Background: For optimal management of obstructive uropathy the function of each renoureteral unit needs to be assessed precisely. Usage of nuclear scan for estimation of split renal function has been standard technique till now. Renal parenchymal volume percentage, which is calculated through multislice CT, used as a surrogate marker of split renal function. The aim of the study was to correlate the renal volume percentage calculated from contrast enhanced computed tomography (CECT) of kidney, ureter and bladder (KUB) with split renal function estimated by the gold standard 99mTc-DTPA (diethylene triamine pentaacetic acid) among obstructive uropathy patients.Methods: Patients who have been diagnosed as chronic unilateral renal obstruction and were requiring 99mTC-DTPA nuclear scan for functional assessment of kidneys were included as our study subjects. A total of 46 patients were taken as our study sample and for all these patients CECT KUB was done and the reports were collected and the renal volume percentage was obtained through those images. Correlation was made between the measurements made by nuclear scan and CECT images in unilateral renal obstruction patients.Results: A positive linear correlation was obtained between DTPA nuclear scan and CECT images in the detection of renal volume/renal function with r value 0.904 (p<0.05) in obstructive renal units and similarly among non-obstructive renal units the r value was 0.889 (p<0.001).Conclusions: Though 99mTc-DTPA renal scan is a safest choice by considering its less radiation exposure and no contrast requirement still cost and its universal availability make us to consider CECT as a better alternative.
Background: To evaluate the effect of silodosin, darifenacin and combination therapy of two agents in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents.Methods: A total of 150 patients underwent placement of a double-J ureteral stent after retrograde ureteroscopy for urinary stone disease. All patients received polyurethane double-J ureteral stents (4 Fr and length 26 cm), which were removed at a mean of around 14 days postoperatively. A total of 40 patients were given no medication (group 1), 39 patients were given silodosin 4 mg once daily (group 2), 40 patients were given darifenacin 7.5 mg once daily (group 3), and 31 patients were given a combination of two agents postoperatively (group 4). International prostate symptom score (IPSS) and visual analogue pain scale (VAPS) questionnaires were completed by each patient at 1st day postoperatively and on the day of stent removal.Results: In the total group of patients, the mean age was 50.24±12.90 years. There was a significant difference in the IPSS total score between group 1 and groups 3 and 4. Group 4 also differed significantly from group 1 in the irritative subscore. The obstructive subscore differed between groups 2 and 4 and group 1. There was a statistically significant difference between group 1 and group 4 in the quality of life (QoL) score.Conclusions: Combination therapy with silodosin and darifenacin improved both irritative and obstructive symptoms more than in the other groups. Combination therapy should be strongly considered for patients who complain of stent-related symptoms.
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