A retrospective study on retrograde Intra-renal Surgery with versus without the use of Ureteral Access Sheaths in patients with Nephrolithiasis

INTRODUCTION@#Placement of ureteral access sheath (UAS) prior to retrograde intra-renal surgery (RIRS) is done to provide easier re- entries, shorter operation time and better vision. However, some studies have associated the placement of UAS to increased morbidity and complications.@*OBJECTIVE@#The study aimed to compare outcomes of patients with nephrolithiasis who underwent RIRS with versus without placement of UAS.@*METHODS@#This is a retrospective cohort study among patients with nephrolithiasis who underwent RIRS with or without placement of UAS. The authors analyzed a total of 52 patients who underwent RIRS, 22 without, and 30 with UAS. Comparison of patients’ clinical profile, duration of post-operative hospital stay and the difference of their frequency were determined using Independent Sample T-test, Mann-Whitney U test and Fisher’s Exact test, respectively. STATA 15.0 was used for data analysis.@*RESULTS@#The two groups were similar in terms of clinical profile and operative outcomes. In terms of complications, there was one patient who had a failed surgery in the UAS group. Bleeding was reported in both groups. One-fourth of the patients had abdominal/bladder cramps and 13% had fever. Stone-free rate was 94% at 1 month and 92% at 3 months post-op. Readmission within 3 months was seen in four patients (8%) and retreatment was done on three patients (6%).@*CONCLUSION@#There is no significant difference in placing UAS or not prior to RIRS in terms of clinical profile and operative outcomes. Safety measures should be observed to prevent any bleeding and ureteral injuries during placement of UAS intra-operatively.

Crossed testicular ectopia in a patient presenting with undescended testis

@#Crossed Testicular Ectopia (CTE), is a rare congenital anomaly in which both gonads migrate towardthe same hemiscrotum. This may be due to a deviation of testicular descent resulting in unilaterallocation of both testes. Reported is a case of crossed testicular ectopia in a 1-year-old boy whopresented with undescended testis. On exploration, both testes were present in the right hemiscrotum.Subsequently, transseptal orchidopexy was performed. CTE should be considered in patientspresenting with undescended testis, unilateral hernia and concurrent cryptorchidism of the contralateralside. In suspected cases, laparoscopy and ultrasonographic evaluation may be helpful in diagnosingthis condition.