Fragmented ureteral stent extraction by antegrade and retrograde access:using ureteroscope and nephroscope.

there are different complications of using ureteral stents in urology field, one of the challenging complications is stent fragmentation which is frequent in patients with missed and forgotten stents accompanying encrustation, presented case was 70- year-old female, left single kidney with stent fragmentation After TUL and stent insertion one year ago, because of retained fragments in kidney, ureter, and bladder, combined antegrade and retrograde approach was used for stent fragments extraction, for preventing stent related complications we should signify the importance of timely extraction of ureteral stents during inpatient and outpatient visits and using remembrance methods.

Fever after percutaneous nephrolithotomy: contributing factors.

BACKGROUND AND PURPOSE: The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. METHODS: In a cross-sectional study, from September 2003 to March 2004, all 217 patients with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were studied. Data were collected before, during, and after surgery. RESULTS: The frequency of fever after PCNL was 25.8% (n=56) although in 62.2% of the cases (n=135), no prophylactic antibiotics had been administered. The mean durations of hospitalization in patients with and without fever were 5.4+/-2.3 and 3.4+/-1.7 days, respectively (p=0.001). Significant correlations were observed between fever and female sex (p=0.005), positive urine culture (p=0.02), and nephrostomy tube insertion (p=0.041). Other variables did not prove to be significant. In logistic regression analysis, female sex and nephrostomy tube insertion were independently related to post-operative fever. CONCLUSION: Although a considerable proportion of our patients had not received prophylactic antibiotics, the rate of fever after PCNL was no higher than is reported in the literature. Use of only a short course of antibiotics before surgery for staghorn stones did not result in a higher rate of fever. Female sex created a higher risk for fever, probably because of the greater propensity to urinary tract infection. The significant relation of a nephrostomy tube to fever could be attributed to its role as a foreign body or to use in more complicated cases.

Surgical management of stress urinary incontinence.

INTRODUCTION: This review evaluates the most recent knowledge regarding surgical management of stress urinary incontinence. MATERIALS AND METHODS: A comprehensive MEDLINE search was performed, limited to those articles published from 1995 to 2005. In total, 470 articles were reviewed-the most relevant of which were considered, and additional ones were selected by reviewing these studies' bibliographies. Overall, 53 articles were selected and used in this study. RESULTS: Few randomized controlled trials have been performed. The best results of retropubic procedures are seen when the intrinsic urethral sphincter is competent and its effectiveness is sustained in the long term. A laparoscopic approach, although less popular and with a lower short-term cure rate, is an alternative. Sling surgeries can be the first-line treatment for all types of stress urinary incontinence. Autologous grafts are still considered the gold standard, but synthetic materials such as tension-free tape have comparable results with standard open retropubic procedures. Still, long-term cure and complication rates have not yet been elucidated. Using urethral bulking agents is the least invasive approach, applicable in both intrinsic sphincter deficiency and urethral hypermobility. However, it has a poor long-term outcome and necessitates repeat injections. CONCLUSION: Long-term data suggest that Burch colposuspension and sling procedures produce similar objective cure rates. New synthetic suburethral slings such as tension-free vaginal tape have gained popularity in recent years. Complications of traditional and newer suburethral slings are declining but still occur and often are associated with serious morbidity. New therapies must be studied in randomized clinical trials.