ABSTRACT
Ureters are retroperitoneal structures and are well protected in the abdominal cavity. Reported incidence of ureteric injuries is 0.5%-10% and iatrogenic factor is the most predominant. Ureteric discontinuity following injury has been traditionally treated by open surgery. With the advent of improved Endoscopic instruments and fiber optics it is possible to stent these lesion percutaneously or retrogradely. We describe a retrograde endoscopic approach to re-establish ureter integrity successfully in a case of fire arm injury resulting in complete transection of ureter and subsequently ureterocutaneous fistula. We illustrated usefulness of Endoscopic approach for the management of ureteric injuries as an alternative to traditional approach
ABSTRACT
To evaluate success rate, auxiliary procedures and complications associated with ureteroscopic pneumatic lithotripsy of ureteric stones. The study was conducted among 100 patients between May 2011 and July 2013. The mean age of the patients was 32 +/- 3 years. Ureteroscopic pneumatic lithotripsy was performed using rigid Wolf ureteroscope and Swiss Lithoclast devices. Stone diagnosis and localization was done by CT KUB without contrast. IVU was done in cases where indicated. Stone size ranged from 0.6 cm to 2.0 cm with mild to marked obstructive changes in collecting system. All patients had normal renal function test results. The majority of the patients [60%] presented with lower ureter calculi, 28% with upper ureter calculi and 12% with middle ureter calculi. The patients were followed up with plain X-ray KUB and USG for two months. Stone-free status was declared as complete clearance of stone fragments from the urinary tract. The overall success rate was 96%. Auxiliary procedures conducted included balloon dilatation of ureterovesical junction [67%] and of upper ureteric stricture [1%], retrograde urography [1%], dormia basket manipulation [88%] and D-J stent placement [87%]. The complications encountered were mild transient hematuria [67%], migration of stone fragments [4%], urosepsis [2%], and residual stone fragments [4%], D-J stent associated discomfort [33%] and repeat procedure [2%]. Ureteroscopic Pneumatic Lithotripsy is an effective and safe treatment modality with unremarkable complications for ureteric stones
ABSTRACT
Germ cell tumors are rare in children. This group of tumors in children is distinct from that in adults in terms of their behavior, histological nature, metastasis and the treatment needed. 85% of the yold sac tumors in children present as clinical stage I disease as compared to 35% in adults. AFP can be used as reliable tumor marker as the levels are increased in more than 90% of yolk sac tumors. In children inguinal orchidectomy followed by stringent surveillance for two years is the preferred treatment option. Combination chemotherapy may be reserved for metastatic disease or recurrence. Retroperitoneal Lymph Node Dissection [RPLND] is preferable in adults. In this case report we describe the clinical presentation, imaging findings, diagnosis and up-to-date management of yolk sac tumor in an eight-month old child
ABSTRACT
Objectives: To develop curative treatment for complex stricture disease involving anterior urethra
Materials and Methods: Twenty patients with a median age of 35 years with history of repeated optical internal urethrotomies >5 underwent surgery
Stricture site and length were evaluated by Retrograde and Antegrade urethrogram. Stricture calibration was done by retrograde ureteric catheter insertion of variable sizes. Onlay or tubular was flap applied over partial or blind stricture respectively ranging from 5cm to 15cm
Results: The period of follow up was 24 months. Complications like patchy necrosis of penile skin [3] external meatal stenosis [2], Fistula [1] stricture at anastomotic site [1]and post void dribbling [5] were noted. The patient's quality of life improved following surgery
Conclusion: Distal penile fasciocutaneous flap is an effective tool for recurrent stricture disease involving anterior urethra
ABSTRACT
To develop curative treatment for complex stricture disease involving anterior urethra. Twenty patients with a median age of 35 years with history of repeated optical internal urethrotomies >5 underwent surgery. Stricture site and length were evaluated by Retrograde and Antegrade urethrogram. Stricture calibration was done by retrograde ureteric catheter insertion of variable sizes. Onlay or tubular was flap applied over partial or blind stricture respectively ranging from 5cm to 15cm. The period of follow up was 24 months. Complications like patchy necrosis of penile skin [3] external meatal stenosis [2], Fistula [1] stricture at anastomotic site [1] and post void dribbling [5] were noted. The patient's quality of life improved following surgery. Distal penile fasciocutaneous flap is an effective tool for recurrent stricture disease involving anterior urethra