ABSTRACT
Background: It is important to detect and manage hydronephrosis early for improved clinical outcomes. The objective of this study is to detect and manage the hydronephrosis which occurs antenatally.Methods: Hospital based cross sectional study was carried out in 20 cases of hydronephrosis in pregnant women as per the inclusion and exclusion criteria laid down for the present study. Patients with mild hydronephrosis were observed. Patients with PUJ obstruction underwent pyeloplasty. Patients with posterior urethral valves underwent cystoscopic dilatation. Patients with VUR were put on prophylactic antibiotic and observed. The patients were followed up post operatively with USG and DTPA scan as indicated.Results: Among the 20 cases with hydronephrosis, majority were males. All cases in terms of side affected were found to be equally distributed. Hydronephrosis was found to be mild in seven (35%) of the cases. Renal dysplasia and bilateral hydronephrosis were found to be the predictors of post natal pathology. Grade 3 and grade 4 were 40% each. There was no persistent case. The most common cause of hydronephrosis was transient hypertension in 5 (33.3%) of the cases.Conclusions: Mild hydronephrosis resolves early and there is no persistence. Renal dysplasia and bilateral hydronephrosis are the important predictors of the post natal hydronephrosis.
ABSTRACT
Background: Hypospadias is a relatively common congenital defect of male external genitalia. It is present in approximately 1 in 300 males new born. The meatus may be located anywhere along the shaft of the penis from glans to scrotum or even perineum. The objective is to study the efficacy of MAGPI procedure in the management of hypospadias.Methods: Detailed case study was done as per the proforma, in majority of cases patient's mother were informants, thorough clinical examination was done in all cases and looked for any congenital anomalies and family history was also taken, and any drugs intake was also taken. All the cases routine investigation was done like (Hb, BT, Ct, Wt). USG was done in required cases. Routine pre-operative preparation was done like keeping nil orally, preparing parts was done. The type of surgery for each patient was assessed after clinical examination of location of meatus: Anterior, Middle, and Posterior. On discharge, the patients and mothers were advised to bring their children for regular check up to hospital.Results: Most common position of hypospadias was glanular and coronal. The most common surgery performed was Snodgrass technique and for distal and mid penile hypospadias and MAGPI for glanular type of hypospadias. MAGPI procedure was most commonly performed for glanular and coronal type of hypospadias. Other minor Complication was wound infection and penile torsion of mild degree and was managed conservatively.Conclusions: There is significant difference in outcome of hypospadias surgery done by pediatric urologist and other surgeons.