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   1997| July-December  | Volume 13 | Issue 1  
 
 
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Self-dilation in urethral stricture recurrence
P VLN Murthy, T HSG Rao, A Srivastava, KS Ramaiah, N Ramamurthy, K Sasidharan
July-December 1997, 13(1):33-35
Visual Internal Urethrotomy (VIU) for urethral stricture was employed in 136 patients during a 30-month period. All these patients were advised to do self-dilatation once a day for a period of one year and respectively the effect of self-dilatation on prevention of urethral stricture recurrence was studied. The data was analysed for 63 patients with a follow-up of 6 to 30 months after VIU (study group). Patients who did not like to do self-dilatation formed the controlled group (24 pts.) and patients who did self-dilatation regularly after VIU formed the treatment group (39 pts.). 75 percent of the control group (18 pts.) underwent 2 to 3 times, internal urethrotomy in the first year follow-up for uretheral stricture recurrence. Only 6 of the patients in the treatment group (15.5 percent) required additional procedures in the first year of follow-up. 20 of the 39 patients in the treatment group have been followed up between 6 to 18 months after stopping self-dilatation. All of them were stricture-free at the time of reporting.
[ABSTRACT]   Full text not available   
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Distinction between obstructive and non-obstructive hydronephrosis : value of diuresis duplex Doppler sonography
H SGT Rao
July-December 1997, 13(1):76-77
kidney and the difference between the mean resistive indices of both kidneys were calculated before and after administration of 0.5 mg furosemide per kilogram of body weight. A receiver operating characteristic curve was generated to determine the discriminatory resistive index value for diagnosing obstruction. Resistive indices were not significantly different between kidneys with non-obstructive dilatation and normal kidneys before and after diuresis. Significant differences in resistive indices before and after diuresis were seen between kidneys with obstructive dilatation and kidneys with non- obstructive dilatation and between normal kidneys. Kidneys with obstructive dilatation showed a significant increase in resistive index after administration of furosemide. In the indeterminate kidneys, furosemide had a heterogeneous effect on the resistive indices, indicating obstructive resistive indices in five kidneys and non- obstructive resistive indices in four kidneys. Receiver operating characteristic analysis revealed a diuresis resistive index of O. 75, which resulted in an accuracy rate of 95 in diagnosing renal obstruc- tion. The authors conclude that Diuresis Duplex Doppler Sonography is accurate in the differentiation of obstructed from non-obstructed kidneys and may facilitate the distinction between obstructive and non- obstructive hydronephrosis, notably in kidneys classified as indeter- minate according to diuretic renography.
[ABSTRACT]   Full text not available   
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Tetracycline, Sclerotherapy in the treatment of primary hydrocele
AK Agrawal, S Guleria, RK Khazanchi, SN Mehta
July-December 1997, 13(1):12-14
One hundred and eleven patients with, one hundred and twenty-one hydrocele were treated with tetracycline sclerotherapy. These were divided into four groups depending upon the volume of fluid aspirated. Ten ml of oxytetracycline was injected after complete aspiration. Repeat accumulations were retapped and sclerosed. These patients were followed up for six months. 98 percent of patients were cured on six months of follow up. Patients with large hydroceles tended to be erratic on follow up. The commonest side effects included pain in 39.8 percent and induration in 16.9 percent of patients. Tetracycline sclerotherapy is a safe and effective modality for the treatment of primary hydrocele.
[ABSTRACT]   Full text not available   
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Non-clostridial gas gangrene of penis due to Candida albicans
KS Ramaiah, S Kumar, H SGT Rao
July-December 1997, 13(1):60-61
Full text not available   
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Repair of complex vesicovaginal interposition : a different design fistulas using peritoneal flap
SV Punekar, AR Prem, AR Kelkar, VR Ridhorkar
July-December 1997, 13(1):24-28
The surgical repair of complex vesicovaginal fistulae (WF) necessitates the use of adjunctive measures to improve success rate. Twenty-three patients, age 19 to 45 years with complex WF (11 recurrent, 10 large and 2 multiple) underwent abdominal repair with peritoneal flap interposition. An inverted 'U'-shaped flap of adequate size was developed from peritoneum covering bladder dome and was tacked to vaginal suture line after excision and closure of WF. The successful repair was achieved in 83 percent obstetric and 90 percent post- hysterectomy fistulae. Two conceptions are reported 4 and 13 months after surgery. This paper presents the technique and experience in managing 23 patients with complex vesicovaginal fistulae, using peritoneal flap interposition.
[ABSTRACT]   Full text not available    [CITATIONS]
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Pelvic ectopic kidney with ipsilateral orthotopic ureterocele : a rare association : report of 3 cases
A Thomas, AS Albert, S Bhat, KR Sunil, S Shenoy
July-December 1997, 13(1):62-65
Pelvic ectopic kidney is a rarity. This condition is usually asymptomatic and often detected serendipitously or by the presence of symptoms related to urinary system or other system anomalies present. An association of pelvic ectopic kidney and simple ureterocele has not been reported so far. We are reporting 3 such cases with single system where this combination was symptomatic. Diagnosis and management are also discussed.
[ABSTRACT]   Full text not available   
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Microinjection using testicular sperm : a new treatment option for treating azoospermic men
A Malpani, R Shah, B Stewart, A Jones
July-December 1997, 13(1):45-47
So far medicine has had nothing to offer the azoospermic man with testicular failure or irreversible obstruction in the way of treatment. His only treatment choices were: adoption, or donor insemination. However, now it is possible to extract sperm from the testis of these patients, and inject them into their wife's eggs. This is called TESE with ICSI which stands for Testicular Sperm Extraction with Intracytoplasmic Sperm Injection. (A more colourful name for this technique however would be TSEICSI - pronounced as "sexy"!) This paper describes the laboratory aspects of how ICSI is performed in the IVF laboratory; and our results with using TESE with ICSI in treating azoospermic men.
[ABSTRACT]   Full text not available   
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New technique for repair of complex genitourinary rectal fistulae using peritoneum for urethral reconstruction and as an interpositional tissue
BG Matapurkar, HS Rehan
July-December 1997, 13(1):36-44
The complex genitourinary rectal fistula is a rare but distressing condition. The management is difficult and has high complication rate. Some cases are even considered inoperable and the patients of this condition suffer for the whole life. Apart from fistula the problem in management is due to large defect of urethra resulting from partial or total urethral loss. The need of improvement in existing surgical procedures has been realised worldwide. Sixteen patients were repaired using peritoneum for interpositional purpose and for urethroplasty based on embryo-logical principles. All the fistulae closed successfully. Postoperative retrograde cysto-urethrogram revealed no stricture formation. Urinary incontinence was during initial postoperative period only. Other complications were minimum. The scientific rationale of use of peritoneum has been discussed.
[ABSTRACT]   Full text not available    [CITATIONS]
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Role of bulb ureterogram before pyeloplasty in children
JM Thomas, SV Letchumanan, KS Ramgopal
July-December 1997, 13(1):21-23
Ureteropelvic junction obstruction is a common cause of hydronephrosis in children for which pyeloplasty is the most acceptable surgical treatment. Complete visualization of the ureter needs additional investigations before pyeloplasty. The routine performance of bulb uretero-gram has not yielded additional findings which would have altered the planned surgical technique. Hence bulb ureterogram is advocated routinely only in failed pyeloplasties
[ABSTRACT]   Full text not available   
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"Urethral steinstrasse" : an unusual complication of ESWL
HS Bhat, KS Ramgopal, J Philipraj
July-December 1997, 13(1):52-52
Urethral Steinstrasse is rare and requires immediate intervention. Steinstrasse following ESWL usually form in the ureter in approximately 20 percent of cases. Only two cases of urethral Steinstrasse have been previously reported.
[ABSTRACT]   Full text not available    [CITATIONS]
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Urethral haemangioma : managed by marsupialisation and interval fulguration
P VLN Murthy, T HSG Rao, A Srivastava, K Sasidharan
July-December 1997, 13(1):69-71
Urethral haemangioma is a rare benign lesion that can cause significant hemorrhagic morbidity. Although benign in nature these lesions tend to recur and extend further unless completely eradicated by local resection or radical extirpative surgery. We report two cases of urethral haemangioma managed by marsupialisation and direct vision interval ambulatory surgical fulguration. Subsequent urethral closure in the manner of Johanson was accomplished after full control of lesion by this less radical approach.
[ABSTRACT]   Full text not available   
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Major complications of circumcision : report of five cases
U Lodh, S Ramaiah, S Kumar
July-December 1997, 13(1):48-51
Circumcision operation has a number of minor and major complications. Major complications such as total penile skin loss, urethra-cutaneous fistula, amputation of penis in five patients are discussed.
[ABSTRACT]   Full text not available   
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Congenital Phimosis complicated by penile cancer in a 15 year old boy
KS Ramaiah, S Kumar, H SGT Rao
July-December 1997, 13(1):54-55
Full text not available   
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Efficacy of terazosin, finasteride or both in benign prostatic hyperplasia
H SGT Rao
July-December 1997, 13(1):75-76
Patients with benign prostatic hyperplasia can be treated with alpha-1 adrenergic-antagonist drugs or with 5 alpha-reductase inhibitors. However, the effects of these two classes of pharmacological agents were not compared till the publication of the present multicenter study. This study group compared the safety and efficacy of placebo, 1Omg daily of terazosin, 5 mg daily of finasteride and the combination of both the drugs in 1229 men with benign prostatic hyperplasia. AUA symptom scores and peak urinary-flow rates were determined at base line and periodically for one year. The mean changes from baseline in the symptom scores in the placebo, finasteride, terazosin and combination groups at one year were decreases of 2.6, 3.2, 6.1 and 6.2 points respectively (p less than 0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). The mean alteration at one year in the peak urinary- flow rates were increases of 1.4,1.6, 2.7 and 3.2 ml per second respectively (p less than 0.001 for the comparisons of both terazosin and combination therapy with finasteride and with placebo). Finasteride had no more effect on either measure than placebo. In the placebo group, 1.6 per cent of the men discontinued the study because of adverse effects, as did 4.8 to 7.8 per cent of the men in the other three groups. The authors conclude that in men with benign prostatic hyperplasia, terazosin was effective therapy, whereas finasteride was not and the combination of terazosin and finasteride was no more effective than terazosin alone.
[ABSTRACT]   Full text not available   
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Value of detailed structural study of urinary calculi
AD Bhandarkar, L Prabhu, P Venugopal
July-December 1997, 13(1):15-20
Thin section polarising microscopy was used to study the structure and composition of 300 urinary calculi. The commonest structural form was the crystalline pattern in 112 (37 percent) calculi. This was followed by radially striated compact pattern in 67 (22.3 percent) calculi. Whewellite, the most common stone mineral (87 percent) was found in three different structural patterns. 59 percent of calculi had central nuclei, whereas, 7 percent of them had an eccentric nucleus. In the remainder 21 percent, nuclei were not clearly discernible. Majority of calculi had microcrystalline material in their nuclei, supporting the role of primary agglomeration as mechanism of stone formation. Variable crystal aggregation behavior observed in the study suggests more than one mechanism of calculogenesis. In addition to gaining insight into the etiopathogenesis of urolithiasis, structural studies of urinary calculi can help to explain varied response of a calculus to various fragmentation techniques, and especially ESWL.
[ABSTRACT]   Full text not available   
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Scintigraphic measurement of glomerular filtration rate
IC Benjamin, BN Abraham, G Gopalakrishnan
July-December 1997, 13(1):29-32
Glomerular filtration rate (GFR) was estimated in 32 healthy voluntary kidney donors (in the age range of 24-55 yrs) by conventional biochemical (creatinine clearance) and by scintigraphic methods. The former was found to be cumbersome and inaccurate. GFR obtained by the scintigraphic method (mean 94.14 plus 19.78 ml per min per 1.73 m sq) (mean plus ISD) was comparable with figures quoted in literature.
[ABSTRACT]   Full text not available   
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Horseshoe kidney associated with bilateral megaureters and urolithiasis : a case report
HS Bhat, K Ramesh, KS Ramgopal
July-December 1997, 13(1):58-59
Horseshoe kidneys are associated with various anomalies of the urinary tract. Their association with bilateral obstructive megaureters has not been previously reported. Herein we discuss such a case associated with bilateral ureteric and renal calculi and its management.
[ABSTRACT]   Full text not available   
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An anatomical functional and aetiological classification of lower urinary tract symptoms to facilitate understanding and diagnosis storage insufficiency symptom trouble score (SI-STS) and emptying insufficiency symptom trouble score (EI-STS) for facilitating therapeutic decision making in obstructive BPH
S Kumar
July-December 1997, 13(1):77-81
Limitations of the current usage of the term "lower urinary tract symptoms" and its classifications are briefly reviewed and an anatomical- functional and aetiological classification of lower urinary tract symptoms is proposed to facilitate understanding and diagnosis. Further, the limi- tations of available scoring systems for lower urinary tract symptoms as applied to therapeutic decision making in obstructive BPH are summarised and a Storage Insufficiency Symptom Trouble Score (SI-STS) and Emptying In- sufficiency Symptom Trouble Score (EI-STS) are proposed for facilitating therapeutic decision making in obstructive BPH. A decision-making matrix is also presented for choosing appropriate treatment.
[ABSTRACT]   Full text not available   
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In vivo repair of congenital renal arteriovenous malformation
H SGT Rao, A Srivastava, KS, Sasidharan Ramaiah
July-December 1997, 13(1):53-54
Full text not available   
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CASE REPORT
Scrotal guinea worm : a clinical curiosity
W Zaman, AL Babel
July-December 1997, 13(1):65-66
Full text not available   
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Hyperglycaemic hyperosmolar syndrome with hyperchloraemic metabolic acidosis in a post-operative patient of urinary diversion surgery
M Satyanarayana, V Chandrasekhar, SK Babu, NA Jadeja, VS Kumar
July-December 1997, 13(1):74-74
Full text not available   
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Acquired immune deficiency syndrome in urology practice
HK Moorthy, GP Abraham
July-December 1997, 13(1):5-11
This is a review of literature on the recent aspects of Acquired Immuno Deficiency Syndrome and implication of the disease in urological practice.
[ABSTRACT]   Full text not available   
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Process monitoring; bridging needs and supply gap in assessing the quality of patient care
S Kumar
July-December 1997, 13(1):79-83
Medical professionals have been compelled to pay attention to the quality of patient care largely because of the increasing questioning of medical care quality by patients in their new found awareness as consumers of medical services and attendant litigations. Collecting information on patient care (assessment) is the basic step towards ensuring the quality of patient care. Besides informal opinions, hospital death meetings and departmental statistical meetings are two organised methods of assessing patient care that are currently used. These methods of assessing patient care fail to cover all patients and do not review all details of patient care. The method of process monitoring based on record review is presented with a view to meet the needs of patient care assessment and its philosophy and methodology is discussed. Process monitoring based record review could improve the quality of patient records and it provides information towards ensuring the quality of patient care. It could also facilitate retrospective research reviews and safeguard the medical team's interests in the event of litigation.
[ABSTRACT]   Full text not available   
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Haematospermia following injection sclerotherapy for haemorrhoids
KS Ramaiah, S Kumar, H SGT Rao
July-December 1997, 13(1):68-69
Full text not available   
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Diplopia : a rare presentation of prostate carcinoma
J Gnanaraj, OJ Cherian, A Devasia, L Gnanaraj, AP Pandey
July-December 1997, 13(1):59-60
Full text not available   
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Malakoplakia prostate mimicking malignancy : a case report
NP Gupta, M Talwar, AK Dinda
July-December 1997, 13(1):55-56
Full text not available   
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Fat-soluble vitamin profile in filarial chyluria : a preliminary study
M Sridhar, DK Pal, ID Saxena, US Dwivedi, V NP Tripathi, PB Singh
July-December 1997, 13(1):18-20
Full text not available   
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'Wire coil sign' : a fluoroscopic guide to enhance the accuracy of tract dilatation for Percutaneous Nephrostomy in giant hydronephrotic kidneys
D Dalela, R Agarwal, KM Singh
July-December 1997, 13(1):72-73
Full text not available   
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Inflammatory pseudofibroma of spermatic cord
JC Dhall, S Marwah, AR Bansal, R Sharma, N Marwah
July-December 1997, 13(1):67-68
Full text not available   
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Malignant fibrous histiocytoma of the renal capsule : a case report
R Sharma, N Marwah, P Garg, A Sharma, S Marwah
July-December 1997, 13(1):57-58
Full text not available   
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Contrast agents for urologic imaging : prevention and management of toxic reactions
S Das
July-December 1997, 13(1):1-4
Full text not available    [CITATIONS]
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