61 research outputs found
Second look PCNL for residual renal calculi: experience in Hospital Universiti Kebangsaan Malaysia
BACKGROUND
Presence of residual calculi post PCNL is not rare. Due to the presence of residual
calculi, patientm ight be subjectedt o a repeatP CNL under generala naesthesiaw hich
is not without the risk of increased morbidity. Second look PCNL might reduce the
chanceo f a repeatP CNL and subsequentlyre ducet he risk of morbidityto the patient.
AIM
To audit retrospectivelyt he outcomeo f secondl ook PCNL in our centerf rom January
2003 to October 2005.
MATERIALAND METHOD
33 patients underwent second look PCNL for residual stone in our center from January
2003 to October 2005.The records of each patient were traced and the data analysed.
The stone clearance. tolerability of procedure, complications and operation time
were the variables and outcome studied.
RESULT
Out of 33 patients, 4 achieved complete clearance, 8 almost complete clearance, and
13 partial clearancew hile only 4 patientsh ad unsuccessfusl econdl ook operation
due to technical difficulties. In another 4 patients, the KUB x-rays were doubtful and
second look operation confirmed the absence of stone in the pelvicalyceal system.
There were no complications and the procedure well tolerated by all the patients.
CONCLUSION
Due to its advantagesa nd low morbidity, secondl ook PCNL shouldb e an alternative
method of treatment for residual stones whenever indicated
Ruptured testicular abscess: a rare complication of epididymo-orchitis
Epididymo-orchitis is a medical condition characterised by inflammation of epididymis and testis
which is a common urological diagnosis encountered by healthcare professionals. Misdiagnosis and
under treatment can lead to poor outcome such as infarction and abscess formation. We presented
a 33-year-old man, with no known medical illness, presented with one-week history of left
testicular pain, swelling and fever. He was commenced on Amoxicillin by his general practitioner.
Physical examination showed left swollen and tender testis and normal right testis. Investigations
showed an elevated white cell count (WCC) 41.3x103 /L and colour doppler ultrasound (USG) testes
showed left epididymo-orhitis. He was admitted and treated with IV Unasynยฎ
(Ampicillin+Sulbactam) for 5 days. His symptoms improved, and he discharged home well with one
week oral Unasynยฎ. He represented 2 weeks later with worsening left scrotal swelling and pain.
Clinical examination found a swollen, tender and erythematous scrotum with 1x1cm defect in the
left scrotum with purulent discharge. He underwent operation incision and drainage of left scrotum
and left orchidectomy. Post-operatively he recovered well. Histopathology reported as epididimoorchitis with abscess, necrosis and perforation. As a conclusion, testicular rupture and abscess
formation secondary to epididymo-orchitis is an uncommon reported complication. Immediate
recognition and treatment is crucial as a delayed diagnosis can lead to sepsis and infertility
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