Occurrence of carcinoma prostate in the Pune Metropolitan Region: A 5-year study from 2007 to 2011.

BACKGROUND: A retrospective study was carried out to know only the occurrence of carcinoma prostate (CAP) in the Pune Metropolitan Region (PMR) over a period of five years (January 01, 2007 to December 31, 2011). All the histopathological (HPE) reports of all prostate specimens were collected from 23 medical colleges, private institutions and stand-.alone HPE laboratories in PMR. MATERIALS AND METHODS: Four types of prostate specimens were examined - endoscopic resection, open prostatectomy, transrectal needle biopsy of prostate and prostate from the cystoprostatectomy specimen (surgery carried out for primary carcinoma bladder). Specimens of radical prostatectomy were excluded as the biopsy was carried out earlier. RESULTS: A total of 5006 reports of the prostate specimens were examined out of which 779 showed the presence of CAP. Analysis of annual occurrence of CAP revealed that there was no significant variation in the CAP cases. Thus giving an average of CAP cases of 155.8 per year in PMR. Population data of the PMR was obtained from the official Government of India Census department for the year 2011. Total population of PMR in 2011 was 5,049,968 out of which the male population was 2,659,484. Thus the occurrence of CAP in the PMR works out to 5.86/100,000 male population. Results were compared with the published reports of CAP by the Indian Council of Medical Research (ICMR) of 7.2/100,000 and Globocon of 4.2/100,000 males. CONCLUSIONS: Occurrence of CAP in PMR is low at 5.86/100,000 male population is comparable with published figures of ICMR & Globocon 2012.

Removal of migrated metallic prostatic stent by holmium laser.

A 90-year-old male with prostatic hyperplasia with a history of ischemic heart disease and right-sided hemiplegia had undergone a Urolume stent placement because of acute urinary retention 9 months earliar. The stent had migrated into the bladder causing dysuria and a poor stream of urine. We fragmented the prostatic stent by Holmium (HO: YAG) laser followed by a laser prostatectomy. After the procedure, the patient voided satisfactorily.

Is stenting required before retrograde intrarenal surgery with access sheath.

BACKGROUND: Flexible ureterorenoscopies continue to assume an increasing role in the armamentarium of the endourologist. In many centers around the world, prior stenting is carried out before retrograde intrarenal surgery (RIRS) to passively dilate the ureter, which facilitates passage of a flexible ureteroscope with or without an access sheath. In our series, the first stage of passive dilatation with prior stenting was totally avoided without compromising the success of the procedure. MATERIALS AND METHODS: From January 2004 to December 2007, 54 patients with 55 renal units underwent RIRS. The patients were between 28 and 65 years old. All patients had renal stones ranging in size from 8 mm to 22 mm. The mean serum creatinine level was 1.1 mg%. The lower ureter was dilated under 'C - arm' fluoroscopy guidance up to 14 FR. An access sheath of 10/12 Fr was passed over the working guide wire. RIRS (7.5/9.3 Fr) was introduced into the access sheath. The stones were fragmented using a holmium laser. The mean operating time was 85 mins (45-130 mins). RESULTS: In 52 out of 55 renal units (94.5%), a flexible ureteroscope could be passed successfully into the kidney through an access sheath. In 3 of the cases (5.4%), the lower ureter could not be dilated. In these patients, the procedure was staged after passing a 6/26 JJ stent. An X-ray KUB was done at the 3-month follow-up visit. A total of 50 renal units (94.3%) were stone free at the 3-month follow-up visit. CONCLUSION: In a majority of the cases, RIRS could be accomplished successfully during the first sitting. Single stage RIRS did not alter the subsequent stone clearance or increase the incidence of morbidity or complications.

Neonatal myiasis.

This case involves an orphan female neonate-abandoned in a dustbin in Poona, India-who was infected by the larval forms of the blowfly. The blowfly causing this infestation belonged to the family Calliphoridae and genus Calliphora. The fly of this genus is of importance in Indian veterinary science and is found abundantly around decaying matter in Poona. The larvae occurring in carrion, flesh, etc, usually infest open wounds of animals and rarely infest humans.

Percutaneous nephrolithotomy. A study of 171 patients.

One hundred and eighty-one patients with renal calculi were treated by percutaneous nephrolithotomy in 2 1/2 years. In 171 cases the calculi were removed successfully and the complication rate was low. Intrarenal manipulation and irrigation should be done for only a limited period of time. This procedure can be carried out safely, in many centres, with adequate experience and minimal facilities.

A new endoscopic urethral dilator.

A new endoscopic dilator that can be used either with a foroblique or end vision telescope is described. The design of the dilator and its use are demonstrated with diagrams and endoscopic photographs. The safety and the ease of operation are explained.

Endoscopic removal of bladder stones in adults.

Endoscopic removal of bladder stones of all sizes in adults has been discussed and illustrated by 100 cases. 3 different techniques were used to remove the stones viz. (1) extraction by Dormia basket, (2) cystoscopic lithotrity and (3) electronic lithotripsy by Russian-made "URAT 1". Safety and economic advantages to the patients have been discussed.