Urology, Nephrology and Andrology International

Introduction: Nephrectomy is the surgical removal of a kidney. The Indications for nephrectomy include kidney cancer, severe trauma to the kidney and benign disease such as symptomatic hydronephrosis, chronic infection, polycystic kidney disease, shrunken kidney, hypertension or renal calculus. The purpose of the present study is to investigate the indication for nephrectomy in tertiary care at Mysore, India. Materials and Methods: It is a retrospective study based on medical records of patients who underwent nephrectomy from period of July 2017 to October 2018. It was studied based on indication, clinical presentation. Statistical Analysis: The data obtained was expressed as Mean ± S.D and percentage. The comparison was made using one-way ANOVA with a p-value less than 0.05 as statistically significant. Results: Out of the 25 nephrectomies, 21 were performed for nonmalignant condition, 4 were for malignant condition. Among nonmalignant condition most are due to obstructive pathology caused by stone (09), PUJ obstruction in 06, infective in 4, stricture in 2 patients. Conclusion: In spite of recent advance in diagnosis and treatment, preventable cause continues to play major role in in countries like India.

Keywords: Nephrectomy; Malignant; Benign; Stone; Stricture; PUJ Obstruction.

Introduction: Compared to traditional open radical nephrectomy, the laparoscopic approach has been proven to have several benefits such as decreased blood loss, less postoperative narcotic requirements, and shorter hospital stay and duration of convalescence. Aim: Laparoscopic radical nephrectomy for clinical stage T1 and T2 tumors which are greater than 7 cm. Materials and methods: It is retrospective study done between September 2016 and august 2019 were retrospectively reviewed. Laparoscopic Radical Nephrectomy was performed in 87 patients with tumors 7 cm or greater. Results: Out of 87 patients were analysed 47 (54%) patients were men, tumour size was 5.6 ± 2.3 cm, and the right kidney was involved in 50 (57%) patients. Transperitoneal approach was employed in 64 (73%) procedures. Mean operative time is 170 minutes, blood loss 110 ml and intra operative complications were 10 cases (8.7%) with one cases needed open surgery (1.1%). Postoperatively patient has 7 days of hospital stay with post OP complications in 20 cases (17.4%) and median week of convalescence is 4 weeks. RCC was confirmed in 69 (79%) of the patients, Pathological tumor stage was most of the patients are in pT1 and pT2. Total intraoperative complications in study are 10 cases (11.5%) with vascular/Haemorrhage in most of the cases (6.9%). Post-operative complications were in 13 cases (15%) most of the complications are with wound (4.6%). in operative time and complications which is slightly more in trans peritoneal approach which is significant (p < 0.05). Conclusions: LRN for renal tumours which are larger (greater than 7 cm) is efficacious. Decreased blood loss, lesser complications and shorter hospital stay are the advantages observed.

Keywords: Laproscopic Radical Nephrectomy; Large Renal Tumors; Transperitoneal approach

Introduction: Kidney stones are very common and do not spare the pregnant population. Pathological and physiological changes occur in the pregnancy which alter the risk for development of urolithiasis. Urological emergencies that occur during pregnancy are associated with severe risks to both mother and the fetus. Diagnosis is challenging as imaging options without radiation are limited especially in the rural settings. Management of urolithiasis in the pregnant females is unique and requires utmost care. We share our experience of managing the urolithiasis in pregnant females at our rural centre. Materials and Methods: All the patients who came to the casuality and the outpatient department of Tambe hospital, Sangamner, Maharashtra from August 2016 to July 2019 were included in the study. A total of 39 patients were included and studied. The records of the patients were reviewed to collect data that included age, symptoms, the laterality of renal colic, sizes and locations of urolithiasis , trimester of diagnosis, pain before and after treatment and pregnancy complications. Results: Based on clinical and sonological diagnoses, 13 patients had urolithiasis, and 13 patients had hydronephrosis without definite evidence of calculi. Conservative treatments were successful in 25 patients. Among these treatments, antibiotics were used in 15 patients, and the remaining patients received only hydration and analgesics without antibiotics. Urological interventions were required in 14 patients. The most common intervention was double J stenting, which was performed in 13 patients to treat hydronephrosis or urolithiasis. Percutaneous nephrostomy was done in only one patient. No complications were noted. Conclusion: Urolithiasis during pregnancy is more complex than urolithiasis in general population. Diagnosis is challenging. Conservative management is first-line of treatment. If it fails, then both diversion and definitive treatment are acceptable management options. Patient and surgeon’s preferences, along with clinical variables and available resources, guide decision-making.

Keywords: Urolithiasis, pregnancy; Double J stent; Percutaneous nephrostomy; Renal colic.

Background: Management of ureteric strictures is a challenging task. Subtle presentation, silent progression and complex aetiology may delay diagnosis. Aims: Evaluate daetiology, pathology and management of ureteric strictures at a tertiary care health centre. Materials and methods: This is a prospective study conducted in department for a period of study was 2 years. Total of 26 patients suspected of ureteric strictures were studied. Results: In 26 patients Iatrogenic 10 (38.46%) and idiopathic 6 (23%) are common causes. Other causes includes genitourinary TB, calculus. Flank pain 10 (57.7%) was most common symptomatic presentation followed by UTI and non specific symptoms. 15 are upper ureter strictures and 11 are lower ureter strictures. Upper ureter strictures of <2 cm is more common 7 (26.9%) followed by 5–10 cm lower ureter strictures 6 (23%). Altogether 5–10 cm strictures are most common in study 9 (34.6%). Most of patients had Uretero ureterostomy as upper and mid ureteric strictures. Surgery failed in 2 cases, among which one required nephrectomy, and another required redo surgery. Success rate is 92.3% after surgery. Conclusion: Significant advances in technique and technology have led to an improved ability to treat ureteral strictures without the need for open surgery in many patients.

Keywords: Of ureteric strictures; Iatrogenic; Uretero ureterostomy.

Aims: To study the patients with ileal and colon conduits after radical cystectomy in bladder carcinoma. Assess the postoperative complications and quality of life during follow up period. Materials and methods: It is prospective Hospital-based clinical study (oncological and functional data) in 20 patients. All patients with bladder carcinoma that underwent radical cystectomy, both genders, for urothelial and non-urothelial tumour at any age. In this study 20 patients were included; 14 patients with ileal conduit (Group-IC) and 6 patients with transverse colon conduit (Group-TVCC). The age of the patients included in this study ranged from 19 to 81 years. The average follows up of the patients included in our study was 2 years with the range of the follow up period 1–12 months. Results: 8 females (40%) and 12 male (60%) are present in study with male prepondrence and ratio of females: Males is 2:3. In Ileal conduit approach after radical cystectomy average operative time was 4.0 hours the average blood loss was 400 ml and no intraoperative complications were observed. The average postoperative hospital stay was 16 days for patients with colon conduit and 14 days in cases with ileal conduit one (16.6%) patient who underwentcolon conduit had hydronephrosis managed by nephrostomy tube insertion, no postoperative complications observed in ileal conduit. In over all cases Ileal conduit (20%) has less complication in comparison with colon conduit (33%). Ileal conduit has better scoring of satisfaction than in comparison with colon conduit. Conclusion: Ileal Conduit can be considered an appropriate surgical solution after RC in most patients because of the relative simplicity of the surgical technique, the acceptable complication rate, and the satisfactory postoperative QoL.

Keywords: Radical Cystectomy; Bladder carcinoma; Ileal conduit.