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A retrospective analysis of the factors associated with increased risk of readmission within 30 days after primary transurethral resection of bladder tumor

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Current urology 2023年第4期17卷 257-261页

作者： Tarun Jindal Ankush Sarwal Prateek Jain Rajan Koju Satyadip Mukherjee department of uro-oncologyy Tata Medical CentreKolkataIndia department of uro-Oncology NH Narayana Superspeciality HospitalHowrah711103India department of Head and Neck Surgery Tata Medical CentreKolkataIndia

Background:Transurethral resection of bladder tumor(TURBT)is associated with perioperative morbidity of 5%to 10%,which can lead to unplanned *** this study,we aimed to identify the factors that lead to an increased risk of unplanned readmissions within 30 days of primary *** and methods:A retrospective study was conducted to identify patients who underwent primary TURBT at our institute from 2011 to *** and demographic factors,history of smoking,antiplatelet drugs intake,comorbidities,tumor size(3 cm),multifocality,and histopathological type were *** who were readmitted were identified,and reasons for admission were ***:A total of 435 patients were *** median age of the patients was 66 *** 378 male patients(86.9%),110(25.3%)and 37(8.5%)had a history of smoking and antiplatelet agents intake,*** the cohort,166 patients(38.2%)were diabetic,239(54.9%)were hypertensive,72(16.6%)had chronic obstructive pulmonary disease,and 78(7.9%)had hypothyroidism.A total of 206 patients(47.4%)had a tumor>3 cm;multifocality was seen in 140(32.2%)patients,whereas muscle invasive tumors were present in 161 patients(37%).A total of 22 patients(5.06%)had readmissions within 30 days,with hematuria being the most common *** univariate and multivariate analyses,a history of smoking(p=0.006 and p=0.008,respectively)or antiplatelet agents intake(p<0.001 and p<0.001,respectively)was significantly associated with increased unplanned ***:Our study revealed smoking and antiplatelet agents intake as factors leading to an increased risk of unplanned readmissions.

关键词： Bladder cancer Complication Cystoscopy Readmission Urinary bladder surgery

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Concurrent laparoscopic management of giant adrenal myelolipoma and contralateral renal cell carcinoma

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Asian Journal of urology 2022年第1期9卷 97-98页

作者： Tarun Jindal Pravin Pawar Neeraj Subedi department of uro-oncology Tata Medical CentreKolkataIndia

Dear editor,Myelolipomas are uncommon,benign tumors of the adrenal gland that can occasionally attain a large *** tumors,very rarely,can occur along with renal cell carcinoma[1].We describe the first case of a giant right sided adrenal myelolipoma co-existent with a contralateral renal cell carcinoma,both of which could be operated laparoscopically in the same sitting.

关键词： adrenal renal laparoscopic

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Encrusted cystitis and ascites due to urethral calculus

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Asian Journal of urology 2022年第2期9卷 197-198页

作者： Tarun Jindal Satyadip Mukherjee department of uro-oncology Tata Medical CentreKolkataIndia

Dear editor,A 55-year-old man presented with dyspnea and involuntary dribbling of urine for 1 *** had history of straining during micturition and weak urinary stream for a *** examination,he was disoriented and had abdominal *** revealed marked ascites,pleural effusion,bilateral hydroureteronephrosis,and distended bladder with prostatic urethral calculus.A non-contrast computerized tomography scan additionally showed thickened bladder wall with florid mucosal calcification suggestive of encrusted cystitis and a 2.9 cm×2.5 cm calculus in the prostatic urethra extending to the bulbar urethra(Fig.1).His hemoglobin was 6 g/dL;urea and creatinine were elevated(114 mg/dL and 8.4 mg/dL,respectively);and the leucocyte count was 16.3×109/*** initial resuscitation,ultrasound guided supra-pubic catheterization was *** urine pH was 8.4 while the microscopy revealed numerous pus cells,bacteria,and inorganic crystals.A nephrology consultation was taken and considering the clinical picture of encrusted cystitis,he started on intravenous *** also received a session of *** patient died of cardiovascular collapse on the second post admission *** urine culture report,obtained posthumously,revealed Corynebacterium urealyticum corroborating the diagnosis of encrusted *** strain was multidrug resistant and showed only sensitivity to teicoplanin and vancomycin.

关键词： bladder urine ascites

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Assessment of the efficacy of reduced-radiation noncontrast computed tomography scan compared with the standard noncontrast computed tomography scan for detecting urolithiasis:A prospective single-center study

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Current urology 2023年第1期17卷 18-24页

作者： Gaurav Aggarwal Samiran Das Adhikary department of uro-Oncology Tata Medical CenterKolkata700156India department of urology Apollo HospitalBhubaneshwarIndia

Background:Noncontrast computed tomography(CT)scan of the kidneys,ureter and bladder is the standard investigative modality for diagnosing and following up patients with *** each scan,a patient receives radiation of 18-34 *** considerations become pertinent because of a 10%lifetime incidence rate and higher than 50%risk of recurrence,necessitating repeated imaging in the lifetime of a stone ***,this study aimed to assess the sensitivity of"reduced-radiation"CT imaging by altering scan settings to lower than the"standard"*** and methods:Altogether,222 patients(255"kidney-ureter"stone-bearing units or"renal units")with urolithiasis and patients undergoing CT for other reasons with incidental findings of renal/ureteric calculi between 2017 and 2019 were *** patients were subjected to 3 sequential scans at tube current settings of 250 mA(CT-N/Standard),100 mA(CT-100),and 50 mA(CT-50)at a constant voltage of 120 *** clinicodemographic and radiological findings were recorded and assessed for ***:Of the 255 renal units,117 were between 30 and 44 years of age,75%were *** the 255 patients,178(70.1%)reported a first stone episode and 77 had *** ureteric calculi were predominant(40.4%).All calculi were identified on CT-N;CT-100 failed to detect calculi in 1 patient,and CT-50 failed in 3 patients,where all calculi wereurolithiasis with significantly lower radiation *** study lays the foundation to accept low-dose CT in general and CT-50 in particular,as the new"standard of care,"and attempt further dose reduction without loss of diagnostic

关键词： Low-dose computed tomography scan Reduced-radiation computed tomography scan Reduced-radiation imaging Ureteric colic urolithiasis

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Nephrectomy in a Patient with Medullary Sponge Kidney Associated with Severe Nephrocalcinosis and Nephrolithiasis: A Rare Condition

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Open Journal of urology 2021年第9期11卷 332-341页

作者： Landry Oriole Mbouché Achille Aurèle Mbassi Junior Mekeme Mekeme Axel Stéphane Nwaha Makon Pierre Joseph Fouda Fru Fobuzshi Angwafo III department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaoundé Cameroon department of uro-andrology Yaoundé Central Hospital Yaoundé Cameroon department of Surgery Higher Institute of Medical Technology Yaoundé Cameroon

Background: Medullary sponge kidney (MSK) is a disturbance of renal development characterized by cystic dilation and diffuse precalyceal duct ectasia. The disease affects both genders in equal proportions and is generally diagnosed in adulthood, as a result of recurrent calcium nephrolithiasis and nephrocalcinosis. The most frequently encountered manifestations being renal colic, microscopic or macroscopic hematuria, and fever. The intravenous pyelogram is standard for diagnosis and metabolic workup is required to identify the underlying cause. The main goal of treatment is to prevent recurrence and disease progression. Though considered a benign condition, a nephrectomy may often be required in patients presenting late with irreversible complications and end-stage renal disease. Aim: To highlight and discuss the presentation and management of a rare case of nephrocalcinosis and nephrolithiasis secondary to the medullary sponge kidney. Case presentation: We report herein the case of a 56-year-old male with long-standing hematuria in whom a diagnosis of medullary sponge kidney disease was made and he underwent a left total nephrectomy. The postoperative course was uneventful. Conclusion: Nephrocalcinosis and nephrolithiasis are complications of MSK and can result in irreversible renal damage. A high index of suspicion is necessary for patients presenting with renal colic, recurrent urinary tract infections, or hematuria for prompt diagnosis and management.

关键词： Medullary Sponge Kidney Nephrolithiasis Nephrocalcinosis Nephrectomy

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Post-Obstructive Diuresis: Physiopathology, Diagnosis and Management after urological Treatment of Obstructive Renal Failure

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Open Journal of urology 2018年第9期8卷 267-274页

作者： Sumba Harrison Abdelouahed Lasri Youness Jabbour Amine Slaoui Jacquet Djamal Tariq Karmouni Kadir El Khader Abdelatif Koutani Ahmed Ibn Attiya Andaloussi department of urology “B” Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohamed V University Rabat Morocco department of uro-andrology Faculty of Health Sciences Cotonou Benin

Obstructive acute renal failure is both a medical and a surgical emergency. The first treatment modality is urological by relief of obstruction. Post-obstructive diuresis is an abnormal condition of prolonged polyuria, involving both excessive solute and water loss, after acute drainage of obstructed urinary tract system. Physiopathology mechanisms are multiples. In most patients, diuresis will resolve once the kidneys normalize the volume and solute status and homeostasis is achieved. Post-obstructive diuresis can occur in up to 50% of patients with substantial urinary tract obstruction and can be life-threatening if it becomes pathologic. It can be detected by hourly monitoring of diuresis. Medical treatment of post-obstructive diuresis consists of oral or intravenous fluids adjusted to the findings of clinical examination, diuresis (volume and electrolytes) and close monitoring of patient. Fluid compensation should be tapered off over several days. Patients at high risk of post-obstructive diuresis should be identified and appropriately monitored.

关键词： Post-Obstructive Diuresis Acute Renal Failure Water and Electrolyte Compensation

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Cystitis Glandularis: A Rare Benign Condition Presenting as Bladder Tumor

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Open Journal of urology 2018年第12期8卷 336-343页

作者： Sumba Harrison Hamza Lamchahab Jacquet Djamal Youness Jabbour Touzani Alae Tariq Karmouni Kadir El Khader Abdelatif Koutani Ahmed Ibn Attiya Andaloussi department of urology “B” Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohamed V University Rabat Morocco department of uro-andrology Faculty of Health Sciences Cotonou Benin

Cystitis glandularis or glandular metaplasia of the urinary bladder, is a benignreactive metaplasia of the urothelium, which occurs in the context of chronic irritation, in less than 2% of the general population. It is a condition in most casesasymptomatic, but also characterized by nonspecific symptoms and paraclinical findings, which is why this condition is underdiagnosed. Its evolution is mainly focused on the risk of malignant degeneration. This condition affects men much more commonly than women. Two forms of cystitis glandularis are recognized: typical and intestinal form. They differ in their histology, incidence, difficulty of diagnosis, and possible association with adenocarcinoma of the bladder. Diagnosis of certainty is histological by careful analysis of chips from bladder endoscopic resection. This rare pathology is managed by endoscopic bladder resection, with repeated cystoscopy as a monitoring tool. Extensive surgical is needed in severe or recurrent cases. We present here-in a case of a female patient having cystitis glandularis presenting with lower urinary tract symptoms. We review equally data reported in literature. To the best of our knowledge our case represents the fourth case of cystitis glandularis affecting a female patient reported in the English literature so far.

关键词： Cystitis Glandularis Cystoscopy Bladder Resection

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urologic Complications after Gynaecologic and Obstetric Surgery at the urology-andrology Teaching Clinic of Teaching Hospital of Cotonou

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Open Journal of urology 2014年第10期4卷 121-125页

作者： Hounnasso Prince Pascal Avakoudjo Josué Georges Babadi Naméoua Paré Abdoul Karim Ouattara Adama Vodounou Alexandre Agounkpé Michel Michael uro andrology Clinic Teaching Hospital Hubert Koutoucou Maga Cotonou Benin Division of urology Teaching Hospital Souro Sanou Bobo-Dioulasso Burkina Faso

Objective: To study the epidemiology and current trend in the management of urologic complications following obstetric and gynaecologic surgeries at CUUA University hospital of Cotonou. Patients and Methods: It was a retrospective study of patients referred with urologic complications following obstetric and gynaecological surgeries. The study took place at the Teaching Clinic of urology andrology at CNHU of Cotonou between April 1, 2008 and March 31, 2013. Results: Forty-one patients were studied. They represented 3.5% of people hospitalized at CUUA throughout the study period. The average age was 41 years swith range of 20 and 57 years. Twenty-one (51.2%) of them were married. Thirty patients (73.2%) were referred from a non-academichospital, while 7 patients (17.1%) were referred from academic hospital. Caesarean section was the primary gynecological surgery in 22 cases (53.7%) and hysterectomy in 19 cases (46.3%). Clinically, the pre- dominant symptoms were leakage of urine throughout the vagina and obstructive anuria with or without back pain. We found 31 cases of VVF, 5 cases of bilateral ligation of the ureters, 3 cases of unilateral ligation of the ureter, 1 ureteralinjury and 1 uretero-vaginal fistula. These complications were diagnosed postoperatively in 95.1% of cases. Surgeries done included VVF repair in 31 cases (75.6%), unilateral ureteral reimplantation in 4 cases (9.8%), removal of ligation of the ureters in 3 cases (7.3%), bilateral ureteral reimplantation for 2 cases (4.9%) and end-to-end anastomosisin 1 case (2.4%). The postoperative period was uneventful in 29 cases and we observed 7 cases of surgical site infection. The overall success rate was 87.8%. Conclusion: urological complications following gynecologic surgeries managed at the urologic department of teaching hospital of Coto-nou had an even higher incidence. Early diagnosis especially during the operative procedure would save the patients’ serious complications and open surgery due to th

关键词： urological Complications Gynaecological and Obstetrical Surgery Cotonou

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Treatment of Kidney Stones by Percutaneous Nephrolithotomy: Evaluation of the Results of the First Series of Our Experience in the urology department of the Idrissa Pouye General Hospital in Dakar

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Open Journal of urology 2024年第2期14卷 104-114页

作者： Mouhamadou Moustapha Mbodji Mohamed Jalloh Medina Ndoye Abdourahmane Diallo Issa Labou Lamine Niang Serigne Magueye Gueye department of urology and andrology Hospital General Idrissa Pouye Dakar Senegal

The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On uro-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.

关键词： HOGIP Kidney Stones PCNL Stone Free uro CT Scan

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Surgical Treatment of the Upper Urinary Tract Lithiasis at the urology department of the Hopital General Idrissa Pouye

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Open Journal of urology 2024年第5期14卷 290-300页

作者： Mouhamadou Moustapha Mbodji Mohamed Jalloh Medina Ndoye Abdou Fall Cheikh Gassama Babou Sakho Serigne Mbacké Ndiaye Moussa Sene Abdourahmane Diallo Issa Labou Lamine Niang department of urology and andrology Hopital General Idrissa Pouye Dakar Senegal

Upper urinary tract lithiasis is a condition characterized by the presence of stones which is a stony concretion of crystallized substances in the kidney and/or ureter. Objective: The objective of this work is to study the epidemiological, clinical and therapeutic aspects of upper urinary tract stones on the one hand, then to compare the different types of surgical treatments and their results. Materials and Methods: This is a retrospective and descriptive study focusing on the surgical management of upper urinary tract stones, between January 2017 and December 2020, at the urology department of the Hopital General Idrissa Pouye. Results: During the study period, 7.59% of surgical interventions performed were related to the treatment of upper urinary tract stones. Average age was 45.20 ± 16.4 years, the age group [41 - 60] years was more affected with 42.68%. A history of urolithiasis was present in 25.52% of cases. Lower back pain was present in 97.48% of cases. On uro-CT scan, the stone was located more at the level of the ureter (49.57%). The size between 10 to 15 mm was more frequent (30.96%) and the density greater than 1000 HU was more frequent (33.47%). The most used therapeutic procedure was ureteroscopy (52.08%), followed by PCNL (40.83%) and open surgery (7.08%). The success rate (stone free) was 93.68% for the URS, 89.36% for the PCNL. The length of hospital stay for open surgery was 6.76 ± 4.25, for PCNL 2.62 ± 2 days and for URS 1.75 ± 1.62 days. Postoperative complications were present in 23.52% for open surgery, 11.22% for PCNL and 8% for URS. Conclusion: urolithiasis is constantly growing in our regions. Effective endourological treatment is increasingly replacing open surgery. However, global access to these new techniques in our regions is slow to be effective.

关键词： Endo-urology Open Surgery Renal Lithiasis Ureteral Lithiasis uro-CT Scan

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