ABSTRACT
Medical expulsion therapy has been shown to be a useful adjunct to observation in the management of ureteral stones. Alpha-1-adrenergic receptor antagonists have been studied in this role. Experimental study. This study was conducted Urology at GMMMC Hospital Sukkur from January 2008 to December 2010. In this study 480 patients were selected, with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received hyoscine N-butyl bromide [HBB], Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received teraozin. The subjects were prescribed diclofenac injection [75 mg] intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. The average stone size for groups 1, 2, 3 and 4 was comparable [6.13, 5.83, 5.59 and 5.48 mm respectively]. Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 +/- 6.21 days in group 1, 738 +/- 5, 55 days in group 2, 785 +/- 5.11 days in group 3 and 7.45 +/- 5.32 days in group 4. Alpha blockers were found to be superior to HBB [p <0.05]. Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a significantly increased stone-expulsion rate and decreased expulsion time when compared with HBB, HBB seems to have a negative effect on stone-expulsion rate
ABSTRACT
Trauma literature regarding management of penile trauma affecting all age groups in the face of coexisting life-threatening injuries is underdeveloped. Furthermore it had potential for significant complications including infection, incontinence, erectile dysfunction and infertility. presuming these facts we intend to assess the efficacy, safety, and complications of penile injuries and its proper management in our setup. Thirty patients of penile injuries having age of 4-64 years were selected from department of urology services hospital, Lahore. Patients having genital tumors or injured due to radiation and bums were excluded from study. Demographic details, brief clinical history and thorough local and systemic examination were carried out in these patients. Each subject was investigated for blood complete picture, urinalysis, and radiographic studies. Taken as a whole two third of our study population result shows fine outcome. Following the result of early and delayed management of cases, significant number of patients shows excellent outcome as compared to patients who were presented late in hospital. early presented patients to hospital shows promising outcome with reduced risk of long term sequelae as compared to patients presented late