Analysis of the Skin to Calyceal Distance (SCD) to the upper pole calyx among Filipino patients: A guide to upper pole access Percutaneous Nephrolithotomy (PCNL)

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> Precise entry to the upper posterior calyx is key to a successful and safe upper pole access PCNL. The surgeon's knowledge of the average skin to calyceal distance can serve as a guide to avoid inadvertent injury to both the kidney and collateral organs during the percutaneous puncture.<br /><strong>METHODS:</strong> The authors analyzed the radiologic images of 84 patients who underwent unenhanced 64-slice helical CT scan (Toshiba®). Skin-to-calyceal distance (SCD) to the upper posterior calyx were measured using the Vitrea® software inherent to the CT scan.<br /><strong>RESULTS:</strong> The mean SCDs is non-hydronephrotic kidneys were 54.9 ± 13.7 mm and 61.4 ± 12.5 mm on the right and left, respectively while in hydronephrotic kidneys, the mean SCDs were 60.3 ± 11.8 mm and 58.6 ± 13.1 mm on the right and left, respectively. There was no statistically significant difference between the right and left upper pole SCD in both groups (p = 0.84).<br /><strong>CONCLUSION:</strong> The mean SCD to the upper posterior calyx among Filipino adults is about 6.0 cm. By limiting the depth of the initial puncture to within the distance, the endourologist may avoid overshooting the targeted calyx, thus avoiding undue injury to the kidney or intraabdominal structures.</p>

Use of local prototype electrical stimulator in denervated cat bladder

Electrical stimulators as a substitute to lower urinary tract function are relatively expensive and not available locally. A local prototype electrical stimulator was used in the spinal shock phase of cats to determine its effectivity based on adequate bladder evacuation, return of detrusor activity and complications. Spinal shock was surgically induced in eighteen male domestic cats, then they were randomly assigned to intermittent catheterization and electrical stimulation. Electrical stimulation of the spinal sacral roots resulted in earlier urination. Residual urine volume determined by catheterization revealed that adequate bladder evacuation was achieved. Moreover urinary tract integrity was maintained in the cats undergoing electrical stimulationThese findings showed that the local prototype electrical stimulator is effective.

An in-vitro study comparing a locally produced ionic contrast medium (RC-1), with meglumine ioxithalamate (Telebrix) and meglumine amidotrizoate (Angiografin) in its ability to detect urolithiasis

A locally produced contrast medium, RC-1, was synthesized and compared with its foreign counterparts in its ability to detect urolithiasis. Two controls, namely meglumine ioxithalamate (Telebrix) and meglumine amidotrizoate (Angiografin) were used. Three concentrations of the media, namely, undiluted, 50% and 24% were tested against tubes containing different sizes, types, and number of radioopaque and radiolucent stones randomly distributed in the different tubes. Plain films of the set-up were taken before and after each tube was filled with the different concentrations and were read by 2 radiologists who were blinded as to the type, size, and number of stones, and the type of contrast media used. Results showed that RC-1 could detect radio-opaque stones at least 4 mm in diameter, and radiolucent stones 3 mm in diameter, both of which were comparable to the control. Optimum concentration of RC-1 was determined to be at 24%. The total production cost of a 50 ml vial of RC-1 is P190, which is much cheaper than foreign brands. The authors recommend that further studies be done to establish the safety and effectivity of the in vivo use of RC-1.