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APMC-Annals of Punjab Medical College. 2016; 10 (3): 166-169
in English | IMEMR | ID: emr-185644


Background: Penile carcinoma is an uncommon condition, accounting for less than 1% of all male cancers. It typically presents as a superficial lesion involving the Glans and Penile Shaft. Risk factors for penile carcinoma include phimosis, human papilloma virus infection and tobacco smoking. The spread of the tumor to the loco-regional lymph nodes is the most relevant prognostic factor

Case Presentation: The current case report is about a 65 years old male who presented with non-healing ulcer involving glans and shaft of penis for two months. Examination of Perineum revealed an ulcer of size about 3 cm in length involving glans and distal penile shaft, with eaten up most of glans surface. Wedge biopsy histopathology report showed moderately differentiated Squamous cell carcinoma of the penis involving sub-epithelial tissue with lympho-vascular invasion and involvement of corpora cavernosa. CT-Scan abdomen with IV contrast showed no evidence of metastasis or lymphadenopathy. So partial penectomy was planned and carried out subsequently

Conclusion: Although squamous cell carcinoma of the penis a rare disease, mainly affecting the elderly population but all the penile ulcers not responding to medial therapy must be evaluated for malignancy. Most of these cases remain neglected because of inadequate evaluation and investigation by the local doctors which leads to late presentation. Due to these circumstances the patients have already metastatic disease at presentation. So, it is required to educate local doctors as well as general population to create proper awareness of this disease

APMC-Annals of Punjab Medical College. 2015; 9 (3): 136-139
in English | IMEMR | ID: emr-186190


Background: DJ Stents have been in use since long for the management of ureteral obstruction. The obstruction may be due to stone, stricture, PUJ Obstruction etc. DJ Stents if kept for long time are associated with different complications like, blockage, break, migration, encrustation, stone formation etc. These long stayed DJ Stents need additional procedures for their removal like, URS, PCNL, and Pyelolithotomy etc

Objectives: i] to analyze the data retrospectively to see the number of patients having forgotten DJ Stents. ii] to see the level of awareness of patients regarding their DJ removal

Study Design: retrospective study

Place and duration of study: Urology Department, Allied Hospital, Faisalabad from Jan 2011 to Dec 2014

Materials and Methods: record of patients of forgotten DJ Stents for 4 years

Results: during 4 years period 35 patients were found to have forgotten DJ Stents and maximum duration of forgotten DJ Stents was 14 years. 41.66% patients in first group [indwell time 3- 12months] were having encrustations. Overall 11/35 [31.42%] needed litholopaxy for their DJ removal and 24/35 [68.57%] needed URS and it was successful in 22/24 patients. One patient needed PCNL and one had pyelolithotomy for their removal

Conclusion: patients should be stressed / counseled properly regarding its removal by telling its complication. Thread attached to the DJ stent may be left outside external urethral meatus. It must be properly documented in discharge slip. A register must be maintained to keep record of these patients and it should have their address and phone number so that they should be reminded of about their DJ removal well in time

APMC-Annals of Punjab Medical College. 2014; 8 (2): 121-125
in English | IMEMR | ID: emr-175337


Background: It has been a matter of great controversy whether the sonography [USG] and intravenous urography [IVU] both are mandatory for the evaluation of hydronephrosis and hydro ureter in female patients having urinary fistulae. So we planned to conduct a study on this subject

Objectives: To compare the sensitivity of IVU and USG in showing the degree of Hydro nephrosis and hydro ureter in the patients having VVF

Study Design: Prospective study

Place and Duration of Study: Department of Urology Punjab Medical College /Allied Hospital Faisalabad from January 2013 to October 2014

Methodology: Thirty consecutive female patients suffering from urinary incontinence who presented in outpatient department and were diagnosed to have VVF were taken for study. Patients with urge incontinence, patients with malignancy, patients who underwent surgery or received radiation were excluded from this study. Informed consent for study purpose and surgery were taken. USG and IVU were done in every patients to find the hydronephrosis or hydro ureter

Results: Twenty seven out of thirty patients who had not hydronephrosis on USG, they also had not hydronephrosis or hydro ureter on IVU, while only three patients had hydronephrosis on USG had also hydronephrosis on IVU

Conclusion: This study concluded that USG and IVU have almost equal sensitivity in finding hydro nephrosis or hydro ureter in patients having VVF. Therefore, any one of them can suffice to find out hydronephrosis. IVU is an invasive procedure and have the risk of reaction to contrast material and exposure to radiations. USG is cost effective, non-invasive and hence can be used in place of IVU

APMC-Annals of Punjab Medical College. 2013; 7 (2): 154-160
in English | IMEMR | ID: emr-175303


Introduction: Percutaneous Nephrolithotomy [PCNL] is an effective treatment for large renal calculi and usually a nephrostomy tube is placed in the kidney at the end of PCNL

Objective: To compare the outcome of conventional percutaneous nephrolithotomy with postoperative PCN tube versus tubeless Percutaneous Nephrolithotomy, in terms of duration of surgery and postoperative hospital stay

Study Design: Randomized control trial

Setting: Urology Department Punjab Medical College / Allied Hospital Faisalabad

Materials and Methods: Sixty patients were taken with non probability consecutive sampling technique. They were divided into group A[n=30] with conventional PCNL having postoperative nephrostomy tube and group B[n=30] with tubeless PCNL by computer generated random number table. They were compared in terms of duration of surgery and post operative hospital stay

Results: Age distribution of total patients ranged from 15 to 77 years, mean age was 35.07 +/- 15.89. Mean duration of postoperative hospital stay was 6.2 +/- 0.81and 4.07 +/- 1.2 days [p-value=00001] in group A and group B respectively. The operating time was 80 to 145, minutes, mean time 110.17 +/- 15.87 in group A. In group B, operating time was between 65 to 140 minutes mean time 95.18 +/- 22.43

Conclusion: Tubeless PCNL reduces duration of surgery and postoperative hospital stay significantly as compared to conventional PCNL with postoperative nephrostomy tube

APMC-Annals of Punjab Medical College. 2012; 6 (2): 126-130
in English | IMEMR | ID: emr-175253


Foetal hydronephrosis is commonly caused bycongenital pelviureteric Junction [PUJ] obstruction.It is either due to nerve deficiency or due to intrinsicmuscular defect at PUJ or it may be due to lowerpolar aberrant crossing vessel just compressing thePUJ. The purpose of this study is to see thecontribution of crossing vessels in causing the PUJobstruction

Aims and objectives: [1] to find thecontribution of crossing vessels in causing PUJobstruction on naked eye examinationperoperatively, [2] To histologicaly verify the causeof PUJ obstruction in cases of crossing vesselscompressing the pelvi-ureteric junction [PUJ]

Patients and methods: 27 cases of Congenital PUJobstruction were taken during four year period whowere candidatesfor operation. All underwent Anderson HynesPyeloplasty and specimen of PUJ with narrowsegment below it was taken and preserved in 10%formalin. The specimen was sent to histopathologistalong with other specimens where PUJ obstructionwas not caused by crossing vessels for nervedetection by S-100 immunohistochemistry and forhistopathological examination

Results: Five out of27 cases of PUJ obstruction were caused by crossingvessels and in these five cases, four [80%] werehaving normal histology showing that crossingvessels were the cause of PUJ obstruction merelycompressing the PUJ mechanically

APMC-Annals of Punjab Medical College. 2009; 3 (2): 86-89
in English | IMEMR | ID: emr-104436