Urinary calculi in Minia governorate statistical study

The study included 3000 patients who attend the outpatient urology clinic and 500 patients who were admitted into urology department in one year duration from January 1990 to December 1990. Renal stones constitute 36.6 percent of all patients ham-urinary stones in the outpatient study and 27.3 percent in the inpatient study, the mean age of patients was 36.3 +/ -15.5 years, males constitute 81.3 percent and 63.3 percent of patients life in rural communities. The incidence of ureteric stones was 47.3 percent in the outpatient study and 38 4 percent in the admitted patients. The age incidence was 35.0 +/- 13.5 years; the male to female ratio was 5:1 in primary stone, 22:1 in stones formed above ureteric stricture. Stone bladder constitute 3.5 percent of hospital attendance, it affects male more than females. It constitutes 16.1 percent of all urinary tract stones. Age incidences is high from 1 to 5 years

Spongiosography: for diagnosis of urethral strictures

The available investigations of urethral strictures do not reveal the fibrosis and scarring of the corpus spongiosum. To obtain better information of fibrotic tissue damage in urethral strictures we had performed spongiosography, that is opacification of the spongy body by injection of contrast medium, in 23 patients in whom the diagnosis had already been established by uroflowmetry, urethrography and urethroscopy. Another 5 patients with erectile dysfunction were served as the control group. The investigation was well tolerated by all patients and no side effects or complications were encountered. Attenuation or even interruption of the contrast medium within the corpus spongiosum on spongiosography clearly revealed the fibrosis in urethral strictures. The extent of scarring was completely independent of the clinical symptoms and urethrographic findings. Accordingly, our decision on the appropriate surgical treatment was based mainly on the results of spongiosography. If used as an additional routine investigation in cases of urethral stricture spongiosography may help to decrease the recurrence rate in the future

Recurrent urinary tract infection in female patients

One hundred and fifty female patients suffering from recurrent urinary tract infection presented to El-Minia University Hospital in a period of 1.5 years were included in this study. All cases were randomly selected and divided into 6 groups; 42 pregnant, 24 pregnant diabetics, 56 middle aged, 18 diabetic middle aged, 10 unmarried females and 15 cases non - symptomatized were investigated as control. Mid-stream urine samples were taken from every patient and examined for biochemical reactions, microscopic examination, bacterial culture and sensitivity. We found significant bacteriaria in 42.7 percent of cases with bacterial count above 10[5] organisms per ml,., 52 percent of cases with bacterial count less than 10[5], while in 5.3 percent of cases the results of the cultures showed no growth although they were presented with urinary tract infection [U.T.I.]. Escherichia coli, staphylococcus aureus, streptococcus pyogenes and staphylococcus albus were the commonest organisms isolated from the diabetic pregnant females. While E. coli, Klebsiella, proteus and staphylococcus aureus were the commonest organisms isolated from the non - pregnant females. The most effective types of antibiotics used were Norfloxacin, Ofloxacin, Cefotaxim, and Cefoperazone. Short term therapy with these agents gave good results in uncomplicated upper U. T. I. with stones, abnormalities and other pathologies. Pseudomonas followed by E. Coli, staph. aureus and Klebsiella were the strongest [beta- lactamase producing organisms. Significant bacteriuria may be present in the absence of pyuria and vice versa

Endoscopic treatment of bilharzial bladder ulcer

Several methods of treatment have been tried for chronic bilharzial bladder ulcers. Endoscopic treatment of bilharzial bladder ulcers has been tried in this study, aiming for evaluation of its results as a line of treatment. Our study included 75 patients, 69 males and 6 females treated in Urology Department of El Minia University Hospital over two years duration, transuretheral resection was done for 45 patients, and transuretheral excision for 30 patients with no marked difference between the two techniques. However, transuretheral resection has the advantage in multiple ulcers. Follow up for those patients after treatment for 6 months revealed that 58 patients [77.3%] were symptoms free, 12 patients [16%] had slight burning micturition, and 5 patient [6.7%] had persistent symptoms. Cytoscopic examination was done 6 months after treatment revealed that recurrent ulceration still present in 5 patients [6.7%]. We concluded that endoscopic treatment of chronic bilharzial bladder ulcers is quite safe satisfactory manouver provided that the cases is accurately selected

Surgical management of female urinary fistulas

Our study included 32 female patients suffering from urinary fistula, were treated at El-Minia University Hospital in a period of 2.5 years. In 9 cases the fistulas were ureterovaginal and were treated transperitoneally by ureteroneocystostomy in 5 cases and Boari's flap in 4 cases with 100% success rate. In 22 patients with vesicovaginal fistulas, vaginal approach by flap splitting and vaginal flap techniques were applied for 8 cases with 50% success. The rest of the cases [14 plus the 4 cases of failed vaginal repair] were corrected successfully by the transabdominal approach using the bladder bisection technique with good dissection and separation of the bladder and vaginal wall and omental flap in complicated cases. One case of vesicouterine fistula also was treated in this study. All patients were continent postoperatively except 3 of them, were suffering from urge incontinence. We concluded that results of fistula repair depending mainly on surgeons clinical experience and individual technique