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Background Renovascular hypertension (RVHTN) is a rare, often complex condition due to multiple etiologies including congenital stenoses, vasculitides, and fibromuscular dysplasia. Among children with RVHTN who require multiple and escalating medications to control blood pressure, the optimal timing of a procedural intervention involves a balance of numerous factors. Case-diagnosis/treatment In this presentation of a 1-month-old girl with RVHTN, the treating medical team had to consider multiple factors in the initial management and timing of interventions to treat her underlying cause of RVHTN, including concerns for kidney health, degree of hypertension, age and size of the patient, and potential methods of procedural intervention. Initially, she was treated conservatively until concern for poor renal growth arose and a durable surgical intervention was thought feasible and safe. Conclusion The evidence regarding the timing of non-medical interventions in pediatric RVHTN is limited. Considerations should include patient age, size, disease severity, comorbid conditions, and degree of medical management required to maintain safe blood pressures that allow for growth and reverse cardiac damage. The optimal interventions have not been evaluated by controlled trials and should be decided on a case-by-case basis with consideration of center expertise and family preferences., Author(s): Zubin J. Modi [sup.1] [sup.2] , David B. Kershaw [sup.1] Author Affiliations: (1) grid.214458.e, 0000000086837370, Division of Pediatric Nephrology, Department of Pediatrics, University of Michigan, , Ann Arbor, MI, [...]

Background We evaluated the risk factors for the requirement of surgical intervention in infants with nephrolithiasis. Methods The medical records of 122 (156 kidney units (KU)) infants were reviewed. The clinical features, stone characteristics, changes in stone status, and treatment protocols were noted. The stone status of the KU was categorized into 3 groups according to the change in size between the first and last ultrasound: resolution, unchanged, and growth. Results The median age was 8 months (r: 2-12). The median length of follow-up was 16 months (r: 10-36). Resolution was detected in 94 KUs (60%). Stone growth was detected in 39 KUs (25%), and stone size was unchanged in 23 KUs (15%). Surgical intervention was required in 26 patients (17%). A history of intensive care unit (ICU) follow-up and a stone size > 5 mm at time of diagnosis were defined as independent risk factors for stone growth (p = 0.005, 5 mm and stones with pelvic localization (p = 0.018, 0.021, respectively). Stone resolution was higher in patients with stone size [less than or equal to] 5 mm (p = 0.018). Conclusion A stone size > 5 mm at the time of diagnosis and a history of ICU follow-up are independent risk factors for stone growth. Pelvic localization of stones and stones > 5 mm are associated with an increased risk of surgical intervention., Author(s): Seha Kamil Saygili [sup.1] , Elif Altinay Kirli [sup.2] , Emre Tasdemir [sup.1] , Nur Canpolat [sup.1] , Salim Çaliskan [sup.1] , Lale Sever [sup.1] , Zübeyr Talat [sup.2] [...]

Trials were performed to compare the efficacy and safety of the pubovaginal sling by using autologous rectus fascia and Burch colposuspension procedures 24 months after surgery. The autologous fascial sling showed a higher rate of successful treatment of stress incontinence but also greater morbidity than the Burch colposuspension.

The aim of this study was to assess the effects of the writing technique on postoperative course in interaction with different levels of risk. Participants were 40 urologic inpatients waiting to undergo transurethral resection of the prostate, with different levels of surgical risk as assessed with the Goldman Preoperative Risk Index (L. Goldman et al., 1978). Only 20 participants wrote for 3 days about the experience of being in the hospital. Measures were days of stay in the hospital after the operation, the Symptom Check List (SCL-90; L. R. Derogatis, 1977; Italian version: G. Magni, C. Messina, D. De Leo, A. Mosconi, & M. Carli, 1983) scores, and a medical evaluation of postoperative course. A significant positive effect of writing on all three dependent variables emerged only in low-risk participants. High-risk writing participants showed a nonsignificantly worse postoperative course on all parameters than did high-risk nonwriting participants. In highly stressful conditions, writing therefore should be employed only with caution. Keywords: written disclosure; surgical risk; distress; health; prostate

Code Number: is03080 ABSTRACT Aims & Introduction: To provide the surgeon with information and physical data so as to optimize the safety and efficiency of the ureteral stents in their [...]

Byline: Hakan. Ozturk Dear Editor, With reference to the recent article on venous air embolism during percutaneous nephrolithotomy published in your journal, [sup][1] we would like to reiterate that air [...]

Byline: Manjula. Rao, Nischith. D'Souza, Altaf. Khan, Mujeebu. Rahiman Laparoscopic pyeloplasty is viable standard minimally invasive alternative to open pyeloplasty for the treatment of ureteropelvic junction obstruction. Intrathoracic bleeding is [...]

Byline: Amilal. Bhat, Karamveer. Sabharwal, Mahakshit. Bhat, Ramakishan. Saran, Manish. Singla, Vinay. Kumar Introduction: Additional cover after neourethra formation to decrease the fistula rate, has been described using the dartos, [...]

Byline: Hamdy. Aboutaleb Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal [...]

Byline: Rajendra. Nerli, Mallikarjun. Reddy, Sujata. Jali, Murigendra. Hiremath Introduction: Laparoscopic dismembered pyeloplasty is an acceptable option for ureteropelvic junction (UPJ) obstruction in the paediatric population. We compared our results [...]

Byline: Reisuke Imaji (1), Paddy A. Dewan (1) Keywords: Posterior urethral valves Congenital obstructive posterior urethral membrane Cystoscopy Cystourethroscopy Fulguration Abstract: In patients with congenital posterior urethral obstruction, transurethral fulguration (TUF) is usually the treatment of choice if the patient is in a stable condition. However, few papers have described the proportion of patients who need further fulguration. We reviewed 83 boys with a congenital obstructive posterior urethral membrane (COPUM) to assess the role of re-do fulguration, as judged by prospective video recordings. Between December 1990 and March 2000, 83 boys (aged from newborn to 15 years) underwent cystourethroscopy for investigation of a urethral anomaly and were found to have a COPUM. TUF was performed endoscopically with a hook diathermy electrode. Two to 3 months later boys who had cauterisation had a further urethroscopy and diathermy as required. Of the 83 membranous lesions in the posterior urethra, 38 were considered severe, 20 moderate, and 21 minor. Four patients had inadequate data to be properly classified. Eighteen (47.4%) of the 38 patients who had a severe obstructive membrane equired further endoscopic intervention to obliterate residual membrane elements. As over 45% of patients who had a severe obstructing membrane needed further fulguration, it is important to follow patients carefully and to repeat the cystourethroscopy. Author Affiliation: (1) Urology Unit, Royal Children's Hospital, the Department of Paediatrics, University of Melbourne and Murdoch Children's Research Institute, Victoria, Australia Article History: Accepted Date: 04/06/2001 Article note: Electronic Publication

Byline: E. Johnson, Gurpreet. Singh The advent of specialized spinal units and better understanding of the pathophysiology of neurogenic urinary tract dysfunction has made long-term survival of these patients a [...]

Byline: Rajan. Veeratterapillay, Helen. Morton, Andrew. Thorpe, Chris. Harding Since the original description of the trans-appendicular continent cystostomy by Mitrofanoff in 1980, a variety of techniques have been described for [...]

Byline: Alistair. Rogers, Tahseen. Hasan Pelviureteric junction obstruction (PUJO) of the kidney can lead to a number of different clinical manifestations, which often require surgical intervention. Although the success of [...]

Byline: Andrew. Thorpe I would like to sincerely thank the Editor of the Indian Journal of Urology for inviting me to guest edit a symposium on Reconstructive Urology. In putting [...]

Byline: R. Prabhavathi, Narasimha. Reddy, TS. Sekhar, Vivek. Menacherry Sir, We report a case of stricture urethra in a 59 years male undergoing buccal mucosal graft (BMG) urethroplasty for partial [...]

Byline: Hagop. Sarkissian, Brian. Irwin The objective was to give a general overview of common complications and rates reported in the current literature during performance of a variety of urologic [...]

Byline: B. Srinivas, S. Vasan, Sajid. Mohammed Surgery to augment penile length has become increasingly common. Lack of standardization of this controversial procedure has led to a wide variety of [...]

Byline: B. Srinivas, S. Vasan, Sajid. Mohammed Penile fracture is a rare injury, most commonly sustained during sexual intercourse. We report the case of a 29-year-old man who presented with [...]

Byline: Apul. Goel Objective: To prospectively evaluate for the presence or absence of Gerota's fascia in a pelvic ectopic kidney, as this is not well documented. Materials and Methods: Between [...]

Byline: Atsushi. Fujikawa, Yasushi. Yumura, Masahiro. Yao, Futoshi. Tsuchiya, Akira. Iwasaki, Masatoshi. Moriyama Objective: Repeat transurethral resection (ReTUR) is an effective treatment for non-muscle-invasive bladder cancer (NMIBC) to prevent disease [...]

Byline: R. Nerli, S. Shirol, Ajay. Guntaka, Shivagouda. Patil, Murigendra. Hiremath Introduction: Surgery for bladder exstrophy has been evolving over the last four to five decades. Because survival has become [...]

Byline: Rohit. Upadhyay, Rakesh. Kapoor, Amish. Srivastava, Narendra. Krishnani, Anil. Mandhani Aims: Detrusor muscle in initial transurethral resection of the bladder tumor (TURBT) may not be found in up to [...]

Byline: Rishi. Nayyar, Nikhil. Khattar, Rajeev. Sood Functional evaluation of the renal unit has often been quoted as a standard practice for management of stone disease of the upper urinary [...]

Byline: Rohit. Kathpalia Summary Percutaneous nephrolithotomy (PCNL), first reported in 1976 by Fernstrom and Johannson, [sup][1] is a valuable option for the management of renal stone disease. The modified Clavien [...]

Byline: Rohit. Kathpalia Summary One of the most critical steps during percutaneous nephrolithotomy (PNL) is obtaining access to the collecting system. Fluoroscopy is the imaging modality most often used to [...]

Byline: Nobhojit. Roy, Santosh. Waingankar, Gaurav. Aggarwal Background: Ureteral stents, despite their ubiquitous use, have not been evaluated for their safety and strength after removal from the patient. While literature [...]

Byline: Arun. Chawla Summary There has been significant evolution in the treatment of stress urinary incontinence (SUI). Prior to the mid-urethral tapes, options of transvaginal needle suspension, Burch colposuspension, and [...]

Byline: Dheeraj. Gupta Summary In this study, 11 men with complicated strictures of the bulbo-membranous urethra were treated by interposition of a tailored intestinal flap. A segment of intestine, with [...]

Byline: Mario. Maestro, Luis. Martinez-Piñeiro, Emilio. Gonzalez Malignant melanoma originating in the urethra is considered extremely rare and has a very poor prognosis. Consequently, therapeutic reviews are retrospective describing assorted [...]

Byline: Aparajita. Panda, Sukhminder Jit Singh. Bajwa, Subroto. Sen, S. Parmar Aim: Peri-operative pain relief in children can be provided by conventional general anaesthesia or by regional nerve blocks. The [...]

Byline: Nitin. Kekre Traditionally, surgery has been learnt by apprenticeship. Innovations are usually born out of necessity. With the rapid advancement of science over the last 25 years, surgery in [...]

Byline: Pranjal. Modi, Jigish. Vyas, Pankaj. Dholaria, Varun. Sharma Tips and Trick of the Operative Procedure Patient was given general anesthesia with endotracheal intubation. Lateral flank position was given with [...]

Byline: Rohit. Kathpalia, Swarnendu. Mandal, Apul. Goel Summary The traditional approach to the management of patients with complete posterior urethral disruption has been suprapubic drainage followed by delayed open surgical [...]

Byline: Ramanitharan. Manikandan, Lalgudi. Dorairajan, Santosh. Kumar Objectives : Pelvic fracture urethral distraction defect (PFUDD) may be associated with disabling complications, such as recurrent stricture, urinary incontinence, and erectile dysfunction. [...]

Byline: Apul. Goel, Anuj. Goel, Abhishek. Jain, Bhupendra. Singh Introduction : Treatment of panurethral stricture is considered a surgical challenge. We searched the literature to present a comprehensive review. Materials [...]

Byline: Shrawan. Singh, Santosh. Agrawal, Ravimohan. Mavuduru Objective : Management of distal anterior urethral stricture is a common problem faced by practicing urologists. Literature on urethral stricture mainly pertains to [...]

Byline: W. Zimmerman, Richard. Santucci Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely [...]

Byline: Deepak. Dubey Urethral stricture disease is one of the commonest conditions encountered by urologists in the Indian subcontinent. Though there has been a recent interest in urethroplasty, most urologists [...]

Byline: Hariprasada. Rao, S. Sriram, B. Srinivas, Sundaram. Challa, Ram. Ch, Pisapati. Murthy In recent years, a rare distinctive kidney tumor composed of a mixture of stroma and epithelium with [...]

Byline: Rishi. Nayyar, Narmada. Gupta Bladder cancer has variable biological behavior pattern in different individuals and the debate regarding peri-operative use of systemic chemotherapy with the surgical management remains. The [...]

Byline: Nitin. Abrol, Narmada. Gupta, Rajeev. Kumar Calculi in a neobladder usually present with irritative lower urinary tract symptoms, flank pain, and haematuria. We report a case of giant stones [...]