Introduction: Objective: To assess the effectiveness and safety of tranexamic acid in lowering postoperative haemoglobin and hematocrit decline, operational time, postoperative complications, and hospitalisation in percutaneous nephrolithotomy patients. Methods: A 40-patient Al-Hilla Teaching Hospital randomised controlled clinical trial ran from January 2020 through July 2022. All ultrasound-guided PCNL patients with renal stones were randomised into two groups. Group A consisted of 20 patients (13 males and 7 females) with a mean age of (45.05 ±12.23) years who received tranexamic acid (1gm slow intravenous infusion diluted in 100 cc normal saline over 10 minutes) on call to surgery and then (0.5 gm infusion every 8 hours for the first 24 hours postoperatively). Group B included 20 non-tranexamic acid-treated patients (9 males and 11 females) with a mean age of 42.15 ± 10.64 years. We are comparing haemoglobin and hematocrit decline, operational time, postoperative complications, and hospitalisation between two groups. Results: Group A had a much lower postoperative haemoglobin decline than group B, 12.97 ±1.21 g/dl vs 11.82 ±1.44 (p = 0.010). Group A had a much lower postoperative hematocrit decline (39.11 ±3.95%) than group B (34.86 ±3.73%) (p = 0.001). 63.25 ±10.79 minutes against 73.50 ±16.31 minutes (p = 0.024). Group A had a significantly shorter hospital stay than group B (54.00 ±10.66 hours vs. 60.60 ±11.74 hours, p = 0.021). All patients in two groups had postoperative moderate hematuria, however group B had 4 (20.0%) instances of severe hematuria, whereas group A had just one (5%) case (p = 0.047). Four (20.0%) group B patients and one (5%) group A case required blood transfusion, a statistically significant difference (p = 0.047). Conclusions: TXA reduces postoperative haemoglobin and hematocrit drops and blood transfusions in PCNL with minimal side effects and a shorter operational time and hospital stay.

Introduction: Urological treatment of urinary calculi has changed much in the past 20 years (1). Endoscopic intra Ureteral lithotripsy has developed as the result of advances in techniques for uretroscopy and lithotripsy Aim of the study to determine the utility and the efficacy of pneumatic lithoclast in the treatment of uretric stone as early experience in AL- HillA city. Method: cross sectional study of one hundred patients with uretric stone with size ranged from (0.5-1.5 cm) and different level (upper, middle, lower Ureter 15, 20, 65 respectively) treated with uretroscopy and pneumatic lithoclast under general and spinal anesthesia. Result: About 90 patients have cleared from uretric stone within 2 weeks. The other 10patient’s not responding because Upward migration (6 patients), Ureteral perforation (4 patients). 50 patient’s need’s double j stenting at the end of the procedure because large number of fragments’ and due to hematuria. The other 50 patients not need double j stenting because small stone and easy to pass spontaneous. Conclusion: By conclusion early intervention is advisable .mid or upper ureteric stone also can deal with.