Hilar tumours are the renal tumours, which abut the renal artery or vein. Nephron sparing surgery (NSS) is of proven benefit among those with small renal masses. Hilar tumours are usually offered radical surgery due to the presumed difficulty in dissection, upgrading to tumour stage, and risk of conversion to radical surgery. We present our results of patients with hilar tumour undergoing nephron sparing surgery. We performed a retrospective analysis of patients who underwent NSS for renal hilar tumours in our tertiary referral institute from June 2017 to December 2022. The case sheets of all the patients who had undergone NSS were analysed and their radiology images reviewed. Those with hilar tumours were analysed based on demographic characters, perioperative and postoperative and follow-up details. Among a total of 21 patients undergoing partial nephrectomy, ten had hilar tumours. The median age was 43 years. Nine patients had robot-assisted partial nephrectomy and one underwent open partial nephrectomy. Seven patients had incidentally detected tumours. One had Grade 3 chronic kidney disease. The mean operative time and robot console time were 225 and 125 min, respectively. Median warm ischaemia time (WIT) was 36 min (25–48 min). One patient had grade 2 complication and two had grade 3 complication. Eight had clear cell renal cell carcinoma and one had positive margin. None had recurrence at a median follow-up of 38 months. Nephron sparing surgery, especially with robot-assisted approach, is feasible in hilar tumours with prognosis and complications similar to non-hilar tumours in short-term follow-up.
{"title":"Nephron sparing surgery for renal hilar tumours: short-term follow-up of predominantly robot-assisted surgery cohort","authors":"Anandan Murugesan, Ramesh Chinnusamy, Devdas Madhavan","doi":"10.1186/s12301-024-00410-9","DOIUrl":"https://doi.org/10.1186/s12301-024-00410-9","url":null,"abstract":"Hilar tumours are the renal tumours, which abut the renal artery or vein. Nephron sparing surgery (NSS) is of proven benefit among those with small renal masses. Hilar tumours are usually offered radical surgery due to the presumed difficulty in dissection, upgrading to tumour stage, and risk of conversion to radical surgery. We present our results of patients with hilar tumour undergoing nephron sparing surgery. We performed a retrospective analysis of patients who underwent NSS for renal hilar tumours in our tertiary referral institute from June 2017 to December 2022. The case sheets of all the patients who had undergone NSS were analysed and their radiology images reviewed. Those with hilar tumours were analysed based on demographic characters, perioperative and postoperative and follow-up details. Among a total of 21 patients undergoing partial nephrectomy, ten had hilar tumours. The median age was 43 years. Nine patients had robot-assisted partial nephrectomy and one underwent open partial nephrectomy. Seven patients had incidentally detected tumours. One had Grade 3 chronic kidney disease. The mean operative time and robot console time were 225 and 125 min, respectively. Median warm ischaemia time (WIT) was 36 min (25–48 min). One patient had grade 2 complication and two had grade 3 complication. Eight had clear cell renal cell carcinoma and one had positive margin. None had recurrence at a median follow-up of 38 months. Nephron sparing surgery, especially with robot-assisted approach, is feasible in hilar tumours with prognosis and complications similar to non-hilar tumours in short-term follow-up.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"203 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139517904","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}
Extracorporeal shock wave lithotripsy (ESWL) is a well-established non-surgical treatment of urolithiasis. ESWL as a monotherapy to treat vesical calculi is still unfamiliar among many urologists, despite its early introduction in the 1990’s. ESWL monotherapy for vesical calculi was performed in our study in a unique fashion in supine position with full bladder unlike any other previous reported studies. We aimed this study to report our experience with ESWL as a monotherapy in treating urinary bladder stones with a unique technique. A total of 29 patients with vesical calculi were treated with ESWL monotherapy from May 2021 to January 2023 using Dornier delta lithotripter in the supine position with the full bladder without per urethral catheterisation. Patients with stone size > 2.5cm or Hounsfield units > 1200 were excluded. Stone clearance was assessed with the help of fluoroscopy and ultrasonography on a second visit on day 7 after the procedure. Patients were followed up for 3 months. The mean size of vesical calculus was 1.6 cm (SD 0.32), and the mean Hounsfield unit was 940 HU (SD 86.61). None of the study subjects required surgical intervention. The stone clearance was obtained in 93.1% after a single session. The remaining two patients (6.9%) required one more session of ESWL following which stone clearance was obtained. One patient had acute urinary retention, and five (17.2%) patients had mild haematuria. ESWL monotherapy is a safe and effective treatment option for vesical calculi, with minimal or no patient discomfort, when done in supine position without routine per urethral catheterisation as described in the study. It should be considered more often by practicing urologists for vesical calculi.
{"title":"Extracorporeal shock wave lithotripsy as monotherapy for vesical calculi","authors":"Arjun Nagaraj, Bhavana Chowdary Madineni, Nagaraj Harohally Krishnareddy, Jeevan Nagaraj, Tariq Iqbal, Nitin Kumar Kamble, Jofin John Varghese","doi":"10.1186/s12301-023-00407-w","DOIUrl":"https://doi.org/10.1186/s12301-023-00407-w","url":null,"abstract":"Extracorporeal shock wave lithotripsy (ESWL) is a well-established non-surgical treatment of urolithiasis. ESWL as a monotherapy to treat vesical calculi is still unfamiliar among many urologists, despite its early introduction in the 1990’s. ESWL monotherapy for vesical calculi was performed in our study in a unique fashion in supine position with full bladder unlike any other previous reported studies. We aimed this study to report our experience with ESWL as a monotherapy in treating urinary bladder stones with a unique technique. A total of 29 patients with vesical calculi were treated with ESWL monotherapy from May 2021 to January 2023 using Dornier delta lithotripter in the supine position with the full bladder without per urethral catheterisation. Patients with stone size > 2.5cm or Hounsfield units > 1200 were excluded. Stone clearance was assessed with the help of fluoroscopy and ultrasonography on a second visit on day 7 after the procedure. Patients were followed up for 3 months. The mean size of vesical calculus was 1.6 cm (SD 0.32), and the mean Hounsfield unit was 940 HU (SD 86.61). None of the study subjects required surgical intervention. The stone clearance was obtained in 93.1% after a single session. The remaining two patients (6.9%) required one more session of ESWL following which stone clearance was obtained. One patient had acute urinary retention, and five (17.2%) patients had mild haematuria. ESWL monotherapy is a safe and effective treatment option for vesical calculi, with minimal or no patient discomfort, when done in supine position without routine per urethral catheterisation as described in the study. It should be considered more often by practicing urologists for vesical calculi.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139460316","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}
Renal cystic diseases are one of the commonest renal lesions encountered in clinical practice. Although common, most of the cysts are solitary, benign, asymptomatic and seldom clinically significant. But, renal lymphangiectasia is an exception. These are rare lymphatic malformation seen around the kidneys and in the retroperitoneum. It masquerades clinically like ADPKD and renal tumors and radiologically like a complex renal cyst. Although the cyst is benign, it possesses a significant impact on the quality of life. Because of its rarity, the management of this condition has not been well defined in the literature. A clinician must be aware of this rare condition and able to differentiate it from other similar conditions to aid in appropriate management. Hence, we present a case report of a female with bilateral renal lymphangiectasia managed successfully by laparoscopic excision. A 34-year-old hypertensive female came with complaints of bilaterally progressive flank masses for 3 months and breathlessness for 2 weeks. On examination, she had bilateral pitting pedal edema, bilateral palpable renal mass and ascites. She had nephrotic range proteinuria, hypoalbuminemia and normal renal function. Imaging showed 22-cm bilateral peri-renal and hilar multi-loculated cystic lesions, suggestive of bilateral renal lymphangiectasia. Antihypertensives and percutaneous interventions were not successful in relieving her symptoms. Subsequently, she was managed with laparoscopic excision on both sides. After surgery, she had an uneventful postoperative period and good symptomatic relief. No recurrence of the lesion found in follow-up CT imaging after 18 months. Renal lymphangiectasia is a rare yet clinically significant cystic lesion of the kidney. It can be diagnosed confidently by noninvasive imaging modalities. Medical treatment offered for mild symptomatic disease. Patients with severe symptoms need surgical intervention especially if it is not responding to medical management. Minimal invasive approach is feasible and successful in the management of this voluminous disease.
{"title":"Bilateral renal lymphangiectasia: a rare renal cystic disease managed by minimal invasive approach—a case report","authors":"Navaneethakrishnan Venkatachalam, Anandan Murugesan","doi":"10.1186/s12301-023-00399-7","DOIUrl":"https://doi.org/10.1186/s12301-023-00399-7","url":null,"abstract":"Renal cystic diseases are one of the commonest renal lesions encountered in clinical practice. Although common, most of the cysts are solitary, benign, asymptomatic and seldom clinically significant. But, renal lymphangiectasia is an exception. These are rare lymphatic malformation seen around the kidneys and in the retroperitoneum. It masquerades clinically like ADPKD and renal tumors and radiologically like a complex renal cyst. Although the cyst is benign, it possesses a significant impact on the quality of life. Because of its rarity, the management of this condition has not been well defined in the literature. A clinician must be aware of this rare condition and able to differentiate it from other similar conditions to aid in appropriate management. Hence, we present a case report of a female with bilateral renal lymphangiectasia managed successfully by laparoscopic excision. A 34-year-old hypertensive female came with complaints of bilaterally progressive flank masses for 3 months and breathlessness for 2 weeks. On examination, she had bilateral pitting pedal edema, bilateral palpable renal mass and ascites. She had nephrotic range proteinuria, hypoalbuminemia and normal renal function. Imaging showed 22-cm bilateral peri-renal and hilar multi-loculated cystic lesions, suggestive of bilateral renal lymphangiectasia. Antihypertensives and percutaneous interventions were not successful in relieving her symptoms. Subsequently, she was managed with laparoscopic excision on both sides. After surgery, she had an uneventful postoperative period and good symptomatic relief. No recurrence of the lesion found in follow-up CT imaging after 18 months. Renal lymphangiectasia is a rare yet clinically significant cystic lesion of the kidney. It can be diagnosed confidently by noninvasive imaging modalities. Medical treatment offered for mild symptomatic disease. Patients with severe symptoms need surgical intervention especially if it is not responding to medical management. Minimal invasive approach is feasible and successful in the management of this voluminous disease.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"22 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139083587","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}
Pub Date : 2024-01-03DOI: 10.1186/s12301-023-00405-y
Hamza Bashir, Abraish Ali, Muhammad Nauman, Asad Shahzad Hasan
Schwannomas are benign neurogenic encapsulated peripheral nerve tumors of Schwann cells that rarely occur in the retroperitoneum. We present a case of a 22-year-old man who presented with right flank pain and was initially diagnosed as hydatid cyst based on the imaging and borderline results of anti-echinococcus (IgG). Albendazole was prescribed and taken for 4 months with no response and later underwent surgical excision of the mass. The diagnosis and morphology confirmed the nature of the schwannoma. Complete surgical excision remains the gold standard for the management of these tumors. The preoperative diagnosis is usually difficult; however, the definitive diagnosis is made upon histopathological examination.Author name: Please confirm if the author name are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: Asad Shahzad, Last name: Hasan.correct
{"title":"Atypical presentation of an ancient retroperitoneal schwannoma mimicking a renal hydatid cyst: a case report and literature review","authors":"Hamza Bashir, Abraish Ali, Muhammad Nauman, Asad Shahzad Hasan","doi":"10.1186/s12301-023-00405-y","DOIUrl":"https://doi.org/10.1186/s12301-023-00405-y","url":null,"abstract":"Schwannomas are benign neurogenic encapsulated peripheral nerve tumors of Schwann cells that rarely occur in the retroperitoneum. We present a case of a 22-year-old man who presented with right flank pain and was initially diagnosed as hydatid cyst based on the imaging and borderline results of anti-echinococcus (IgG). Albendazole was prescribed and taken for 4 months with no response and later underwent surgical excision of the mass. The diagnosis and morphology confirmed the nature of the schwannoma. Complete surgical excision remains the gold standard for the management of these tumors. The preoperative diagnosis is usually difficult; however, the definitive diagnosis is made upon histopathological examination.Author name: Please confirm if the author name are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: Asad Shahzad, Last name: Hasan.correct","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"46 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139083319","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}
Pub Date : 2024-01-03DOI: 10.1186/s12301-023-00404-z
Farooq Hameed, Adeel Anwaar
This study evaluated the safety and feasibility of ablation of both non-muscle invasive and muscle invasive bladder tumors using single- and dual-wavelength diode lasers (980 nm and 980/1470 nm). We retrospectively examined 151 patients with bladder tumors of any type from 2009 to 2021 who underwent V-LABT (visual laser ablation of bladder tumor) with both single- and dual-wavelength diode lasers at Shalamar Hospital Lahore, Pakistan. All procedures were performed by the same surgeon. Shalamar Medical and Dental College review board approved this retrospective cohort study (IRB No. -623-2023). The collected clinical data were consolidated into a single group, encompassing various variables such as the patients’ age, tumor size, number of tumors, tumor location, tumor grade, ablation duration, postoperative catheterization time, bladder discomfort, obturator nerve reflex, intraoperative and postoperative complications, and recurrence of tumors at the ablation sites. The patients were monitored for a minimum of 12 months to observe recurrence at the ablation sites through cystoscopy performed postoperatively every three months. The data were analyzed using Chi-square test, and p value < 0.05 was considered significant. The average age of the 151 patients was found to be 64.72 ± 13.85 years. The size of the tumors was 4.88 ± 2.16 cm, with 48/151 (31.7%) patients having tumors larger than 3 cm. Among the cases studied, 117/151 (77.4%) patients had a single tumor, while the remaining patients had multiple tumors ranging in size from 5 to 7 cm in aggregate. Ablation took 1.57 ± 0.73 h to complete on average. None of the patients required a conversion to TURBT in 151 patients. No obturator reflexes or bladder perforations were observed in any case. Postoperatively, histopathology results showed 53/151 (35%) and 92/151 (60.9%) high- and low-grade tumors. The average catheterization duration was 6.58 ± 1.47 days. Tumors located on difficult sites, such as the anterior wall, lateral wall, and bladder neck, were ablated with ease. There was no recurrence seen on previously tumor ablated sites till 12-month follow-up. Ablation of bladder tumors of any type using single- or dual-wavelength diode laser (980 nm and 980/1470 nm) is safe and feasible. These lasers possess the capability to effectively ablate/coagulate bladder tumors in challenging anatomical locations including diverticular tumors with minimal difficulty.
{"title":"Bladder tumor ablation with 980-nm and 980-/1470-nm diode lasers: a retrospective study","authors":"Farooq Hameed, Adeel Anwaar","doi":"10.1186/s12301-023-00404-z","DOIUrl":"https://doi.org/10.1186/s12301-023-00404-z","url":null,"abstract":"This study evaluated the safety and feasibility of ablation of both non-muscle invasive and muscle invasive bladder tumors using single- and dual-wavelength diode lasers (980 nm and 980/1470 nm). We retrospectively examined 151 patients with bladder tumors of any type from 2009 to 2021 who underwent V-LABT (visual laser ablation of bladder tumor) with both single- and dual-wavelength diode lasers at Shalamar Hospital Lahore, Pakistan. All procedures were performed by the same surgeon. Shalamar Medical and Dental College review board approved this retrospective cohort study (IRB No. -623-2023). The collected clinical data were consolidated into a single group, encompassing various variables such as the patients’ age, tumor size, number of tumors, tumor location, tumor grade, ablation duration, postoperative catheterization time, bladder discomfort, obturator nerve reflex, intraoperative and postoperative complications, and recurrence of tumors at the ablation sites. The patients were monitored for a minimum of 12 months to observe recurrence at the ablation sites through cystoscopy performed postoperatively every three months. The data were analyzed using Chi-square test, and p value < 0.05 was considered significant. The average age of the 151 patients was found to be 64.72 ± 13.85 years. The size of the tumors was 4.88 ± 2.16 cm, with 48/151 (31.7%) patients having tumors larger than 3 cm. Among the cases studied, 117/151 (77.4%) patients had a single tumor, while the remaining patients had multiple tumors ranging in size from 5 to 7 cm in aggregate. Ablation took 1.57 ± 0.73 h to complete on average. None of the patients required a conversion to TURBT in 151 patients. No obturator reflexes or bladder perforations were observed in any case. Postoperatively, histopathology results showed 53/151 (35%) and 92/151 (60.9%) high- and low-grade tumors. The average catheterization duration was 6.58 ± 1.47 days. Tumors located on difficult sites, such as the anterior wall, lateral wall, and bladder neck, were ablated with ease. There was no recurrence seen on previously tumor ablated sites till 12-month follow-up. Ablation of bladder tumors of any type using single- or dual-wavelength diode laser (980 nm and 980/1470 nm) is safe and feasible. These lasers possess the capability to effectively ablate/coagulate bladder tumors in challenging anatomical locations including diverticular tumors with minimal difficulty.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"2 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139083252","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}
Pub Date : 2023-12-17DOI: 10.1186/s12301-023-00402-1
Sawyer Joseph Reed, Stefanie Nasui, Nicholas Farber
Mesothelioma is a rare cancer that generally affects the lining of the lungs. However, in more rare cases, there are extra-pleural involvement of organs that are lined with mesothelial cells, including the testicle. Mesothelioma of the tunica vaginalis of the testicle typically presents with a painless scrotal mass with accompanying hydrocele of the affected side. The most common predisposition to mesothelioma of the tunica vaginalis is previous asbestos exposure, long-standing hydrocele, and previous scrotal surgeries. In this case we present a patient with isolated left tunica vaginalis mesothelioma of the testicle, yet without classic risk factors or other sites of disease. Left radical orchiectomy was performed and subsequent follow-up imaging did not reveal any sites of recurrence or metastasis. Although, mesothelioma of the tunica vaginalis is a rare cancer, it should be seen as a possible differential when evaluating new testicular masses.
{"title":"Atypical presentation of testicular mesothelioma","authors":"Sawyer Joseph Reed, Stefanie Nasui, Nicholas Farber","doi":"10.1186/s12301-023-00402-1","DOIUrl":"https://doi.org/10.1186/s12301-023-00402-1","url":null,"abstract":"Mesothelioma is a rare cancer that generally affects the lining of the lungs. However, in more rare cases, there are extra-pleural involvement of organs that are lined with mesothelial cells, including the testicle. Mesothelioma of the tunica vaginalis of the testicle typically presents with a painless scrotal mass with accompanying hydrocele of the affected side. The most common predisposition to mesothelioma of the tunica vaginalis is previous asbestos exposure, long-standing hydrocele, and previous scrotal surgeries. In this case we present a patient with isolated left tunica vaginalis mesothelioma of the testicle, yet without classic risk factors or other sites of disease. Left radical orchiectomy was performed and subsequent follow-up imaging did not reveal any sites of recurrence or metastasis. Although, mesothelioma of the tunica vaginalis is a rare cancer, it should be seen as a possible differential when evaluating new testicular masses.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"8 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138690312","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}
Pub Date : 2023-12-17DOI: 10.1186/s12301-023-00401-2
Mahmoud F. Rohiem, Nesreen F. Ibrahim, Mostafa Magdi Ali, Ahmed Issam Ali
To evaluate the benefits of using transurethral cystoscope and resectoscope for managing possible complications that may occur during open transvesical prostatectomy operation. Open transvesical or retropubic prostatectomy remains, in less technologically developed countries, the standard option for treatment of complicated large benign prostatic hyperplasia. Complications rate with open prostatectomy procedures, especially post-operative bleeding and urinary incontinence, represent a real challenge facing urologists. Hopefully, recent advances in endourology section helped greatly in management of complicated benign prostatic hyperplasia and also offered a tool to deal with possible open prostatectomy complications. In a prospective study, fifty (50) male patients with complicated large benign prostatic enlargement associated with large single or multiple bladder stones with stone burden ≥ 3cm3 planned to undergo transvesical prostatectomy divided randomly into two groups. Group (A) included 25 patients who underwent standard T.V.P. and group (B) included 25 patients in whom diagnostic urethro-cystoscopy and a mono-polar resectoscope were used pre- and post-prostatic adenoma enucleation. Patients had follow-up evaluation visits at 1, 3 and 6 months postoperatively to evaluate IPSS, post-void urine estimation, Qmax., and quality of life. A total of 50 patients were divided equally into two groups. Group (A) included 25 patients who underwent standard transvesical prostatectomy, while group (B) included 25 patients who underwent initial diagnostic urethro-cystoscopy, then bilateral ureteric catheter insertion, followed by prostatic apical demarcation using a monopolar resectoscope. Finally, transurethral hemostasis of the prostatic bed is done after standard transvesical adenoma enucleation. Mean operative time in group (A): 48.3 ± 12.4 min. while in group (B): 68.9 ± 14.1 min (p < 0.001), Hemoglobin deficit in group (A): 2.8 ± 1.1 g/dl. while in group (B): 1.1 ± 0.39 g/dl. (p < 0.001). Enucleated prostate volume in group (A): 89.2 ± 16.1g, while in group (B): 91.2 ± 17.2g (p = 0.673). Post-operative IPSS, Post-void residual urine and Qmax showed insignificant differences between the two groups. Trans-urethral endoscopically assisted transvesical prostatectomy provides more safety and fewer morbidities and complications rate compared to standard T.V.P.
{"title":"Evaluation of intra-operative trans-urethral endoscopic management of possible open transvesical prostatectomy complications","authors":"Mahmoud F. Rohiem, Nesreen F. Ibrahim, Mostafa Magdi Ali, Ahmed Issam Ali","doi":"10.1186/s12301-023-00401-2","DOIUrl":"https://doi.org/10.1186/s12301-023-00401-2","url":null,"abstract":"To evaluate the benefits of using transurethral cystoscope and resectoscope for managing possible complications that may occur during open transvesical prostatectomy operation. Open transvesical or retropubic prostatectomy remains, in less technologically developed countries, the standard option for treatment of complicated large benign prostatic hyperplasia. Complications rate with open prostatectomy procedures, especially post-operative bleeding and urinary incontinence, represent a real challenge facing urologists. Hopefully, recent advances in endourology section helped greatly in management of complicated benign prostatic hyperplasia and also offered a tool to deal with possible open prostatectomy complications. In a prospective study, fifty (50) male patients with complicated large benign prostatic enlargement associated with large single or multiple bladder stones with stone burden ≥ 3cm3 planned to undergo transvesical prostatectomy divided randomly into two groups. Group (A) included 25 patients who underwent standard T.V.P. and group (B) included 25 patients in whom diagnostic urethro-cystoscopy and a mono-polar resectoscope were used pre- and post-prostatic adenoma enucleation. Patients had follow-up evaluation visits at 1, 3 and 6 months postoperatively to evaluate IPSS, post-void urine estimation, Qmax., and quality of life. A total of 50 patients were divided equally into two groups. Group (A) included 25 patients who underwent standard transvesical prostatectomy, while group (B) included 25 patients who underwent initial diagnostic urethro-cystoscopy, then bilateral ureteric catheter insertion, followed by prostatic apical demarcation using a monopolar resectoscope. Finally, transurethral hemostasis of the prostatic bed is done after standard transvesical adenoma enucleation. Mean operative time in group (A): 48.3 ± 12.4 min. while in group (B): 68.9 ± 14.1 min (p < 0.001), Hemoglobin deficit in group (A): 2.8 ± 1.1 g/dl. while in group (B): 1.1 ± 0.39 g/dl. (p < 0.001). Enucleated prostate volume in group (A): 89.2 ± 16.1g, while in group (B): 91.2 ± 17.2g (p = 0.673). Post-operative IPSS, Post-void residual urine and Qmax showed insignificant differences between the two groups. Trans-urethral endoscopically assisted transvesical prostatectomy provides more safety and fewer morbidities and complications rate compared to standard T.V.P.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"43 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714812","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}
Pub Date : 2023-12-13DOI: 10.1186/s12301-023-00393-z
Sameh Kotb, Mohammed A. Abdel-Rassoul, Mohamed Magdy Elkousy, Galal El-Shorbagy, Ahmed S. Elsayed, Sherif Abdel-Rahman, Amr Moustafa Sayed
We compare the outcome of microsurgical subinguinal varicocelectomy (MSV) using the pulling technique (P-MSV) compared to the standard technique (S-MSV). A total of 60 patients were diagnosed with varicocele compounded with infertility and/or scrotal pain not responding to medical treatment. Twenty-nine patients were randomized to the P-MSV, while 31 were randomized to S-MSV. The number of ligated veins was counted intraoperative and compared. Follow-up was done at 1 and 3 months including clinical examination, scrotal duplex ultrasound scan, and semen analysis. A total of 85 sides were operated upon, 43 (50.5%) were done by the P-MSV technique while 42 (49.5%) were done by the S-MSV technique. The median gained cord length after using the P-MSV was [3 cm; IQR 2–5 cm]. For the P-MSV technique, the mean number of detected internal spermatic veins after cord pulling was (4 ± 1.3 SD) compared to (6 ± 1.4 SD) before pulling (P value < 0.01) and for the S-MSV was 3 (2.75–5). There was no statistical or clinically significant difference in the perioperative outcomes between both groups. The overall conception rate was 47.1%. Ninety-two percent of patients complaining of preoperative scrotal pain had resolution of the pain on follow-up with no statistical difference between both techniques (P values 0.53, 0.3 respectively). There was no statistical difference in the recurrence rate between both groups (P = 0.11). The number of ligated veins decreased significantly using the P-MSV technique leading to an improvement in the surgical feasibility of MSV. There is a significant benefit for the new pulling technique in decreasing the number of internal spermatic veins which leads to improving the surgical feasibility of microsurgical varicocelectomy.
{"title":"Comparison of the pulling technique versus the standard technique in microsurgical subinguinal varicocelectomy: a randomized controlled trial","authors":"Sameh Kotb, Mohammed A. Abdel-Rassoul, Mohamed Magdy Elkousy, Galal El-Shorbagy, Ahmed S. Elsayed, Sherif Abdel-Rahman, Amr Moustafa Sayed","doi":"10.1186/s12301-023-00393-z","DOIUrl":"https://doi.org/10.1186/s12301-023-00393-z","url":null,"abstract":"We compare the outcome of microsurgical subinguinal varicocelectomy (MSV) using the pulling technique (P-MSV) compared to the standard technique (S-MSV). A total of 60 patients were diagnosed with varicocele compounded with infertility and/or scrotal pain not responding to medical treatment. Twenty-nine patients were randomized to the P-MSV, while 31 were randomized to S-MSV. The number of ligated veins was counted intraoperative and compared. Follow-up was done at 1 and 3 months including clinical examination, scrotal duplex ultrasound scan, and semen analysis. A total of 85 sides were operated upon, 43 (50.5%) were done by the P-MSV technique while 42 (49.5%) were done by the S-MSV technique. The median gained cord length after using the P-MSV was [3 cm; IQR 2–5 cm]. For the P-MSV technique, the mean number of detected internal spermatic veins after cord pulling was (4 ± 1.3 SD) compared to (6 ± 1.4 SD) before pulling (P value < 0.01) and for the S-MSV was 3 (2.75–5). There was no statistical or clinically significant difference in the perioperative outcomes between both groups. The overall conception rate was 47.1%. Ninety-two percent of patients complaining of preoperative scrotal pain had resolution of the pain on follow-up with no statistical difference between both techniques (P values 0.53, 0.3 respectively). There was no statistical difference in the recurrence rate between both groups (P = 0.11). The number of ligated veins decreased significantly using the P-MSV technique leading to an improvement in the surgical feasibility of MSV. There is a significant benefit for the new pulling technique in decreasing the number of internal spermatic veins which leads to improving the surgical feasibility of microsurgical varicocelectomy.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"57 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138581776","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}
The supernumerary kidney is the rarest of all renal anomalies, and few cases have been diagnosed and reported over the years. Supernumerary kidneys are most commonly located on the left side of the abdomen with associated pathologic conditions which include malformations of the upper urinary tract and genital tract. More importantly, it usually presents with either unusual abdominal mass or features of urinary tract infections which might pose diagnostic challenges due to infrequent occurrence. In this case report, we present a 35-year-old man with a right-sided unilateral supernumerary kidney complicated by pyelonephritis. He was treated with antibiotics, and the treatment outcome was satisfactory.
{"title":"Late presentation of supernumerary kidney in a 35-year-old man: a case report","authors":"Tume Aondoyima Alfred, Mustapha Shu’aibu Hikima, Rasheed Mumini Wemimo, Latifat Tunrayo Oduola-Owoo","doi":"10.1186/s12301-023-00400-3","DOIUrl":"https://doi.org/10.1186/s12301-023-00400-3","url":null,"abstract":"The supernumerary kidney is the rarest of all renal anomalies, and few cases have been diagnosed and reported over the years. Supernumerary kidneys are most commonly located on the left side of the abdomen with associated pathologic conditions which include malformations of the upper urinary tract and genital tract. More importantly, it usually presents with either unusual abdominal mass or features of urinary tract infections which might pose diagnostic challenges due to infrequent occurrence. In this case report, we present a 35-year-old man with a right-sided unilateral supernumerary kidney complicated by pyelonephritis. He was treated with antibiotics, and the treatment outcome was satisfactory.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"21 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138577206","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}
Pub Date : 2023-12-12DOI: 10.1186/s12301-023-00403-0
Farzaneh Sharifiaghdas, Behzad Narouie, Mohammad Hossein Soltani, Milad Bonakdar Hashemi, Mohadese Ahmadzade, Hamidreza Rouientan, Ali Jouzi, Mohammad Aref Emami
Vesicoureteral reflux (VUR) is a common condition associated with childhood urinary tract infection (UTI) that can lead to chronic renal failure and hypertension. Various anti-reflux treatments were advocated, with various degrees of morbidity and success. The purpose of this study is to analyze and compare the results of modified Gil-Vernet anti-reflux surgery and bulking agent injection in children with unilateral high-grade reflux. The study involved 179 patients who underwent surgical interventions for primary VUR from February 2013 to September 2019. Data on baseline demographics, preoperative symptoms, radiological imaging studies, and postoperative outcomes were analyzed. Treatment goal was defined as when no VUR or downgrading was detected 6 months or later after the intervention. A total of 128 patients underwent modified Gil-Vernet anti-reflux surgery and 51 patients underwent dextranomer/hyaluronic acid (Dx/HA) injection with mean VUR grading of 4.3 in both groups (P = 0.687). The overall VUR resolution rates were significantly higher in modified anti-reflux surgery rather than Dx/HA injection (86% vs. 68%, P = 0.021). Dx/HA injection was associated with shorter operation time (21 ± 8 min vs. 57 ± 11 min, P = 0.01), and shorter hospital stay (0.34 ± 0.22 days vs. 3.50 ± 0.50 days, P < 0.001). No major complications were identified in both groups. Dx/HA injection has a significantly shorter operation time, lower postoperative analgesic usage, and shorter hospital stay, modified Gil-Vernet anti-reflux surgery is associated with significantly higher VUR downgrading and resolution rates than Dx/HA injection, particularly in the higher grade VUR.
{"title":"Investigating the clinical outcomes of bulking agent injection in comparison with modified Gil-Vernet anti-vesicoureteral reflux surgery in children with high-grade reflux (4 or 5)","authors":"Farzaneh Sharifiaghdas, Behzad Narouie, Mohammad Hossein Soltani, Milad Bonakdar Hashemi, Mohadese Ahmadzade, Hamidreza Rouientan, Ali Jouzi, Mohammad Aref Emami","doi":"10.1186/s12301-023-00403-0","DOIUrl":"https://doi.org/10.1186/s12301-023-00403-0","url":null,"abstract":"Vesicoureteral reflux (VUR) is a common condition associated with childhood urinary tract infection (UTI) that can lead to chronic renal failure and hypertension. Various anti-reflux treatments were advocated, with various degrees of morbidity and success. The purpose of this study is to analyze and compare the results of modified Gil-Vernet anti-reflux surgery and bulking agent injection in children with unilateral high-grade reflux. The study involved 179 patients who underwent surgical interventions for primary VUR from February 2013 to September 2019. Data on baseline demographics, preoperative symptoms, radiological imaging studies, and postoperative outcomes were analyzed. Treatment goal was defined as when no VUR or downgrading was detected 6 months or later after the intervention. A total of 128 patients underwent modified Gil-Vernet anti-reflux surgery and 51 patients underwent dextranomer/hyaluronic acid (Dx/HA) injection with mean VUR grading of 4.3 in both groups (P = 0.687). The overall VUR resolution rates were significantly higher in modified anti-reflux surgery rather than Dx/HA injection (86% vs. 68%, P = 0.021). Dx/HA injection was associated with shorter operation time (21 ± 8 min vs. 57 ± 11 min, P = 0.01), and shorter hospital stay (0.34 ± 0.22 days vs. 3.50 ± 0.50 days, P < 0.001). No major complications were identified in both groups. Dx/HA injection has a significantly shorter operation time, lower postoperative analgesic usage, and shorter hospital stay, modified Gil-Vernet anti-reflux surgery is associated with significantly higher VUR downgrading and resolution rates than Dx/HA injection, particularly in the higher grade VUR.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"3 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572241","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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