Results of renewed glenn-anderson technique in reimplantation of refluxing or obstructed lower end ureter [25 patients]

The aim of this study is to analyze the efficacy and outcome of distal tunnel ureteral reimplantation in refluxing and obstructed lower end ureter. The present study included 25 patients[17 males and 8 females], selected from Al-Azhar University Hospital [New Damietta], at the period between April 2005 and April 2007, Glenn-Anderson advancement [distal tunnel] ureteral reimplantation was performed in 10 patients with refluxing ureter [8 patients with secondary reflux and 2 patients with primary reflux], and 15 patients with obstructed lower end ureters. The success rate At 3 months improvement was observed in 20 cases [80, 0%] while at 9 months success rate was 88% and at 18 months success rate was 92%, The results of the present work revealed that the Glenn-Anderson technique [intravesical ureteral reimplantation] is a suitable and excellent for treatment of both refluxing or obstructed lower end ureter [stricture] whatever the cause

Extravesical ureteral reimplantation in stricture lower end ureter

Ureteral stricture is a problem that always has confronted the surgeons. Traditionally, stricture occurs most often in the ureter injured at operation and repair of the stricture has been accomplished by open surgical management. The aim of the work was to evaluate the extravesical ureteral reimplantation in stricture lower end ureter. The study was carried out on 11 patients [8 males and 3 females] with stricture lower end ureter, selected from Al-Azhar University Hospital [New Damietta] between April 2005 to April 2007. All cases were submitted to full history taking, clinical examination and laboratory investigations [urine analysis, blood urea and serum creatinine]. Imaging studies in the form of abdominopelvic ultrasound and excretory urography both pre and postoperatively. In addition to ascending cystography postoperatively at 3, 9 and 18 months. Post operative follow up by Ultrasound revealed improvement in 8 patients out of 10 with pervious moderate hydronephrosis while 2 patients show stabilization. In one patient with severe hydronephrosis shows stabilization without further deterioration. Using excretory urography followup, 6 patients of grade II hydronephrosis and 4 patients of grade III hydronephrosis showed improvement while in one patient with grade IV hydronephrosis remained stabilized. Hospital stay ranged from 5 to 6 days. The results of the present study demonstrated that extravesical ureteral reimplantation is a reliable procedure with a low complication rate, and we have found that this approach is applicable to many different situations but is especially advantageous for ureteral tailoring and the vesical psoas hitch since retrovesical exposure is excellent

Ultrasound guided percutaneous nephrolithotomy [PCNL] in the prone position, novel technique

Because PCNL is frequently difficult and time consuming relatively high radiation doses may be absorbed by the surgeon and other members of the interventional team in addition to the patient. A novel technique ultrasound guided percutaneous nephrolithotomy in the prone position with no radiation risk on patients, doctors and medical personnel has been tried. Twenty nine patients underwent Ultrasound guided percutaneous nephrolithotomy [PCNL] in the prone position between January 2001 and January 2007, 18 males and 11 females their ages ranged between 15 and 71 years [mean age 42.9 +/- 14.2 years]. Only in 13 patients stone was single and in 3 patients it was recurrent. All patients fulfill our inclusion criteria. The whole procedure was performed under ultrasound guidance in the operating room by urologists. No imaging or exposure to radiation has occurred during all steps of the operation. We used Nephromax balloon dilator 10 cm length; deflated 10 CH; inflated 30 CR [Nephromax; Boston Scientific, Natick, MA]. Twenty six patients were stone free[86.6%]. Auxiliary procedures were needed in 3 patients only, ureteroscopy and double J in one patient to treat leakage of urine on closure of nephrostomy tube, and ESWL in two patient for small non targeted stones. one failure due to Slippage of the system outside kidney. our complications were treated conservatively which include minimal pelvic perforation in 3 patients, minimal perirenal extravasations in one patient, pain in 14 patients, fever in 3 patients and urinary tract infection in patients. Ultrasound guided percutaneous nephrolithotomy in the prone position is safe and easy to learn technique with no radiation risk on patients, doctors and medical personnel. It is advisable to replace standard PCNL especially in radiolucent stones. Nephromax balloon is an easy, one step, with minimal bleeding, rapid tract dilator and minimal complications compared with other modalities

Ultrasound guided drainage of symptomatic benign renal cysts: value of ethanol injection

Seventy patients with symptomatic simple renal cysts were enrolled in this study. Their mean age was 41 [30-70] years. They were managed either by ultrasound guided drainage mono-therapy [40 patients, group A] or drainage with single injection of ethyl alcohol [97%] concentration [30 patients, group B]. All patients were followed up with abdominal ultra-sonography at monthly intervals in the first three months, then every three months for the next 18 months. Complete disappearance of renal cysts was achieved in 24 patients of group A and in 26 patients of group B. It was concluded that ultrasound guided drainage of symptomatic simple renal cysts is attractive minimally invasive procedure. The injection of sclerosing agent as ethyl alcohol after drainage improved the outcome and reduced the recurrence rate