scholarly journals A Prospective Study to Assess the Effectiveness of Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy for Proximal Ureteral Calculi Between Sizes 5 to 10 mm

2020 ◽  
Vol 19 (2) ◽  
pp. 65-69
Author(s):  
Bikash Bahadur Rayamajhi ◽  
Anjan Khadka ◽  
Narayan Thapa
Keyword(s):  
Ureteral Calculi ◽  
National Guidelines ◽  
Female Ratio ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Mean Size ◽  
Surgical Options ◽  
The Mean ◽  
Enhanced Computed Tomography ◽  
A Prospective Study

Introduction: There are various international guidelines for the surgical treatment of upper ureteral calculi. For upper ureteral stone of less than 10 mm size, ESWL and URS are regarded as first line treatment. However, there is lack of national guidelines for appropriate surgical options for such stone in our settings. Methods: The study was prospective comparative type involving 100 patients who were divided into ESWL and URS groups comprising 50 patients in each. ESWL and URS were performed after confirmation of stone size with ultrasonography and non-contrast enhanced computed tomography. All patients underwent X-ray KUB at one week and six weeks post procedure for confirmation of stone clearance. Those with residual calculi of size < 5 mm were considered stone free. Statistical analysis was done using Graph pad prism version 6. Results: The mean age of patients in ESWL and URS groups were 41.28 ± 15.3 years and 42.84 ± 16.1 years respectively. The male to female ratio was higher in ESWL group. The mean size of the stone pre ESWL was 8.58 mm and pre URS was 8.44 mm. The percentage of stone clearance at one week and six weeks for ESWL was 56% and 90% respectively whereas for URS, it was more than 90% at both one week and six weeks. The complications were higher with URS (20%) than ESWL (8%). Conclusions: The ESWL and URS are equally effective in stone clearance. The duration is longer with ESWL and the complications were more in URS group.

scholarly journals EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY;

2017 ◽  
Vol 24 (12) ◽  
pp. 1781-1787
Author(s):  
Iftekhar Ahmed ◽  
Muhammad Farooq ◽  
Abdul Mannan Qureshi ◽  
Muhammad Saeed ◽  
Sami Ur Rehman
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Urinary Tract Obstruction ◽  
Urinary Calculi ◽  
P Value ◽  
Female Ratio ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
The Mean

Background: Urolithiasis is a common ailment that costs billions of Dollars everyyear. Recurrent urinary tract obstruction or urolithiasis may stimulate the fibrogenic flow, whichis responsible for the definite functional loss of renal parenchyma. In the few past years, themanagement of urinary calculi undertook a remarkable modification. Open surgery for stonesis nearly replaced by minimal or non-invasive operative procedures like ureterorenoscopy,percutaneous nephrolitholapaxy and extracorporeal shock wave lithotripsy (ESWL). StudyDesign: Randomized Controlled Trial. Setting: Department of Urology Services HospitalLahore. Duration of Study: 1st January -30th December 2016. Material and methods: Thecomparative study of 60 cases through Non probability convenient sampling was conducted toevaluate the outcome of ESWL in patients with single lithiasis of lower pole calyx with differentinfundibulopelvic angles as measured on pre-treatment IVU. Results: The mean age of all thepatients was 33.70±10.72 years. Out of 60 Patients 32(53.3%) were males while 28(46.7%)were females with 1.14 male to female ratio. In group A, the mean LIPA was 78.83±4.71o andin group B, was 100.53±5.73o. The overall mean LIPA of the patients was 89.68±12.11o.Stoneclearance was noted in 39 (65%) patients. 15 patients (38.46%) and 24 patients (61.53%) ingroup A and B respectively. p-value=0.015. After ESWL stone clearance was more in patientshaving IPA ≥ 90°as compared to IPA 70-90o. Conclusion: Stone clearance is significantlyhigher with IPA>90o as compared to IPA70-90o.In future now we are able to implement the useof IPA>90o instead of using <90o that is more successful in achieving stone clearance.

Clinicopathologic characteristics that affect the treatment and recurrence of rectal carcinoid tumor in Korea.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 684-684
Author(s):  
Dong Ho Lee ◽  
Young Soo Park ◽  
Jae Jin Hwang ◽  
Hyun chae Jung
Keyword(s):  
Carcinoid Tumor ◽  
Endoscopic Resection ◽  
Carcinoid Tumors ◽  
Rectal Carcinoid ◽  
Resection Margins ◽  
Female Ratio ◽  
Rectal Carcinoid Tumor ◽  
Mean Size ◽  
The Mean

684 Background: The increase of colonoscopy procedures has led to an increase in the diagnosis of rectal carcinoid tumors. The aim of this study was to evaluate the clinical and pathological characteristics that affect the treatment and recurrence of rectal carcinoid tumors. Methods: Between 2003 and 2014, the medical records of patients with rectal carcinoid tumors were retrospectively reviewed. Patient and tumor characteristics, treatment and recurrence were analyzed. Results: The mean age was 51.7 ± 11.7 (range, 22-80 years) and the male to female ratio was 1:0.58. The mean tumor size was 8.7 ± 4.9 (3-27) mm. Four hundred-seven out of 424 patients were treated by endoscopy (mean size of tumor: 8.6 ± 3.6 mm) and 17 were treated by surgery (mean size of tumor: 12.5 ± 5.7 mm, p = 0.023). However, the histology showed that 87 patients treated by endoscopy had positive resection margins; 68 cases (16.0%) had a polypectomy and 19 cases (4.4%) had a endoscopic mucosal resection (p = 0.033). The mean follow-up duration was 29.1 ± 31.3 months, and there were five recurrences of rectal carcinoid tumors.All cases of recurrence of rectal carcinoid tumor were successfully re-treated by additional endoscopic resection. Conclusions: Endoscopic resection was an effective method for the treatment of rectal carcinoid tumors. Moreover, even for small rectal carcinoid tumors, follow-up examination should be performed to evaluate for tumor recurrence.The recurrence of rectal carcinoid tumor should be successfully controlled by additional endoscopic resection.

Etiology and cranial CT scan profile of nontumoral hydrocephalus in a tertiary black African hospital

2011 ◽  
Vol 7 (4) ◽  
pp. 397-400 ◽  
Author(s):  
Olufemi Idowu ◽  
Adebayo Olumide
Keyword(s):  
Pediatric Population ◽  
Third Ventricle ◽  
Aqueductal Stenosis ◽  
Female Ratio ◽  
Black African ◽  
The Mean ◽  
Walker Malformation ◽  
A Prospective Study ◽  
Evans Ratio ◽  
Mantle Thickness

Object Hydrocephalus is a common condition in the pediatric population. The cause of hydrocephalus, Evans ratio, ventricular index, and cerebral mantle thickness are some of the factors associated with poor surgical outcome. This study was conducted to evaluate the profile of these factors in the authors' patient population. Methods The authors conducted a prospective study from the August 1, 2006, to May 30, 2010. The consecutive patients were all 6 years of age or younger. The demographic information, cause of hydrocephalus, and cranial computerized measurements were taken (including widths of the frontal/occipital horns, third ventricle, and cerebral mantle thickness) and entered into the procedural forms. Results One hundred thirty-seven patients presented to the unit over the stipulated period. The male/female ratio was 1.1:1. The median age at presentation was 4 months (mean 7.3 months, range 4 days to 6 years). Myelomeningocele-associated hydrocephalus, aqueductal stenosis, and postmeningitic hydrocephalus accounted for 30.7%, 22.6%, and 17.5%, respectively, of the cases. The mean Evans ratio was 0.56 (range 0.43–0.70), the mean ventricular index was 197.18 (range 135.0–245.3), and the mean cerebral mantle was 10.8 mm (10–14 mm). Conclusions This study shows that the congenital form of hydrocephalus is the predominant variety in the authors' population. Myelomeningocele-associated hydrocephalus, aqueductal stenosis, Dandy-Walker malformation, and postmeningitic hydrocephalus are common causes of hydrocephalus.

scholarly journals Urolithiasis Management in Resource-Limited Settings: A Multicentric Retrospective Study in the Democratic Republic of Congo

2020 ◽  
Author(s):  
Pablo Diangienda Kuntima Diasiama Diasiama ◽  
Dieudonné Molamba Moningo Molamba ◽  
Jean-Robert Rissasy Makulo ◽  
Ernest Kiswaya Sumaili ◽  
Eric Musalu Mafuta ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Conventional Surgery ◽  
Female Ratio ◽  
Therapeutic Modalities ◽  
Resource Limited ◽  
Extracorporeal Shock Wave ◽  
The Mean ◽  
Male To Female ◽  
Treatment Of Urolithiasis

Abstract ObjectiveThis study aimed to analyze different therapeutic modalities used in the treatment of urolithiasis in the Democratic Republic of Congo.ResultsAmong the 194 patients included in this study, 69% (n=133) were males, with a male to female ratio of 2.2: 1, and an age mean (SD) of 48.1 (17.3) years. Urolithiasis was symptomatic in 52.6% (n=141) of patients. Renal colic was the most common clinical expression. Overall, 86.1% (n=167) of stones were removed by surgery, 9.8% spontaneously resolved, 3.1% were extracted after ureteroscopy, and 1% of patients had undergone extracorporeal shock wave lithotripsy. Lumbotomy was the most frequent used route (39.2%) in conventional surgery. The mean (SD) size of the extracted stones was 23.4 (17.0) mm.Most patients in this study were treated by conventional surgery. These results suggest the need to increase the use of minimally invasive surgery.

EFFICACY AND SAFETY OF URSLAND MINI-PCNL FOR TREATMENT OF IMPACTED LARGE UPPER URETERAL CALCULI: A PROSPECTIVE STUDY.

2021 ◽  
pp. 55-57
Author(s):  
N. Jitendra Singh ◽  
Kh. Ibomcha Singh ◽  
Kangjam Sholay Meitei
Keyword(s):  
Clearance Rate ◽  
Treatment Options ◽  
Ureteral Calculi ◽  
Ureteral Calculus ◽  
Medical Sciences ◽  
Stone Clearance ◽  
Secondary Endpoints ◽  
Suitable Treatment ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: For the management of large impacted upper ureteral calculi, the available minimally invasive endourologic methods are minipercutaneous nephrolithotomy (Mini-PCNL), ureteroscopic lithotripsy (URSL), and laparoscopic ureterolithotomy. This study aimed to compare Mini-PCNLand URSL, and to evaluate the better choice for large impacted upper ureteral calculi. Methods: Between January 2017 and December 2020, at the Urology Unit, Department of Surgery, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Porompat, Imphal, 40 patients with large impacted upper ureteral calculi (>15 mm) who were consecutively enrolled were included. The patients were randomly divided (1:1) into Mini-PCNL and URSL groups. The primary endpoint was the success of stone removal measured 1 month postoperatively and the secondary endpoints were intraoperative and postoperative parameters and complications. Results: Eight patients after URSLand 2 patients after Mini-PCNLneeded auxiliary ESWLtreatment. The stone clearance rate in the Mini-PCNL group was 95 % (19/20) and 75 % (15/20) in the URSL group. Operation-related complications were similar among the two groups (all p > 0.05). Hospital stay was shorter in the URSL group compared with Mini-PCNL (p < 0.001). However, the mean operative duration was shorter in the URSLgroup compared to the Mini-PCNLgroup (p < 0.001). Conclusions: Mini-PCNL and URSL are suitable treatment options for impacted upper ureteral calculus with a diameter of >15 mm. Though the success rate and stone clearance rate are lower but acceptable, URSL could be considered if the patient is not suitable for general anesthesia and with other comorbidities, or if it is the patient's preferred treatment option

scholarly journals Safety and efficacy of percutaneous nephrolithotomy for the treatment of paediatric urolithiasis

2012 ◽  
Vol 94 (8) ◽  
pp. 588-592 ◽  
Author(s):  
R Veeratterapillay ◽  
MBK Shaw ◽  
R Williams ◽  
P Haslam ◽  
A Lall ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Surgeon Experience ◽  
The Mean ◽  
Free Rate

INTRODUCTION Paediatric percutaneous nephrolithotomy (PCNL) has revolutionised the treatment of paediatric nephrolithiasis. Paediatric PCNL has been performed using both adult and paediatric instruments. Stone clearance rates and complications vary according to the technique used and surgeon experience. We present our experience with PCNL using adult instruments and a 28Fr access tract for large renal calculi in children under 18 years. METHODS All patients undergoing PCNL at our institution between 2000 and 2009 were reviewed. Demographics, surgical details and post-operative follow-up information were obtained to identify stone clearance rates and complications. RESULTS PCNL was performed in 32 renal units in 31 patients (mean age: 10.8 years). The mean stone diameter was 19mm (range: 5–40mm). Twenty-six cases required single puncture and six required multiple tracts. Overall, 11 staghorn stones, 10 multiple calyceal stones and 11 single stones were treated. Twenty-seven patients (84%) were completely stone free following initial PCNL. Two cases had extracorporeal shock wave lithotripsy for residual fragments, giving an overall stone free rate of 91% following treatment. There was no significant bleeding or sepsis encountered either during the operation or in the post-operative setting. No patient required or received a blood transfusion. CONCLUSIONS Paediatric PCNL can be performed safely with minimal morbidity using adult instruments for large stone burden, enabling rapid and complete stone clearance.

scholarly journals A Prospective Study on the Degree of Hyponatremia in Transurethral Resection of Prostate

2021 ◽  
pp. 639-644
Author(s):  
Maryam Fatima ◽  
Zainab Ali ◽  
Zubia Zafar
Keyword(s):  
Transurethral Resection ◽  
Transurethral Resection Of Prostate ◽  
Sodium Potassium ◽  
High Incidence ◽  
Turp Syndrome ◽  
Mean Size ◽  
The Mean ◽  
A Prospective Study ◽  
Duration Of Operation

Background: Systemic uptake of hypotonic fluid during irrigation performed at the time of Transurethral Resection of the Prostate (TURP) may cause electrolyte changes including sodium, potassium and calcium. The present study was aimed to assess the degree of sodium changes during Transurethral Resection of Prostate (TURP). Methods: 50 males aged 54 to 86 years, presented for TURP, were enrolled in the study with ASA classification of I to IV grades. Glycine 1.5% was used with height of irrigation kept at 60 cm. One day preoperatively and one hour postoperative, levels of serum sodium were measured for all the patients. Results: Spinal anaesthesia was given in 31 patients, whereas 19 patients were managed under general anaesthesia, with mean duration time being 72.42 ± 24.77min. The mean size of the resected prostate was 54.82 ± 25.04g. 58% patients developed mild hyponatremia, 4% had asymptomatic moderate hyponatremia and no patient developed severe hyponatremia or TURP Syndrome. The systemic diseases like hypertension, DM, or IHD found to be insignificant. Conclusion: TURP was associated with a high incidence of asymptomatic mild hyponatremia. Duration of operation was one of the most important factors.

Sign in / Sign up

Export Citation Format

Share Document