Experience of upper urinary tract stones with dornier mpl 9000 lithotripter

To report our experience with Dornier MPL9000X Lithotripter in terms of safety, efficacy and complications in the management of upper urinary tract stones. Retrospective study. From 19[th] April 1998 to 15 August 2007 in the department of Nephrology, Chandka Medical College, Larkana. All patients who had renal calculi up to 2.5cm in size were selected for extra corporeal shock wave lithotripsy with Dornier MPL 9000 on the basis of clinical examination, laboratory investigations, X-Ray, intravenous urography and ultrasonography. Simple analgesics /sedation were used before the procedure, except in children where general anesthesia was used. A total of 1965 patients were treated with 3930 sessions [Average 4.1 sessions per patients]. Male to female ratio was 1.8:1. Average age of the patients was 35.3 years. The average stone burden was 1.8cm in diameter. Stone did not break in 3.3% cases, where as in 53 [2.69%] cases partial fragmentation had occurred. Over all success rate was 84%. About 10.2% cases were lost to follow up. Complications like colic pain, transient haematuria and stein Strasse was observed in 33%, 17% and 2.5% respectively. Extra corporeal shock wave lithotripsy for renal calculi was simple, safe and effective in selected group of patients

Trans vesical prostatectomy; judging the symptoms severity and quality of life

To determine the effectiveness of prostectomy in reducing symptom severity and quality of life. A prospective study. Urology department civil hospital Dadu. 2005 to 2007. 100 men under going prostectomy were assessed using the American urological Association [AUA] symptom index score and quality of life. The adverse events like urinary incontinence, erectile dysfunction and retrograde ejaculation also detected. The outcome was assessed after 3 month of prostectomy. Prostectomy was effective in reducing symptoms. Initial mean IPSS was 25 and reduced to 7 with p value < 0.001. Quality of life also assessed which showed majority of cases were mostly satisfied. Adverse events like transient incontinence 10%, retrograde ejaculation in 65% and erectile dysfunction in 25% respectively. Prostectomy is effective in reducing symptom severity and improve quality of life which was detected by IPSS and quality of life questionnaire

Prostatic hyperplasia transurethral electro vaporization: our experience

To asses the efficacy, safety and complication of TUEVP on the basis of subjective and objective parameters and to establish an alternative procedure in our setup. The study was conducted at Urology Department Services Hospital Lahore over a period of four years [I996-2000]. A total 50 patients suffering from Bladder outflow symptoms due to BPH were selected for the study. The TUEVP done by standard technique. The mean age was 64.16 with standard deviation of 7.86 years. The mean operating time in TUEVP was 20.6. Mean volume of irrigating fluid during the procedure was 8.28. Few patients require blood transfusion could be shorter resection time and less bleeding during TUEVP. Mean preoperative serum sodium was 138.8 mEq/1. After TUEVP mean changes in serum sodium was 1.1 mEq/1. Post operative mean volume of irrigant used was 11.12 liters. In TUEVP no patients developed significant haemorrhage during first 24 hours. Mean estimated cost of operation was Rs.4160/. Early complication rate like clot retention occurs in 4% and fever occurs [4%] while haemorrhage, TURP syndrome, retention of urine and DVT not reported. Late post operative complication included secondary infection [4%], Epididymoorchitis [4%], U.T.I in [12%], Retrograde ejaculation [24%] and stricture urethra [4%] patients. The mean symptomatic improvement in IPSS Score was 12.76 after two weeks, 8.72 after three month. Peak flow rate increased 13.4 ml/s after two weeks and 14.44 ml/s after three months. TUEVP is the effective and safe procedure with fewer complication and better recovery in our setup but required clinical trials to different urological centers to established its long term efficacy and safety

Distal hypospadias; Barcat-Redman urethroplasty

To assess the efficacy, safety and complication of Barcat-Redman urethroplasty technique in the management of distal hypospadias. Prospective study was completed at Urology Department, Services Hospital Lahore and Larkana from 1998 to 2007. Fifty patients of distal hypospadias were selected from the Urology Department of Services Hospital Lahore and Larkana for Barcat-Redman urethroplasty technique. Age of the patients range from 5 to 25 years. The mean age was 11 years. Forty [80%] patients belonged to urban areas while 10 [20%] were of rural areas. All the patients presented with dystopia of external urethral meatus and chordee [ventral curvature] while 25 [50%] presented with misdirected stream, 3 [5%] spraying of urine and 3 [5%] narrow stream. The subcoronal type of distal hypospadias was commonly seen in our study. Forty [80%] patients had subcoronal and 10 [20%] distal penile urethral opening. Following barcat-redman technique 35 [70%] patients had good result and 8 [16%] patients were declared as fair result while 4 [14%] declared failure. The overall morbidity rate was 30% while hospital stay was 3 days. Barcat-Redman urethroplasty technique is simple, less time consuming and has success rate for the management of Distal hypospadias

Duckett urethropusty: technique in the management of distal hypospadias

To assess the efficacy, safety and complication of Duckett urethroplasty technique in the management of distal hypospadias. Prospective study. At Urology Department, Services Hospital Lahore and larkana. From 1 998 to 2007. Fifty patients of distal hypospadias were selected from the Urology Departmental services hospital lahore and larkana for duckett urethroplasty technique. Age of the patients ranged from 5 to 22 years. The mean age was 1 0 years, forty [80%] patients belonged to urban areas while 10 [20%] were of rural areas.AII the patients presented with dystopia of external urethral meatus and chordee [ventral curvature]. 25 [50%] presented wih misdirected stream, spraying of urine 3 [5%] and narrow stream 3[5%]. The subcoronal type of distal hypospadias was commonly seen in our study. Forty [80%] patients had subcoronal and 10 [20%] distal penile urethral opening. All the patients were had distal type of hypospadias associated with chordee. Following duckett technique 32 [64%] patients had good result and 10[20%] patients have fair result while 8[1 6%] were decleared as a failed cases. There is still no operative procedure.which can be labelled as ideal operation for hypospadias.however duckett technique have lower success rate but statistically insignificant as compared to other procedures