Indian Journal of Urology Users online:224  
IJU
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size


 
  Table of Contents 
EDITORIAL
Year : 2017  |  Volume : 33  |  Issue : 1  |  Page : 4-5
 

What's inside


Editor, Indian Journal of Urology, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication2-Jan-2017

Correspondence Address:
Rajeev Kumar
Editor, Indian Journal of Urology, All India Institute of Medical Sciences, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.197327

Rights and Permissions

 

How to cite this article:
Kumar R. What's inside. Indian J Urol 2017;33:4-5

How to cite this URL:
Kumar R. What's inside. Indian J Urol [serial online] 2017 [cited 2017 Mar 29];33:4-5. Available from: http://www.indianjurol.com/text.asp?2017/33/1/4/197327



   Genitourinary Sarcoidosis Top


Genitourinary involvement in sarcoidosis is typically reported as single cases or small series and often escapes a consideration for most urologists. Block et al. and Kava [1] review the urological manifestations of sarcoidosis and show that the disease may involve multiple organs including the adrenal, kidneys, ureter, bladder, prostate, urethra, penis, and the scrotal structures. It often mimics malignancy in the form a mass lesion. Hypercalcemia and hypercalciuria may be additional manifestations in renal sarcoidosis.


   Erosion of Artificial Urinary Sphincters Top


The increasing use of robotic radical prostatectomy may be accompanied by an increase in the number of incontinent patients seeking placement of an artificial urinary sphincter (AUS). Agarwal et al.[2] review their large data of 1800 AUS placements with a < 6% erosion rate and conclude that the majority of erosions occur in the 1st year after implant and iatrogenic injury due to incorrect catheterization through the sphincter remains an important cause of erosions. This would be an important lesson in India where the number of such implants is low its awareness among patients and physicians is limited. The high cost of these devices often makes them once-in-a-lifetime surgery and minimizing the risk of failure may require improved counseling.


   Avoiding Radiation in Kidney Donor Work-Up Top


Minimizing harm to health, voluntary kidney donor is essential for the success of the organ donation program. Patil et al.[3] evaluated 43 donors with both a computed tomography (CT) and noncontrast magnetic resonance angiogram for evaluation of the renal anatomy and showed a high degree of concordance between the two modalities such that omitting the CT would not result in adverse donor outcomes.


   Pelvicalyceal Anatomy from Cadaveric Kidneys Top


Understanding the anatomy of the pelvicalyceal system is central to all endourological upper-tract procedures. It is uncommon to find a detailed study looking at cadaveric dissections and the report by Anjana et al.[4] reconfirms the myriad variations of the pelvis and calyces. They suggest that unlike traditional expectation of independent upper, middle and lower pole calyces, the commonest anatomy consists of a bicalyceal system with the middle pole calyx draining into one of these calyces. This would be relevant while planning punctures for percutaneous access.


   Training for Percutaneous Nephrolithotomy Top


Even though urolithiasis is one of the most common urological problems, percutaneous nephrolithotomy (PCNL) remains a difficult surgery to learn and master. In the first of three articles in this issue related to endourology, Jaipuria et al.[5] present a prospective study evaluating a step-wise training protocol using Guy's stone score to determine the surgical difficulty and suggest that using this method, they were able to reduce operative time and complications among trainees.


   New Armamentarium for Percutaneous Nephrolithotomy Top


The continuing quest for the ideal PCNL equipment sees a new technique and device being described by Shah et al.[6] This “Super-Perc” consists of a 10/12F hollow sheath with a silicon valve mechanism for entry of the telescope to prevent air or fluid leak. Suction tubing is connected to the side port of the sheath, allowing continuous evacuation of fragments. Continuous irrigation of the collecting system is obtained through a ureteral catheter placed in the pelvis and connected to an irrigation device. The authors use a 4.5/6F ureteroscope for stone fragmentation through the sheath. They report the outcomes of this technique in 52 patients with a mean stone burden of 19 mm (ranging from 10 to 37 mm). Two patients required conversion to larger tract sizes and only three required a nephrostomy tube. The authors report a 96% clearance rate.


   Reducing Pain during Stent Removal Top


The high costs associated with flexible scopes means that most ureteral stent removals in India are performed using rigid cystoscopes under local anesthesia. This is undoubtedly an uncomfortable procedure and Karthikeyan et al.[7] report a randomized trial on the use of oral diclofenac tablets to reduce the pain. Among 121 adult men, the group that received a 75 mg oral dose of diclofenac 1 h before the procedure reported significantly lower pain measured on a visual analog scale.


   Double-Breasting the Spongiosum in Urethroplasty Top


Urethrocutaneous fistulae are among the most common complications following hypospadias surgery, and there are numerous techniques to reduce their incidence. Bhat et al.[8] describe another technique where they “double-breast” the spongiosum over the urethral closure plate, avoiding an overlapping suture line. In a prospective study on sixty patients with a mean age of under 4 years, they report a single fistula.


   Intermediate Risk Prostate Cancer Top


The D'Amico risk stratification for prostate cancer is widely followed in clinical practice. Patients are determined to have an intermediate risk if they fulfill any one of three conditions; stage T2b lesion, Gleason score of 7, prostate-specific antigen between10 and 20 ng/ml. However, this group of patients has a heterogeneous outcome and Fuyabashi et al.[9] reviewed data of 222 patients in this group who underwent radical prostatectomy. They noted a progressively worse survival with increasing number of risk factors. Further, a patient with Gleason score of 7 as a risk factor did worse than those with other factors, suggesting disease biology to be the most important determinant of outcomes.

Financial support and sponsorship:

Nil.

Conflicts of interest:

There are no conflicts of interest.

 
   References Top

1.
Block NL, Kava BR. Genitourinary sarcoidosis: An essential review for the practicing clinician. Indian J Urol 2017;33:6-12.  Back to cited text no. 1
  Medknow Journal  
2.
Agarwal DK, Linder BJ, Elliott DS. Artificial urinary sphincter urethral erosions: Temporal patterns, management, and incidence of preventable erosions. Indian J Urol 2017;33:26-29.  Back to cited text no. 2
  Medknow Journal  
3.
Patil AD, Shailage K, Nadarajah J, Harigovind P, Mohan RK. Comparison of computed tomographic angiography and noncontrast magnetic resonance angiography in preoperative evaluation of living renal donors. Indian J Urol 2017;33:30-35.  Back to cited text no. 3
  Medknow Journal  
4.
Anjana T, Muthian E, Thiagarajan S, Shanmugam S. Gross morphological study of the renal pelvicalyceal patterns in human cadaveric kidneys. Indian J Urol 2017;33:36-40.  Back to cited text no. 4
  Medknow Journal  
5.
Jaipuria J, Suryavanshi M, Desai AP, Goyal S, Patel K, Parhad SS, et al. Stepwise case selection using Guy's stone score reduces complications during percutaneous nephrolithotomy training. Indian J Urol 2017;33:41-47.  Back to cited text no. 5
  Medknow Journal  
6.
Shah K, Agrawal MS, Mishra DK. Superperc: A new technique in minimally-invasive percutaneous nephrolithotomy. Indian J Urol 2017;33:48-52.  Back to cited text no. 6
  Medknow Journal  
7.
Karthikeyan VS, Keshavamurthy R, Mallya A, Manohar CM, Kumar S, Chandrashekar CR. Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial. Indian J Urol 2017;33:53-57.  Back to cited text no. 7
  Medknow Journal  
8.
Bhat A, Bhat M, Kumar R, Bhat A. Double breasting spongioplasty in tubularized/tubularized incise plate urethroplasty: A new technique. Indian J Urol 2017;33:58-63.  Back to cited text no. 8
  Medknow Journal  
9.
Furubayashi N, Negishi T, Iwai H, Nagase K, Taguchi K, Shimokawa M, et al. Biochemical failure after radical prostatectomy in intermediate-risk group men increases with the number of risk factors. Indian J Urol 2017;33:64-69.  Back to cited text no. 9
  Medknow Journal  




 

Top
Print this article  Email this article
 

    

 
   Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (276 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Genitourinary Sa...
    Erosion of Artif...
    Avoiding Radiati...
    Pelvicalyceal An...
    Training for Per...
    New Armamentariu...
    Reducing Pain du...
    Double-Breasting...
    Intermediate Ris...
    References

 Article Access Statistics
    Viewed590    
    Printed10    
    Emailed0    
    PDF Downloaded22    
    Comments [Add]    

Recommend this journal

HEALTHWARE INDIA