Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study

PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.

Anxiety status and its relationship with general health related quality of life among prostate cancer patients in two university hospitals in Kuala Lumpur, Malaysia

This study aimed to determine the prevalence of anxiety among prostate cancer patients, and to ascertain the association between stress status, socio-demographic, medical and surgical illness, current urinary problem and cancer status with general health-related quality of life [HRQOL] among these patients. A hospital based, cross sectional study was conducted at Surgical Clinic, University Malaya Medical Centre [UMMC] and Universiti Kebangsaan Malaysia Medical Centre [UKMMC] using universal sampling. A total of 193 patients were recruited. The prevalence of anxiety was 25.4% [95%CI: 19.2 - 31.6]. The anxiety ratings were mild anxiety [10.4%], moderate anxiety [13.6%] and severe anxiety [1.6%]. The total quality of life among stress group was 59.2 +/- 14.7 and among non-stress group was 73.9 +/- 12.7. There was a significant negative weak correlation between anxiety score and total quality of life [r[s]=-0.534, P<0.001]. In multivariable analysis, there was a significant difference in the total quality of life [QOL] among anxiety status [adj. mean diff. = -9.1 [95%CI: -15.2, -4.7]]. The adjusted mean difference was associated by age category of the patients [P<0.001]; living partner [P<0.001]; in-termittency [P=0.035] and problem of hematuria during micturition [P=0.005]. The prevalence of anxiety among prostate cancer was moderately high. Treating the urination problem as well as encouraging living with spouse/family may improve the quality of life among anxiety condition of these patients

Primary sclerosing lipogranuloma: an unusual scrotal mass

Sclerosing lipogranuloma [SLG] of the male external genitalia is a rare benign condition presenting as subcutaneous masses. The underlying pathological process is a granulomatous reaction of fatty tissue in this area. The cause of this is unclear but hypothesis stems around the pathogenesis of exogenous lipid degeneration from injection of foreign bodies such as paraffin for penile augmentation. However, endogenous lipid degeneration from other various causes such as infection, trauma, and allergic mechanisms has also been reported. We present the case of a 40-year-old man with primary SLG of the external genitalia. Literature review on the treatment strategies are addressed and discussed