Percutaneous extraction of renal calculi in patients with solitary kidneys: technique-complications long term follow-up

53 cases with renal stones in solitary kidney were treated by PCNL. The technique was a standard two stage procedure. Complete clearance of the targeted stone [S] was achieved in 92.5%. Residual stones were left in 4 cases. Early complications were reported in 7 cases [13.2%]. Patients were followed up from 12-60 months [average 40 months]. Late sequaele were reported in 5 cases [9.4%]. True stone recurrence was noted in 3 cases [5.6%]. Kidney function showed improvement [28 cases] or stabilization [23 cases]. However,deterioration was documented in two cases.The results achieved suggest that percutaneous removal of renal calculi from patients with solitary kidneys should be considered a viable and effective alternative to open surgery

Visual internal urethrotomy for stricture urethra

50 patients with stricture urethra were treated with V.I.U. in our department and follow up after 6 months. The bulbous urethra was the commonest site of structure in 17 patients [34%]. The most common cause of stricture was traumatic [36/50]. The complications were minor and only in 14%. The success rate was 88%. Urethral dilatation is essential in most of the cases to maintain urethral patency

Ileal replacement of the bilharzial ureter

Our 14 years experience with the use of isolated ileal segments, for replacement of the bilharzial ureter is retrospectively analyzed. Fifty two patients were subjected to this procedure. Follow up data are available for 38 patients in whom 52 ureters were repaired. The results are generally unsatisfactory because of the high rate of morbidity and mortality and the low percentage of functional improvement. The risk is higher in those with low creatinine clearance. We recommend avoiding this operation as far as possible. If the operation is unavoidable tapering of the ileal segment with antireflux ileovesical anastomosis may improve the outcome, although this has to be proved