Aim:The aim of the study was to compare the efficacy and postoperative complications of stented and nonstented open pediatric dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction.Settings and Design:A balanced, parallel group, prospective randomized controlled trial comparing stented and nonstented Anderson-Hynes Dismembered Pyeloplasty.Subjects and Methods:It included 42 children who required Anderson-Hynes dismembered pyeloplasty for UPJ obstruction (UPJO). Patients were randomized into stented (double “J” [DJ] stent) and nonstented pyeloplasty groups. The intraoperative and postoperative course was compared. Both groups were analyzed for problems such as dysuria, frequency, pain, hematuria and urinary tract infection, and postoperative renal status.Statistical Analysis:Mann–Whitney U-test, Fisher's exact test, Student's t-tests, and Chi-squared test were used.Results:Surgical duration was significantly shorter for the nonstented group as compared to the stented group (60.4 ± 6.49 min vs. 78.9 ± 8.17 min). The intraoperative negotiation of DJ stent was troublesome in 21.7% patients belonging to the stented group. The hospital stay was comparable in both groups (4.67 ± 1.9 vs. 4.28 ± 0.67 days). Patients in stented group had experienced dysuria, loin pain, lower abdominal spasmodic pain, and frequency significantly higher than nonstented group. However, the other problems such as fever, hematuria, and urinary tract infections were more common in stented group, but the difference was not statistically significant. There was no difference in resolution of hydronephrosis in both groups.Conclusions:There is no statistically significant difference in resolution of hydronephrosis following nonstented or stented dismembered pyeloplasty in children with UPJO. However, the patient is more symptomatic due to stent in the postoperative period.
Introduction: Prostate cancer is second most common cancer in Indian men1. Early detection may be the cause of this increasing trend in urban areas. In our study, we have tried to study correlation between preoperative serum PSA, Gleason score and staging using MRI with postoperative histopathological outcome following robot assisted radical prostatectomy (RARP). Objectives of the study: To correlate between preoperative PSA, Gleason score, and staging with MP-MRI with pathological outcome following RARP in men with clinically localized cancer prostate and assess accuracy of preoperative Gleason score and staging with MRI with post operative histopathology. Materials and Methods:Asingle center, hospital based prospective observational study of 87 patients with age > 50 years with localized prostate cancer was conducted in department of urology at tertiary care center for study period between November 2019 to November 2021. Data collected from these patients' included demographic, clinical history, physical ndings, detailed investigations, operative details, postoperative ndings and results were analyzed. Results:Atotal of 87 localized carcinoma prostate patients were enrolled into the study. It was found that in nal histopathology report post RARP, organ conned disease was seen in 52 (59.77%) patients, capsular involvement in 35(40.22%), seminal vesicle invasion seen in 14(16%) and 2 (0.25%) had positive lymph node involvement. On correlating serum PSA, biopsy Gleason score and staging with MRI with postoperative pathology, it was found that in localized carcinoma prostate on MRI with higher serum PSA, raised Gleason score and higher stage, organ conned disease decreases linearly with signicant P value of (0.005), (0.005), (0.007). Conclusion: Based on data of our study we conclude that patients with localized prostate cancer on MRI, if they have higher preoperative serum PSA, higher Gleason score, and higher stage, then they have more chances of locally advanced disease on postoperative histopathology
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