Search

Urethral stricture disease has significant economic impact throughout world. The bulbar urethra is the commonest site for urethral strictures (Approx 50%) followed by penile urethra in most of the published literature. In developing countries trauma (road traffic accident and iatrogenic) is the leading cause of urethral stricture disease. Younger patients have usually idiopathic type as compare to old age group, which present more frequently with iatrogenic and trauma related urethral strictures.This Qausi Experimental study was conducted from May2012-June2016 of duration at Liaquat National Hospital Karachi. All the patients diagnosed with short urethral strictures related to bulbar urethra were included in this study. All the patients underwent non transecting bulbar urethroplasty. All patients were assessed preoperatively, peri-operatively and postoperatively and on follow-up visits as; on 2nd, 8th and 24th week. All the data regarding outcome was recorded on the Performa and analyzed on SPSS V20.Total of 179patients were included, mean age was 38±SD15.3years (range 20- 65years). Anatomically bulbar urethra was affected in 52% of the cases followed by bulbopenile, bulbomembranous region. Etiologically idiopathic type was found in 40% cases, while trauma 21%, iatrogenic injury 26% and UTI 13% were also reasons. Stricture length was mean1.1±SD 1.4 cm (range 0.5-2.5cm). Preoperative Uroflowmetry revealed mean Qmax of 10.5±SD 5.3 ml/sec. Mean operative time was 35±SD 4.6 minutes, 7 patients had conversion to other procedures (3.91%), Postoperative complications were minimal. Mean follow up was 12±SD 21 months (range 6 months to 3 years). On initial follow up at 8th week and 24th week, Qmax was significantly improved. Only 3 patients required DVIU after the 24th week. Initial success rate after 24th week was 98.3% and eventually 100% at the long-term follow-up.non-transecting anastomotic bulbar urethroplasty (NTABU) is a new standard of care for the short bulbar urethral stricture up to 2.5cm. Idiopathic aetiology, iatrogenic and posttraumatic urethral strictures in selective patients can safely be operated with this technique.

To compare the stone clearance of upper with middle and lower ureteric stones by using ureteroscopic pneumatic lithotripsy.The study was conducted in the Department of Urology, Liaquat National Hospital, Karachi, from February 2009 to February 2010. A total of 90 patients were selected and divided into three groups of 30, each according to the location of stone in the ureter. All patients underwent ureteroscopic pneumatic lithotripsy with 8.5 Fr Wolf rigid ureteroscope and Wolf 2mm probe used for stone fragmentation. All patients were evaluated with X-ray KUB, ultrasound KUB and IVU. Follow-up studies included X-ray and ultrasound KUB performed on 1st postoperative day, after 1 week and at the end of 2nd week. Presence of stone after last follow-up was considered as failure of the procedure.Total number of patients were 90 and mean age was 27.47 +/- 5.8 years. Male female ratio was 2.1:1. Mean stone size was 11.44 +/- 1.41mm. According to the location of the stones, the success rate of pneumatic lithotripsy for upper, middle, and lower ureteral stones was 86.7%, 93.3%, and 96.7% respectively. Completely fragmented stones cleared spontaneously within two weeks in 83 of 90 cases so the overall stone-free rate was 92.2%.Ureteroscopic Pneumatic Lithotripsy is an acceptable form of treatment for upper ureteric calculi in addition to middle and lower ureteric calculi. It is a simple, reliable, effective, rapid and safe procedure.