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  Citation statistics : Table of Contents
   2011| July-September  | Volume 27 | Issue 3  
    Online since September 26, 2011

 
 
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ORIGINAL ARTICLES
Risk factors for prostate cancer: An hospital-based case-control study from Mumbai, India
B Ganesh, Sushama L Saoba, Monika N Sarade, Suvarna V Pinjari
July-September 2011, 27(3):345-350
DOI:10.4103/0970-1591.85438  PMID:22022057
Background : In India, prostate cancer is one of the five leading sites of cancers among males in all the registries. Very little is known about risk factors for prostate cancer among the Indian population. Objectives : The present study aims to study the association of lifestyle factors like chewing (betel leaf with or without tobacco, pan masala, gutka), smoking (bidi, cigarette), comorbid conditions, diet, body mass index (BMI), family history, vasectomy with prostate cancer. Materials and Methods : This an unmatched hospital-based case-control study, comprised of 123 histologically proven prostate 'cancer cases' and 167 'normal controls. Univariate and regression analysis were applied for obtaining the odds ratio for risk factors. Results : The study revealed that there was no significant excess risk for chewers, alcohol drinkers, tea and coffee drinkers, family history of cancer, diabetes, vasectomy and dietary factors. However, patients with BMI >25 (OR = 2.1), those with hypertension history (OR = 2.5) and age >55 years (OR = 19.3) had enhanced risk for prostate cancer. Conclusions : In the present study age, BMI and hypertension emerged as risk factors for prostate cancer. The findings of this study could be useful to conduct larger studies in a more detailed manner which in turn can be useful for public interest domain.
  11 6,213 247
SYMPOSIUM
Buccal mucosa urethroplasty for adult urethral strictures
W Britt Zimmerman, Richard A Santucci
July-September 2011, 27(3):364-370
DOI:10.4103/0970-1591.85441  PMID:22022061
Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely useful tool in the armamentarium of the Reconstructive Urologist is buccal mucosal urethroplasty. We like buccal mucosa grafts because of its excellent short and long-term results, low post-operative complication rate, and relative ease of use. We utilize it for most our bulbar urethral stricture repairs and some pendulous urethral stricture repairs, usually in conjunction with a first-stage Johanson repair. In this report, we discuss multiple surgical techniques for repair of urethral stricture disease. Diagnosis, evaluation of candidacy, surgical techniques, post-operative care, and complications are included. The goal is to raise awareness of buccal mucosa grafting for the management urethral stricture disease.
  9 11,011 585
SURGICAL CRAFT
Robotic-assisted inguinal lymph node dissection: A preliminary report
PN Dogra, Ashish Kumar Saini, Prabhjot Singh
July-September 2011, 27(3):424-427
DOI:10.4103/0970-1591.85458  PMID:22022077
Penile cancer with inguinal lymph node metastasis is a common cancer in India. Open inguinal lymphadenectomy is the gold standard treatment of metastatic inguinal lymph nodes. We report our experience and technique of robotic assisted inguinal lymph node dissection in two patients presented with palpable inguinal lymph nodes, which to our knowledge is the first reported case series from India.
  8 7,648 76
SYMPOSIUM
The current role of direct vision internal urethrotomy and self-catheterization for anterior urethral strictures
Deepak Dubey
July-September 2011, 27(3):392-396
DOI:10.4103/0970-1591.85445  PMID:22022065
Introduction : Direct visual internal urethrotomy (DVIU) followed by intermittent self-dilatation (ISD) is the most commonly performed intervention for urethral stricture disease. The objective of this paper is to outline the current scientific evidence supporting this approach for its use in the management of anterior urethral strictures. Materials and Methods : A Pubmed database search was performed with the words "internal urethrotomy" and "internal urethrotomy self-catheterization." All papers dealing with this subject were scrutinized. Cross-references from the retrieved articles were also viewed. Only English language articles were included in the analyses. Studies were analyzed to identify predictors for success for DVIU. Results : Initial studies showed excellent outcomes with DVIU with success rates ranging from 50% to 85%. However, these studies reported only short-term results. Recent studies with longer followup have shown a poor success rate ranging from 6% to 28%. Stricture length and degree of fibrosis (luminal narrowing) were found to be predictors of response. Repeated urethrotomies were associated with poor results. Studies involving intermittent self-catheterization following DVIU have shown no role in short-term ISD with one study reporting beneficial effects if continued for more than a year. A significant number of studies have shown long-term complications with SC and high dropout rates. Conclusions : DVIU is associated with poor long-term cure rates. It remains as a treatment of first choice for bulbar urethral strictures <1 cm with minimal spongiofibrosis. There is no role for repeated urethrotomy as outcomes are uniformly poor. ISD, when used for more than a year on a weekly or biweekly basis may delay the onset of stricture recurrence.
  8 6,218 460
CASE REPORTS
Persistent Mullerian duct syndrome with testicular seminoma: A report of two cases
Renuka V Inuganti, G Saila Bala, Y Kiran Kumar, Y Krishna Bharathi
July-September 2011, 27(3):407-409
DOI:10.4103/0970-1591.85451  PMID:22022070
Persistent Mullerian duct syndrome is a rare form of male pseudohermaphroditism, characterized by the presence of the Mullerian duct structures in an otherwise phenotypically as well as genotypically normal male. We report two cases of males with cryptorchidism, and seminoma in the undescended abdominal testis along with Mullerian duct derivatives (uterus and fallopian tube).
  5 2,679 40
ORIGINAL ARTICLES
Budd-Chiari syndrome in urology: Impact on nephrectomy for advanced renal cell carcinoma
Samir P Shirodkar, Mark S Soloway, Gaetano Ciancio
July-September 2011, 27(3):351-356
DOI:10.4103/0970-1591.85439  PMID:22022058
Objectives : Budd-Chiari syndrome (BCS) is a poorly understood entity in urology. It results from obstruction of the hepatic veins and the subsequent complications. It has been infrequently reported to be secondary to hepatic venous obstruction from invasion by an inferior vena cava (IVC) tumor thrombus in renal cell carcinoma (RCC). We report the largest known series of patients with RCC and BCS. Patients and Methods : Ten patients presented to a tertiary hospital with locally advanced RCC with IVC tumor thrombus. All were evaluated and had clinical or radiographic evidence of BCS. All underwent nephrectomy, IVC thrombectomy or ligation, and tumor removal from the hepatic veins. The perioperative and pathological factors were measured. These included estimated blood loss (EBL) and transfusions. Inpatient factors including duration of intubation, length of intensive care unit (ICU) stay, and overall length of stay (LOS) were recorded. The tumor-free status was evaluated. Results : The average age was 59 years. No intraoperative deaths occurred. Two intraoperative complications were noted. The mean EBL was 4244 cc; mean surgery length was 8 hours 12 minutes; and the mean ICU stay was nine days. The overall LOS averaged 13.25 days. One patient died postoperatively of sepsis and multisystem organ failure. One patient required reoperation for an abdominal wall hematoma caused by subcutaneous enoxaparin administration. Average follow-up was 28 months. Five patients are alive with no evidence of disease. Conclusions : Budd-Chiari syndrome is a rare entity in urology, with a potential for significant morbidity and mortality. Surgical excision of the primary tumor along with thrombectomy results in alleviation of BCS and improvement in the patient.
  4 2,388 57
REVIEW ARTICLES
Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature
Mayank Mohan Agarwal, Shwaran K Singh, Ravimohan Mavuduru, Arup K Mandal
July-September 2011, 27(3):310-319
DOI:10.4103/0970-1591.85423  PMID:22022052
Regulation of fluid and dietary intake habits is essential in comprehensive preventive management of urolithiasis. However, despite large body of epidemiological database, there is dearth of good quality prospective interventional studies in this regard. Often there is conflict in pathophysiological basis and actual clinical outcome. We describe conflicts, controversies and lacunae in current literature in fluid and dietary modifications in prevention of urolithiasis. Adequate fluid intake is the most important conservative strategy in urolithiasis-prevention; its positive effects are seen even at low volumes. Of the citrus, orange provides the most favorable pH changes in the urine, equivalent to therapeutic alkaline citrates. Despite being richest source of citrate, lemon does not increase pH significant due to its acidic nature. Fructose, animal proteins and fats are implicated in contributing to obesity, which is an established risk factor for urolithiasis. Fructose and proteins also contribute to lithogenecity of urine directly. Sodium restriction is commonly advised since natriuresis is associated with calciuresis. Calcium restriction is not advisable for urolithiasis prevention. Adequate calcium intake is beneficial if taken with food since it reduces absorption of dietary oxalate. Increasing dietary fiber does not protect against urolithiasis. Evidence for pyridoxine and magnesium is not robust. There is no prospective interventional study evaluating effect of many dietary elements, including citrus juices, carbohydrate, fat, dietary fiber, sodium, etc. Due to lack of good-quality prospective interventional trials it is essential to test the findings of pathophysiological understanding and epidemiological evidence. Role of probiotics and phytoceuticals needs special attention for future research.
  3 6,350 472
CASE REPORTS
Familial transverse testicular ectopia unrelated to persistent Müllerian duct syndrome
Eiji Hisamatsu, Shizuko Takagi, Yoshikiyo Nakagawa, Yoshifumi Sugita
July-September 2011, 27(3):397-398
DOI:10.4103/0970-1591.85446  PMID:22022066
Transverse testicular ectopia (TTE) is rare. Although several familial cases of TTE have been reported, most of them were associated with persistent Mullerian duct syndrome (PMDS), which may be inherited as an autosomal-recessive or X-linked recessive trait. We experienced two brothers with TTE unrelated to PMDS. A genetic etiology may be involved even in TTE unrelated to PMDS.
  2 3,214 32
SYMPOSIUM
Management of panurethral strictures
Apul Goel, Anuj Goel, Abhishek Jain, Bhupendra Pal Singh
July-September 2011, 27(3):378-384
DOI:10.4103/0970-1591.85443  PMID:22022063
Introduction : Treatment of panurethral stricture is considered a surgical challenge. We searched the literature to present a comprehensive review. Materials and Methods : A review of literature was performed using MEDLINE/PubMed database using terms "urethral stricture" and "urethroplasty." Only articles published between 1990 and 2009 and written in English language were included in the review. Results : The main causes of panurethral strictures are previous catheterization, urethral surgery, and lichen sclerosus. The treatment of each individual case has to be tailored according to the etiology, history of previous urethral surgeries, availability of local tissues for flap harvesting, availability of appropriate donor tissue, and the expertise of the treating surgeon. In patients with complicated strictures, previously failed urethroplasties and in patients with poor quality of urethral plate two-stage surgery is a better option. In all other situations, either a flap or graft urethroplasty or if adequate tissue is not available then combination of flap and graft gives reasonable success rates. Conclusions : Panurethral strictures are relatively less common. For successful results, the surgeon should be experienced and should be familiar with all the treatment modalities.
  2 3,603 549
CASE REPORTS
Emphysematous epididymo-orchitis: A rare entity
Alok Mathur, Anand Manish, Madhukar Maletha, Niti B Luthra
July-September 2011, 27(3):399-400
DOI:10.4103/0970-1591.85447  PMID:22022067
Emphysematous epididymo-orchitis is a rare cause of an acute scrotum and is a surgical emergency. Diagnosis is clinically difficult, and sonography with a high-frequency probe is useful to pick up gas shadows in the scrotal wall or testicular substance. A diabetic patient presented with fever, urinary tract infection, and an acute scrotal swelling. The patient needed orchidectomy and scrotal debridement. As in emphysematous pyelonephritis, this condition occurs in diabetics, and patients may need surgery. There is a need to perform sonography in all diabetic patients with an acutely inflamed scrotum, because detection of gas shadows makes surgical intervention more likely.
  1 4,636 44
ORIGINAL ARTICLES
Pathological outcomes and strategies to achieve optimal cancer control during robotic radical prostatectomy in Asian-Indian men
Ashutosh K Tewari, Abhishek Srivastava, Prasanna Sooriakumaran, Sonal Grover, Snider Desir, Harveer Dev, Rajiv Yadav, Robert Leung, Maria Shevchuk
July-September 2011, 27(3):326-330
DOI:10.4103/0970-1591.85428  PMID:22022054
Introduction and Objectives : There is a paucity of information in the literature about the characteristics of prostate cancer in the Asian-Indian population. We wanted to evaluate the oncological outcomes of Asian-Indians and Caucasians. We also derived a nomogram for prediction of extraprostatic extension (EPE) and presented biochemical recurrence (BCR) rates in the Asian-Indian population. Materials and Methods : A total of 2367 D'Amico low-risk patients underwent robotic-assisted radical prostatectomy (RARP) for clinically localized prostate cancer between January 2005 and July 2010 by a single surgeon. Of these 56 (2.4%) patients were Asian-Indians and 2025 were Caucasians (85.6%). Univariate and multivariate models were created for predicting EPE. A multivariate logistic regression model was used to develop a predictive nomogram. BCR was defined as a prostate-specific antigen ≥0.2 at any postoperative time point. Kaplan-Meier survival analysis was used to investigate BCR rates. Results : A significantly greater percentage of Asian-Indians compared to Caucasians had EPE (32.3 vs. 16.5; P = 0.01). In multivariate analysis adjusted for significant variables from univariate analyses, Asian-Indian race (P = 0.028), age (P = 0.050), maximum percentage cancer on biopsy (P < 0.001), and pathology prostate weight (P = 0.047) were independent predictors of EPE. Kaplan-Meier analysis demonstrated BCR free rates of 94.6% and 95.4%, for Asian-Indians and Caucasians, respectively, at a median follow-up of 16 months (range 2-70 months). There was no statistically significant difference in BCR rates across the two cohorts (log-rank P-value = 0.405). Conclusions : This study highlights that while Asian-Indians have more advanced cancer variables, their risk of BCR after surgery is similar to Caucasian patients. Further work is required to better understand the social, genetic and environmental factors that affect the biology of prostate cancer in men of Asian-Indian descent.
  1 2,461 74
Preliminary safety and efficacy results with robotic high-intensity focused ultrasound : A single center Indian experience
Shashikant Mishra, Rajan Sharma, Chandra Prakash Garg, V Muthu, Arvind Ganpule, Ravindra B Sabnis, Mahesh R Desai
July-September 2011, 27(3):331-336
DOI:10.4103/0970-1591.85431  PMID:22022055
Background : There are no Indian data of high-intensity focused ultrasound (HIFU). Being an alternative, still experimental modality, reporting short-term safety outcome is paramount. Aims : This study was aimed at to assess the safety and short-term outcome in patients with prostate cancer treated by HIFU. Settings and Design : A retrospective study of case records of 30 patients undergoing HIFU between January 2008 to September 2010 was designed and conducted. Materials and Methods : The procedural safety was analyzed at 3 months. Follow-up consisted of 3 monthly prostate-specific antigen (PSA) levels and transrectal biopsy if indicated. All the patients had a minimum follow-up of 6 months. Results : A mean prostate volume of 26.9 ± 8.5 cm 3 was treated in a mean time of 115 ± 37.4 min. There was no intraoperative complication. The postoperative pain visual analogue score at day 0 was 2.1 ± 1.9 and at day 1 was 0.4 ± 0.8 on a scale of 1-10. Mean duration of perurethral catheter removal was 3.9 days. The complications after treatment were: LUTS in seven patients, stress incontinence in two, stricture in two, and symptomatic urinary tract infection in five. Average follow-up duration was 10.4 months (range, 6-20 months). Mean time to obtain PSA nadir was 6 ± 3 months with a median PSA nadir value of 0.3 ng/ml. Two patients had positive prostatic biopsy in the localized (high risk) group. Conclusions : HIFU was safe in carcinoma prostate patients. The short-term results were efficacious in localized disease. The low complication rates and favorable functional outcome support the planning of further larger studies.
  1 2,670 58
Retropubic radical prostatectomy: Clinicopathological observations and outcome analysis of 428 consecutive patients
Jagdeesh N Kulkarni, Dayal Partap Singh, Shweta Bansal, Manisha Makkar, Rohan Valsangkar, Avinash T Siddaiah, Pushkar Sham Choudhary
July-September 2011, 27(3):337-344
DOI:10.4103/0970-1591.85437  PMID:22022056
Aim : We report the outcome analysis of retropubic radical prostatectomy (RRP) performed in 428 patients in terms of pathological findings, complications, and survival. Materials and Methods : Systematically recorded case reports forms of consecutive 428 RRPs done over a 14-year period were analyzed using the SPSS 14 software. Secondary analysis was done to evaluate era specific (pre and post 2002) changes in clinical features and survivals. Results : Seven-year overall survival (OAS), cancer-specific survival (CSS), and event-free survival (EFS) was 83.2%, 82.8%, and 69.8% respectively in our series. Era-specific survival showed higher CSS post 2002, and there was an increase in presentation with organ-confined disease. Univariate and multivariate analysis showed statistically significant impact on era specific outcome. With the improvement in techniques decrease in complications rate and increase in quality of life was noted. Conclusions : Our series spanning over decade demonstrates that RRP is viable option to offer cure to organ-confined carcinoma prostate. Further, there is evidence of stage migration and improvements in outcome in post 2002 patients. Although our series is modest in number, the success rates and outcome data matches those reported in the literature.
  1 2,382 77
Herbo-mineral supplementation in men with idiopathic oligoasthenoteratospermia : A double blind randomized placebo-controlled trial
Rajeev Kumar, Vaibhav Saxena, Monis Bilal Shamsi, S Venkatesh, Rima Dada
July-September 2011, 27(3):357-362
DOI:10.4103/0970-1591.85440  PMID:22022059
Introduction : There is insufficient scientific data on the medical management options for idiopathic oligoasthenoteratospermia (iOATs). We conducted a double blind, randomized, placebo-controlled trial to assess the efficacy and safety of the herbo-mineral supplement, Addyzoa® , in infertile men with iOATs. We also evaluated its effect on semen reactive oxygen species (ROS) levels, total antioxidant capacity (TAC) and DNA fragmentation index. Materials and Methods : Fifty infertile men with iOATS were recruited into an institutional ethics committee approved protocol from April to August 2009. Randomization was done using numbered, identical containers. Baseline semen samples were evaluated for routine parameters, ROS level, DNA fragmentation index and TAC. Drug/placebo was administered at a dose of two capsules twice a day for 3 months. All parameters were reassessed at 3 months and clinical side-effects were recorded. The study was registered with the Clinical Trials Registry of India and is available at www.ctri.in as study protocol number CTRI/2009/091/000551. Results : Forty-four subjects completed the study, 21 in the drug arm and 23 in the placebo arm. There was no difference in baseline parameters between the two groups. Men in the drug group had significant improvement in mean total motility from 23.2 ± 17.3% to 33.4 ± 23.2% (P-value: 0.008) and mean progressive (Type A+B) motility from 15.7 ± 12.6% to 22.6 ± 18.0% (P-value: 0.024). ROS, TAC and DFI did not change significantly in either group and did not show any correlation with other semen parameters. Conclusions : Treatment with Addyzoa resulted in a significant improvement in total and progressive motility in the semen of men with iOATs after 3 months of therapy. There was no change in the sperm concentration, ROS, DFI or TAC levels.
  1 2,789 103
SYMPOSIUM
Current concepts in the management of pelvic fracture urethral distraction defects
Ramanitharan Manikandan, Lalgudi N Dorairajan, Santosh Kumar
July-September 2011, 27(3):385-391
DOI:10.4103/0970-1591.85444  PMID:22022064
Objectives : Pelvic fracture urethral distraction defect (PFUDD) may be associated with disabling complications, such as recurrent stricture, urinary incontinence, and erectile dysfunction. In this article we review the current concepts in the evaluation and surgical management of PFUDD, including redo urethroplasty. Materials and Methods : A PubMedTM search was performed using the keywords "pelvic fracture urethral distraction defect, anastomotic urethroplasty, pelvic fracture urethral stricture, pelvic fracture urethral injuries, and redo-urethroplasty." The search was limited to papers published from 1980 to March 2010 with special focus on those published in the last 15 years. The relevant articles were reviewed with regard to etiology, role of imaging, and the techniques of urethroplasty. Results : Pelvic fracture due to accidents was the most common etiology of PFUDD that usually involved the membranous urethra. Modern cross-sectional imaging, such as sonourethrography and magnetic resonance imaging help assess stricture pathology better, but their precise role in PFUDD management remains undefined. Surgical treatment with perineal anastomotic urethroplasty yields a success rate of more than 90% in most studies. The most important complication of surgical reconstruction is restenosis, occurring in less than 10% cases, most of which can be corrected by a redo anastomotic urethroplasty. The most common complication associated with this condition is erectile dysfunction. Urinary incontinence is a much rarer complication of this surgery in the present day. Conclusions : Anastomotic urethroplasty remains the cornerstone in the management of PFUDD, even in previously failed repairs. Newer innovations are needed to address the problem of erectile dysfunction associated with this condition.
  1 5,745 728
CASE REPORTS
Priapism associated with Niemann-Pick disease in a 15-year-old boy
MV Krishna Shetty, M Udaya Kumar, TK Sen
July-September 2011, 27(3):410-412
DOI:10.4103/0970-1591.85452  PMID:22022071
A 15-year-old boy presented with priapism of 46 h duration. There was no known cause of priapism detected in him. During evaluation, biopsy of the lymph node and bone marrow aspiration detected patient to be having Niemann-Pick disease. He was managed with cavernous aspiration, saline irrigation, and intracavernosal phenylephrine injection. Although priapism is associated with many known diseases, about half of the cases are of idiopathic origin. We are reporting the first case of priapism associated with Niemann-Pick disease in the literature.
  - 13,601 51
A case of signet ring cell adenocarcinoma of the bladder with spontaneous urinary extravasation
Sanish S Shringarpure, Joseph V Thachil, T Raja, Rama Mani
July-September 2011, 27(3):401-403
DOI:10.4103/0970-1591.85449  PMID:22022068
Primary signet ring cell adenocarcinoma (PSRCC) of the bladder is a relatively rare variant of adenocarcinoma of the bladder with poor prognosis. Also PSRCC of the bladder presenting with spontaneous urinary extravasation is very rare. We present the case of a 48-year male who presented with spontaneous urinary extravasation and was diagnosed to have PSRCC of the urinary bladder on evaluation. He was treated with radical cystectomy and adjuvant chemotherapy. This report emphasizes the need to rule out other primary sites of adenocarcinoma in the body, which may metastasize to the urinary bladder.
  - 3,468 61
Cystic retroperitoneal renal hilar ancient schwannoma: Report of a rare case with atypical presentation masquerading as simple cyst
Rishi Nayyar, Nikhil Khattar, Rajeev Sood, Meenakshi Bhardwaj
July-September 2011, 27(3):404-406
DOI:10.4103/0970-1591.85450  PMID:22022069
Schwannoma is a benign soft tissue tumor of neural origin arising from the Schwann cells of the neural sheath. It has rarely been reported in renal or perirenal region. The preoperative diagnosis has mostly been confused with renal cell carcinoma in this location in most previous reports. We report a case that presented with a large "simple cystic" mass at the renal hilum. The preoperative differential diagnosis included hilar renal cortical cyst, renal sinus cyst, ureteropelvic junction obstruction (UPJO), or even a hydatid cyst. The final diagnosis was clinched only on histopathological examination.
  - 2,419 32
COMMENTARIES
Are metal ureteral stents indicated in cases of benign upper urinary tract obstruction?
Petros Sountoulides
July-September 2011, 27(3):305-306
DOI:10.4103/0970-1591.85419  PMID:22022050
  - 1,945 113
Metal ureteral stents in chronic obstructions
Daniel Yachia
July-September 2011, 27(3):307-309
DOI:10.4103/0970-1591.85421  PMID:22022051
  - 2,630 109
EDITORIAL
Urethral stricture disease - Have we found the magic wand?
Nitin S Kekre
July-September 2011, 27(3):303-304
DOI:10.4103/0970-1591.85417  PMID:22022049
  - 2,942 278
IJU VIDEOS
A technique of stenting after laparoscopic ureterolithotomy
Anil Mandhani
July-September 2011, 27(3):418-419
DOI:10.4103/0970-1591.85455  PMID:22022074
  - 1,923 98
Retroperitoneoscopic ureterolithotomy
Pranjal Modi, Jigish Vyas, Pankaj Dholaria, Varun Sharma
July-September 2011, 27(3):420-421
DOI:10.4103/0970-1591.85456  PMID:22022075
  - 1,629 52
Trans-sinus fat laparoscopic partial nephrectomy for parahilar tumors
Rajesh Kumar Ahlawat, Rakesh Khera, Prasun Ghosh, Manav Suryavanshi
July-September 2011, 27(3):422-423
DOI:10.4103/0970-1591.85457  PMID:22022076
  - 2,278 41
REVIEW ARTICLES
Mid-urethral slings in female incontinence: Current status
Ryan M Krlin, Alana M Murphy, Michael S Ingber, Sandip P Vasavada
July-September 2011, 27(3):320-325
DOI:10.4103/0970-1591.85424  PMID:22022053
The advent of the mid-urethral sling (MUS) 15 years ago has drastically changed the surgical management of stress urinary incontinence (SUI). Both retropubic and transobturator MUS can be placed in the ambulatory setting with excellent results. The tension-free vaginal tape (TVT) sling has the most robust and long-term data, but more recent literature suggests that the transobturator tape sling may offer comparable efficacy in appropriately selected patients. Single incision sling (SIS) is the newest addition to the MUS group and was developed in an attempt to minimize morbidity and create an anti-incontinence procedure that could be performed in the office. The efficacy of SIS remains unknown as the current literature regarding SIS lacks long-term results and comparative trials. The suprapubic arc sling appears to have equally effective outcomes in at least the short-term when compared with TVT. Although evolution of the SIS has led to a less invasive procedure with decreased post-op pain and reduced recovery time, durability of efficacy could be the endpoint we are sacrificing. Until longer-term data and more quality comparison trials are available, tailoring one's choice of MUS to the individual patient and her unique clinical parameters remains the best option.
  - 2,641 238
SYMPOSIUM
Management of the stricture of fossa navicularis and pendulous urethral strictures
Shrawan K Singh, Santosh K Agrawal, Ravimohan S Mavuduru
July-September 2011, 27(3):371-377
DOI:10.4103/0970-1591.85442  PMID:22022062
Objective : Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to bulbar urethral stricture and pelvic fracture urethral distraction defect. The present article aims to review the management of the strictures of fossa navicularis and pendulous urethra. Materials and Methods : The literature in English language was searched from the National Library of Medicine database, using the appropriate key words for the period 1985-2010. Out of 475 articles, 115 were selected for the review based on their relevance to the topic. Results : Etiology of stricture is shifting from infective to inflammatory and iatrogenic causes. Stricture of fossa navicularis is most often caused by lichen sclerosus et atrophicus and instrumentation. Direct visual internal urethrotomy is limited to selected cases in the management of pendulous urethral stricture. With experience and identification of various prognostic factors, conservative management by dilatation and internal urethrotomy is being replaced by various reconstructive procedures, using skin flaps and grafts with high success rates. Single-stage urethroplasty is preferred over the 2-stage procedure as the latter disfigures the penis and poses sexual problems temporarily. Conclusions : Flaps or grafts are useful for single-stage reconstruction of fossa navicularis and pendulous urethral strictures. The buccal and lingual mucosa serves as a preferred resource material for providing the inner lining of the urethra. Off-the-shelf materials, such as acellular collagen matrix, are promising.
  - 4,478 468
SYMPOSIUM-EDITORIAL
Management of urethral strictures
Deepak Dubey
July-September 2011, 27(3):363-363
DOI:10.4103/0970-1591.85448  PMID:22022060
  - 2,487 342
URORADIOLOGY
Bladder hernia: Multidetector computed tomography findings
Ankur Gadodia, Raju Sharma, Rajinder Parshad
July-September 2011, 27(3):413-414
DOI:10.4103/0970-1591.85453  PMID:22022072
Herniation of bladder in inguinal hernia is rare, with most cases diagnosed intraoperatively. Preoperative diagnosis is even rarer. We report a case of bladder as content of inguinal hernia diagnosed using multidetector computed tomography.
  - 2,237 49
Pelvic neurofibroma arising from prostate in a case of neurofibromatosis-1
Manisha Jana, Shivanand Gamanagatti, Rajeev Kumar, Sandeep Aggarwala
July-September 2011, 27(3):415-417
DOI:10.4103/0970-1591.85454  PMID:22022073
Pelvic neurofibroma is a rare condition and can be associated with neurofibromatosis-1 (NF-1). The diagnosis is primarily based on histopathology, though certain characteristic imaging features like the 'target sign' on T2W MRI are highly suggestive of the diagnosis. We describe a case of pelvic plexiform neurofibroma in a case of NF-1.
  - 2,693 43
UROSCAN
Role of combined fluoro-deoxyglucose positron emission tomography with computed tomography for bladder tumor
Swarnendu Mandal, Manoj Yadav, Apul Goel
July-September 2011, 27(3):428-429
  - 1,363 75
Magnets in stone extraction: Fact or fiction?
Deepak S Nagathan, Amod Dwivedi, Apul Goel
July-September 2011, 27(3):429-430
  - 1,339 63
Olfactory detection of prostate cancer by dogs sniffing urine: A step forward in early diagnosis
Manoj Kumar, Swarnendu Mandal, Apul Goel
July-September 2011, 27(3):430-431
  - 1,788 51
Long-term results of early endoscopic realignment of complete posterior urethral disruption
Rohit Kathpalia, Swarnendu Mandal, Apul Goel
July-September 2011, 27(3):431-432
  - 1,288 58
Is there a role of post percutaneous nephrolithotomy routine computer tomography scan to anticipate complication?
Swarnendu Mandal, SN Sankhwar, Apul Goel
July-September 2011, 27(3):433-434
  - 1,820 71
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