Purpose: The study aimed to assess the outcome and safety of PCCL in the pediatric population coming with bladder stones in developing countries.
Methodology: Patients of pediatric age with vesical calculus were evaluated for PCCL. Department of Peads Urology Institute of Kidney Diseases Thirty participants were included in the single center study, with enrollment beginning in January 2000 and ending in August 2021. General anesthesia was used for the operation. Following a cystoscopy examination, a suprapubic puncture was performed, and the urethral tract was dilated to a maximum of 26 Fr. Pneumatic lithotripsy was used to break up the stone. A nephroscope was used to see where it was lodged so it could be removed. A percutaneous urethral catheter was inserted was taken out after 48 postoperative hours.
Findings: The patients' median age was 4.1 (1-10). Patients tended to be men. The typical size of a gem was 10.1 millimeters. The average operational time to successfully remove the stones was just 30 minutes. Hematuria, infection, and mild mucosal damage were the only serious complications seen during or after surgery, and all were treated conservatively. Ammonium acid urate comprised the bulk of the stones and the nucleus in 26 cases (86%). Percutaneous suprapubic lithotripsy is a tested and reliable method with a high success rate for treating bladder stones in children. The procedure is short and has few adverse effects.
To compare the successful outcome of flap versus no-flap in O'Conor & Sokol technique for simple vesicovaginal fistula (VVF) repair. Methods: This quasi-experimental study was conducted in department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex Peshawar, Pakistan from March 2015 to December 2019. During this study period, 64 eligible patients, selected through non-probability convenient sampling technique were assigned to two Groups. Group A included 34 patients who underwent VVF repair through O'Conor & Sokol technique without interposition flap while Group B comprised 30 patients with VVF repair with interposition flap. Patient getting completely dry with no urinary incontinence at primary endpoint of 6 months was labelled as successful outcome. All the pre-operative, per-operative and postoperative data was collected on structured proforma and analyzed on SPSS version-21. Results: The mean age of the patient was 33.8±7.8 years in group A and 35±6.3 years in group B. About 76.5% (n=26/34) patients in group A and 80% (n=24/30) patients in Group B developed VVF due to obstetrical trauma. Overall, O'Conor and Sokol technique of VVF repair was successful by curing urinary incontinence in 95.3% (n=61/64) patients. Successful outcome for O'Conor & Sokol technique was achieved in 94.1% (n=32/94) patients in Group A and 96% (n=29/30) patients in Group B, at 6 months of follow-up (p>0.05). Conclusion: There is no significant difference between interposition flap and noflap in outcome of simple VVF repair through O'Conor & Sokol technique. The decision of interposition can be individualized depending upon preference of surgeon.
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