Search

Introduction: Objective of this study was to assess the diagnostic efficacy of the most commonly used radiological evaluation in form of contrast enhanced computed tomography of abdomen with adrenal protocol, basic functional evaluation and surgical outcomes of primary adrenal masses. Material and methods: We have retrospectively analysed the institutional records of 108, patients admitted from August 2017 to September 2023, who had underwent surgical intervention for their adrenal mass after thorough evaluation and stabilization. Results: Flank pain was the most common symptoms in 44 (40.74%) patients. Non-functional adrenal adenoma was found in 36 (33.33%) patients. Pheochromocytoma was the most the common functional adrenal mass found in 24 (22.22%) patients. CECT abdomen had suggested features of malignancy in 16(14.81%) patients. In final histopathological report 26(24.07%) patients had pheochromocytoma and 12 (11.11%) patients had adrenocortical carcinoma. CECT abdomen had sensitivity of 75%, specificity of 95.6%. Plasma free metanephrines and normetanephrine analysis had shown sensitivity of 90%, specificity of 92.86%, aldosterone to renin ratio had sensitivity of 92%, specificity of 100%. Sensitivity and specificity of the low-dose dexamethasone suppression test and plasma dehydroepiandrosterone was 100% in our study. Eighty patients (74.07%) were operated with laparoscopic adrenalectomy, 20 (18.52%) patients with open adrenalectomy. Eight patients (7.41%) were converted from laparoscopic to open. Laparoscopic approach had significantly lesser mean operating time, lesser blood loss, lesser hospitalization and lesser post-operative complications. Conclusion: Radiological analysis and functional analysis has shown good sensitivity and high specificity. Laparoscopic approach has advantage of lesser operative time, lesser hospitalization and lesser post-operative complications. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to conduct a comparative analysis of various intraoperative parameters and postoperative outcomes between the laparoscopic extravesical repair versus the laparoscopic O'Connor repair techniques in management of supratrigonal vesicovaginal fistula. Methods: A prospective nonrandomized study was conducted from January 2018 to January 2023, in which 36 patients who met inclusion criteria like primary or recurrent, single, simple, supratrigonal vesicovaginal fistula were included. Among these patients 18 patients were operated with laparoscopic O'Connor repair, while 18 were operated with laparoscopic transperitoneal extravesical vesicovaginal fistula repair. Intraoperative and postoperative parameters of these 2 techniques were compared. Results: Laparoscopic O'Connor repair had longer operative time of 140 minutes, while laparoscopic extravesical VVF repair had an operative time of 117 minutes (P = .026). Mean blood loss was also significantly higher in laparoscopic O'Connor (210 mL versus 95 mL) (P = .004). Postoperative complications and analgesics requirement were less with laparoscopic extravesical repair. Hence, laparoscopic extravesical repair reduced mean hospital stay (3.2 days versus 3.9 days) (P = .003). A success rate of 83.33% for laparoscopic O'Connor and 94.45% for laparoscopic extravesical repair (P = .153) was recorded. Conclusion: Laparoscopic extravesical approach appears to be a convenient and effective method in selective supratrigonal vesicovaginal fistula repair. [ABSTRACT FROM AUTHOR]

Introduction: With the objective to assess the correlation between the resistive index of intratesticular artery as predictor of spermatogenesis this case control study was conducted., Methods: A Prospective study conducted during period April 2021 to March 2023. Total 50 patients, with oligoasthenozoospermia taken as cases and other 50 men with normal sperm count taken as controls. History taken & clinical examination, Semen analysis, hormonal evaluation & Color Doppler ultrasonography of scrotum done. Resistive Index of testicular arteries was obtained. Cases and controls were compared., Results: The age of the study group ranged between 21 and 40 years. Among the cases maximum patients 23 out of 50 and among controls with maximum number 21 out of 50 patients were belonged to age group 26-30 years.The mean semen volume for the cases & controls was 2.76 ± 0.44 ml and 3.32 ± 0.54 ml respectively. The Mean sperm concentration in the cases & controls was 14.33 million/ml & 84.8 million/ml. Mean Type A sperm motility was 20.82% ± 7.86 in cases and 54.96% ± 5.41 in controls. The mean testicular volume in cases was 18.36 ± 0.75 & in controls was 18.39 ± 0.62 ml. Hormonal evaluation done in both cases and controls and mean value of FSH in cases and controls was 7.57 ± 2.34 and 6.27 ± 3.55 respectively ( p -value = 0.036). Mean value of Resistive Index (PSV - EDV)/PSV) in cases and controls were found 0.63 ± 0.32 and 0.53 ± 0.37 respectively ( p -value = 0.001)., Conclusion: The intratesticular artery resistive index can be utilized as valuable predictive marker to indicate spermatogenesis., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.