ABSTRACT
Background: Computed tomography of the kidneys, ureters and bladder (CT-KUB) is increasingly used for urinary lithiasis. Its higher sensitivity in detecting small, radiolucent calculi with the avoidance of intravenous contrast media is very beneficial and replacing the traditional intravenous urography. Materials and methods: A Prospective study at Gandhi Hospital, Hyderabed was conducted from August 2013 to January 2016. Study Group I: calculus CT density less than 900 HU and study Group II: calculus CT density more than 900 HU. Results: Most of the stones were located in lower calix, followed by renal pelvis in both the groups. Hematuria persisted more than 24 hours among 6 (6%) patients in group 1 while18 (22.5%) in group 2. Steinstrasse was seen in 8 patients among group 1 which was managed medically in 6 patients where as ureteric stenting required in 2 patients .Where it was 3 patients in group 2 among them 1 required ureteric stenting, which appears to be significantly low but it was not when calculated among successful fragmentation as it is secondary complication to fragmented caliculi drainage. Conclusion: In patients with CT density <900 HU the ESWL was successful in 88%, with 58% of the patients required only one session and two or three ESWL sessions in remaining; with mean no 1.58 ESWL sessions are required. In patients CT density >900 HU, ESWL was successful in fewer than half of the patients (44%), only13% of them in a single session, and 76% requiring three sessions with failure rate of 80% in that group.
ABSTRACT
Background: Vesicovaginal fistula (VVF) is an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence. It is the most distressing complications of gynecologic and obstetric procedures. Materials and methods: It was a prospective study conducted at Gandhi Medical College and Hospital in Department of Urology from February 2014 to July 2015 for a period of 18 months. All cases were subjected to clinical examination, ultrasonography, IVP, cystoscopy, vaginoscopy, and cystogram for confirmation of diagnosis. All cases were managed surgically by different modalities and results were analyzed. Results: Our study included the patients in the age group of 18 to 56 years. 22 patients presented with continuous urine leak with voiding and 13 patients presented with voiding in addition to incontinence of urine. Out of 35 cases 25 were secondary to Gynecological surgeries and 10 were of Obstetric fistulas. Conclusion: The diagnosis of VVFs has traditionally been based on clinical methods and dye testing. The best chance of a successful repair is at the first attempt. The arguments about the most appropriate route for repair continue and are not clarified by the publications so far. However, the role of interposition grafts at both abdominal and vaginal repairs is viewed positively.