Post-ERCP Dormia basket impaction: a case report and literature review

The incidence of Common bile duct stones (CBD) in patients undergoing cholecystectomy is 10%. The present-day management of common bile duct stone may be pre-, intra-, or post-operative Endoscopic retrograde cholangio-pancreatography (ERCP) with stone extraction. The reported complications of ERCP and CBD stone extraction range from 5 to 10% cases, that might be life threatening. Herein, we reported a case of calculus obstructive jaundice and cholangitis. Unfortunately, trials for ERCP and stone retrieval was followed by impacted Dormia basket which was successfully managed by surgerys.

The utility of instruments and disposables during endourologic practice among Egyptian urologists

Objective: We aimed to investigate the prevalence of utilization of different endourological instruments and disposables among Egyptian urologists and to see how availability could affect the deviation from the universal standards that might result in reduced patient safety. Patients and method: We surveyed members of the Egyptian Urological Association by a questionnaire evaluating the importance of different instruments and disposables used during ureteroscopy and percutaneous nephrolithotomy. All responses were collected by a commercially available Internet-based survey host ( www.surveymonkey.com ) over 8 weeks. Results: One hundred and fifty-two responses were received. For ureteroscopy, the most mandatory instruments and disposables included the C-arm device (83%), Dormia basket (61%), ureteral stone forceps (58%), pneumatic lithotripter (50%), and regular PTFE guide wire (49%). The instruments and disposables described as optional included 4.5 Fr ureteroscope (74%), flexible ureteroscope (70%), and hydrophilic guidewire (67%). For percutaneous nephrolithotomy, the most mandatory instruments and disposables were pneumatic lithotripter (78%), Alken metal dilator (75%), fascial dilator (45%), and regular PTFE guidewire (42%); while instruments and disposables described as optional included flexible cystoscope (70%), hydrophilic guidewire (67%), balloon dilator (57%), and laser machine (52%). Conclusion: The prevalence of the utilization of newly introduced instruments and disposables is low among Egyptian urologists.

A COMPARISON BETWEEN TRANSURETHRAL CYSTOLITHOCLASTY AND VESICOLITHOTOMY IN PEDIATRIC MALE PATIENTS

ABSTRACT BACKGROUND & OBJECTIVE: To compare transurethral cystolithoclasty with ureteroscope over open vesicolithotomy in pediatric male patients. METHODOLOGY: Study comprises of hundred pediatric male patients, divided into two equal groups of 50 each, labeled as Group-A and Group-B. All the patients having stones less than 20mm size (average 14mm) were included. Group-A patients were treated with transurethral cystolithoclasty by using ureteroscope and pneumatic lithoclast assisted with the help of Dormia basket. Group-B patients were treated with open vesicolithotomy.RESULTS: All hundred male pediatric patients were between the ages of 1-15 years (mean age 8 years). Hospital stay was 2-3 days (average 2.5 days) in Group-A patients and 3-5 days (average 4 days) in Group-B patients. In Group-A3 (6%) patients had urinary tract infection, 1(2%) had urethral injury and 2(4%) had residual stone post-operatively. While Group-B4 (8%) suffered from urinary tract infection, 1(2%) had wound infection, 1(2%) had hematuria, and 2(4%) had fever. Retention of urine was 1(2%) in each Group. CONCLUSION: Transurethral cystolithoclasty is a much better way of treating vesical calculus in pediatric male patients because it is a procedure with short hospital stay, minimal invasion, no scar and less complication. KEYWORDS: Bladder Calculus, Comparison, Cystolithoclasty, Ureteroscope, Pneumatic Lithoclast, Dormia basket, Vesicolithotomy.

Usage of Forceps and Dormia basket in the Management of Ureteric Stone: Comparison between Holmium: YAG Laser and Pneumatic Lithotripsy in a Referral Hospital, Bangladesh

Now lithoclast has become more popular tool than various intracorporeal lithotripters for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. This study was conducted to compare the use of Forceps and Dormia basket in the management of ureteric stone between Holmium: YAG Laser and Pneumatic Lithotripsy. It was a longitudinal follow-up comparative study conducted at Combined Military Hospital, Dhaka. All the respondents were admitted patients in Combined Military Hospital Dhaka, under Urology Ward. A total of 100 patients were enrolled for this study under convenient purposive sampling method. They all were admitted with the complaints of upper ureteric stone who underwent ureteroscopic lithotripsy from October 2010 to September 2012. In 50 patients, Laser Lithotripsy (LL) was used and in other 50 patients Pneumatic Lithotripsy (PL) was used. Same ureteroscope, video monitor, baskets and irrigation devices were used in both the samples. Patients were followed up after 1st and 3rd months interval. Lithotripsy follow-up was done with radiograph and ultrasonography of kidney, ureter and bladder. Patients with migrated fragments or incomplete clearance were underwent an auxiliary procedure such as shock wave lithotripsy. Mean stone size was 1.36 ± 0.36 cm in group Laser lithotripsy (LL) and 1.37± 0.36 cm in group Pneumatic lithotripsy (PL). The immediate stone clearance rate was significantly higher in Group LL (94.0%) than Group PL (76.0%). Proximal migration of fragments were 6.0% in LL group and 24.0% in PL group. Use of stone retrieval equipment (baskets, forceps) was 16.0% and 64.0% in LL and PL group respectively (p<0.05). On the other hand stone fragments clearance requiring auxiliary procedures were 6% and 24% in LL and PL group respectively. The mean lithotripsy time was 40.46 ± 19.25 min and 36.86 ± 14.83 min the LL and PL group respectively. Use of stone retrieval equipment(baskets, forceps) was significantly lower in Holmium: YAG assisted ureteroscopy than pneumatic lithotripsy group. Bangladesh Med J. 2019 Jan; 48 (1): 26-30