A comparative study on the use of holmium laser and pneumatic lithotripser for intracorporeal lithotripsy of upper ureteric stones

Background: In the last decade different minimally invasive modalities for management of urolithiasis have been available requiring an intelligent decision by the urologist to choose one as per patients need and preferences.Methods: The present cross sectional study was conducted among patients who underwent ureterorenoscopic lithotripsy for proximal ureteric stones in the Department of Urology. Using consecutive sampling technique, patients were randomly allocated to two groups for treatment with either pneumatic lithotripser (group A) or Holmium laser lithotripser for fragmentation of calculi (group B) and the comparison of both these techniques was done.Results: 117 patients were included (57 and 60 in group A and group B respectively) in the study. The difference in age in the two groups was found to be statistically significant (p=0.03). The total operative time, length of stay in hospital and complications were more in group A patients. The difference in two groups for total operative time and length of stay in hospital was statistically significant (p=0.00 and 0.00 respectively).Conclusions: Holmium laser lithotripser has better safety profile when compared to pneumatic lithotripser especially in stone clearance rate and retropulsion rates and could be used as modality of choice in proximal ureteric stones.

Nephron-Sparing Surgery for Giant Angiomyolipoma of the Kidney.

Renal angiomyolipomas are rare benign tumors known to occur sporadically and in association with genetic syndromes, tuberous sclerosis and lymphangioliomyomatosis. Surgical removal or radiographic embolisation of angiomyolipomas larger than 4 cm is usually indicated because of an increased risk of spontaneous hemorrhage. We describe successful nephron-sparing surgery for a giant angiomyolipoma and discuss relevant management issues in a patient with angiomyolipoma.

Primarily Closed Bladder Exstrophy in a Female Patient Complicated by a Bladder Calculus and Squamous Cell Carcinoma-A Rare Presentation.

Bladder exstrophy is a rare congenital anomaly with an estimated incidence of 1 in 10,000 and 1 in 50,000 live births. It is even rarer in females with a male-to-female ratio being 5:1 to 6:1.We report a 19yrs old female who had primary closure of exostrophy at the age of 6months and now presented with vesical calculus and squamous cell carcinoma of bladder..