ObjectiveAlthough medical expulsive therapy (MET) is shown to be effective for ureteric calculi, the optimum duration and the stone size suitable for MET are not well established yet. The objectives of the study were to determine the optimum duration and maximum stone size suitable for MET.ResultsAll patients with radiologically confirmed uncomplicated ureteric calculi treated with MET using tamsulosin over a period of 6 months in the outpatient setting were followed up. There were 213 patients. 165 were men. Mean age was 42 years. At presentation 42 stones were in upper ureter (19.7%), 51 in mid ureter (23.9%), 120 in lower ureter (56.3%). The majority (82.7%) of stones were less than 10 mm. Seven stones (3.3%) were over 15 mm. Ninety-two (43.2%) patients had spontaneous passage of stones within 6-weeks of MET. Another 38.9% passed the stone within the next 6-weeks. Thirty-eight patients (17.8%) required surgery. Uncomplicated ureteric stones up to 10 mm can be given a trial of MET using tamsulosin which can be extended up to 12-weeks with a success rate over 92%. This may have substantial clinical and fiscal benefits by reducing the number of interventional procedures especially in resource-poor settings.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2974-1) contains supplementary material, which is available to authorized users.
Introduction: A retrospective study was done to assess the efficacy of saline reduction without radiological guidance for uncomplicated intussusceptions at a tertiary care children's hospital from April 2014 to May 2015. Methods: Clinical records of consecutively admitted 103 children were analysed. Results: 85 children were successfully treated with a single attempt of saline reduction while another 11 patients were successfully managed with second or third attempt of saline reduction. Only seven children needed laparoto my. Overall success rate of the procedure in this sample was 93.2%. Conclusions: Hydrostatic reduction can be used effectively and safely in the absence of ultrasound facilities to manage uncomplicated intussusceptions.
A 58-year-old gentleman presented with right side ureteric colic for six months duration. He had undergone an extended pyelolithotomy for a pelviureteric junction calculus 10 years back and he had defaulted follow up. His X-ray KUB revealed a large renal calculus with a calcified feeding tube, along with a large bladder calculus with encrustation of the tube in the bladder. Cystolitholapaxy was performed for the bladder calculus, and percutaneous nephrolithotomy was performed and the renal calculus along with the calcified feeding tube was removed. At the end of the procedure, the patient was left with only a single incision of 2cm length.
Renal cell cancer (RCC) represents 2-3% of all cancers with male predominance affecting old age. Risk factors include smoking, obesity, hypertension and genetic factors. Presentation can vary from non-visible hematuria to symptoms from metastatic disease to bones, lung, brain and lymph nodes. Only 6-10% presents with classical presentation of loin pain, loin mass and hematuria (3). We presents a case of a patient who had non-visible hematuria later progressing to metastatic renal cell carcinoma.
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