ABSTRACT
Colonic perforation is an unusual and serious complication of percutaneous nephrolithotomy. It can result in more complicatedopen exploration of the abdomen, involving colostomy construction. The necessity of a second operation for the closure of thecolostomy causes financial and emotional burden on the patients and surgeons.
ABSTRACT
To determine an optimal medical and invasive intervention for renal colic patients during pregnancy. Amongthe available interventions, we investigated the reliability of a medical and inavasive interventions duringpregnancy. Between Nov 2015 and Nov 2016, a total of 200 pregnant patients came to the obstetrics andgynaecology opd, and 15 of these patients had renal colic that were referred to urological opd. The meanpatient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed tocollect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain followingtreatment and pregnancy complications. Based on ultrasonography diagnosis, 15 patients had urolithiasis,all had ureteric calculi with one having hydronephrosis and pyonephrosis and other one patient havingsevere hydronephrosis, pyonephrosis and sepsis. Conservative treatment was successful in 13 patients.Five patients were in the first trimester and ten patients in the second trimester. Out of the five patients inthe first trimester four were managed conservatively using antibiotics, hydrations and analgesics and oneamong them had severe hydronephrosis with pyonephrosis with sepsis with upper ureteric calculi in whomconservative management failed and patient was counselled and MTP was done and following that PCNLwas done as a definitive procedure. Ten patients in the second trimester medical expulsive therapy usingTamsulosin .4mg was used and complete stone clearance was achieved in Nine patients and one didn'tresponded , developed severe hydronephrosis and pyonephrosis in whom USG guided PCN was placedfor rest of the gestational period and after delivery patient underwent PCNL and complete stone clearancewas achieved. Only one patient required urological intervention that is PCN insertion. Renal colic due tocalculus during pregnancy can be effectively managed by conservative measures using hydration,antibiotics,analgesics and tamsulosin .4mg in most of the instances. Cases who do not respond to the conservativemeasure or who develops severe hydronephrosis, pyonephrosis PCN insertion and Ureteral stent insertioncan be done and patient in who develops life threatening sepsis MTP should be done followed by definitivetreatment that is PCNL.
ABSTRACT
Low urinary tract symptoms (LUTS) are a common problem during pregnancy. This study aimed to compare changes in the prevalence of LUTS during pregnancy between primiparous and multiparous women. A chart review of consecutive pregnant women who attended our antenatal clinic from August 2015 to December 2016 was performed. All of the women were asked to respond to a LUTS questionnaire in either of the three trimesters. Of the 270 women included, 164 were nullipara and 106 were multipara. The most common LUTS during pregnancy were frequency (77%), followed by nocturia (75.6%), stress urinary incontinence (SUI) (51.1%), incomplete emptying (43.7%), dysuria (17.8%), and urgency incontinence (10.4%). There was a significantly higher prevalence of SUI (P < 0.001) and urgency incontinence (P= 0.005) in the multiparous compared to the nulliparous women. Increasing prevalence rates of frequency, nocturia, SUI, and incomplete emptying were reported with gestational age in both the nulliparous and multiparous women. Frequency and nocturia were the two most common LUTS during pregnancy. The prevalence rates of all LUTS increased with increasing gestational age except for frequency in the nulliparous women during the second trimester. In addition, multipara was a predictor of SUI during Pregnancy.
ABSTRACT
Xanthogranulomatous pyelonephritis (XPN) is an variant of chronic pyelonephritis difficult to differentiate from renal malignancy on preoperative evaluation.We report an unusual case of XGP occurring in an immunocompetent patient in the absence of either urinary obstruction or nephrolithiasis, presenting as a diagnostic dilemma.
ABSTRACT
AIM: To study the levels of serum ferritin in patients of renal cell carcinoma (RCC). PATIENTS AND METHODS: Serum ferritin levels were measured preoperatively in 32 patients with radiological evidence of RCC using an enzyme immunoassay. The largest diameter of the primary tumor was measured in the pathological specimens in patients undergoing radical nephrectomy while in patients with non-operable tumor maximum tumor dimension was taken from CT scan. Pathological staging was done according TNM-1997. RESULTS: Mean serum ferritin value in patients of RCC was 283.23+/-77.38 ng/ml while in controls the mean value was 79.98+/-32.96 ng/ml (P CONCLUSIONS: Serum ferritin levels are elevated in patients with RCC although its actual source is unclear. Further studies are needed to establish the role of ferritin in RCC.