Morphometric analysis of posterior fossa and foramen magnum

Introduction: Configuration and size of the foramen magnum and posterior fossa plays an important role in the pathophysiology of the posterior fossa and craniovertebral junction disorders. This study is aimed to find out various dimensions of the foramen magnum and posterior fossa. Materials and Methods: This is a prospective study of 100 consecutive normal computerized tomography (CT) scans of posterior fossa and 100 dry adult skulls without any bony abnormality. The posterior fossa volume was calculated by abc/2 in method 1 and by advanced work station of CT scan in method 2. Various dimensions of posterior fossa and foramen magnum were also studied. Results: Age ranged from 16 to 89 years with a mean of 51.3 years. Mean height of posterior fossa were 3.01 cm (±0.22) and 3.52 (±0.43) cm in dry skull and CT scan group, respectively (P 0.05). All the dimensions of posterior fossa and foramen magnum were larger in male as compared to female. Mean anteroposterior (AP), transverse diameter and surface area of the foramen magnum were 3.31 (±0.35) cm, 2.76 (±0.31) cm, and 729.15 (±124.87) mm2, respectively, in CT scan group as compared to 3.41 (±0.29) cm, 2.75 (±0.25) cm, and 747.67 (±108.60) mm2, respectively, in dry skull group. Conclusion: Normal values of posterior fossa and foramen magnum could serve as a future reference. Dry skull dimensions could be different from CT scan measurement. More studies are needed as there could be variations in dimensions in different regions in Indi

Evaluation of Impact of Voiding Posture on Uroflowmetry Parameters in Men

Purpose: To evaluate the impact of voiding position on uroflowmetry parameters and to assess its potential clinical implications. Materials and Methods: We conducted a prospective study from 2013 to 2015 and included men between 18 and 77 years old who were either healthy volunteers with an International Prostate Symptom Score (IPSS) ≤7 or men with benign prostate enlargement that were on alpha-blocker medication and had an IPSS ＜10. Participants underwent uroflowmetry and post-void residual urine (PVRU) measurements twice, once in a sitting position and once in a standing position. The participants were divided into 4 groups based on age (35 years or younger, 36 to 50 years, 51 to 60 years, and older than 60 years). Results: A total of 740 men with a mean age of 40.35 years were evaluated. There was no significant difference in uroflowmetry parameters until the age of 50 years between the voiding positions. However, in those older than 50 years, PVRU volume was significantly lower in the sitting position than the standing position, whereas voiding time was significantly higher in the sitting position than the standing position. Other uroflowmetry parameters, including maximal and average urine flow rates, were non-significant. Conclusions: The voiding position plays an important role in the uroflowmetry parameters of elderly men. Voiding in the sitting position was found to be optimal for elderly men, whereas the role of the voiding position in healthy young men could not be determined. More research is needed to further study this issue

Outcome analysis of holmium laser and pneumatic lithotripsy in the endoscopic management of lower ureteric calculus in pediatric patients: a prospective study

ABSTRACT Objective: To analyse outcomes of holmium laser and pneumatic lithotripsy in treatment of lower ureteric calculus in pediatric patients. Materials and methods: Prospective study conducted between August 2013 and July 2015. Inclusion criteria were lower ureteric calculus with stone size ≤1.5cms. Exclusion criteria were other than lower ureteric calculus, stone size ≥1.5cms, congenital renal anomalies, previous ureteral stone surgery. Patients were divided into two groups. Group A underwent pneumatic and group B underwent laser lithotripsy procedure. Patient's baseline demographic and peri-operative data were recorded and analysed. Post operatively X-ray/ultrasound KUB (Kidney, ureter and bladder) was performed to assess stone free status. Results: A total of 76 patients who met the inclusion criteria to ureteroscopic intracorporeal lithotripsy were included. Group A and B included 38 patients in each. Mean age was 12.5±2.49 in Group A and 11.97±2.74 years in Group B respectively (p=0.38). Overall success rate was 94.73% in Group A and 100% in Group B, respectively (p=0.87). Conclusion: Holmium Laser lithotripsy is as efficacious as pneumatic lithotripsy and can be used safely for the endoscopic management of lower ureteric calculus in pediatric patients. However, holmium laser requires more expertise and it is a costly alternative

Intraoperative breakage of Sachse’s knife blade: a rare complication of optical internal urethrotomy (one case managing experience)

ABSTRACT Optical internal urethrotomy (OIU) is the most common procedure performed for short segment bulbar urethral stricture worldwide. This procedure most commonly performed using Sachse’s cold knife. Various perioperative complications of internal urethrotomy have been described in literature including bleeding, urinary tract infection, extravasation of fluid, incontinence, impotence, and recurrence of stricture. Here we report a unique complication of breakage of Sachse knife blade intraoperatively and its endoscopic management