Urology, Nephrology and Andrology International

Urolithiasis is a common disease that is the problem of most of the persons. Urolithiasis is a disease that is commonly affecting males as compare to females. The proportion between males and females are approximately 2:1. Most of the young people are visiting to the OPDs for their treatment in urology and nephrology which will find the disease type. Many centuries human are having the problem of renal stones (urolithiasis). It is a metabolic syndrome. In India about 12% of population is having the problem of renal 6 stones (urolithiasis) in which 50% may cause a severe renal or kidney damage/ failure. Young population are basically very prone to this disease visited opds nephrology urology department for their treatment.

Result¹: The overall assesed patients of Urolithiasis is about 11.4% and of 45% of which family had a history of other disease. This disease is usually occuring on those people that will having the disease history of urolithiasis. It is basically occurs to the people having low immune system and having diseases.

Background: Urolithiasis is basically spreading all over the word. It is the disease that affects the renal system of the body ureters urethra are the main parts that is affected. It occurs to those who are having the history of any type of disease. It is most probably occur to men’s as compare to women. The renal kidney disease is termed as nephrolithiasis.³

Keyword: Renal system; Ureters; Urethra; Kidney; Renal calculi;Gallbladder, Urinary system.

Introduction: Bladder spasms and penile erections are common problems after urethroplasty and may affect surgical outcomes. Bladder spasms may also induce erections and manifest as intermittent abdominal cramps, perineal pain, urgency to void or may result in urinary leakage and fistula. Our study aimed to analyse the efficacy of anti-erection treatment during postoperative period after urethroplasty.

Objective: To compare the effectiveness of short term anti-erection measures using Oxybutynin, phenobarbitone and ethinyl estradiol in reducing frequent bladder spasms, erections and postoperative complications after hypospadias repair.

Study design: A retrospective study was conducted in which case records of68 patients who had undergone repair for distal and mid-penile hypospadias bythe Snodgrass technique over 2 years (2017-2019) were reviewed. Patients were divided in two groups with 34 patients in each group. Patients in GroupA received anti-erection therapy in post-operative period including Oxybutynin (0.2mg/kg/day), Phenobarbitone (3-5mg/kg/day) and Ethinyl estradiol (0.01mg/day) while Group B consisted of patients who didn’t receive antierection therapy. Anti-erection measures were given until post-operative day 10 when the urinary catheter was removed. Post-operatively, patients were followed up for complications such as urge to pass urine, preputial edema, extravasation of urine from the neomeatus, pain in the perineum/phallus, urethrocutaneous fistula and wound dehiscence.

Results: The median age was 4.1 years (Group A) and 4.4 years (Group B). Most common type of complications encountered were preputial edema (14/68 patients,20.59%) and urge to pass urine (14/68 patients, 20.59%) among all patients in both the groups. Post-operative complications viz. Urge to pass urine while catheter in situ(GrA-11.7%, GrB-29.4%),Urinary extravasation (GrA-5.8%, GrB-14.7%), pain in phallus/perineal pain(GrA-8.8%, GrB20.5%), Urethrocutaneous fistula(GrA-11.7%, GrB-17.6%), preputial edema (GrA-14.7%, GrB-26.4%)and wound dehiscence(GrA-2.9%, GrB-11.7%) were frequent among group B patients who haven’t received anti-erection therapy but correlations for urge to pass urine and pain in phallus/perineal pain found to be statistically significant (<0.05).

Discussion: The study demonstrates that anti-erection treatment reduces bladder spasm and erection, subsequently reducing post-operative complications significantly.

Conclusion: Our study demonstrates that short-term therapy with Oxybutynin, phenobarbitone and ethinyl estradiol is an effective and safe method for decreasing the frequency of bladder spasms, frequent erections and ultimately complications after urethroplasty.

Keywords: Hypospadias; Anti erection treatment; Oxybutynin; Phenobarbitone; Ethinyl estradiol.

Introduction: Urinary stones constitute the third most common disease of the urinary tract after urinary tract infections and prostate pathologies. Ureteric stones may cause many complications such as renal/ureteric colic, ureteric/ renal obstruction, hydroureteronephrosis, and infections like pyelonephritis and pyonephrosis. The treatment of ureteric stones includes ureteroscopic lithotripsy (URSL) semi-rigid or flexible, percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy, medical expulsive therapy (MET), and laparoscopic surgery. Compared to other procedures, URS has a greater stone freerate.The insertion of ureteric stents routinely, reduces the risk of ureteral obstruction, hydronephrosis, renal colic, ease the path for drainage of stone fragments from ureter to the bladder,prevent steinstrasse formation, promotes healing of any mucosal injury caused during surgeries and prevents the ureteric stricture formation. Still, the use of ureteric stents for the treatment of ureteric stones is debatable due to the stent-associated symptoms and complications.Our study aimed to evaluate the role of ureteric stents in resolution of hydronephrosis in ureteric stone patients following URSL.

Methods: This was an analytical study with prospective and retrospective approach. Our study involved 390 ureteric stone patients who underwent URSL [295 patients (75.6%) with double J stent placement and 95 patients (24.3%) without double J stent placement]. Data consisting of baseline characteristics, pre-operative status, intraoperative characteristics, and postoperative complications were collected from and presented descriptively. The patients were divided into two groups based on double J stent placement or not. Comparison of hydronephrosis resolution between the groups was analysed with Chi-square test.

Results: Impacted ureteric stones were the most common indication of ureteric stent placement following URSL (30.5%). Dysuria was the most frequent symptom that occurred in patients undergoing stent insertion with a total of 41 patients (13.8%) and 18 patients (6.1%) had the major complaint of low back pain. Among the patient in the non-stenting group increased frequency was present in 5 patients (5.2%) and low back pain and haematuria in 3 patients (3.1%) each. After stenting, 270 patients (91.5%) had their hydronephrosis resolved significantly compared with 39 (75%) patients in the non-stent placement group (p< 0.05). The analysis results showed that stent placement had a significant effect on the decrement of postoperative hydronephrosis in patients who had preoperative hydronephrosis.

Conclusion: Ureteric stenting significantly reduces/resolves pre-operative hydronephrosis after URS lithotripsy in patients with ureteric stone. Ureteral stent placement should be the preferred method for the treatment of preoperative hydronephrosis due to ureteric stones.