Laparoscopic decortication of symptomatic simple renal cysts

To investigate the technique and assess results of laparoscopic decortication of symptomatic simple renal cysts. Ten patients underwent trans-peritoneal laparoscopic decortication of symptomatic simple renal cysts. Complex renal cysts were excluded. Out of the 10 patients, 8 had undergone previous cyst aspiration with injection of sclerotic material for intended ablation. Out of these cysts, 8 were peripheral and 2 were peripelvic. The mean operative time was 116 +/- 37.7 minutes [range 90- 180] and blood loss was minimal. Symptomatic success was achieved in 9 patients with a mean follow up of 7 months [range 3-9], and radiologic success was achieved in 8 patients. Laparoscopic decortication of simple renal cysts is a safe and effective alternative to open surgery in patients who have failed conservative measures. Peripelvic cyst location makes laparoscopic decortications more challenging in the term of technical dissection yet feasible for the clinical outcome

Does urge incontinence contraindicates surgery for stress urinary incontinence?

Urge incontinence is commonly associated with female stress urinary incontinence [SUI]. Many surgeons hesitate to operate for SUI if associated with urgency. Our aim is to define whether urge incontinence contraindicates surgery for SUI or not. This study was conducted on 35 female patients complaining of mixed incontinence [Urge and stress]. Patients with uninhibited detrusor contractions in cystometrogram [CMG] excluded from the study. All patients underwent preoperative assessment by history, physical examination, oblique cystogram, urodynamics [CMG, flowmetry and Valsalva leak point pressure [VLPP]] and cystoscopy. All patients were managed with fascial patch sling either from anterior rectus sheath or fascia lata [in patients with previous suprapubic incision or scarring]. All patients were followed up for one year with the same preoperative parameters. SUI was cured in 34 patients [97.1%] while urge incontinence was cured in 25 patients [71.4%] and persisted in 10 patients [28.6%]. In conclusion, patients complaining of mixed incontinence with urodynamically proved signs of urethral relaxation, as the main component of urge incontinence, will benefit significantly from surgery of SUI

Pubo-scrotal incision for repair of penile fractures

Fracture penis is a urologic emergency, which should be managed with prompt exploration and repair of the tunical tear. In this study we have evaluated a puboscrotal incision for the repair of penile fractures. Between Feb. 1995 till Dec. 2000, 42 cases of fracture penis were operated upon for repair using a puboscrotal incision. Patients presented at the emergency room and outpatient clinic of our department Full history, clinical examination and preoperative cavernosogram were done to all the patients to delineate the sites of Tunical tear. If urethral injury was suspected urethrography was performed. All cases included in this study presented to our department within 3-72 hours from injury. Their ages ranged from 18 to 44 years [mean 27.5 +/- 6.95 years]. Urethral injury was found in 5 cases [12%]. The follow-up of cases ranged from 12 to 34 months [average was 18 months]. The puboscrotal incision gave almost no complications in 30 cases [62.5%] and complications when happened were minimal and self-limiting. They included wound infection in one case [2.4%], residual fibrotic area in 3 cases [7.1%] minimal penile curvature in 2 cases [4.8%], painful erection during coitus in one case [2.4%], hematoma formation [small] in 2 cases [4.8%] and finally weak erection that resolved after 3 months postoperative in one case [2.4%]. In conclusion the puboscrotal incision is a good exposure of the penis with satisfactory repair of penile fractures and concomitant urethral injury. It avoids incision into markedly edematous penile skin

Suprapubic endoscopic procedures: a percutaneous approach

This study was carried out to assess whether suprapubic endoscopic surgery can be helpful in situations where trans urethral access is inadequate, difficult or likely to be associated with urethral damage. We have applied a new technique for percutaneous access to the bladder by using the self-retaining [locking] laparoscopic trocar. Forty male patients with lower urinary tract disorders were selected from the patients who attended the urology department at Benha University Hospitals during the period from June 1997 to October 1999. The patients ages ranged from 2 to 80 years old with a mean age of 48.1 years. According to the procedures done, 30 patients underwent percutaneous stone bladder clearance: 4 of them underwent a concomitant antegrade bladder neck incision. 6 patients treated with antegrade endoscopic dilatation [cut-to-the light of stricture posterior urethra] and 4 children underwent antegrade ablation of posterior urethral valve [PUV]. We concluded that, percutaneous access to the bladder by using the locking trocar is simple and safe technique. It avoids drawbacks of the other technique of creating and dilating the tract over a guide wire

Dead schistosome eggs in urine: a valuable finding not to be overlooked

Many histopathological examinations of the vesical pathology, including tumours and chronic lesions, reported the presence of dead calcified schistosome eggs in the examined specimen. This point directed our attention to investigate patients with dead schistosome eggs in simple urine analysis, thoroughly. By using the sedimentation and centrifugation method of urine analysis, 126 patients with dead bilharzia eggs in their urine were subjected to physical and radiological examinations, cystoscopy and biopsy under anaesthesia. 78 patients [61.9%] proved to have bladder carcinoma, 42 patients [33.3%] had chronic bladder lesions and 6 patients [4.8%] revealed no abnormality. No correlation was found between the quantity of dead schistosome eggs in urine and the type of the lesion whether malignant or non malignant. Also, no correlation was found between the quantity of dead schistosome eggs in urine and the grade of the tumour