Tamsulosin in the management of distal ureteric calculi

Introductions: Ureteral stones account for 20% urinary stone. Two third ofureteral stones are seen in lower third of ureter. Medical expulsive therapy iseffective for such stones. This study was designed to observe the efficacy of‘tamsulosin’ a selective alpha-1 adrenoreceptor antagonist in the managementof lower ureteric stone.Methods: A cross sectional study of 70 cases of distal ureteral stones of sizes 5to 10 mm was taken in the Department of Surgery of Shree Birendra Hospital,Nepalese Army Institute of Health Sciences (NAIHS) from January 2011 to2013. Patients were randomly divided into tamsulosin and analgesic onlygroups. Stone expulsion at the end of three weeks was confirmed by X-ray orUltrasonography.Results: Out of 70 patients, stone clearance rate in tamsulosin group was 28in 35 cases (80%) and 21 in 35 cases (60%) in group II with analgesic only. The mean time of stone expulsion was 8.3 days in group I and 13.5 days in group II.Conclusions: In this study the use of tamsulosin in treatment of lower ureteralstones less than 10 mm was safe and effective.Keywords: alpha blockers, ureteral stone, tamsulosi

Extracorporeal Shock Wave Lithotripsy in Management of Urolithiasis

Introductions: Since 1980, when Chaussy in West Germany first demonstrated the efficacy of Dornier prototype lithotripsy HM1, extra corporeal shock wave lithotripsy has become a convenient, noninvasive, outpatient procedure used to fragment urinary stones. It is a standard internationally accepted first line preferred option for the management of renal stone less than 2.5 cm size.Methods: A cross sectional study was conducted in the department of surgery of Shree Birendra Hospital on outpatient department basis during the period of March 2002 to February 2012. All consecutive patients presenting with renal and upper ureteric stones detected either on X-ray or ultrasound of the Kidney-Ureter-Bladder who were treated with extra corporeal shock wave lithotripsy. Descriptive analysis included age, sex, stone location, need of total session, use of double J stent and complications.Results: Total 710 diagnosed cases of urolithiasis were taken for the study. The youngest age was 16 years and oldest 69 years of age. Overall stone clearance rate was 73.52%. The stone free rate for upper, middle, and lower calyx were 85.94%, 90.20% and 50.52% respectively.Conclusions: Extracorporeal shock wave lithotripsy was successful in themanagement of the stones smaller than 2.5 cm in all caliceal locations and minimal morbidity.Keywords: ESWL, steinstrasse, urolithiasi

Outcome of Laparoscopic Nephrectomy in Benign Renal Disease

Introductions: Laparoscopic surgery is rapidly emerging option in urology. With the advances in technology and instruments currently this is viable alternative to treat complex surgical diseases as well as reconstructive surgery. Methods: This is a prospective observational study to analyze the outcome of laparoscopy nephrectomy. A total of 51 patients’ had undergone laparoscopy nephrectomy over the period of five years. The variables analyzed were, age, sex, operative time, estimated blood loss, length of hospital stay, conversion rate and complication. Results: The mean patient's age was 41.1 years (range 15 - 71 years). Indications of nephrectomy were non-functional kidney secondary to stone disease in 26 (50.98%). Mean operative time was 1.43 hours. Median hospital stay was 2.3 days. Conclusions:  Laparoscopy surgery is a safe and feasible treatment option for the benign renal disease with comparable outcomes. Non functional kidney secondary to renal stone was the major cause of nephrectomy in this study. Keywords: benign renal disease, laparoscopic nephrectomy, nonfictional kidney, nephrolithiasi

Cystoscopic removal of an intravesical gossypiboma mimicking a bladder mass: a case report

<p>Abstract</p> <p>Background</p> <p>Intravesical retained surgical sponges are very rare and only a few cases have been removed by minimally invasive techniques.</p> <p>Case presentation</p> <p>We report a case of an intravesical gossypiboma in a 71-year-old man from western Nepal, who presented with urinary retention and persistent lower urinary tract symptoms one year after open cystolithotomy. He was diagnosed with an intravesical mass using ultrasonography. The retained surgical sponge was found during cystoscopy and removed through endoscopy.</p> <p>Conclusion</p> <p>Intravesical gossypibomas are rare and can mimic a bladder mass. This is one of the few reported cases of cystoscopic removal.</p