Characteristics of Obstructive Anuria Patients in a Tertiary Hospital in East Java, Indonesia

Obstructive uropathy is an obstruction of urinary passage which may lead to anuria, a condition where urine production is less than 50 to 100 ml in 24 hours. The varying etiologies and underlying pathophysiology among different cases based on different demographics can make it difficult for physicians to decide the proper management. Therefore, we aimed to evaluate the clinical profile and management of anuria patients in Dr. Soetomo General Academic Hospital over a four-year period. This was a descriptive study with a retrospective approach evaluating all patients with anuria admitted from January 2016 to December 2019. Patient data taken from the medical record were presented descriptively. A total of 176 patients were obtained. Only 161 patients were included. Most of the patients were female (n=100, 62.11%) aged 51 to 60 years old (n=63, 39.1%). Postrenal obstruction due to urinary stone was the most frequent etiology (n=86, 53.4%). Consequently, some patients developed hydronephrosis, which was mostly dominated by the bilateral (n=130, 80.8%) and severe types (n=75, 46.6%). A total of 129 patients (80.1%) underwent hemodialysis. Most of the patients were treated with definitive treatment (n=46, 38.7%). Normalization of renal function mostly occurred in patients who underwent percutaneous nephrostomy (PNS) before giving a definitive treatment.

Role of Endogenous and Exogenous Factors in the Process of Stone Formation during Urolithiasis. Types and Chemical Composition of Uroliths

Urolithiasis is one of the most common urological pathologies, the prevalence of which is growing every year. Scientists attribute this fact to changes in diet, water quality, lifestyle, climatic conditions, and global aging of the population. The medical and social and economic significance of the urolithiasis problem is that in the vast majority of cases this pathology is noted among people of working age and has a high tendency to relapse. In some cases, against the background of disease progression, disability occurs. At the heart of the pathogenesis of urolithiasis is a violation of metabolic processes, leading to the formation of calculi in the organs of the urinary system. The main clinical manifestations of urolithiasis include pain, pyuria, hematuria, obstructive anuria. The appearance of a pain symptom is explained by the stretching of the renal capsule with urine due to its inability to enter the bladder. The favorite localization of stones during urolithiasis is the right kidney due to the peculiarities of its anatomical location, in men this pathology is noted more often. Kidney stones can be found in any age group, but mainly affect people aged 25–50 years and almost always bring a lot of suffering. A general practitioner should have a general idea of the clinical picture of the manifestations of urolithiasis and the structure of stones, since recommendations on the observance of the diet and maintaining an appropriate lifestyle depend on this knowledge [1].

Obstructive Neoplastic Anuria Overview at Ibn Rochd University Hospital–A Retrospective Study

Introduction : Obstructive anuria due to pelvic cancers is the most common obstructive anuria in our context, its diagnosis is easy, but it causes a lot of morbidity with often heavy and long management. Materials and methods : This is a retrospective study containing 40 cases of confirmed neoplastic anuria treated in the urology department at the Ibn Rochd University Hospital in Casablanca Morocco between January 2016 and October 2018. Purpose : The aim of our study was to establish the epidemiological, clinical, therapeutic and natural historyin patients with neoplastic obstructive anuria. Results : The mean age was 56 years old with a notable female predominance. The male to female ratio was 0.6. Sixty percent (60%) of our patients were consulted within24 hours after the onset of anuria, the main symptoms preceding or accompanying anuria were lower back pain (75%) and hematuria (37.5%). Criteria for a positive diagnosis included urinary retention with complete absence of diuresis, the anuria was confirmed by probing or ultrasound, dilation of the urinary excretory system on ultrasound and acute impairment of renal function. To prevent patient from going into metabolic disorders, hemodialysis was performed in 27 patients (67.5%). Internal diversion of urine by mounting a JJ catheter was initially attempted in 40% of the cases. In case of attempt failure, or in case of locally advanced pelvic tumors, percutaneous nephrostomy was performed with a success rate of 100%. Upon follow up for 30 months, mortality rate was 5% (n=2), 95% of the patients benefited from a specialized follow-up for their etiological neoplasm. Conclusion : The management of neoplastic obstructive anuria must be rapid, the type of urinary diversion is chosen according to the clinical presentation and the technical platform available.