Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.
Background: The objective of the study was to study clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital.Methods: This was a retrospective study conducted between January 2018 to June 2019. Six patients underwent treatment for urinary bladder foreign body at Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India. Medical records were analyzed retrospectively with regard to nature of foreign body, each patient’s clinical presentation, the mode of insertion and how the foreign was managed.Results: A total of six foreign bodies were retrieved from patients’ urinary bladders. The patients range in age from 28 to 65 years (mean age was 45 years). The Clinical presentation includes Lower urinary tract symptoms. Four patients were male and two were female. Circumstance of insertion was iatrogenic in 5 patients and self-insertion in 1 patient. Five patients were treated endoscopically (cystoscopy retrieval with or without cystolithotrity) and one patient with supra pubic cystostomy. Post-operative hospital stay was of 1 to 2 days. Mean follow up period was 3 months. Psychiatric referral and counseling were done in patients with history of self-insertion of foreign body in urinary bladder.Conclusions: Foreign body in the urinary bladder remain a challenge to the urologist. Removal of the foreign body without injury to the urinary bladder or the urethra gives good outcome.
INTRODUCTIONColorectal cancer (CRC) is the second leading cause of death from cancer in western countries.1 Forty to fifty percent of patients who undergo potentially curative surgery alone ultimately relapse and die of metastatic disease.2 The most important prognostic indicator of survival in early colon cancer is the stage of the tumor, determined by the depth of penetration through the bowel wall and the number of involved lymph nodes.3 Currently 60% of malignant diseases occur in persons over 65 years of age. More than half of them are over 70 years age and one fourth of them are over 80 years old. 4 Although on a smaller scale than in the west, CRC is on important health problem in India, particularly so because of the misconceptions and ignorance those exist among the people about bowel habits and changes in them. 5,6 The five year survival rate for CRC has improved slightly over the past 20 to 30 years. 7 Although results are improved overall prognosis for patients of CRC is still same. There is greater need for early diagnosis and further identification of prognostic factors which may decide final outcome in individual case. ABSTRACTBackground: Colorectal carcinoma is the most common of the gastrointestinal tract malignancy. Aim of our study is to look for the clinical profile and factors affecting the surgical outcome of colorectal malignancy in rural India. Methods: In this study, 60 patients, whose surgery and follow up was performed by same correspondent Surgeons between years Nov 2011 to Oct 2013, were prospectively analyzed. Results: Of the 60 cases analyzed, we encountered the highest number of cases in the sixth and seventh decade in both sexes with male to female ratio 1:1. Alternating bowel habits, bleeding per rectum, giddiness and anorexia, weight loss, pain in abdomen were the most common presenting complaints with mean duration of symptoms was 6 months before diagnosis. Rectum and recto-sigmoid was the commonest site for occurrence of large bowel cancer (56.66%). Duke's system of staging with Turnbull et al modification shows majority of cases (50.00%) in category C. Well differentiated adenocarcinoma is the commonest histological pattern noted in more than half of cases. Postoperative recurrence was detected in 16.67% of cases with 33.33% of cases have not had a detectable recurrence to date. Conclusions: Rectum being the commonest site for occurrence of colorectal malignancy, diet and other predisposing factors could not be implicated in the occurrence. Age, weight loss, emergency admission, operation type, advanced stage of disease at presentation, loss of regular follow-up and lower socio-economic status of patients of rural India significantly affect the outcome of surgery.
Background: aim of the study was to present the experience in managing forgotten/encrusted Double J (DJ) ureteral stents and to review the literature on the subject.Methods: Author retrospectively studied patients presenting to the Outpatient Department from January 2016 to January 2019 with forgotten DJ stent(s) (six or more than six months after the insertion). Data was collected for age, gender, indication for DJ stenting, clinical features at presentation, radiological imaging and surgical procedure performed to extract the DJ stents. The post-operative stay, complications of the procedures and morbidity was also studied.Results: During the study period, a total 32 patients reported to the department with history of forgotten DJ stents. Most common age group involved was 41-60 years. Most common presenting symptoms were lower urinary tract symptoms (LUTS) or dysuria. Duration of stent in-situ ranged from 6 month to 15 years. Most common sites of encrustations along the forgotten DJ stent were ureter and kidney followed by urinary blabber. Fluoroscopic guided DJ stent removal was done in 8 patients. A combination of Cystolithotripsy, URSL and PCNL was needed to clear the stone and extract the DJ stent in remaining patients.Conclusions: Forgotten/encrusted DJ stent may lead to complications ranging from urinary tract infections to loss of renal function. They can be safely and successfully removed, and the renal function can be preserved. Endo-urological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.
Introduction: Transurethral resection instruments are designed as per western standards and are often found to be larger for Indian patients, leading to urethral trauma during instrumentation or higher incidence of urethral strictures postoperatively. Aim: To assess and record the calibre of the External Urethral Meatus (EUM) among Indian male and female population. Materials and Methods: This cross-sectional study was done at a tertiary health care centre over a period of one and half years from July 2016 to December 2017. All male and female patients above the age of 12 years undergoing lower urinary tract instrumentation at the institute underwent assessment for EUM calibre. A total of 1,127 males and 182 females were enrolled in the study. Descriptive statistics (mean, Standard Deviation, and range) were performed for age, height and the EUM in males and females. Linear regression analysis was used to analyse the correlation between EUM calibre and age; and EUM calibre and body height. The correlation was considered statistically significant when p<0.05. Results: The mean EUM calibre of the male population was observed to be 23.23±1.60 Fr and that of the female population was 23.58±2.00 Fr. On linear regression analysis, a significant but weak correlation was found between EUM calibre and body height in male (R2 value: 0.024, p-value<0.0001). On the other hand, no correlation was observed between EUM calibre and body height in females (R2 value: 0.009, p-value= 0.196). Conclusion: The average calibre of the EUM in Indian males was 23.23 Fr which is about 3 Fr smaller than the standard transurethral resectoscope sheath. Thus, use of larger sized sheaths may result in urethral stricture in narrow calibre urethra.
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