Introduction : The incidence of ectopic kidney in autopsy series is around 1 in 900 otherwise it is 1 in 3000. There are various treatment modalities that can be utilised to treat these renal calculi e.g., extracorporeal shock wave lithotripsy, laproscopy assisted per-cutaneous nephrolithotomy, retrograde intra-renal surgery using the flexible ureteroscope, laproscopic/robotic pyelolithotomy and open surgery. We here describe a case of RIRS for stone in the pelvis of ectopic left kidney located on the right side just below the right kidney, it was crossed but not fused. To the best of our knowledge, this is first such case to be reported in crossed non-fused ectopic kidney. Case Report : A 33 years young male came with complaints of intermittent pain right loin for 2-3 months, mild initially but severe for last 24 hours. Physical examination suggested mild tenderness right iliac fossa. Ultrasonography and intravenous pyelography suggested ectopic left kidney located on right side below the right kidney in the right iliac fossa and not fused or attached to the right kidney with a large 21mm pelvic calculus with mild hydronephrosis. He later underwent retrograde intra-renal surgery where stone was completely lased and double J stent was kept at the end of the procedure. Results : Complete stone clearance was confirmed visually and under c-arm. Post operative USG and x-ray KUB showed no residual calculus. Patient was discharged on second postop day. There were no post-op complications. The double J stent was removed after two weeks. Conclusion : RIRS is a very good option to treat stones in an ectopic kidney. It may require more than one session sometimes, but considering the minimal invasive nature, the bothersome is less. Disposable ureteroscopes have further revolutionised the armamentarium of the urologist, who can now offer a personalised treatment plan for each patient. Keywords : RIRS, ectopic kidney, crossed ectopic non-fused kidney, stone in ectopic kidney, minimal invasive laser surgery
{"title":"RIRS A Boon for The Crossed Ectopic Non fused Kidney Calculi Patients First Case Report","authors":"Sanjay P Dhangar, Rishabh Mehta, Vasistha Martha","doi":"10.52338/aou.2024.4009","DOIUrl":"https://doi.org/10.52338/aou.2024.4009","url":null,"abstract":"Introduction : The incidence of ectopic kidney in autopsy series is around 1 in 900 otherwise it is 1 in 3000. There are various treatment modalities that can be utilised to treat these renal calculi e.g., extracorporeal shock wave lithotripsy, laproscopy assisted per-cutaneous nephrolithotomy, retrograde intra-renal surgery using the flexible ureteroscope, laproscopic/robotic pyelolithotomy and open surgery. We here describe a case of RIRS for stone in the pelvis of ectopic left kidney located on the right side just below the right kidney, it was crossed but not fused. To the best of our knowledge, this is first such case to be reported in crossed non-fused ectopic kidney. Case Report : A 33 years young male came with complaints of intermittent pain right loin for 2-3 months, mild initially but severe for last 24 hours. Physical examination suggested mild tenderness right iliac fossa. Ultrasonography and intravenous pyelography suggested ectopic left kidney located on right side below the right kidney in the right iliac fossa and not fused or attached to the right kidney with a large 21mm pelvic calculus with mild hydronephrosis. He later underwent retrograde intra-renal surgery where stone was completely lased and double J stent was kept at the end of the procedure. Results : Complete stone clearance was confirmed visually and under c-arm. Post operative USG and x-ray KUB showed no residual calculus. Patient was discharged on second postop day. There were no post-op complications. The double J stent was removed after two weeks. Conclusion : RIRS is a very good option to treat stones in an ectopic kidney. It may require more than one session sometimes, but considering the minimal invasive nature, the bothersome is less. Disposable ureteroscopes have further revolutionised the armamentarium of the urologist, who can now offer a personalised treatment plan for each patient. Keywords : RIRS, ectopic kidney, crossed ectopic non-fused kidney, stone in ectopic kidney, minimal invasive laser surgery","PeriodicalId":517843,"journal":{"name":"Annals of Urology","volume":"33 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141836150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective : Men with multiple sclerosis (MS) tend to present with urinary symptoms potentially translating to significant findings on urodynamics (UDS). We sought to assess the reliability and prognostic value of the International Prostate Symptom Score (IPSS) and Quality of Life (QoL) in patients with MS. Methods : A prospective study between July 2014 and August 2016 included 40 consecutive men with MS and lower urinary tract symptoms (LUTs) referred for video UDS. All participants completed the IPSS and QoL assessments. Results were compared and correlated to UDS parameters. Results : Mean (±SD) age, IPSS, and QoL were 53.7 ± 13.5 years, 16.7 ± 8.9 and 4.1 ± 1.4, respectively. The most common presenting symptom and UDS finding were urinary frequency (79%) and detrusor overactivity (68%). 72% had moderate-severe symptoms base on the IPSS. Reduced bladder compliance on UDS was associated with intermittency and straining answers on IPSS (p = 0.02 and p = 0.03). QoL did not predict UDS parameters. Conclusion : QoL and total IPSS scores are likely insufficient for MS and LUTs patient assessment due to the variability of UDS findings. However, in these patients, IPSS storage symptom questions had significant correlation with UDS. Furthermore, presenting symptoms in MS & LUTs did not correlate with UDS findings. Therefore, in patients with MS and LUTs, UDS must be performed for adequate disease assessment
{"title":"Use of the International Prostate Symptom Score in men with Multiple Sclerosis","authors":"Bilal Chughtaia","doi":"10.52338/aou.2024.3925","DOIUrl":"https://doi.org/10.52338/aou.2024.3925","url":null,"abstract":"Objective : Men with multiple sclerosis (MS) tend to present with urinary symptoms potentially translating to significant findings on urodynamics (UDS). We sought to assess the reliability and prognostic value of the International Prostate Symptom Score (IPSS) and Quality of Life (QoL) in patients with MS. Methods : A prospective study between July 2014 and August 2016 included 40 consecutive men with MS and lower urinary tract symptoms (LUTs) referred for video UDS. All participants completed the IPSS and QoL assessments. Results were compared and correlated to UDS parameters. Results : Mean (±SD) age, IPSS, and QoL were 53.7 ± 13.5 years, 16.7 ± 8.9 and 4.1 ± 1.4, respectively. The most common presenting symptom and UDS finding were urinary frequency (79%) and detrusor overactivity (68%). 72% had moderate-severe symptoms base on the IPSS. Reduced bladder compliance on UDS was associated with intermittency and straining answers on IPSS (p = 0.02 and p = 0.03). QoL did not predict UDS parameters. Conclusion : QoL and total IPSS scores are likely insufficient for MS and LUTs patient assessment due to the variability of UDS findings. However, in these patients, IPSS storage symptom questions had significant correlation with UDS. Furthermore, presenting symptoms in MS & LUTs did not correlate with UDS findings. Therefore, in patients with MS and LUTs, UDS must be performed for adequate disease assessment","PeriodicalId":517843,"journal":{"name":"Annals of Urology","volume":"208 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140286941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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