ABSTRACT
The tension-free vaginal tape procedure(TVT) has become a state of the art operation for female stress urinary incontinence. The most common problems after the TVT seen are voiding difficulties. Although the incidence of urinary retention appears to be low after the TVT procedure, it is recommended that patients be counseled about the risk and carefully monitored for voiding symptoms during the first 3 weeks postoperatively. When obstruction after the TVT is clinically evident, immediate tape adjustment in the operating room by open vaginal incision, may be indicated. We report of voiding difficulty 8 weeks after the TVT who was successfully managed with urethral dilation.
Subject(s)
Female , Humans , Incidence , Operating Rooms , Suburethral Slings , Urinary Incontinence , Urinary RetentionABSTRACT
PURPOSE: To evaluate the efficacy and safety of retroperitoneoscopic nephroureterectomy in patients with a transitional cell carcinoma of the renal pelvis and the ureter. MATERIALS AND METHODS: A total of 30 patients underwent nephroureterectomy for an upper tract transitional cell carcinoma. Of these, 16 underwent a retroperitoneoscopic nephroureterectomy(RNU) and 14 an open nephroureterectomy(ONU). After the retroperitoneal radical nephrectomy had initially been performed, a 5-6cm modified Gibson incision was then created to allow dissection of the lower ureter and bladder cuff and extraction of the intact specimen. A retrospective chart review was performed and the operating time, blood loss, analgesic requirement, ambulation time, interval to resume oral intake, hospital stay and complications assessed in both surgical groups. RESULTS: The RNU was superior to the ONU group with regard to blood loss(240.6+/-103.1 versus 519.3+/-62.3ml, p0.05). CONCLUSIONS: A retroperitoneoscopic nephroureterectomy is better tolerated by patients than an open nephroureterectomy as the surgery for an upper tract transitional cell carcinoma, and is also an efficacious alternative to open surgery. However, a long-term oncological evaluation will be required.
Subject(s)
Humans , Carcinoma, Transitional Cell , Kidney Pelvis , Laparoscopy , Length of Stay , Nephrectomy , Pelvis , Retrospective Studies , Ureter , Urinary Bladder , WalkingABSTRACT
PURPOSE: To report our experience of extracorporeal shock wave lithotripsy (ESWL), with the Dornier Compact Delta(R). MATERIALS AND METHODS: A total of 361 cases underwent EWSL using Dornier Compact Delta(R). The location and sizes of stones, session, success rate, and causes of failure and complications of ESWL, were retrospectively reviewed. The mean diameter of the stones was 8.7mm, ranging from 5 to 37mm. RESULTS: Of the 361 cases, there were 71 (19.7%) and 290 (80.3%) cases of renal stones and ureteral stones, respectively. The overall success rate was 92.5%, with success rates of 98.2, 86.2, 62.5 and 100% for stone sizes Subject(s)
Kidney
, Lithotripsy
, Retrospective Studies
, Shock
, Ureter
, Urinary Calculi
ABSTRACT
PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Subject(s)
Humans , Length of Stay , Nephrectomy , Operative Time , PiroxicamABSTRACT
PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Subject(s)
Humans , Length of Stay , Nephrectomy , Operative Time , PiroxicamABSTRACT
Lymphoceles are the most frequent surgical complications following kidney transplantation. Symptomatic lymphoceles following kidney transplantation are managed best by surgical marsupialization with intraperitoneal drainage. We performed laparoscopic intraperitoneal drainage in a patient with a large lymphocele and secondary hydronephrosis following a kidney transplant.
Subject(s)
Humans , Drainage , Hydronephrosis , Kidney Transplantation , Kidney , Laparoscopy , Lymphocele , TransplantationABSTRACT
Male pseudohermaphroditism can be caused by absent m llerian regression, inadequate synthesis of testosterone, inadequate synthesis of dihydrotestosterone, or androgen receptor deficiency. Defects in either the production or the action of androgenic steroids have been demonstrated to cause pseudovaginal perineoscrotal hypospadias, a syndrome of male pseudohermaphroditism. This is mostly caused by a deficiency of 5alpha-reductase, which controls the conversion of testosterone to 5alpha-dihydrotestosterone. We report a case of male pseudohermaphroditism due to 5alpha-reductase deficiency who was born with ambiguous genitalia and was reared as female.
Subject(s)
Female , Humans , Male , Disorder of Sex Development, 46,XY , Androgen-Insensitivity Syndrome , Dihydrotestosterone , Disorders of Sex Development , Hypospadias , Steroids , TestosteroneABSTRACT
Endometriosis is defined as the presence of endometrial tissue (gland and stroma) outside the uterus. The most frequent sites of implantation are the pelvic viscera and the peritoneum. About 1% of woman with endometriosis have urinary tract lesions, of which 85% involve the bladder. We report one case of vesical endometriosis that have been treated by partial cystectomy.