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   2009| July-December  | Volume 1 | Issue 2  
    Online since September 26, 2009

 
 
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CASE REPORTS
Prolonged priapism following single dose administration of sildenafil: A rare case report
Sachit Sharma, Sabyasachi Panda, Shilpa Sharma, Santosh K Singh, Amlesh Seth, Narmada Gupta
July-December 2009, 1(2):67-68
DOI:10.4103/0974-7796.56041  
A case of priapism following the consumption of a single dose of sildenafil is reported. A 25-year-old unmarried healthy man consumed non-prescribed 50 mg sildenafil purchased over the counter. He developed painful priapism 30 min after the drug intake that had lasted for 4 days (96 h) when he sought medical advice as an emergency. The corpus spongiosum and glans was soft and the corpus cavernosa was rigid. Winter's shunt was done. Fifteen milliliters of dark blood was aspirated with 16 G needle. Detumescence was achieved within 30 min. He was discharged after 12 h. On one month follow-up, he had normal morning erections. A genetic basis with cross-reactivity of PDE-3 in addition to PDE-5 resulting in a cumulative erection effect may be possible elucidation for this unwanted side effect in rare cases. However, the number of cases reported with this side effect is still too less to draw further conclusions.
  16,366 792 -
ORIGINAL ARTICLES
Transobturator tape for female stress incontinence: A day surgery case
Waleed Al Taweel
July-December 2009, 1(2):44-46
DOI:10.4103/0974-7796.56042  
Aim: To evaluate the effectiveness of transobturator vaginal tape (TOT) in the treatment of female stress urinary incontinence (SUI) and to analyze functional results and quality of life after12 months follow up. Materials and Methods : All women with SUI who underwent TOT procedure from outside to inside under general or regional anesthesia from December 2004 to January 2007 were included in the study. All must have had a minimal follow up of one year. The patients were prospectively evaluated with history including pads use/day, physical examination - pelvic examination, urinalysis, urogenital distress inventory (UDI-6), and analog global satisfaction scale - and urodynamic studies - filling cystometry, pressure-flow studies, and Valsalva leak point pressure. Results: Sixty two consecutive patients who fulfilled the inclusion criteria underwent TOT procedure by one surgeon. The mean age was 52 ± 9 years (range, 34-70 years) and minimal follow up was one year (12-24 months). The mean operative time was 17 ± 4 minutes (15-31) with average amount of bleeding 62 ± 22 cc. We found objectively 89% cure or improvement rate after one year. Conclusion: The out-in transobturator approach is a very effective treatment of SUI with low morbidity and high success rate. However, longer follow up in larger populations should assess the long-term reliability of this attractive procedure.
  9,728 1,314 -
Minimally-invasive management of prostatic abscess: The role of transrectal ultrasound
Punit Bansal, Aman Gupta, Ritesh Mongha, Maloy Bera, K Ranjit, Anup K Kundu
July-December 2009, 1(2):56-60
DOI:10.4103/0974-7796.56047  
Context and Aim: Prostatic abscess is an unusual condition. The prevalence of prostatic abscess is about 0.5% of all prostatic diseases. The purpose of the study is to present and discuss the role of transrectal ultrasound (TRUS) in the management of prostatic abscess. Settings and Design: Retrospective study. Materials and Methods: We retrospectively reviewed the medical records of all eight patients diagnosed and treated for prostatic abscess in the last threeyears. TRUS was used for diagnosis in all cases. Four patients had TRUS guided aspiration for management of prostatic abscess. Data collected regarding etiology, clinical features, investigations and treatment was compared with the available literature. Results: The age of patients ranged from 18-65 yrs (mean 47.12 yrs). Out of the eight patients, six were diabetics. TRUS revealed one or more hypoechoic areas within the prostate in all the patients. Successful treatment of prostatic abscess with TRUS guided needle aspiration was done in all fourpatients in whom it was used. Mean hospitalization time was 9.4 days, and most frequent bacterial agent was S. aureus. Conclusions: TRUS is useful in diagnosis as well as in guidance for aspiration of such abscesses. TRUS guided needle aspiration is an effective method for treating prostatic abscess. Most of the patients are diabetics and usually grow Staphaureus. So an antibiotic with staphylococcal coverage should be used empirically.
  9,088 857 -
Laparoscopic ureteroneocystostomy for management of lower ureteric strictures
Aman Gupta, Punit Bansal, MK Bera, Anup Kumar Kundu, Aradhana Kalra, Mukesh Kumar Vijay, Arindham Dutta, Suresh Singla, Punit Tiwari
July-December 2009, 1(2):47-51
DOI:10.4103/0974-7796.56044  
Aim: We assessed the results of laparoscopic transperitoneal ureteroneocystostomy with or without a psoas hitch for management of lower ureteral strictures. Materials and Methods: Between October 2005 and August 2008, 16 patients with lower ureteric strictures underwent laparoscopic ureteroneocystostomy with or without a psoas hitch. Etiology of strictures was gynecological surgery in 11, surgery for stone disease in 3, ureterovaginal fistula in 1 and primary obstructive megaureter in 1. Transperitoneal 3- or 4-port laparoscopic ureteroneocystostomy was performed with or without psoas hitch. Results: All operations were successfully completed without any need for conversion to open. Mean operative time was 171.56 min (range 130 to 260 min), mean blood loss was 93.44 cc (range 30 to 200 cc) and total hospital stay was 3.73 days (range 3 to 6 days). Mean time to resume oral intake was 12.5 h (range 8 to 22 h). Mean follow-up period was 21.83 months (range 6-39 months). Postoperative follow-up investigations revealed successful outcome in all 16 patients, success being defined as relief of symptoms and radiological improvement, irrespective of the refluxing status. Non-refluxing status was achieved in 15 out of 16 patients as determined by micturition cystography. Conclusions: Laparoscopic ureteroneocystostomy is a safe and effective procedure, with inherent advantages of laparoscopic surgery.
  7,258 758 -
CASE REPORTS
Dermoid cyst of testis in a 72-year-old man: A rare entity
Vijay Sreedhar Babu Kinnera, Kumaraswamy Reddy Mandyam, Mutheeswaraiah Yootla, Venkatarami Reddy Vutukuru
July-December 2009, 1(2):61-63
DOI:10.4103/0974-7796.56045  
Dermoid cyst is a mature-type teratoma containing sebaceous material and predominantly tufts of hair or teeth along with skin appendages. It is most commonly observed in the ovary but is rare in the testis, and only a few cases have been reported so far. In most of the reports, the cyst tended to be diagnosed in a younger age group. Here, we report a dermoid cyst of the testis in a 72-year-old man.
  4,625 552 -
LETTER TO EDITOR
Resorption of distal appendix: A rare complication after Mitrofanoff's appendicovesicostomy
Dinesh Sarda, Gursev Sandlas, Parag Karkera, Paras Kothari
July-December 2009, 1(2):69-69
DOI:10.4103/0974-7796.56039  
  3,785 493 -
CASE REPORTS
Ureteral stump transitional cell carcinoma after radical nephrectomy: A case report with review of literature
B Satheesan, Sunil B Jayanand, N Kathiresan
July-December 2009, 1(2):64-66
DOI:10.4103/0974-7796.56043  
Primary transitional cell carcinoma (TCC) of the ureter accounts for less than 1% of all malignancies of upper genitourinary tract .Ureteral stump after radical nephrectomy may develop malignancy very rarely, TCC being the commonest. Definite risk exists if the urinary bladder harbored TCC. Presence of TCC of the urinary bladder and persistent urinary tract infections in a nephrectomized patient may indicate closer evaluation.
  3,538 515 1
ORIGINAL ARTICLES
Hypercalciuria, a promoting factor to urinary tract infection in children
Alaleh Gheissari, TajSaadat Adjoodani, Peyman Eshraghi
July-December 2009, 1(2):52-55
DOI:10.4103/0974-7796.56046  
Aim: Urinary tract infection (UTI) is one of the most common diseases of urogenital tract in children. Detecting predisposing factors for UTI takes an important place in managing patients with UTI. Recently, a few studies emphasized on idiopathic hypercalciuria (IH) as a predisposing factor for UTI and dysfunctional voiding. Therefore, we carried out a survey to find out whether non-calculus IH is a contributing factor in children with the first attack of pyelonephritis. Materials and Methods: This is a case-control study carried out on 60 children aged 2-11 years admitted at St Al-Zahra hospital, Isfahan, Iran, with the first episode of upper UTI and 200 age- and gender-matched normal healthy children between September 2003 and February 2005. We used second fasting spot urine sample to measure calcium and creatinine. Two urine samples were obtained one week apart to increase the accuracy of measurement. All samples were collected after at least 6 weeks of completing the treatment course of pyelonephritis. Ultrasound examination and VCUG were performed in all patients before entering the survey as case group to rule out obstruction and VUR. Results: Mean age of case and control group were 4.86 ± 3.08 years and 4.22 ± 2.9 years, respectively. The mean calcium to creatinine ratio (Ca/Cr) in case and control group were 0.308 ± 0.21 and 0.208 ± 0.12 mg/mg, respectively, P < 0.001. The difference between the mean values of these two groups was significant only in age group ≤6 years, P < 0.0001 and odds ratio was 2.1 (95% CI 1.03-7.8). After determining the mean values of urine Ca/Cr ration according to both age groups and gender, it was cleared that only significant difference was related to male <6 years. Conclusion: The likelihood of hypercalciuria should be assessed especially in male children with UTI and without any urinary tract obstruction.
  3,091 603 -
Pediatric urololithiasis in coastal Tunisia
Akram Alaya, Nouri Abdellatif, Mohammed Fadhel Najjar
July-December 2009, 1(2):39-43
DOI:10.4103/0974-7796.56040  
Context: We will try to show an outline of the clinical and biological characteristics of pediatric urolithiasis among Tunisian children in the coastal region. Materials and Methods: This retrospective study included 168 children below 16 years (100 boys and 68 girls) presented with urinary stones. Patients were reviewed in a multi-centric study with regard to age at diagnosis, sexual, historical, physical, laboratory, and radiologic findings. The physical and chemical analysis of stones was carried out by a stereomicroscope and infra-red spectroscopy respectively. Statistical Analysis: Statistical analysis of data was carried out using software SPSS 11.0 for Windows. Statistical significance was determined using chi-square test. Results: The sex ratio was 1.47. Clinical presentation of this pathology was dominated by abdominal pain (28%), hematuria (25.6%), dysuria (16.7%) and urinary tract infection (14.3%). Stones were located in the upper urinary tract in 75.6% of cases. Of the urine cultures, 14.3% were positive. Whewellite is found more frequently in children stones than infants (P < 0.05) and was the main component in 46.4% of stone section and 55.4 % of stone surface. Stuvite stones were more frequent among boys stones than girls' (11 Vs 2.9%) (P < 0.05). Conclusions: The male prevalence of pediatric urolithiasis is less obvious in Tunisia. Calcium oxalate is the most frequent chemical compound in Tunisian pediatric urolithiasis.
  2,953 679 -
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