Background: Prolonged urinary leakage after nephrostomy tube removal leads to increased morbidity of PCNL and increased hospitalization. Objective: To evaluate factors affecting post nephrostomy removal urinary leakage after percutaneous nephrolithotomy. Patients and Methods: One hundred eight (108) patients older than 18 years who underwent PCNL were studied prospectively. The reasons that can affect urinary leakage postoperatively were divided into 4 categories according to individual factors including age, gender, and body mass index; Renal factors; including, previous operation, history of ESWL, parenchymal cortical thickness, and grades of hydronephrosis; stone factor (stone burden); and surgical factors including the number of tracts, presence of double J stent, nephrostomy tube diameter and stay duration. These data were compared for postoperative urine leak. Results: Urinary leakage was revealed in 76 of 108 patients (70.3%). There was no statistically significant relationship between individual factors and urinary leakage (P >0.05). Among renal factors, just parenchymal cortical thickness and grade of hydronephrosis were strongly related to the urinary leakage (P <0.001). The renal stone burden did not affect urinary leakage (P >0.05). Among surgical factors, placing of ureteral double-J stent highly minimized the incidence of urinary leakage (P<0.001), and the urinary leakage significantly correlated with the increased diameter of the nephrostomy tube and staying duration (P<0.05). Conclusion: After PCNL surgery, some factors show to influence post-PCNL urinary leakage. however most of the urinary leakage was treated conservatively, but it increases morbidity and hospitalization. Keywords: Percutaneous nephrolithotomy; postsurgical complications; risk-factor; leaking of urine
Background:Meatal stenosis is one of the late and potential complications of male circumcision in children who underwent circumcision in early infancy by a heat cautery.Objective: To estimate the incidence of Meatal Stenosis (MS) in children who undergone circumcision in early infancy by a heat cautery which had been done by a medical sub staff in our locality (Erbil)Patients and Methods: From September 2020 to May 2021, 113 children were examined in urology outpatient departments at Rizgary Teaching Hospital/ Erbil after a referral from primary health centers by general practitioners for evaluation of genitourinary symptoms. All children included in the study were circumcised during the early infancy period by heat cautery devices by medical sub-staffs. The examination included a focused genital system examination focusing on meatus opening and detail history has been taken from their parents. Results: Within Eight Months, we evaluate 113 children (13 children Excluded) in the urology outpatient department in Rizgary Teaching Hospital/ Erbil City, 55% having stenosis of urethral meatus after circumcision by heat cautery, and it was most common in group B (6-12 years of age) 34% and 21% in group A (3-6 years of age) and can explain this either that most of the children represented Group B or might be due to neglecting by their families. Conclusion: Circumcision in early infancy using a heat cautery device may lead to meatal stenosis in children. In our study, the incidence of meatal stenosis was surprisingly high (55%) compared to other research, and this can be explained by the fact that non-qualified personnel is engaging in this surgical procedure or medical sub staffs with inexperienced medical knowledge and no training course are indulging in this surgery to gain quick money. Keywords: Penis, Circumcision, Meatal Stenosis, Erbil
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