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ABSTRACTS
Year : 2020  |  Volume : 12  |  Issue : 5  |  Page : 35-36  

Abstract - SUA202 (Endourology)


Date of Web Publication9-Jun-2020

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DOI: 10.4103/0974-7796.286038

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How to cite this article:
. Abstract - SUA202 (Endourology). Urol Ann 2020;12, Suppl S1:35-6

How to cite this URL:
. Abstract - SUA202 (Endourology). Urol Ann [serial online] 2020 [cited 2021 Sep 21];12, Suppl S1:35-6. Available from: https://www.urologyannals.com/text.asp?2020/12/5/35/286038


   The role of imaging after ureteroscopy and the rate of hydronephrosis Top


Hamad Alakrash, Mohand Alzughaibi1, Ali AlGonaim, Alhareth Baarimah2, Abdulaziz Alenazi3, Tarek Alzahrani, Hossam S. El-Tholoth, Ahmad Alzahrani

Urology Department, Prince Sultan Military Medical City,1Urology Department, National Guard Hospital,3Urology Department, Security Forces Hospital, Riyadh,2Urology Department, International Medical Center, Jeddah, Saudi Arabia

E-mail: [email protected]

Introduction: Ureteroscopy is the most common modality of management for ureteric stones. Routine ultrasound post ureteroscopy as follow up in 3 weeks period is not routinely applied by urologists. Our aim is to evaluate the incidence of hydronephrosis after ureteroscopy and possible etiologies.

Methods: Retrospectively, this study reviewed all ureteroscopies done for ureteric stone during the period between March 2011 and March 2018. We reviewed the post-operative ultrasound results for the presence of hydronephrosis.

Results: We were able to identify 260 ureteroscopies done during this period. Two hundred and ten cases were done using semi rigid ureteroscope and 50 cases by flexible ureteroscope. Post-operative follow-up ultrasound was done in mean period of 4.8 months after the endoscopy. Thirty one (11.9%) cases showed residual hydronephrosis, 22(8.5%) cases showed ureteric stone, 4(1.5%) cases had ureteric ureter and 203 (78%) cases showed no hydronephrosis in the ultrasound.

Conclusion: We recommend that patients who underwent ureteroscopy undergo imaging in the short post-operative period to ensure the absence of silent hydronephrosis and prevent any complication.


   Practice patterns of flexible ureteroscopy for treating renal stones in Saudi Arabia Top


Mohannad Nasser, Moath Bin Hazaa1, Bader Alharbi2, Abdurahman Alruwaily1

Division of Urology, King Fahad Medical City,1Department of Surgery, Imam Mohammed bin Saud University,2Department of Surgery, Alqaseem University, Alqaseem, Riyadh, Saudi Arabia

E-mail: [email protected]

Introduction: Flexible ureteroscopy (fURS) has been more utilized in the treatment of renal stones in the Saudi Arabia. However, there is a wide variations in technique, and indications. We conducted a survey of practicing Urologists in Saudi Arabia to have information about the current usage of fURS.

Methods: Online questionnaire assessing fURS treatment of renal stones, consisting of 34 items, was sent to members of the Saudi Urological Association in December 2019. Responses were collected through the Google Forms system over a 1-month period.

Results: Questionnaires were answered by 30 surgeons from 5 areas in Saudi Arabia with a response rate 25%. Central area accounted for 43.3% of all respondents' areas. Two-third of respondents were aged from 41-50 years old. One-Third of respondents has fellowship training in Endourology. About half of responders reported doing more than 20 cases per year. Majority of respondents would prefer using fURS for lower pole stone and stones less than 2 cm. One-third of respondents preferred using fURS for stones more than 2 cm. About half of respondents would place a ureteral stent and arrange for fURS later if they could not advance beyond the ureteral orifice during the procedure. Half of respondents are using a ureteral access sheath for treating all renal stones. Only a quarter of respondents have a laser machine of 100-120 Watt. One-third of respondents considered that there is no standard setting in treating on the holmium laser for stone fragmentation. 7% of respondents use stent on string placement after fURS routinely to treat renal stones. Two-third of respondents would keep patients on antibiotics for more than 3 days after fURS. Two-third of respondents would not give Medical Expulsive Therapy before fURS. 36.7% of responders considered 3 mm as an important stone size criteria to determine the patent is stone free.

Conclusion: Majority of Urologists practicing in Saudi Arabia using fURS as a first line treatment of renal stones less than 2 cm, however There is a wide variation of fragmentation technique, different-power holmium laser, and pre and post-operative management.


   Laparoscopic lower pole hemi-nephrectomy for duplex kidney in children: A propos of two cases Top


Abdulrahman Ba Wazeer, Ahmad Al-Shamari, Osama Sarhan, Fouad Al Kawai

Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

E-mail: [email protected]

Introduction and Objective: The laparoscopic technique in pediatric urology has become very popular in recent years. Hemi-nephrectomy in a duplex kidney is a technically demanding procedure used for the complicated clinical course and requires a learning curve. We present two cases of laparoscopic transperitoneal hemi-nephrectomy in children with a duplex kidney and a poorly functioning lower moiety.

Methods: Two boys 8 and 10 years of age underwent transperitoneal laparoscopic lower pole hemi-nephrectomy. Indication of surgical intervention was refluxing lower pole ureter with recurrent febrile urinary tract infections. A significant decrease of lower pole function (< 10%) in the DMSA scan was observed in both cases with a significantly dilated ureter in case 2.

Results: The two cases were successfully done without the need for conversion or injury of the upper moiety in any. Operative time was 3.5 and 3 hours for case 1 and case 2, respectively. The two patients had a smooth postoperative course and they were discharged home on the 4th postoperative day. Postoperative Renal US and Doppler showed intact vascularity of the upper moiety with no evidence of urinoma.

Conclusions: Although laproscopic transperitoneal lower pole hemi-nephrectomy is a challenging procedure, it can be done safely with an accepted outcome.

Keywords: Children, duplex kidney, heminephrectomy, laparoscopy, partial nephrectomy


   Surgical correction of gliding testes, which approach should we use? Top


M. Aljaafar, A. Alsuwaiegh1, A. El Helaly2, A. Al Otay2, M. Al Ghanbar2, Z. Nakshabandi2, O. Sarhan1

Department of Urology, King Abdulaziz Hospital, Al Ahsa,2Department of Urology, Prince Sultan Military Medical City, Riyadh,1Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

E-mail: [email protected]

Introduction and Objectives: Gliding testis is the a form of cryptorchidism where the testis could be manipulated to the scrotum and irreversible damage is to be expected if not treated. We aimed to evaluate different surgical approaches to that category of undescended testicles together with its clinical outcomes.

Materials and Methods: 350 patients with UDT in the period between, (2010-2016), were retrospectively evaluated. The medical records were reviewed. Categorization of cases depend on the examination under anesthesia. Non palpable, palpable non gliding testes, redo cases, those with incomplete records or missed follow up were excluded. Included patients are those who have gliding testes. All underwent either prescrotal (group A) or inguinal (Group B) approach, with sub-dartos pouch fixation. We evaluated operative time, postoperative pain, early postoperative, surgery related, emergency department (ED) visits and family satisfaction in both groups.

Results: After a mean follow up period of 5 years, range (3-9 years), we included 197 patients with gliding testes, ( group A) 118 patients (of them 32 bilateral) and (group B) 79 patients, (of them 21 bilateral). Mean age at surgery was ( 5.6 vs 3.9 years), range ( 9 months to 13 years VS 1 to 12 years), in group A and group B respectively. Mean operative time was ( 24 vs 43.6 minutes), range ( 12-46 vs 27-70 minutes, p-value is < .0001). Postoperative period ED visits were (2 vs 9 patients, p-value is .0036), related to pain or swelling in the operation site. Testicular atrophy or hypotrophy was encountered in ( 4 vs 6 patients, p-value is 0.18). patients needed redo surgery are (6 vs 5, p-value is 0.99). Family anxiety related to surgical scars was more in group B than in group A.

Conclusions: Prescrotal approach could be considered the standard approach for gliding testes. Shorter operative time, easier surgery, less post-operative pain, higher family satisfaction, excellent cosmoses with single wound and less postoperative complications.




 

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