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   2012| October-December  | Volume 28 | Issue 4  
    Online since January 10, 2013

 
 
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CASE REPORTS
Complete penoscrotal transposition: A three-stage procedure
Ivan Somoza, Maria G Palacios, Roberto Mendez, Diego Vela
October-December 2012, 28(4):450-452
DOI:10.4103/0970-1591.105775  PMID:23450271
Complete penoscrotal transposition (CPST) with an intact scrotum is a rare anomaly in which the scrotum is located cephalic to the penis. It is the most severe degree of malformation of a spectrum of abnormalities in scrotal development. There are few cases reported in the literature, and there are few descriptions of the technique for correction and results. We describe a new case of CPST and its sequential correction.
  9,674 88 -
REVIEW ARTICLES
Vitamin D receptor as a therapeutic target for benign prostatic hyperplasia
Parmeet Kaur Manchanda, Aaron J Kibler, Mei Zhang, Janani Ravi, Hemant K Bid
October-December 2012, 28(4):377-381
DOI:10.4103/0970-1591.105745  PMID:23450267
The bioactive form of vitamin D, 1α, 25-dihydroxyvitamin D3 (1α, 25(OH)2D3), is a secosteroid hormone that binds to the vitamin D receptor (VDR), a member of the nuclear receptor super-family expressed in many cell types, and modulates a variety of biological functions. 1α, 25(OH)2D3 is essential for bone and mineral homeostasis, but also regulates growth and differentiation of multiple cell types, and displays immunoregulatory and anti-inflammatory activities. The antiproliferative, prodifferentiative, antibacterial, immunomodulatory and anti-inflammatory properties of synthetic VDR agonists could be exploited to treat a variety of chronic inflammatory and autoimmune diseases, including benign prostatic hyperplasia (BPH). It has been hypothesized that VDR may influence both the risk of a variety of diseases and their occurrence and prognosis. However, earlier studies investigating the associations between specific VDR polymorphisms and various diseases often show controversial results. We performed a systematic review of the current literature on vitamin D and BPH using the PubMed and Web of Knowledge databases. The aim of this review is to summarize the current knowledge on the utility of the VDR gene regarding prostate growth as well as the pathogenesis and treatment of BPH, a complex syndrome characterized by a static component related to prostate overgrowth, a dynamic component responsible for urinary storage symptoms, and an inflammatory component. Despite the massive advances in recent decades, further research is needed to fully characterize the exact underlying mechanisms of VDR action on BPH and to comprehend how these cellular changes translate into clinical development in physical concert.
  6,514 188 4
Exstrophy epispadias complex- Issues beyond the initial repair
Jai K Mahajan, Kattragadda L.N. Rao
October-December 2012, 28(4):382-387
DOI:10.4103/0970-1591.105747  PMID:23450435
Despite advances in the management of exstrophy epispadias complex (EEC), the quality of life of these patients is far from good. The post-operative period is complicated by numerous and variable events - infection, dehiscence, upper tract dilatation with deterioration, fistulas, stone formation and incontinence to name a few of the major complications. Redo surgery for bladder closure, bladder neck reconstruction, epispadias repair and closure of fistulas are frequently required. The current focus is on limiting the frequency and morbidity of the reconstructive procedures. A successful initial closure and early satisfactory cosmetic and functional results are gratifying for the family and the health care team, but this is only the beginning of the lifelong care necessary for bladder exstrophy (BE) patients. In this article, the long-term outcome of various treatment options and the continent procedures in BE has been reviewed, tracing the journey of these patients into adolescence and adulthood.
  4,950 230 1
ORIGINAL ARTICLES
Prospective evaluation of complications using the modified Clavien grading system, and of success rates of percutaneous nephrolithotomy using Guy's Stone Score: A single-center experience
Swarnendu Mandal, Apul Goel, Rohit Kathpalia, Satyanarayan Sankhwar, Vishwajeet Singh, Rahul J Sinha, Bhupender P Singh, Divakar Dalela
October-December 2012, 28(4):392-398
DOI:10.4103/0970-1591.105749  PMID:23450640
Introduction and Objectives: To prospectively document the perioperative complications of percutaneous nephrolithotomy (PCNL) using the modified Clavien grading system. Evaluation of complications and clearance rates according to stone complexity using the validated Guy's Stone Score (GSS) was also done. Materials and Methods: A total of 221 renal units underwent 278 PCNL procedures at a urology resident training center between September 2010 and September 2011 and data were recorded prospectively in our registry. Patients with co-morbidities like diabetes, renal failure, hypertension and cardiopulmonary diseases were excluded. Stone complexity was classified according to the GSS while peri-operative complications were recorded using the modified Clavien grading system. Results: Two hundred and forty-five complications were encountered in 278 PCNL procedures involving 116 renal units (41.72%). Complications of Grades 1, 2, 3a, 3b, 4a, 4b and 5 were seen in 52 (18.7%), 122 (43.8%), 42 (15.1%), 18 (6.4%), 6 (2.1%), 4 (1.4%) and 1 (0.3%) renal units respectively. There were 68, 98, 50 and 5 renal units in GSS I, II, III and IV groups, respectively. All grades of complications were more common in GSS III and IV (P<0.05). For GSS I, II, III and IV 100%, 74%, 56% and 0% of renal units, respectively, were stone-free after one session and 0%, 24%, 44% and 60% respectively needed two sessions to be stone-free. Conclusion: Although the complication rates were higher most were of low grade and self-limiting. Complications were significantly more common with higher GSS and the GSS effectively predicted stone-free rates.
  4,393 266 7
Proteus: Mythology to modern times
Senthy V Sellaturay, Raj Nair, Ian K Dickinson, Seshadri Sriprasad
October-December 2012, 28(4):388-391
DOI:10.4103/0970-1591.105748  PMID:23450503
Aims: It is common knowledge that proteus bacteria are associated with urinary tract infections and urinary stones. Far more interesting however, is the derivation of the word proteus. This study examines the origin of the word proteus, its mythological, historical and literary connections and evolution to present-day usage. Materials and Methods: A detailed search for primary and secondary sources was undertaken using the library and internet. Results: Greek mythology describes Proteus as an early sea-god, noted for being versatile and capable of assuming many different forms. In the 8 th century BC, the ancient Greek poet, Homer, famous for his epic poems the Iliad and Odyssey, describes Proteus as a prophetic old sea-god, and herdsman of the seals of Poseidon, God of the Sea. Shakespeare re-introduced Proteus into English literature, in the 15 th century AD, in the comedy The Two Gentleman of Verona, as one of his main characters who is inconstant with his affections. The 'elephant man' was afflicted by a severely disfiguring disease, described as 'Proteus syndrome'. It is particularly difficult to distinguish from neurofibromatosis, due to its various forms in different individuals. The Oxford English Dictionary defines the word 'protean' as to mean changeable, variable, and existing in multiple forms. Proteus bacteria directly derive their name from the Sea God, due to their rapid swarming growth and motility on agar plates. They demonstrate versatility by secreting enzymes, which allow them to evade the host's defense systems. Conclusions: Thus proteus, true to its name, has had a myriad of connotations over the centuries.
  4,311 103 -
URORADIOLOGY
Intravenous urography supplemented with computerised tomography urogram: A pragmatic hybrid imaging approach to hydronephrosis
Raju A George, Aneesh Mohimen, Jyotindu Debnath, Lovleen Satija, Piyush Joshi, Subhash C Godara
October-December 2012, 28(4):456-460
DOI:10.4103/0970-1591.105787  PMID:23450645
Background: Image quality in an Intravenous Urogram (IVU) can occasionally be compromised by variables like bowel preparation, renal function and radiographic factors, posing a challenge to all Uroradiologists. The Computerised Tomography Urogram (CTU) yields better diagnostic information than an IVU, due to its inherent superior anatomic delineation and contrast sensitivity, against a trade-off involving radiation dose and cost. Our study was conducted to assess the utility and timing of performing a single-phase CTU, as a problem-solving tool, to clear the diagnostic dilemma in a selected subset of patients, in whom an ongoing IVU could potentially be inconclusive. Material and Methods: Five hundred and twelve patients who underwent IVU studies for urologic referrals at a tertiary care hospital, during the period of January to December 2009, formed the subject of the study, of whom 33 patients with inconclusive IVU findings after the first three radiographs underwent a single-phase CTU, to reach definitive imaging diagnoses. Results: The percentage of inconclusive IVU studies amounted to only 33 / 512 (6.4%), in whom a CTU study revealed definitive diagnoses in 30 patients and no abnormality in three patients, thus conclusively clearing the ambiguities raised on the IVU in all the selected patients. Conclusions: The concept of a CTU limited to a single-phase study to supplement an inconclusive IVU optimizes the contrast and radiation dose to the affected patients. It is a cost-effective, timely, and definitive 'imaging intervention' and should be considered a viable hybrid technique to be utilized selectively and judiciously.
  4,103 116 -
CASE REPORTS
Holmium laser fulguration of superficial urothelial carcinoma of the pendulous urethra
Michael A Liss, Leland Ronningen, Atreya Dash
October-December 2012, 28(4):427-429
DOI:10.4103/0970-1591.105758  PMID:23449892
Urothelial carcinoma may occur anywhere in the urinary tract including the pendulous urethra. To prevent urethral stricture after resection and monopolor fulguration we describe the use of the holmium laser to fulgurate recurrent pTa UC from the urethra. The surgical approach was staged and provided excellent long term results for management of superficial UC.
  4,012 40 -
Robot-assisted laparoscopic bladder diverticulectomy in a seven-year-old child: Case report and points of technique
Raguram Ganesamoni, Arvind P Ganpule, Mahesh R Desai
October-December 2012, 28(4):434-436
DOI:10.4103/0970-1591.105762  PMID:23450060
Congenital bladder diverticulum is an uncommon anomaly of the bladder. Patients can present with urinary infection, heamaturia, and/or urinary obstruction. We report the case of a seven-year-old boy who presented with painful micturition and terminal haematuria due to a congenital bladder diverticulum. Robot-assisted laparoscopic diverticulectomy was performed. The patient had an uneventful recovery. We describe the points of technique pertinent to the procedure.
  3,626 39 -
Management of a renal calculus larger than 4 cm in a patient with tuberous sclerosis complex-associated angiomyolipoma
Koichi Kodama, Yasukazu Takase, Isamu Motoi
October-December 2012, 28(4):442-444
DOI:10.4103/0970-1591.105770  PMID:23450153
Renal calculi in patients with renal angiomyolipomas are difficult to treat because of the hemorrhagic potential of these tumors. We describe the case of a 65-year-old man having tuberous sclerosis complex-associated multifocal renal angiomyolipomas with a large renal calculus. The patient presented with left flank dullness and a previous history of spontaneous angiomyolipoma rupture. Intravenous pyelography revealed a 43 × 16 mm calculus in the pelvis and lower calyx of the left kidney. The calculus was successfully removed by retrograde flexible ureterorenoscopy and holmium-YAG lithotripsy. Flexible ureterorenoscopy is an effective, minimally invasive therapy for patients at high risk of renal hemorrhage.
  3,563 39 -
UROSCAN
Is it necessary to treat all patients with silent ureteral stones? Ongoing dilemma!
Jai Prakash
October-December 2012, 28(4):472-473
  3,397 83 -
ORIGINAL ARTICLES
Correlation between differential renal function estimation using CT-based functional renal parenchymal volume and 99m Tc - DTPA renal scan
Debanga Sarma, Sasanka K Barua, TP Rajeev, Saumar J Baruah
October-December 2012, 28(4):414-417
DOI:10.4103/0970-1591.105753  PMID:23449624
Introduction and Objective: Nuclear renal scan is currently the gold standard imaging study to determine differential renal function. We propose helical CT as single modality for both the anatomical and functional evaluation of kidney with impaired function. In the present study renal parenchymal volume is measured and percent total renal volume is used as a surrogate marker for differential renal function. The objective of this study is to correlate between differential renal function estimation using CT-based renal parenchymal volume measurement with differential renal function estimation using 99m TC - DTPA renal scan. Materials and Methods: Twenty-one patients with unilateral obstructive uropathy were enrolled in this prospective comparative study. They were subjected to 99m Tc - DTPA renal scan and 64 slice helical CT scan which estimates the renal volume depending on the reconstruction of arterial phase images followed by volume rendering and percent renal volume was calculated. Percent renal volume was correlated with percent renal function, as determined by nuclear renal scan using Pearson coefficient. Results and Observation: A strong correlation is observed between percent renal volume and percent renal function in obstructed units (r = 0.828, P < 0.001) as well as in nonobstructed units (r = 0.827, P < 0.001). Conclusion: There is a strong correlation between percent renal volume determined by CT scan and percent renal function determined by 99m TC - DTPA renal scan both in obstructed and in normal units. CT-based percent renal volume can be used as a single radiological tests for both functional and anatomical assessment of impaired renal units.
  3,058 143 1
Neoadjuvant and adjuvant chemotherapy for muscle-invasive bladder cancer: The likelihood of initiation and completion
Ahmed Eldefrawy, Mark S Soloway, Devendar Katkoori, Rakesh Singal, David Pan, Murugesan Manoharan
October-December 2012, 28(4):424-426
DOI:10.4103/0970-1591.105756  PMID:23449818
Introduction: Chemotherapy was shown to improve survival in patients undergoing radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The initiation and completion rates for perioperative chemotherapy are variable. Our aim is to compare the likelihood of initiating and completing neoadjuvant (NAC) and adjuvant chemotherapy (AC) in patients who underwent of RC for MIBC. Materials and Methods: We performed a retrospective analysis of patients who underwent RC between 1992 and 2011. NAC was advised for patients with clinical stage ≥T2, hydronephrosis, extensive lymphovascular invasion (LVI), or prostatic stromal invasion. Patients with ≥pT3 or lymph node metastases were considered for AC. Results: A total of 363 patients were considered for perioperative chemotherapy. Among the 141 patients who were offered NAC, 125 (88.6%) initiated NAC. A total of 222 were considered for AC, and 151 (68.0%) initiated AC (P < 0.001). In the NAC group, 118 (83.5%) completed planned number of cycles of chemotherapy and 7 (5.6%) did not complete the planned chemotherapy. In the AC group, 79 (35.5%) completed at least four cycles and 72 (47.3%) could not complete the planned cycles (P < 0.001). Conclusions: Patients with MIBC are more likely to initiate and complete NAC than AC.
  2,799 113 3
CASE REPORTS
Inadvertent suprapubic gastrostomy: Report of a unique complication of blind percutaneous suprapubic trocar cystostomy
Sandip Kumar Halder, Imran Khan, Prasenjit Mukhopadhyay, Sushil Kumar Paira
October-December 2012, 28(4):445-446
DOI:10.4103/0970-1591.105771  PMID:23450184
Emergency percutaneous trocar suprapubic cystostomy is a common surgical procedure for acute urinary retention. Although uncommon it can be associated with a few complications. The most dangerous complication is iatrogenic bowel injury. Literature shows reported cases of small and large bowel injuries. We report a case of inadvertent placement of suprapubic catheter into a dilated and ptotic stomach. This is the first reported case of this complication of suprapubic cystostomy.
  2,815 54 -
Nonsurgical management of bilateral adrenal abscess in newborn with therapeutic aspiration under ultrasonographic guidance
Vivek Patre, Hulesh Mandle, Onkar Khandwal
October-December 2012, 28(4):453-455
DOI:10.4103/0970-1591.105779  PMID:23450455
Neonatal adrenal abscess is a rare condition. Bilateral adrenal abscess are extremely rare. We present this case focusing on the usefulness of needle aspiration under ultrasonographic guidance. The bilateral suprarenal cystic masses are identified by ultrasonography and different sequences of magnetic resonance imaging.
  2,794 37 -
ORIGINAL ARTICLES
Does urinary metabolic assessment in idiopathic calcium nephrolithiasis matter? A matched case control study among Indian siblings
Gaurav Gupta, Mukha R Paul, Santosh Kumar, Antony Devasia, NV Mahendri, Prasanna Samuel, Nitin S Kekre, Ninan K Chacko
October-December 2012, 28(4):409-413
DOI:10.4103/0970-1591.105752  PMID:23449537
Objective: To identify the differences in urinary profile of a stone former and the matched member of the family. Patients and Methods: This prospective case-control study was conducted from April 2006 to January 2008. Forty-one matched pairs from one geographic region were recruited. Renal/ureteric idiopathic calcium nephrolithiasis in patients of 18 years and above were included as cases. Controls were of the same gender and first-degree relative with no urolithiasis or history. They were living together at least for the last 5 years and consuming minimum of two out of three major meals together per day. For cases and controls besides fluid intake, ambulatory serum analysis for calcium, phosphorus, uric acid, albumin-globulin ratio, sodium, potassium and bicarbonate was done. Ambulatory 24-hour urinalysis was done for urinary volume, calcium, phosphorus, oxalate, uric acid, citrate, magnesium, creatinine and urinary pH was measured. For controls X-ray and USG-Kidney-Ureter-Bladder was done to rule out stone disease. The statistical analysis was done using Mc-Nemar test. Results: Of the 41, 31 cases (76%) were first-time stone formers. No statistical difference was found for 24-hour urinary calcium (P = 0.68), oxalate (P = 0.68), citrate (P = 0.45) and urinary volume (P = 0.14). All pairs had normal 24-hour urinary magnesium, uric acid and urinary pH. Conclusions: The urinary biochemical profile of idiopathic calcium nephrolithiasis was similar to the appropriately matched family member. It appears that an independent intrinsic factor may possibly be present and responsible for stone disease. The usefulness of urinary metabolic evaluation is seems to be of doubtful significance.
  2,701 108 -
CASE REPORTS
Rare case of blastemal predominant adult Wilms' tumor with skeletal metastasis case report and brief review of literature
Rashmi Patnayak, D. V. S. Rambabu, Amitabh Jena, Bodagala Vijaylaxmi, BV Phaneendra, M Kumaraswamy Reddy
October-December 2012, 28(4):447-449
DOI:10.4103/0970-1591.105772  PMID:23450214
Wilms' tumor (nephroblastoma) is extremely rare in adults, skeletal metastasis being still rarer. The clinical course of adult Wilms' tumor is very aggressive. The present case is a rare blastemal predominant adult Wilms' tumor presenting with skeletal metastasis. We report a case of 19-year-old female presented with severe low backache and colicky left loin pain of 3 months and progressive weakness of 15 days duration. Magnetic resonance image (MRI) of lumbosacral spine was reported as spinal metastasis with right renal mass. The patient underwent right radical nephrectomy and the tumor was histopathologically confirmed as adult Wilms' tumor. In case of adult Wilms' tumor, distant metastasis may be the first presentation and this possibility should be considered when an adult patient presents with flank pain and a renal mass.
  2,678 48 1
Rhabdomyosarcomatous differentiation in a spermatocytic seminoma with review of literature
Vikram Narang, Kirti Gupta, Arvind Gupta, Santosh Kumar
October-December 2012, 28(4):430-433
DOI:10.4103/0970-1591.105760  PMID:23449985
The sarcomatous differentiation occurring in spermatocytic seminoma (SS) renders an aggressive behavior with metastatic potential to this relatively indolent neoplasm. Correct identification of this sarcomatous component is essential as further management differs. Herein, we report a case of young male with SS with rapid increase in size of the tumor. Histopathology revealed a rhabdomyosarcomatous component infiltrating the rete-testis and epididymis along with a well-circumscribed SS.
  2,579 41 4
ORIGINAL ARTICLES
Case for resurgence of radical perineal prostatecomy in Indian subcontinent
Rajeev Sood, Nikhil Khattar, Rishi Nayyar, Sachin Kathuria, Vineet Narang, Devashish Kaushal
October-December 2012, 28(4):418-423
DOI:10.4103/0970-1591.105754  PMID:23449760
Introduction: Radical perineal prostatectomy was the first surgery described for prostatic carcinoma (Young, 1904) but it lost its eminent status after Walsh's description in 1982 of anatomic radical retropubic prostatectomy followed by the enthusiasm in laparoscopy and now robotics. It made resurgence after it was realized in early 1990s that the pelvic lymph node dissection is needed only in selected cases. Last decade witnessed over 80 publications addressing the results and advances in the perineal approach. Strangely, centres from the subcontinent have chosen to ignore this resurgence. We describe our early experience with the technique in 35 patients and present the case for its more widespread usage. Patients and Methods: Thirty five patients of clinically localized carcinoma prostate were operated by perineal route in our institution from December 2006 onwards. All patients had serum prostate specific antigen levels less than 10 ng/ml. Results: Operating time was 2 to 3.5 hours (mean 2.5 hours). Rectal injury occurred in three patients but was closed primarily in all and none required a colostomy. Mean duration of hospital stay was four days. The disease was organ confined in 25(71%). Positive margins were seen in 5(14%) patients. Biochemical recurrence occurred in 17% patients at one year. Seventy six percent patients had achieved continence at one year. Conclusions: As the world is taking note of radical perineal prostatectomy again, with a very small learning curve, minimal invasion and good oncological control urologists from Indian subcontinent should also embrace this procedure in view of the relative limited resources available.
  2,540 58 -
Bone densitometric assessment and management of fracture risk in Indian men of prostate cancer on androgen deprivation therapy: Does practice pattern match the guidelines?
Manas R Pradhan, Anil Mandhani, Saurabh S Chipde, Alok Srivastava, Manmeet Singh, Rakesh Kapoor
October-December 2012, 28(4):399-404
DOI:10.4103/0970-1591.105750  PMID:23450674
Objective: Estimation of baseline bone mineral density (BMD) at the time of instituting androgen deprivation therapy (ADT) for metastatic prostate cancer is recommended by several specialty groups and expert panels. The present study was carried out to analyze the practice pattern of Indian urologists with regard to bone densitometric assessment and management of fracture risk in men of prostate cancer on ADT, and their degree of adherence to currently available guidelines Materials and Methods: Telephonic interviews of 108 qualified urologists, randomly selected from the member database of Urological Society of India was carried out with a predefined questionnaire. The responses were analyzed and compared with the available evidences and recommendations. Results: Only 19.4% urologists routinely perform a baseline BMD before starting ADT. Although majority of them prescribe calcium and vitamin D supplementation, only few tell regarding fracture risk and life-style modification to their patients. While 59.6% of the respondents use Zoledronic acid (ZA) in their patients on ADT, half of them prescribe it without knowing the BMD status, which may lead to overuse of ZA. Conclusion: Majority of the urologists in India do not follow the guidelines for BMD measurement in prostate cancer. A baseline BMD may help in reducing the unnecessary use of ZA.
  2,428 81 1
Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: A need for long-term follow-up
Mayank Mohan Agarwal, Sathishkumar Mothilal Raamya, Ravimohan Mavuduru, Arup K Mandal, Shrawan K Singh
October-December 2012, 28(4):405-408
DOI:10.4103/0970-1591.105751  PMID:23450711
Introduction: Urodynamic findings of lower urinary tract of women presenting with voiding dysfunction after successful repair of complex trigonal vesicovaginal fistulas at our institute are presented. Materials and Methods: In this retrospective case series, women presenting with voiding dysfunction after successful repair of obstetric fistulae were evaluated. In addition of standard clinical evaluation with history and clinical examination, all underwent kidney-ureter-bladder ultrasonography, renal function test, urine culture, and multichannel urodynamics. The latter consisted of free uroflowmetry, filling and voiding cystometry. Results: Five women (median age 35 years; range 30-45) presented with difficulty in voiding after the successful repair; two presented within 1 year and 3 after 10 years. The latter three presented with bilateral hydroureteronephrosis; one of these had chronic kidney disease (CKD) grade IV at presentation. Urodynamics (UDS) of all patients revealed poor detrusor compliance (median 11 ml/cm H 2 O; range 5-22), high-end filling detrusor pressures (median 41 cm H 2 O; range 11-46) and no detrusor overactivity. All patients attempted voiding with abdominal straining; with little contribution of detrusor contraction (median 6 cm H 2 O; range 0-9). Two patients could not void during the study, one with Tanagho reconstruction and another with CKD. Conclusion: Even after successful repair, patients with complex trigonal or urethra-vesicovaginal fistulae warrant indefinite long-term follow-up for voiding dysfunction in view of possibility of developing poorly compliant bladder.
  2,366 54 1
CASE REPORTS
Migrated embolization coil: A rare cause of urinary tract obstruction
Anand Bhageria, Amlesh Seth, Girdhar S Bora
October-December 2012, 28(4):437-438
DOI:10.4103/0970-1591.105763  PMID:23450085
Refractory bleeding following percutaneous nephrolithotomy (PCNL) is mainly due to formation of pseudoaneurysm. Transarterial embolization is required to control the bleeding in such cases. We report a case of post-PCNL hematuria in whom angioembolization was done. An early erosion of the embolization coil from the renal vasculature into the urinary collecting system occurred, causing urinary tract obstruction and urinary tract infection (UTI). The coil was retrieved ureteroscopically after control of UTI with antibiotics. Migration of embolization coil into urinary collecting system is a rare but important cause of urinary tract obstruction. The treating physician as well as the patient should be aware of this complication.
  2,275 39 4
EDITORIAL
The rise and rise of technology in urology- Cost-effective medicine vs. new treatments
Nitin S Kekre
October-December 2012, 28(4):375-376
DOI:10.4103/0970-1591.105742  PMID:23450941
  2,094 150 -
CASE REPORTS
Ureteroscopy-assisted retrograde nephrostomy for an obese patient
Takashi Kawahara, Junichi Matsuzaki, Yoshinobu Kubota
October-December 2012, 28(4):439-441
DOI:10.4103/0970-1591.105768  PMID:23450115
Obesity is associated with increased surgical morbidity and mortality. We previously reported on the usefulness of ureteroscopy assisted retrograde nephrostomy (UARN) and here we report a case of renal calculi successfully treated with UARN during percutaneous nephrolithotomy (PCNL) in an obese patient. A 63-year-old female with left renal calculi was referred to Department of Urology, Ohguchi Higashi General Hospital. Her body mass index was 34.0 kg/m 2 . Stone fragments were completely extracted. URS-assisted puncture from the renal collecting system to the skin under fluoroscopic guidance was a safe and easy procedure in our obese patient.
  2,106 42 1
UROPATHOLOGY
Xanthoma of the urinary bladder - A rare entity
M Vimal, D Masih, MT Manipadam, KN Chacko
October-December 2012, 28(4):461-462
DOI:10.4103/0970-1591.105791  PMID:23450680
Xanthomas of the urinary bladder are rare. They may be associated with metabolic disorders. We hereby report a case of bladder xanthoma.
  1,973 45 1
UROSCAN
Effectiveness of a single post-operative Mitomycin-C on prevention of bladder tumor after nephroureterectomy for primary upper urinary tract urothelial carcinoma
Sagorika Paul
October-December 2012, 28(4):464-465
  1,676 48 -
Staghorn morphometry for percutaneous nephrolithotomy
Sagorika Paul
October-December 2012, 28(4):473-474
  1,418 133 -
Current controversies and consensus on extended lymphadenectomy in renal cell carcinoma
RM Sathishkumar
October-December 2012, 28(4):463-464
  1,439 89 -
Spider: The next frontier in urological surgery
Deepak S Nagathan
October-December 2012, 28(4):466-467
  1,245 80 -
Tissue-engineered autologous urethras for complex urethral problems: From envision to reality
Manas R Pradhan
October-December 2012, 28(4):470-471
  1,233 48 -
Near-infrared spectroscopy for diagnosis of detrusor overactivity: A step towards non-invasive evaluation
Neeraj Kumar Goyal
October-December 2012, 28(4):469-470
  1,081 53 -
Impact of timing of surgery in upper tract urothelial carcinoma
Swarnendu Mandal
October-December 2012, 28(4):467-468
  1,079 41 -
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