The traditional choice of procedure for treatment of ureteral stricture is open surgical repair. Advances in endourology have provided the urological surgeon with an alternative to open surgery for ...the treatment of benign ureteral stricture.
Twenty-seven benign ureteral strictures in 24 patients were treated by the endourological method. Twelve endoureterotomies were performed using a cold knife via a 9.5Fr Storz ureteroscope and 15 high pressure balloon dilations were performed. The ureters were stented with 7 Fr double-J stents for 6 weeks.
The success rate was 9/12 (75%) in the endoureterotomy group and 9/15 (60%) in the balloon dilation group after follow-up for more than 6 months.
Endoscopic treatment of ureteral strictures appeared to be a safe and reasonably effective modality for the treatment of ureteral strictures, especially for the short type that are nonischaemic in origin and not associated with radiation therapy. Endourological treatment of ureteral strictures is the procedure of choice for initial management of benign ureteral strictures and has high success rates and fewer complications. (
Asian J Surg 2002;25(2):130-3)
To evaluate the efficacy and the safety of WF10 as adjunct to standard treatment in the management of late hemorrhagic radiation cystitis compared to standard treatment alone.
Cervical cancer ...patients with Grade 2 or 3 late hemorrhagic radiation cystitis, were randomized and treated with WF10 0.5ml/kg body weight, diluted in physiological saline or 5% dextrose water 250ml, intravenous infusions over 2h on 5 consecutive days, every 3 weeks for 2 cycles plus standard treatment (WF10 group) or standard treatment alone (control group). Fifty patients in each group were evaluated by questioning; urinalysis and cystoscopy during a 1 year follow up.
At week 7, 37 patients (74%) in the WF10 group and 32 patients (64%) in the control group showed complete resolution in objective hematuria (P=0.28). Significantly lower use of antibiotics (P=0.002) and antispasmodics (P<0.001) was found in the WF10 group. Among the responders, 24 patients (77%) in the control group experienced recurrent objective hematuria, whereas in the WF10 group only 17 patients (47%) experienced a recurrence (P=0.01). Recurrence of objective hematuria occurred significantly faster in the control group as evidenced by Kaplan-Meier and log-rank statistics (P=0.004), suggesting a long-term effect of WF10. Cystoscopy, at the end of the treatment period and after the one year follow up showed overall improvement without significant difference between two groups. No severe toxicity was monitored.
WF10 therapy is a safe, non-invasive and convenient method in the management of late hemorrhagic radiation cystitis. WF10 therapy, as adjunct to standard treatment, has significantly reduced recurrence of objective hematuria, compared to standard treatment alone, during a one year follow up.
The purpose of laparoscopy in the management of the nonpalpable testis is to provide information regarding testicular presence and location to facilitate overall surgical management. Laparoscopy was ...performed at operation in 20 patients between 14 months to 21 years old (average 63 months), who had 22 nonpalpable testes. Of the testes 13 (59 per cent) were in the inguinal region or just proximal to the inguinal ring, 8 (36 per cent) were in a high intra-abdominal position and 1 (5 per cent) were absent. Anatomical localization of nonpalpable testes facilitated accurate planning of operative repair and the laparoscopy rendered exploration unnecessary in patients with intraabdominal vanishing testes syndrome, and laparoscopic orchiectomy is the treatment for the unilateral intraabdominal testes in patients more than 10 years old.
Acute renal colic from retained missiles is an unusual and interesting delayed complication of missile injuries to the abdomen. It must be considered in patients who present with symptoms of renal ...colic following gunshot and shotgun wounds with retained missiles. We report a case of acute ureteral obstruction secondary to a migrating intraluminal projectile 3 days after a shotgun wound to the back.
Extracorporeal Shock Wave Lithotripsy (ESWL) represents the first choice therapy for renoureteral stone disease. Clinical controversy exists concerning the efficacy of ESWL for lower pole kidney ...stones. Nowadays, the factors that hinder the spontaneous passage of stone debris that results from ESWL of lower caliceal stone are the gravity-dependent position of the lower pole calices and particular features of the inferior-pole collecting system anatomy. We studied the influence of the lower infundibulo-pelvic in the success of ESWL of lower caliceal stones 10-20 millimeters in size in 50 patients with STORZ MODULITH SL-20 machine. At the mean follow-up of 6 months, only 44 per cent of the patients presenting with an infundibulo-pelvic angle of les than 90 degrees became stone free. On the other hand, 86 per cent of the patients presenting with an infundibulo-pelvic angle of greater than 90 degrees became stone free. Our data suggest that acute infundibulo-pelvic angle of the lower pole hinders the spontaneous passage of fragments after ESWL.
SUMMARY
We report a case of bilateral tuberculous epididymo‐orchitis following intravesical Bacillus Calmette–Guerin (BCG) therapy for superficial bladder carcinoma in which the diagnosis was made by ...ultrasonography prior to surgery. The US findings include heterogeneous enlargement of the epididymis and testis, associated with scrotal‐skin thickening and scrotal sinus track. Patients with bladder carcinoma treated with intravesical BCG therapy, the presence of scrotal swelling with scrotal‐skin thickening and epididymal involvement suggests tuberculous epididymo‐orchitis rather than testicular tumour. It is important to be aware of this rare complication and to be familiar with the ultrasonographic features so that appropriate treatment can be given.
PDF
