The impact of nephrostomy balloon inflation volume on post percutaneous nephrolithotomy hemorrhage.

INTRODUCTION: the study aims to match different volumes of nephrostomy balloon inflation to point out the foremost effective volume size of post percutaneous nephrolithotomy (PCNL) bleeding control. METHODS: we have retrospectively reviewed "560" medical records of patients who underwent percutaneous nephrolithotomy between (the years 2017 and 2018) at Prince Hussein Urology Center. The Patients were divided into two teams, group-1 (a number of 280 patients) with nephrostomy balloon inflated concerning three ml and group-2 (a number of 280 patients) the balloon inflated concerning one ml. The preoperative and postoperative hematocrit, the operation duration, the stone size, the postoperative pain severity, the transfusion rate and the duration of hematuria between the two groups were compared during hospitalization. RESULTS: regarding patients with ages (between 18 and 68 years); the preoperative hematocrit (mean values ± SDs) was (40.35% ± 3.57) vs (39.95% ± 3.43) for groups-1 and 2, respectively; the p value=0.066. The postoperative hematocrit was (37.91% ± 3.96) vs (34.38 ± 2.78), respectively; the p value was (0.008); the blood transfusion rate was 11.2% vs 13.4% (the p value was 0.039), respectively. The Postoperative pain score was (4.93 ± 1.44) vs (3.89 ± 1.45) (the p value was 0.012), respectively. CONCLUSION: increasing the nephrostomy balloon volume to a "3cc" competes for a task to decrease bleeding which was found to be as a secure and considerable effective procedure-related factor. However, the disadvantage of this technique resulted in increasing the postoperative pain in patients undergoing such a procedure.

Persistant Mullerian duct syndrome with intra-abdominal seminoma.

Persistent Mullerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism; it is defined by the presence of the Mullerian duct derivatives (the uterus, the fallopian tubes, and the upper vagina) in genotypically and phenotypically males. Seminoma is the most common type of testicular tumor in the third and fourth decade of life. We report a case of intra-abdominal seminoma in a patient with bilateral undescended testes and persistent Mullerian duct syndrome.

Laparoscopic Splenectomy in Children: Safety of Ligasure Usage.

INTRODUCTION: Laparoscopic splenectomy started to be more popular and nowadays it is the first choice for splenectomy in children. The main advantages of laparoscopic splenectomy over open approach are the shorter hospital stay, low complications and the cosmetic results despite the main concern of long operative time and the intra operative bleeding. AIM: The aim of this study was to report our experience with laparoscopic splenectomy in children's with hematological diseases using ligasure regarding vascular control safety, efficacy and complications rate. METHODS: A retrospective study was carried out at Queen Rania Al-Abdullah Hospital for Children over the period from January 2017 to February 2019. Total number of 18 patients with hematological diseases underwent laparoscopic splenectomy using ligasure. Demographic data, complications and outcomes were collected to assess the advantages of ligasure usage for vascular control safety. RESULTS: Out of 18 patients underwent laparoscopic splenectomy using ligasure (10 with spherocytosis, 4 with immune thrombocytopenic purpura [ITP], 3 with sickle cell anemia, 1 with hemangioma), from which number, 8 patients were males and 10 were females. Mean age was 6.7 years (ranges from 4.3 to13.7 years). Mean operative time was 107 minutes (ranges from 70-180 minutes). There was no conversion to open splenectomy and no mortality. Intra operative blood loss was insignificant. CONCLUSION: Laparoscopic splenectomy using ligature is safe with excellent results in decreasing operative time, less complications and decrease incidence of intraoperative bleeding.