Objective: To determine outcomes and complications of vesico-vaginal fistula repair via vaginal and abdominal route. Study Design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation, Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: January 2020 to December 2020. Material & Methods: Patients having vesicovaginal fistula irrespective of age and fulfilling our inclusion criteria were included in the study using non-probability consecutive sampling technique. Patients having very large fistula, fistula involving neck of urinary bladder, failure of previous operation, patients with malignancy or co-morbidities were excluded from the study. Vaginal and abdominal approaches were used for fistula repair depending upon the level of fistula. Those operated via vaginal route were kept in trans-vaginal group and those operated via abdominal route were assigned trans-abdominal group. Results: Total 35 cases were studied having age 16-45 years with mean age of 32.6 ± 4.2 years. Transvaginal fistula repair was done in 37.1% and transabdominal repair was done in 62.8% cases. Most common cause of VVF was previous gynecological surgery in 77% cases. Success rate was 100% in transvaginal fistula repair as compared to 95.4% success rate achieved in transabdominal repair of fistula. Conclusion: Trans abdominal and transvaginal route both are good approaches but Transvaginal route of fistula repair is associated with high success rate than transabdominal route with minimum complications and better outcomes but it needs expert surgeon.
Objective: To compare outcomes, safety and complications of vesical stone management among children by open vesicolithotomy versus percutaneous cystolitholapaxy. Study Design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: July 2020 to December 2020. Material & Methods: Children with vesical stone, having age 1-12 years and fulfilling inclusion criteria were selected for this study. Total 50 cases were selected using non-probability consecutive sampling technique. Patients were divided into two groups Group-A and Group-B on the basis of given treatment each group containing 25 cases. Patients in Group-A were underwent open vesicolithotomy and those in group-B were underwent percutaneous cystolitholapexy. Procedure was done under general anesthesia. Alken metallic dilators were used for the dilatation of tract. Adult nephroscope with 24Fr sheath was used. Postoperative outcomes of both methods were compared with each other. Pneumatic fragmentation was used to break stones > 1.5cm in size. Results: Total 50 cases were studied, 25 cases in each group-A and group-B. Stone size was 1-3 cm in both groups. Age range of the patients was 1-12 years with mean age of 4.25 ± 1.4 years. Mean hospital stay was 2.6 days in group-A and 1.3 days in group-B. Mean requirement of analgesia (ketorolac) was 30.2mg in group-A and 14.8mg in group-B. Most common postoperative complication was fever observed in 28% cases in group-A and hematuria observed in 24% cases in group-B. Conclusion: Percutaneous cystolitholapexy is a minimal invasive procedure suitable among children with high success rate and minimum complications like postoperative fever, hematuria, urinary leakage and pain.
Objective: To evaluate the treatment of hydrocele and compare the post-operative course and outcome of sodium tetradecyl sulfate (3 %) (STDS) as a harmless and active sclerosant followed by aspiration with conventional hydrocelectomy for the management of adult hydrocele. Study Design: Cross Sectional, Randomized study. Setting: Liaquat University of Medical and Health Sciences, Jamshoro. Period: 1st May 2019 to 31st October 2019. Material & Methods: Fifty patients with unilateral or bilateral primary vaginal hydrocele were included in this study. Subjects with secondary vaginal hydrocele (secondary to trauma, malignancy, or epididymo-orchitis), communicating hydrocele, infected hydrocele, having a positive history of previous intervention (sclerotherapy or operation) and/or uncontrolled diabetes mellitus were excluded. Data were analyzed in SPSS version 22.0. Results: All patients were equally divided into two groups A and B. Group A (n = 25) patients were submitted to Sclerotherapy and Group B (n = 25) patients were submitted to the Conventional Surgical Hydrocelectomy. Most of the patients 24(96.0%) who underwent in Group A (Sclerotherapy, n = 25), were discharged within 1-6 days i.e. less postoperative stay whereas the majority of the patients 14(56.0%) who underwent in Hydrocelectomy group were discharged between 1 to 6 days. Patients who underwent Hydrocelectomy had more postoperative stay and in 3 cases up to 18 days. Conclusion: Sclerotherapy is the treatment of choice for primary hydrocele. Complications like pain, hematoma, and infection are less than surgical procedures. Hospital stay is minimal and does not affect the day-to-day work of the patient having sclerotherapy.
Objective: To determine functional outcomes of arteriovenous fistula, its complications and patency rate for one year. Study design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: January 2020 to December 2020. Material & Methods: Patients with Chronic renal failure were selected using non-probability consecutive sampling technique. Patients candidate for CBRC arteriovenous fistula at wrist were selected and those requiring other vascular access were excluded from the study. Arteriovenous fistula were made by standard method and its function and patency rate was assessed for one year duration. Patients of both gender and any age were included. Results: Total 220 cases were enrolled into the study comprising on 57.3% male and 42.7% female cases. Mean age of patients was 59.4 ± 9.7 years. Most common arteriovenous fistula were radio cephalic in 61.8% cases. Fistula failure in first month was seen in 12.7% cases. Fistula patency rate was 79.1% after three months, 69% after six months and one year patency rate was 61.3%. Most common cause of chronic renal failure was diabetes mellitus in cases. Most common fistula related complication was infection and burst fistula in cases. Conclusion: First six months after fistula formation are critical as one third fistula fail during this period. Most common risk factor of fistula failure is diabetes mellitus. Fistula failure was more common among women than men.
Background: European association of urology (EAU) recommended α- blockers for managing distal ureteric stones in the paediatric population. This paper will help to understand the efficacy of Silodosin as a medical expulsive agent for distal ureteric stones in children, along with the required time duration of stone expulsion. Methods: Forty participants were enrolled and evaluated for complaints, pain severity, associated symptoms, and ultrasound was done to confirm the position and size of the distal stone. Follow-ups were scheduled after every 7 days (1 week) for redo ultrasound and assessment of the stone position. Data was entered and analyzed in the SPSS version 23. To evaluate the significance of data chi-square test was performed, p-value <0.005 was considered significant. Results: The minimum and maximum age limits recorded are 3 years and 18 years respectively with a mean age of 9.5±4.5 years and mean stone size was measured as 0.6±0.1 cm. Distribution of stone size indicated the minimum size of 0.4 cm and maximum of 1.0 cm stone in study subjects. Maximum stone expulsion was reported within 14 days or an initial 2 follow-up scans. Conclusion: The efficacy of Silodosin and medical expulsive therapy evaluated the effect on pain management as pain episodes declined with Silodosin treatment and spontaneous passage of stones were increased within the first 14 days of treatment. This study will be a beneficial contribution in literature especially in a developing country population where paediatric urolithiasis is on expansion and ongoing
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.