Search

Background: PCNL outcomes among urologists are different because of the vast heterogeneity in the methods for clinical, academic characterisation and evaluation of surgical outcomes of nephrolithiasis. So assessing the preoperative factors that affect SFR (Stone Free Rate) and complications is critical. Heterogeneity in reporting of PCNL outcomes among different centres has led to the invention of nephrolithotomy scoring systems based on preoperative parameters to better counsel patients contemplating PCNL. The Guy’s stone score, CROES nomogram and the S.T.O.N.E score are seen as predictors of stone-free status (SFS) and complications after PCNL. No universally accepted stone scoring system for predicting SFR and complications after PCNL exists. This is a prospective observational study to compare and analyse the existing stone scoring systems (SSS) and to assess the best parameters to predict PCNL outcomes concerning SFR and complications. Methods: This study is done in a tertiary level institute in eastern India which included 200 patients who underwent PCNL from November 2019 to November 2021. The relevant operative parameters were documented and compared to the preoperative factors with the help of nephrolithotomy scoring systems. Results: The Guy score, CROES nomogram and S.T.O.N.E. score were accurate in predicting the SFR in patients undergoing PCNL. A new IPGMER preoperative stone scoring system based on the most relevant parameters could be used as an alternative to predict SFR and complications in PCNL. Conclusion: The Nephrolithometry scoring systems are simple, straightforward and easily reproducible systems to classify the severity of nephrolithiasis and to stratify the complexity of PCNL.

The term multiparametric MRI, is a useful tool in reference to an approach that takes advantage of the added value of different MR imaging acquisitions to yield anatomic and pathophysiologic information about renal space occupying lesions and to evaluate patients with different tumors, including genitourinary malignancies. The role of multiparametric MRI is continuously growing because of its ability to detect and characterize renal space occupying lesions as well as to assess response to treatment. An observational study was carried out in 50 patients who presented with renal mass, based on clinical suspicion and prior imaging diagnosis of neoplastic renal space occupying lesion. Total renal space occupying lesions were 50, of which, 38 were males & 12 were females. The age range of the study population was 30–80 years. In our study, Agreement analysis between mpMRI diagnosis and HPE diagnosis of different RCC subtypes was statistically significant. So, multiparametric MRI had a role in differentiating the subtypes of RCC which had fair agreement with HPE. The present study results state that the renal mass lesions has different ADC values for different lesions because of the change in tissue contents and there was a statistically significant difference in ADC values between low and high-stage RCCs. Histologic and radiologic profiles of renal space occupying lesions and diverse subtypes of RCC can be used as biologic indicators of clinical behavior, response to treatment, and prognosis.

Aims and objective: Percutaneous nephrolithotomy (PCNL) is treatment of choice now a days in patients with spinal deformity with large kidney stones. Objectives of our present study to compare in which position it is better to perform and costs minimum complications after surgery. Methods: A total of 14 patients with spinal deformity having nephrolithiasis were selected randomly. No preferences for age, gender, size, location, and laterality of stone or BMI. All the patients were fit according to AUA guideline criteria for management by PCNL. Preoperative and postoperative data were collected in all operated patients. Descriptive statistics were performed as means, standard deviations, and ranges using Microsoft excel. For categorical variables percentage were used. Results: A total of 14 patients with spinal deformity having nephrolithiasis underwent PCNL. Seven patients operated in prone position and seven patients operated in modified supine position within approximately 2 years. As compared to prone position in supine position there were reduced operative time, little or no change in Hb concentration, shorter hospital stay, little intraoperative blood loss, and higher significant stone free rate were detected. Conclusions: Supine PCNL in spinal deformity patients with nephrolithiasis is an alternative to the standard prone PCNL. It provides an additional benefit of large operative field performing the procedure in a single position, reduces total operating time, less anesthesia related complications, less neuromusculoskeletal injury, and reduce physical strain on operating surgeon.

Background: Prostate cancer development and progression to androgen-independent disease is correlated with increased expression of growth factors and receptors capable of establishing autocrine and/or paracrine growth-stimulatory loops. Overexpression of the Her2/neu receptor tyrosine kinase has been associated with the progression to androgen independence in prostate cancer cells. Objective: Our primary aim was to investigate the frequency of HER2/neu amplification in prostate biopsy specimens in newly diagnosed metastatic carcinoma prostate and its correlation to progression of androgen independent carcinoma. Materials and Methods: In our study, expression of HER2/neu was carried out by immunohistochemical analysis in TRUS biopsy specimen of newly diagnosed metastatic carcinoma prostate. Results: Out of 36 patients, seven (19.4%) showed her2neu overexpression on immunohistochemical staining. Five out of seven (71%) were associated with higher histological grade >7 at diagnosis ( p 0.05). Conclusion: Overexpression of her2/neu was associated with high grade carcinoma prostate at diagnosis, however progression to castration resistant stage was not related with her2neu expression.

Introduction: Lower urinary tract symptoms (LUTS) in a post-transplant patient can lead to several complications including recurrent UTI and deterioration of the graft kidney function. The aim of this study is to investigate the spectrum of LUTS, possible complications resulting from it and its management after renal transplant in pre-transplant anuric patients operated in our tertiary care institute. Materials and methods: It was a retro-prospective observational study done on post-transplant patients operated in this institute from December 2016 to December 2020. Among 165 patients operated during this period 50 male and 21 female patients were finally included in this study. Urinary symptoms were evaluated using the IPSS Questionnaire. Pre and post-surgery Uroflowmetry findings were compared. Urodynamic assessment was done at least 6 months after surgery to determine the cause behind such symptoms. The data was analyzed with the help of standard statistical methods and SPSS 21 software. Results: The most common LUTS among the post renal transplant patients were frequency and nocturia. There was a marked improvement in voided volume and urinary flow in most of the patients. In 11 male and 7 female patients LUTS symptoms were moderate to severe and were seldom associated with recurrent UTI and graft compromise. A cautious approach in these patients helped in early diagnosis of the etiology behind LUTS, which were treated accordingly. Conclusion: LUTS should be carefully evaluated before renal transplantation. Postoperatively moderate to severe LUTS symptoms should be thoroughly investigated so that graft compromise and related complications can be prevented by early intervention.

Objective: To compare recurrence rate and side effects with two different maintenance regimens of postoperative intravesical therapy with mitomycin and BCG in T1 bladder cancer. Methods: Eighty were enrolled in this study and all received immediate post operative mitomycin. They were then allocated to two groups of 40, one group receiving intravesicle BCG and other a combination BCG and Mitomycin. They were followed up to a period of 2 years. Result: Two year recurrence rate after transurethral resection of bladder tumour with high grade T1 disease in the Combination group is low (20%) as compared to the BCG group (37.5%). Conclusion: Two year recurrences reduced with use of intravesical Mitomycin during maintenance in the combination group which though not statistically significant favours the trial with combination therapy in future studies. Side effect profile did not worsen with combination of Mitomycin and BCG.

Objective: Objective of this case series is accurate access to the respective calyx with stone in horseshoe kidney while performing percutaneous nephrolithotmy in supine position. Reducing operative time and anaesthetic morbidity while performing percutaneous nephrolithotomy in horseshoe kidney with nephrolithiasis in supine position. Materials and Methods: Four patient with one having bilateral renal calculi with horshoe kidney were selected randomly. There were no preference for age, gender; size, location and laterality of stone or BMI. All the patients fit into the AUA guideline criteria for management by percutaneous nephrolithotomy. Preoperative, perioperative and follow up data were collected. Results: Four patients with one having bilateral renal calculi underwent supine tubeless PCNL in 1 year in GMSV position. There was no intraoperative, post operative or on follow up complications in any patient. In all the patients stones were cleared completely in single setting. Conclusion: Supine percutaneous nephrolithotomy in horseshoe kidney is an alternative to the standard prone percutaneous nephrolithotomy in the horseshoe kidney. It provides an additional benefit of performing the procedure in a single position, which is known to reduce total operating time, less anaesthesia related complications and less neuromusculoskeletal injury.

Introduction and objective: Renal cell carcinoma (RCC) accounts for approximately 3% of all cancers. Approximately 25%–30% of patients present with metastatic disease at the time of diagnosis, and metastatic RCC is a treatment-resistant malignancy. Altered expression of cell adhesion molecules such as CD44 on tumor cells suggests a pathogenetic mechanism for tumor metastasis and may provide prognostic information for particular tumors. These cell matrix interactions of CD44 play a role in tumor cell invasion and metastasis. The Wnt/beta-catenin pathway turned out to be a promising target as it is involved in the regulation of cell proliferation, differentiation and apoptosis induction. Method: In this study, the expression of beta-catenin and CD44 was analyzed in primary renal cell carcinoma (RCC) samples to understand their association with development of the disease. For this purpose, immunohistochemical expression analysis of beta-catenin and CD44 was performed in 30 primary RCC histological samples and normal kidney tissues in different subtypes at different clinical stages of Indian patients (year: 2017–2019). Result: Most of the patients who presented were diagnosed as clear cell carcinoma and it was observed that expression of CD44 was high in patients with high stage tumors. Also beta-catenin was increased in advanced grade tumors, but there was insignificant correlation between high expression of molecules and survival or recurrence of disease. Conclusion: Both cd44 and beta-catenin activation was noted in patients with clear cell carcinoma, more in advanced tumors. Both can be promising targets for treatment in clear cell RCCs.

Introduction: Relationship between human papillomavirus infection and chronic prostatitis/chronic pelvic pain syndrome is not clear in the Indian population. The present study evaluated human papillomavirus infection as a risk factor in the development of chronic prostatitis/chronic pelvic pain syndrome. Methods: Patients between the age group of 18 and 50 years, diagnosed with chronic prostatitis/chronic pelvic pain syndrome (Cases) or sexually active asymptomatic men with primary infertility (Controls), were recruited. Recording of the personal and/or family history and National Institute of Health-chronic prostatitis symptom index scoring (pain score, urinary score, and quality-of-life score) was done in all prostatitis patients. Seminal fluids of all study patients were evaluated for genomic sequences of human papillomavirus including oncogenic subtypes human papillomavirus-16 and -18. Results: Study participants were divided in cases (n = 50) and controls (n = 50). The mean age of cases and controls were 30.72 and 32.48 years, respectively. Among the cases, the mean duration of symptoms was 9.98 months and mean total National Institute of Health-chronic prostatitis symptom index scoring score and mean International Prostate Symptom Score were 20.52 and 5.8, respectively. Among cases, 26 (52%) were found positive for human papillomavirus infection compared to only 6 (12%) in control group (risk ratio = 0.43; 95% confidence interval = 0.3–0.62; p 2 = 4.17; risk ratio (confidence interval) (0.39–0.59); p = 0.041). Oncogenic human papillomavirus-18 subtype was not found in any of the group. Conclusion: These observations indicate that infection with human papillomavirus (HPV-16 subtype) can be considered as a risk factor for the development of chronic prostatitis/chronic pelvic pain syndrome in Indian males under the age of 50 years.