Pub Date : 2016-09-09DOI: 10.4172/2168-9857.1000171
K. Gadalla
Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods: During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens- LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done. Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re- treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions: Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.
{"title":"Success Rate of Stone Recurrence after Extracorporeal Shockwave Lithotripsy and Factors affecting Success of Treatment among Egyptian Patients","authors":"K. Gadalla","doi":"10.4172/2168-9857.1000171","DOIUrl":"https://doi.org/10.4172/2168-9857.1000171","url":null,"abstract":"Objectives: To evaluate the factors that affect the success rate of ESWL for treatment of renal stones and to estimate the prevalence of stone recurrence during a 1-year period. Materials and Methods: During the period of January, 2010 and December, 2010, prospective study of 142 subjects with single or multiple renal stones (<30 mm, largest diameter) undergone ESWL monotherapyby Siemens- LITHOSKOP lithotriptor. The results of treatment were assessedafter a follow-up period of 3 months. Treatment success was a complete clearance of the stones or presence of insignificantresidual fragments<4 millimeters. Correlation of the success rate with the characteristics of the subjects, conditionsof the urinary tract and features of the stone was done. Results: During the 3-months follow-up period, the success rate was 111/142 (78%). Re- treatment was needed in 75 patients (52.8%). Post-treatment procedures were done in 12 subjects (8.4%). Post-ESWL complications were observed in 5 subjects (3.5%). Out of 10 prognosticfactors studied, 5 had a powerful influence on the success rate, which are: renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number. Other factors including age, sex, nationality, stonenature (de novo or recurrent) and ureteric stenting had no significant impact on the success rate. Conclusions: Prediction of success of treatment with ESWL and the recurrence depends and may be predicted by renal morphology, presence of congenital anomalies, size of stone, site of stone and treated stones number.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"1 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76320934","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 : 2016-08-10DOI: 10.4172/2168-9857.1000168
A. Budia, V. Caballer, D. Vivas, D. López-Acón, M. Ángeles, J. Díez, P. Bahílo, M. Trassierra
Objective: To determine the better cost-effective treatment strategy for ureteral stones in a health district of Eastern Spain. Methods: A total of 180 patients were treated between June 2012 and December 2013 for ureteral stones using two different strategies (SWL as initial treatment and URS as rescue technique vs URS and laser lithotripsy (up to 2 procedures). We performed an economic evaluation through a cost effectiveness analysis comparing costs and outcome. We performed a differentiating model in patients with lithiasis less than 1 cm or equal to or larger than 1 cm. The effectiveness parameter was the stone free rate (SFR), defined as the absence of lithiasis fragments or the presence of clinically insignificant residual fragments (CIRFs) - less than 3 mm at the 3 month follow up. A decision tree was developed and a Monte Carlo simulation was performed to establish uncertainty. Results: The SWL as first line was equally or more effective and cheaper than URS as first line of treatment for ureteral stones regardless of location or size. The overall cost for SWL (plus URS as second line) was 1,445,86 € and its SFR was 99.7%, and 2,369,21 and 97.62% for URS group. After the Montecarlo sensitivity analysis, the SWL showed dominance or cost-effectiveness in the vast majority of times, for each position and size. Conclusions: SWL as first line of treatment was more efficient in terms of cost effectiveness than first line URS with Ho: YAG laser lithotripsy for ureteral stones. Given its level of stone clearance, a non-invasive, outpatient based treatment like lithotripsy should remain the first-line treatment option for ureteral stones
{"title":"Comparison of Extracorporeal Shock Wave Lithotripsy versus Ureteroscopy Holmium Laser Lithotripsy in the Management of Ureteral Stones: A Cost-effectiveness Analysis","authors":"A. Budia, V. Caballer, D. Vivas, D. López-Acón, M. Ángeles, J. Díez, P. Bahílo, M. Trassierra","doi":"10.4172/2168-9857.1000168","DOIUrl":"https://doi.org/10.4172/2168-9857.1000168","url":null,"abstract":"Objective: To determine the better cost-effective treatment strategy for ureteral stones in a health district of Eastern Spain. Methods: A total of 180 patients were treated between June 2012 and December 2013 for ureteral stones using two different strategies (SWL as initial treatment and URS as rescue technique vs URS and laser lithotripsy (up to 2 procedures). We performed an economic evaluation through a cost effectiveness analysis comparing costs and outcome. We performed a differentiating model in patients with lithiasis less than 1 cm or equal to or larger than 1 cm. The effectiveness parameter was the stone free rate (SFR), defined as the absence of lithiasis fragments or the presence of clinically insignificant residual fragments (CIRFs) - less than 3 mm at the 3 month follow up. A decision tree was developed and a Monte Carlo simulation was performed to establish uncertainty. Results: The SWL as first line was equally or more effective and cheaper than URS as first line of treatment for ureteral stones regardless of location or size. The overall cost for SWL (plus URS as second line) was 1,445,86 € and its SFR was 99.7%, and 2,369,21 and 97.62% for URS group. After the Montecarlo sensitivity analysis, the SWL showed dominance or cost-effectiveness in the vast majority of times, for each position and size. Conclusions: SWL as first line of treatment was more efficient in terms of cost effectiveness than first line URS with Ho: YAG laser lithotripsy for ureteral stones. Given its level of stone clearance, a non-invasive, outpatient based treatment like lithotripsy should remain the first-line treatment option for ureteral stones","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"24 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72985868","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 : 2016-08-10DOI: 10.4172/2168-9857.1000169
Vinod Priyadarshi, N. Sehgal, Anurag Puri, J. Singh, M. Bera, D. Pal
Introduction: Migratory foreign bodies make a separate group of intravesical foreign bodies and any object in vicinity of bladder may migrate into it. Material and methods: Retrospective analysis of migratory intravesical foreign bodies which were treated over last five year, done and discussed with the available literature. Results: Different foreign bodies reported to migrate into the bladder through different route. In most of the cases, they present with minimal lower Urinary Tract Symptoms (LUTS) which are often ignored by patients and clinicians; and it is the haematuria which draw medical attention. With time they encrustate into stone but rarely seen to migrate further. Conclusion: Almost any foreign body in lower abdomen may migrate into urinary bladder through almost any possible route, from where they rarely migrate further. Bladder remains as an ideal receptacle to retain them for long with encrustation.
{"title":"Migrated Intravesical Foreign Bodies: A Five Year Review","authors":"Vinod Priyadarshi, N. Sehgal, Anurag Puri, J. Singh, M. Bera, D. Pal","doi":"10.4172/2168-9857.1000169","DOIUrl":"https://doi.org/10.4172/2168-9857.1000169","url":null,"abstract":"Introduction: Migratory foreign bodies make a separate group of intravesical foreign bodies and any object in vicinity of bladder may migrate into it. Material and methods: Retrospective analysis of migratory intravesical foreign bodies which were treated over last five year, done and discussed with the available literature. Results: Different foreign bodies reported to migrate into the bladder through different route. In most of the cases, they present with minimal lower Urinary Tract Symptoms (LUTS) which are often ignored by patients and clinicians; and it is the haematuria which draw medical attention. With time they encrustate into stone but rarely seen to migrate further. Conclusion: Almost any foreign body in lower abdomen may migrate into urinary bladder through almost any possible route, from where they rarely migrate further. Bladder remains as an ideal receptacle to retain them for long with encrustation.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"10 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79949443","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 : 2016-07-15DOI: 10.4172/2168-9857.1000167
F. Trabelsi, H. Bouthour, Samer Bustame
Rhabdoid tumor of the kidney is a rare pediatric malignancy arising most of the time before the age of two years. The diagnosis is generally difficult. The treatment is not well codified and the forecast remains very dark in spite of the progress of the pediatric oncology. We report a new case of rhabdoid renal tumor diagnosed prenatally and we specify our diagnostic and therapeutic approach.
{"title":"Rhabdoid Tumor of the Kidney: A New Case of Prenatal Diagnosis with Metastases Immediately","authors":"F. Trabelsi, H. Bouthour, Samer Bustame","doi":"10.4172/2168-9857.1000167","DOIUrl":"https://doi.org/10.4172/2168-9857.1000167","url":null,"abstract":"Rhabdoid tumor of the kidney is a rare pediatric malignancy arising most of the time before the age of two years. The diagnosis is generally difficult. The treatment is not well codified and the forecast remains very dark in spite of the progress of the pediatric oncology. We report a new case of rhabdoid renal tumor diagnosed prenatally and we specify our diagnostic and therapeutic approach.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"38 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87965256","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 : 2016-06-27DOI: 10.4172/2168-9857.1000166
M. Matrana, R. Griffin, B. Keith
Papillary renal cell carcinoma is an uncommon non-clear-cell subtype of renal cell carcinoma, representing about 15% of all renal cell carcinomas. There is relatively little data on treatment of papillary renal cell carcinoma. Historically, this subtype has a poor response to most commonly used systemic agents. However, the altered cellular metabolism in papillary renal cell carcinoma presents a weakness that can be exploited by targeted agents. We present a case of a young patient with metastatic papillary renal cell carcinoma who, having progressed on three prior therapies, has an excellent and durable response to bevacizumab and erlotinib. Our case illustrates the importance of recognizing papillary renal cell carcinoma and mutational testing since there are targeted agents that, while not typically considered in renal cell carcinoma, have efficacy and profound impact on patient care
{"title":"A Case of Metastatic Papillary Renal Cell Carcinoma Responsive to Bevacizumab and Erlotinib","authors":"M. Matrana, R. Griffin, B. Keith","doi":"10.4172/2168-9857.1000166","DOIUrl":"https://doi.org/10.4172/2168-9857.1000166","url":null,"abstract":"Papillary renal cell carcinoma is an uncommon non-clear-cell subtype of renal cell carcinoma, representing about 15% of all renal cell carcinomas. There is relatively little data on treatment of papillary renal cell carcinoma. Historically, this subtype has a poor response to most commonly used systemic agents. However, the altered cellular metabolism in papillary renal cell carcinoma presents a weakness that can be exploited by targeted agents. We present a case of a young patient with metastatic papillary renal cell carcinoma who, having progressed on three prior therapies, has an excellent and durable response to bevacizumab and erlotinib. Our case illustrates the importance of recognizing papillary renal cell carcinoma and mutational testing since there are targeted agents that, while not typically considered in renal cell carcinoma, have efficacy and profound impact on patient care","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"30 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75070725","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 : 2016-06-15DOI: 10.4172/2168-9857.1000165
Elsawi Osman, Ziauddin Khan, T. Bhatty
Urinary tract duplication anomalies have a variety of anatomical and clinical manifestations. In broad terms, duplication anomalies are divided into complete and incomplete (partial). We are hereby reporting a case of a 26 year- old man, who presented acutely with right sided loin pain. Subsequent investigations showed right sided complete duplication with a single left ureter, with all three ureters harboring obstructing stones. He underwent urgent bilateral semi-rigid ureteroscopy with LASER lithotripsy with satisfactory outcome. There are no similar case reports in the English literature to the best of our knowledge.
{"title":"Simultaneous Presentation of Three Ureteric Stones in Three Different Ureters in A Patient with Unilateral Ureteric Duplication, An Unlucky Rare Triad!","authors":"Elsawi Osman, Ziauddin Khan, T. Bhatty","doi":"10.4172/2168-9857.1000165","DOIUrl":"https://doi.org/10.4172/2168-9857.1000165","url":null,"abstract":"Urinary tract duplication anomalies have a variety of anatomical and clinical manifestations. In broad terms, duplication anomalies are divided into complete and incomplete (partial). We are hereby reporting a case of a 26 year- old man, who presented acutely with right sided loin pain. Subsequent investigations showed right sided complete duplication with a single left ureter, with all three ureters harboring obstructing stones. He underwent urgent bilateral semi-rigid ureteroscopy with LASER lithotripsy with satisfactory outcome. There are no similar case reports in the English literature to the best of our knowledge.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"53 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87506198","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 : 2016-06-15DOI: 10.4172/2168-9857.1000E115
M. Matrana
{"title":"Bladder Cancer Enters the Targeted Immunotherapy Age","authors":"M. Matrana","doi":"10.4172/2168-9857.1000E115","DOIUrl":"https://doi.org/10.4172/2168-9857.1000E115","url":null,"abstract":"","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"54 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2016-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84590206","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 : 2016-06-05DOI: 10.4172/2168-9857.1000164
Sivasubramaniyan, K. Venkataramaniah
Background: In patients suffering from carcinoma prostate the incidence of skeletal metastases had been found to be very high. The presence of skeletal metastasis could be inferred by the multiple focal hotspots in the skeletal tissue. The metastatic nature of the hotspots could be inferred by multiple lesions, asymmetric distribution with increased tracer concentration. In the case of Solitary focal spot in the bone scan metastatic nature could not be attributed to it. The invasive biopsy procedure could only confirm or discard the metastatic involvement. A new non-invasive Scintimetric characterization and evaluation of skeletal hot spots in bone scans of carcinoma prostate patients was proposed and tested. Materials and methods: The bone scan was done 4 and 24 hours after intravenous injection of 15 to 25 mCi of Tc99m Methylene Di-Phosponate with adequate hydration using the e-cam Siemens dual head gamma camera with e-cam whole body acquisition protocol in 75 patients with biopsy proven carcinoma prostate. Metastatic involvement was seen in 53 patients and was negative in 22. The Serum PSA levels were obtained from the Patient medical records were tabulated. The 185 focal hotspots in various sites in 34 patients were characterized using the temporal scintimetric method. Both 4 and 24hr bone scan images were selected using the general display protocol. Then with the help of the region ratio processing protocol the 4 and 24hr anterior and posterior images were selected separately. Maximum counts in the selected regions were then tabulated. Then the 4/24hr Dr. V. Siva’s retention ratio was derived by dividing the 4hr counts of the focal hotspots with 24hr counts along with the Israel’s 24/4hr ratio as well. Similarly 4/24hr Dr.V.Siva’s retention ratio of whole body scan total counts at 4 and 24hr scans was also calculated.The results were compared and analysed. Results: The mean of 4/24hr Dr. V. Siva’s retention ratio was found to be 12.32 ± 3.3 and that of 24/4hr Israel’s ratio to be 0.08 ± 0.02 for Focal hot spot evaluation. The 4/24hr Dr. V. Siva’s retention ratio was derived by dividing the total whole body counts at 4 and 24hr whole body bone scan was 12.21 ± 2.78 which wascloser to the Focal hot spot retention ratio. The Total PSA, Free PSA and the %PSA Values were 61.8, 19.2 and 26.8 in the Metastatic positive group and 34.5, 6.8 and 12.8 in the negative group respectively. Conclusion: Scintimetric characterization of the skeletal hot spots provided a non-invasive means for identifying the underlying pathology to enable proper management decisions. The 4/24hr Dr. V. Siva’s retention ratio was useful clinically because of its whole integer value, unlike the Israel’s 24/4hr ratio which was in decimal value. The utility of the scintimetric characterization in inferring the metastatic nature of the lesion was confirmed through biopsy of the site afflicted followed by histopathological examination.
背景:前列腺癌患者骨骼转移的发生率非常高。骨转移的存在可以通过骨骼组织中多个病灶热点推断。热点的转移性可以通过多发病灶、不对称分布和示踪剂浓度增加来推断。在骨扫描孤立病灶的情况下，转移性不能归因于它。侵入性活检只能确认或排除转移性病变。在前列腺癌患者骨扫描中，提出了一种新的无创扫描表征和评估骨骼热点的方法。材料和方法:对75例活检证实的前列腺癌患者，采用e-cam西门子双头伽玛相机和e-cam全身采集方案，在静脉注射15至25 mCi的Tc99m二磷酸亚甲基磷酸酯后4和24小时进行骨扫描。53例患者出现转移性侵犯，22例患者呈阴性。从患者病历中获得血清PSA水平，并将其制成表格。应用颞轴测量法对34例患者不同部位的185个病灶热点进行了特征分析。采用常规显示方案选择4和24小时骨扫描图像。然后根据区域比例处理方案，分别选取4、24小时前后图像。然后将所选区域的最大计数制成表格。然后，通过将焦点热点的4小时计数与24小时计数一起除以以色列的24/4小时比率，得出4/24小时Dr. V. Siva的保留率。类似的，4/24小时Dr.V。计算了4小时和24小时全身扫描总计数的Siva保留率。对结果进行了比较和分析。结果:4/24hr Dr. V. Siva保留率平均值为12.32±3.3,24/4hr Israel保留率平均值为0.08±0.02。4/24小时Dr. V. Siva的保留比是通过4和24小时全身骨扫描时的全身计数除以12.21±2.78得到的，这更接近Focal热点保留比。转移阳性组总PSA、游离PSA和%PSA值分别为61.8、19.2和26.8，阴性组分别为34.5、6.8和12.8。结论:骨骼热点的科学表征提供了一种非侵入性的方法来识别潜在的病理，以便做出适当的管理决策。Dr. V. Siva的4/24小时保留率在临床上很有用，因为它是整数值，而不像以色列的24/4小时保留率是十进制值。在推断病变转移性质的科学表征的效用是通过组织病理学检查后对患处进行活检证实的。
{"title":"Non-invasive Quantitative Characterization of Skeletal Metastasis in Carcinoma Prostate by Tc99m MDP Bone Scans Using Dr. V. Sivas Retention Ratio in Correlation with Serum PSA Levels","authors":"Sivasubramaniyan, K. Venkataramaniah","doi":"10.4172/2168-9857.1000164","DOIUrl":"https://doi.org/10.4172/2168-9857.1000164","url":null,"abstract":"Background: In patients suffering from carcinoma prostate the incidence of skeletal metastases had been found to be very high. The presence of skeletal metastasis could be inferred by the multiple focal hotspots in the skeletal tissue. The metastatic nature of the hotspots could be inferred by multiple lesions, asymmetric distribution with increased tracer concentration. In the case of Solitary focal spot in the bone scan metastatic nature could not be attributed to it. The invasive biopsy procedure could only confirm or discard the metastatic involvement. A new non-invasive Scintimetric characterization and evaluation of skeletal hot spots in bone scans of carcinoma prostate patients was proposed and tested. Materials and methods: The bone scan was done 4 and 24 hours after intravenous injection of 15 to 25 mCi of Tc99m Methylene Di-Phosponate with adequate hydration using the e-cam Siemens dual head gamma camera with e-cam whole body acquisition protocol in 75 patients with biopsy proven carcinoma prostate. Metastatic involvement was seen in 53 patients and was negative in 22. The Serum PSA levels were obtained from the Patient medical records were tabulated. The 185 focal hotspots in various sites in 34 patients were characterized using the temporal scintimetric method. Both 4 and 24hr bone scan images were selected using the general display protocol. Then with the help of the region ratio processing protocol the 4 and 24hr anterior and posterior images were selected separately. Maximum counts in the selected regions were then tabulated. Then the 4/24hr Dr. V. Siva’s retention ratio was derived by dividing the 4hr counts of the focal hotspots with 24hr counts along with the Israel’s 24/4hr ratio as well. Similarly 4/24hr Dr.V.Siva’s retention ratio of whole body scan total counts at 4 and 24hr scans was also calculated.The results were compared and analysed. Results: The mean of 4/24hr Dr. V. Siva’s retention ratio was found to be 12.32 ± 3.3 and that of 24/4hr Israel’s ratio to be 0.08 ± 0.02 for Focal hot spot evaluation. The 4/24hr Dr. V. Siva’s retention ratio was derived by dividing the total whole body counts at 4 and 24hr whole body bone scan was 12.21 ± 2.78 which wascloser to the Focal hot spot retention ratio. The Total PSA, Free PSA and the %PSA Values were 61.8, 19.2 and 26.8 in the Metastatic positive group and 34.5, 6.8 and 12.8 in the negative group respectively. Conclusion: Scintimetric characterization of the skeletal hot spots provided a non-invasive means for identifying the underlying pathology to enable proper management decisions. The 4/24hr Dr. V. Siva’s retention ratio was useful clinically because of its whole integer value, unlike the Israel’s 24/4hr ratio which was in decimal value. The utility of the scintimetric characterization in inferring the metastatic nature of the lesion was confirmed through biopsy of the site afflicted followed by histopathological examination.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"52 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89704041","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 : 2016-05-28DOI: 10.4172/2168-9857.1000163
Bouchikhi Aa, D. Amiroune, A. Khallouk, M. Tazi, S. Mellas, J. Elammari, Elliott Mj, M. H. Farih
Introduction: Skeletal muscle is a rare localization of bladder cancer metastasis. Very few cases of urothelial carcinoma metastasis in psoas muscle were reported in the literature. We report concomitant psoas muscle tumor metastasis and splenic metastasis originated from urinary bladder squamous cell carcinoma. This association was never, described in earlier medical literature. Case report: The patient was 45 years old Moroccan male. He underwent trans-urethral bladder tumor resection (TURB). The diagnosis was done a month earlier in the emergency department while consulting for side pain and right leg swelling. The patient was feverish and showed an advanced general state deterioration. The CT-scan revealed a typical aspect of right psoas abscess associating a metastatic splenic localization. The ultrasound of the right leg showed an extended thrombophlebitis. The patient underwent a surgical drainage of psoas abscess and biopsies. The histopathological and immunohistochemistry studies demonstrated squamous carcinoma of the psoas muscle with very low differentiation. These tumors were originated from metastasis of this abscess. Despite the anticoagulant treatment, the patient died of pulmonary embolism after 3 weeks of surgical treatment. Conclusion: The reported psoas squamous carcinoma was originated in the bladder with splenic metastasis. It is the first report in the literature. Considering the possible metastatic origin of the psoas abscess, it is recommended to avoid a useless surgical drainage.
{"title":"Concomitant Occurrence of Psoas Muscle and Splenic Metastasis from Squamous Cell Carcinoma of the Urinary Bladder: A Case Report","authors":"Bouchikhi Aa, D. Amiroune, A. Khallouk, M. Tazi, S. Mellas, J. Elammari, Elliott Mj, M. H. Farih","doi":"10.4172/2168-9857.1000163","DOIUrl":"https://doi.org/10.4172/2168-9857.1000163","url":null,"abstract":"Introduction: Skeletal muscle is a rare localization of bladder cancer metastasis. Very few cases of urothelial carcinoma metastasis in psoas muscle were reported in the literature. We report concomitant psoas muscle tumor metastasis and splenic metastasis originated from urinary bladder squamous cell carcinoma. This association was never, described in earlier medical literature. Case report: The patient was 45 years old Moroccan male. He underwent trans-urethral bladder tumor resection (TURB). The diagnosis was done a month earlier in the emergency department while consulting for side pain and right leg swelling. The patient was feverish and showed an advanced general state deterioration. The CT-scan revealed a typical aspect of right psoas abscess associating a metastatic splenic localization. The ultrasound of the right leg showed an extended thrombophlebitis. The patient underwent a surgical drainage of psoas abscess and biopsies. The histopathological and immunohistochemistry studies demonstrated squamous carcinoma of the psoas muscle with very low differentiation. These tumors were originated from metastasis of this abscess. Despite the anticoagulant treatment, the patient died of pulmonary embolism after 3 weeks of surgical treatment. Conclusion: The reported psoas squamous carcinoma was originated in the bladder with splenic metastasis. It is the first report in the literature. Considering the possible metastatic origin of the psoas abscess, it is recommended to avoid a useless surgical drainage.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"61 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87022827","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 : 2016-04-30DOI: 10.4172/2168-9857.1000162
C. Diouf, I. Diallo, F.B.R. Mbaye, N. Ndoye, A. Faye, O. Ndour, G. Ngom
Long considered a disease of elderly women, urethral prolapse is increasingly found in girls, mostly African. It is a rare disease which causes eversion of the urethral mucosa through the meatus. Such pathophysiology, still debated, contrasts with the purely clinical diagnosis in the presence of genital bleeding or vulva swelling more or less painful, and bleeding when touched. Surgical treatment gives excellent results. We hereby give details of our experience across three cases of urethral prolapse supported surgically with good results.
{"title":"The Urethral Prolapse, a Rare Cause of Genital Bleeding in Girls: Report on Three Cases","authors":"C. Diouf, I. Diallo, F.B.R. Mbaye, N. Ndoye, A. Faye, O. Ndour, G. Ngom","doi":"10.4172/2168-9857.1000162","DOIUrl":"https://doi.org/10.4172/2168-9857.1000162","url":null,"abstract":"Long considered a disease of elderly women, urethral prolapse is increasingly found in girls, mostly African. It is a rare disease which causes eversion of the urethral mucosa through the meatus. Such pathophysiology, still debated, contrasts with the purely clinical diagnosis in the presence of genital bleeding or vulva swelling more or less painful, and bleeding when touched. Surgical treatment gives excellent results. We hereby give details of our experience across three cases of urethral prolapse supported surgically with good results.","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"10 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88659537","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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