Search

Purpose: Our objective was to analyse the clinical efficiency of TFL in large volume stones during retrograde intrarenal surgery. Materials and methods: Patients with large volume renal stones (> 1000 mm3) operated at two different centres, from May 2020 to April 2021, were enrolled in this study. Retrograde intrarenal surgery was performed using 60W Superpulse thulium fibre laser™ (IPG Photonics, Russia). Demographic data, stone parameters, laser time, and total operating time were recorded, and laser efficacy (J/mm3) and ablation speed (mm3/s) were calculated. NCCT KUB was done at 3 months postoperatively to calculate stone-free rate. Results: A total of 76 patients were included and analysed in the study. Mean stone volume was 1753.12 ± 1245.81 (1169.27–2193.25) mm3, mean stone density was 1104.46 ± 313.09 (875.00–1317.00) HU, mean laser time was 537.79 ± 689.89 (21.00–1080.00) sec, mean operating time was 43.38 ± 12.96 (35.00–51.25) min, mean laser efficacy was 20.30 ± 15.5 (8.88–25.57) J/mm3, and mean ablation speed was 1.32 ± 0.7 (0.82–1.64) mm3/sec. A strong positive correlation was found between the stone volume and ablation speed (r = 0.659, p = 0.000), and a moderate negative correlation was found between the stone volume and laser efficacy (J/mm3) (r = − 0.392, p = 0.000). With increasing volume of the stone, J/mm3 decreased significantly and ablation speed increased significantly (p < 0.001). Complications occurred in 21.05% (16/76) patients, most of which were Clavien grades 1–2. Overall SFR is 96.05%. Conclusion: Laser efficiency increases at higher stone volumes (> 1000 mm3), as less energy is required to ablate every mm3 of stone. [ABSTRACT FROM AUTHOR]

Byline: Chaitanya. Deshmukh, Arvind. Ganpule, Mohammad. Islam, Ravindra. Sabnis, Mahesh. Desai Aim: To construct and validate a cost-effective indigenously made retrieval system (Modified Nadiad bag) in minimal access urology. Method: [...]

Byline: Ashwin. Tamhankar, Ravindra. Sabnis, Gagan. GautamIntroduction: In the current era, every broad specialty has diversified into many subspecialties including urology, which is one of the most dynamic fields. The [...]

Byline: Arvind. Ganpule, Abhishek. Singh, Mohammed. Islam, Parag. Sonawane, Ravindra. Sabnis, Mahesh. Desai Ureteral stricture resulting from chronic inflammations such as tuberculosis, recurrent stone disease and multiple endourological interventions are [...]

Background: Chikungunya is a viral infection often associated with lower urinary tract dysfunction. This study evaluates the urological squeal of Chikungunya fever in a single centre after an epidemic in 2006-2007 in India. Materials and Methods: Retrospective analysis of medical records of 13 patients with lower urinary tract symptoms after Chikungunya fever was evaluated and outcome following intervention assessed. Results: A total of 13 patients (M:F=9:4), with age ranging from 30 to 72 years, were included in the study. They presented with chronic urinary retention (n=9, 69.23%) of which two had paraparesis, voiding symptoms alone (n=7, 53.8%), storage symptoms alone (n=3, 23%), and acute urinary retention (n=1, 7.6%). Presentation with lower urinary tract symptoms after an episode of Chikungunya fever was after a mean period of 163 days (range 30-360 days). Mean serum creatinine on presentation was 1.8 mg/dl (0.6-6.5 mg/dl). Evaluation revealed dilated upper tract in four (30.7%) patients. Cystometrography showed acontractile detrusor (n=3, 37.5%), hypocontractile detrusor (n=3, 37.5%), overactive detrusor (n=1, 12.5%) and normal study (n=1, 12.5%). At the mean follow up of 11 months, 11 patients (84.6%) had satisfactory functional outcome after intervention, namely supra pubic diversion and bladder training (n=5, 38.4%), alpha blocker (n=3, 23%), timed frequent voiding (n=2, 15.3%), clean intermittent catheterization (n=2, 15.3%), trial void with alpha blocker (n=1, 7.6%) while two are on continuing supra pubic diversion due to persistent neurological deficit. Conclusions: Chikungunya fever is an uncommon entity in urological practice, often associated with urinary symptoms. An accurate assessment of the symptoms and timely intervention prevents upper tract deterioration and improves the quality of life.