ABSTRACT
Background: Staghorn stones are large branching stones that fill the renal pelvis and renal calyces and they can be complete or partial depending on the occupancy of the collecting system. . PCNL is a demanding procedure mainly for staghorn stones and may require multilple percutaneous tracts or multilple sessions of PCNL for complete clearance of stones. Hence ; we planned the present study to analyse patients undergoing PCNL for staghorn calculi. Material and Methods: In present study 200 patients underwent PCNL for the treatment of staghorn kidney stones. After exclusion criteria patients were selected and underwent standard PCNL. Preoperative , Intraoperative and Postoperative data was collected. Results: Out of 200 patients 95 (47.5%) were males and 105 (52.5%) patients were females. 120 patients (60%) were diagnosed with partial staghorn calculi whereas 80(40%) patients were diagnosed as complete staghorn Calculi. 37.5% patients were rendered stone free through single access port whereas 62.5% required multiple access port for PCNL in which 57.5% needed 2 access ports, 3% needed 3 access ports and only 2% needed 4 access ports for PCNL. 24 (12%) patients required 2nd stage procedure for residual stones and 1 (0.5%) patient become stone free after 3rd stage PCNL. Bleeding requiring blood transfusion was the most common complication in 21% patients. Whereas fever, hemothorax, hydrothorax, paralytic ileus were encountered in 12%,0.5%,0.5% and 4% patients respectively. Conclusion: For staghorn calculus PCNLis safe and effective procedure with acceptable morbidity and without mortality. Now PCNLhas almost replaced the open surgeries like pyelolithotomy , nephrolithotomy . with experience staghorn calculus can now be managed by minimum invasive technique like PCNL with no scar , no risk of incisional hernia , lesser hospital stay and minimum morbidity compared to open procedures
ABSTRACT
Introduction: Clinical benign prostatic hyperplasia (BPH)is one of the most common cause of lower urinary tractsymptoms in ageing men. Gold standard for BPH now days,is transurethral resection of the prostate (TURP). Hence; thepresent study was planned to prospectively analyse 500 TURPcases.Material and methods: 500 patients who underwent TURPafter failed medical therapy for BPH or with absoluteindication for TURP were anlayzed. All patients underwentultrasonography for post void residual urine and prostatesize, Serum PSA, DRE and uroflowmetry. Urine routineand culture along with renal function test was done in allpatients. Urodynamic study was done in patients suspectedfor neurogenic bladder. Data in relation to intraoperativeparameters and postoperative follow-up were analysed.Results: In the present study, data of a total of 500 patientswas analysed. Fever, haematuria and clot retention was foundto be present in 20, 25 and 18 patients respectively. Deathoccurred in 1 patient due to cardiac complication. Bloodtransfusion was required in 50 patients. Stricture and bladderneck contracture was seen in 16 and 9 patients respectively asa manifestation of late complication. Incontinence was foundto be present in 1 patients.Conclusion: TURP is one of the best minimally invasivetreatment for BPH. Along with being cost-effective, it isalso associated with significantly shorter hospital stay andminimum morbidity