Bladder cancer in the three main age groups

Despite of the fact that the incidence of carcinoma of the urinary bladder associated with bilharziasis that occurs at young age compared to non-bilharzial type, the incidence of this tumor in young adults was not high. On the other hand, over 70- years the incidence was three times greater than below the age of 40 years. A retrospective survey of bladder cancer cases during six years from September 1987 to September 1993 showed 18.2% incidence. The two groups of extreme age were analyzed [below 40 years and 70 years and above] and compared with middle age group. Out of the twenty four cases aged below 40 years [4.8%], only 4 patients [0.8%] was classified histologically as transitional cell carcinoma [T.C.C.]. Out of the 90 patients, presented over 70 years of age [18.1%], 45 showed TCC [9%] on histopathological examination, compared to 35.7% in the middle age group

Rigid ureterosocopy: results and complications

From 1987 to 1994, 353 patients with ureteric stones were managed using rigid ureteroscopy. The mean age was 35.9 years. There were 293 males and 60 females. The stones were of different sizes ranged from 3 mm to less than 15 mm in length. Stones were unilateral in 300 patients, bilateral in 53 patients, single in 317 patients, multiple in 36 patients, stones were primary in 319 patients and recurrent in 34 patients. Patients were classified into 3 groups according to method of ureteric dilatation before ureteroscopy. Group 1 [120 patients] in which Teflon dilators were used, group 2 [180 patients], balloon dilatation were used, and group 3 [53 patients] ureteroscopy was done without preliminary dilatation. The success rate for pelvic stones was 95.8% and that for iliac stones was 51.15% with overall success rate of 92.63%. Failure of stones extraction was reported in 26 patients [7.36%] and were managed either by open ureterolithotomy in 14 patients or ureteral stenting in 12 patients. Failures were correlated with stone site, size and number. Complications occurred in 86 patients [24.36%] and included ureteral perforation in [4.53%], ureteral avulsion in [1.69%], hematuria in [2.54%], urinary sepsis in [9.34%], reflux in [2.54%] and loss of the renal unit in [1.69%]. The mean hospital stay was 2.5 days. Ureteroscopy is a safe and objective technique for management of ureteric stones, the success rate and the incidence of complications depend on two important factors, case selection and experience