 75 years, which is comparable to other studies. Out of 22 patients, (100%) had normal T3 levels. 19 patients (86.4%) had normal T4 levels and Ultrasound examination of neck, 2 patients (9.1%) had decreased T4 level and 1 patient (4.5%) had increased T4 levels and 3 patients (13.6%) had abnormal Ultrasound Neck findings. Hence In this Study Cholelithiasis is most commonly seen in Females of age group of 41-60 years and prevalence of raised TSH level in cholelithiasis patient was 9% and most were found in the age group of 61-80 years.

scholarly journals Intraoperative Complications Are Significantly Less in Pcnl in the Treatment of Large Renal Calculi : A Prospective Randomized Controlled Trial

2020 ◽  
Vol 17 (2) ◽  
pp. 71-74
Author(s):  
Syed Alfasani ◽  
Zamanul Islam Bhuiyan
Keyword(s):  
Hospital Stay ◽  
Kidney Stone ◽  
Open Surgery ◽  
Controlled Trial ◽  
Intraoperative Complications ◽  
Renal Calculi ◽  
Stone Disease ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Significant Difference

Objective: To compare the safety and efficacy of percutaneous nephrolithotomy (PCNL) and open surgery in the treatment of patients having large kidney stone(>2 cm ). Materials & Methods: A Randomised controlled clinical trial (RCT ) of 80 patients diagnosed with kidney stone disease admitted in the NIKDU during the period of Jan’ to Dec’2009 were divided conveniently into two groups. Intervention was done in the form PCNL(40) and open surgery (40). Clinical outcome like, peroperativecomplications,durationof surgery,mean hospital stay,convalescence period, amount of analgesia required to relief pain, stone clearance rate were reviewed and compared between the groups. There was no significant difference in preoperative variables such as age,sex, stone size in cm, stone number- single/multiple and stag horn Stone. Results: There were statistically significant difference in the parameters between the groups,( PCNL vs open surgery [mean ± SD]): duration of operation (min), 97.90 ± 24.89 vs 136.62 ± 23.54, postoperative hospital stay (days) ,4.77 ± 3.98 vs 9.55 ± 3.65, mean time return to work (days) , 3.09 ± 1.21vs 6.25 ± 1.53, ( p value is <0.001). Intraoperative complications like bleeding requiring blood transfusion are significantly lower in PCNL (11 cases 34.1%) than in open surgery( 18 cases 45.0%), (Chi-square = 4.82; p = 0.049). Conclusion: PCNL is relatively safe & better treatment option than open surgery in the treatment of large renal calculi, It has definite advantages of statistically less peroperative bleeding and lower morbidity. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.71-74

scholarly journals Open Surgery for Urinary Stones in a Resource Poor Setting: A Look at Dalhatu Araf Specialist Hospital, Lafia, Nigeria

2021 ◽  
Vol 2 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Christian Agbo
Keyword(s):  
Open Surgery ◽  
Urinary Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Endoscopic Management ◽  
Resource Poor Setting ◽  
Cost Of Treatment ◽  
Urinary Stone Disease ◽  
Resource Poor ◽  
The Cost

Urinary stone disease has afflicted humankind since antiquity[1]. It remains a common urological condition worldwide, including in our environment[2]. Although open surgery was previously the main option for stone removal, advances in technology mean that treatment is now largely through minimally invasive surgery, as recommended by a number of urological guidelines[3,4]. Unfortunately, at our centre, we still treat urinary stones solely through open surgery, mostly because we lack endoscopic equipment. In addition, most of our patients, even if referred to facilities where endoscopic management is possible, cannot afford the cost of treatment.

scholarly journals ESWL FOR RENAL AND URETERAL STONES

2014 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Ridha ◽  
Doddy M. Soebadi
Keyword(s):  
Medical Records ◽  
Patient Characteristics ◽  
Renal Stones ◽  
Ureteral Stones ◽  
Shockwave Lithotripsy ◽  
Lower Pole ◽  
Distal Ureter ◽  
Dj Stent ◽  
Staghorn Stone ◽  
Residual Stones

Objective: To report patient characteristics and results of Huikang HK-V extracorporeal shockwave lithotripsy (ESWL) machine for renal and ureteral stones. Material & methods: We retrospectively analyzed medical records of all patients treated with ESWL using HK-V deviceat Department ofUrology Soetomo Hospital from May2011 - February 2012. Results: There were 241 selected patients, consisted of 148 men (61.4%) and 93 women (38.6%). Mean age was 47.8 years (range 7-87). ESWL was conducted to 130 single stones and 111 multiple stones, using fluoroscopy as guidance for 166 patients, ultrasound for 31 patients (12.9%) and both for 44 patients (18.3%). Stone location was 109 in lower pole(41%), 69 in middle pole(26%), 41 in proximal ureter (16%), 28 in upper pole (11%), 14 at renal pelvis (5%), 1 at distal ureter(0.3%) and 2 staghorn stone (0.7%).There were 130 patients with stone less than 10 mm (53.9%), 102 with stone 10-20 mm (42.3%), and 9 more than 20 mm (3.7%). There were slightly more left-sided treatment was 141 patients (58.5%). Of 181 patients with hydronephrosis (75%), 104 had DJ stent inserted (43.2%). Overall, we found 158 patients (65.5%) were stone free after treatment, 49 patients (20.3%) with residual stones less than 4 mm and 34 patients (14.1%) had more than 4 mm residuals. Conclusion: ESWL is the treatment of choice for simple renal and ureteral stones less than 20 mm (opaque and non opaque).Keywords:Extracorporeal Shockwave Lithotripsy, renal stones, ureteral stones.

scholarly journals Renal stone disease: reasons for non-acceptance of surgical treatment among population of Western Rajasthan, India

2020 ◽  
Vol 7 (6) ◽  
pp. 1001
Author(s):  
Rama Kishan Saran ◽  
Ravindra Purohit ◽  
Pradeep K. Sharma ◽  
M. K. Chhabra ◽  
Gordhan Chaudhary
Keyword(s):  
Renal Stone ◽  
Surgical Intervention ◽  
Stone Disease ◽  
Alternative Methods ◽  
Common Disease ◽  
Renal Stone Disease ◽  
Primary Level ◽  
Medical College ◽  
Lower Socioeconomic ◽  
A Prospective Study

Background: Renal stone is a common disease in Western Rajasthan. The aim of this study was to identify the causes of patient with renal disease for opting alternative methods for treatment instead of surgical approach.Methods: A prospective study was conducted at the Department of Urology, Dr. SN Medical College, Jodhpur, Rajasthan between August 2018 and July 2019. Patients with diagnosis of complicated renal stone disease including infected hydronephrosis, pyonephrosis, and calyceal rupture were enrolled in this study. Along with demographic characteristics patients were asked to enumerate causes for delay in seeking surgical intervention in sequential order and the reasons given by each patient were recorded separately.Results: A total of 80 patients with complicated renal stone disease were included in the study. Majority of the patients (77.50%) were men. Out of 80 patients, 32 patients were illiterate and 28 patients had primary level of education. Sixty-two patients reported only single reason for their negligence. Eleven and three patients reported two and three reasons, respectively. However, four patients could not provide any reason. The major cause reported by the patients (57.5%) for neglecting their disease was dependence and trust on alternative methods including ayurvedic medicines, homeopathic medicines, bhopas, and superstition.Conclusions: The majority of patients were belonged to lower socioeconomic class reported that dependence and trust on alternative methods including ayurvedic and homeopathic medicines are the major cause of neglecting their disease.

scholarly journals TO EVALUATE EFFICACY OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES IN TERM OF POSTOPERATIVE HOSPITAL STAY

2022 ◽  
Vol 6 (1) ◽  
Author(s):  
Shivek Mohan ◽  
Ankit Panwar ◽  
Bharat Thakur ◽  
Ved Kumar Sharma
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Normal Activity ◽  
Postoperative Hospital Stay ◽  
Medical College ◽  
Early Return ◽  
Gandhi Medical College ◽  
Laparoscopic Transperitoneal ◽  
Return To Activity

Background: To evaluate efficacy of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones in term of postoperative hospital stay Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: Mean hospital stay was 6.66 days in laparoscopic group and it was 8 days in laparoscopic completed by open method. Maximum no. of patients was discharged within 5 days.  6 (75 %) patients returned to normal activity in less than 30 days which included only successful laparoscopic group and 2 patients returned to normal activity in 40 days which included lap completed by open group. Conclusion: In the present study of Laparoscopic Transperitoneal Pyelolithotomy at Indira Gandhi Medical College, Shimla, the procedure showed a definite decrease hospital stay, early return to activity than who have undergone open surgery Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Hospital stay.

SPLENECTOMY IN PAEDIATRIC AGE GROUP

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Mayur Maheshwari ◽  
Pritanshi Singh
Keyword(s):  
Open Surgery ◽  
Operative Management ◽  
Age Group ◽  
Medical College ◽  
Age At Surgery ◽  
Paediatric Age ◽  
The Mean ◽  
Study Completion ◽  
Haematological Disorders ◽  
Clinical Problems

Background: In view of splenectomy in dealing with certain clinical problems in paediatric age group. Objective: To describe the profile, indications, post-operative management and outcomes of children undergoing splenectomy. Methods: All children undergoing splenectomy from June’2019 till August’2021 at INDEX MEDICAL COLLEGE, INDORE, M.P. Results: The mean age at surgery was 9.9 years (range 3-16). Most splenectomies were per-formed for haematological disorders and were open .The mean post-operative length of stay (LOS) in patients who underwent open surgery was 4 days. No cases of overwhelming post splenectomy infec-tion (OPSI) were noted. At study completion, haematological disorders were the most common indication for splenectomy in children. Conclusion: Indications for paediatric splenectomy mirror those found in international litera-ture. We haven't performed splenectomy, laparoscopically. Within this short span of time, no mortal-ity was recorded. We did not have any case of OPSI. Key words: splenectomy        

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