Objectives: To compare ureterovesical jet frequency in non-obstructed versus obstructed ureter secondary to ureteric stone using ultrasonography in patients presenting with ureteral stones.Study design: Cross-sectional prospective study.

Background: Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large or complex renal stones. The upper pole (supra-costal access) is associated with pulmonary and cardiac complications post-operatively, owing to its proximity to the diaphragm. The prone position also causes restricted chest expansion and decreased pulmonary compliance. In this study, we aim to evaluate pulmonary complications after percutaneous nephrolithotomy by reducing the tidal volume intra-operatively and to assess the appropriate tidal volume for patients undergoing PCNL. Methodology: A retrospective chart review was performed over a period of one year (2019-2020). All patients who underwent PCNL and fulfilled the inclusion criteria were included in the study. They were divided into two groups: low tidal volume (Cases), and normal tidal volume (Controls). The records were evaluated for any pulmonary complications post-operatively, and this was compared between the two groups. Results: A total of 114 patients were included in the study. When patients with low tidal volume were compared to patients with normal tidal volume, no significant difference in pulmonary complications was observed (p-value < 0.05). Conclusion: There was no significant difference between the two groups, in terms of post-PCNL pulmonary complications, with respect to the tidal volume. Further multicenter studies can better elucidate these findings.

Background: Benign Prostatic Hyperplasia (BPH) is the most common urological cause of urinary obstruction, affecting men above 50 years of age. Medical therapy used for managing BPH includes various medical regimes, including 5-alpha reductase inhibitors (5ARI), namely Dutasteride and more. The study aimed to evaluate the efficacy of four weeks' prior treatment with dutasteride on per-operative blood loss in patients of BPH undergoing transurethral resection of the prostate. Methodology: A prospective observational study was conducted from January to December 2019 at the Kidney Centre, Karachi, Pakistan. A total of 64 patients were included and divided into two groups. Group A patients were those who had been taking dutasteride (0.5 mg/day) for four weeks or more before surgery, and group B patients were not taking dutasteride drug before surgery. All patients underwent standard TURP, and the intra-operative blood loss was calculated. The collected data was analyzed using SPSS version 22.0. Results: In our study, there was a significantly less hemoglobin drop (1.2 gm vs. 2.2 gm) during prostate surgery in patients using dutasteride than those who were not using dutasteride. Conclusion: This study has revealed that the use of dutasteride four weeks before surgery significantly reduces intra-operative bleeding.

The use of UAS appeared to prevent the onset of septic shock, with no clear benefit in terms of fever and sepsis outcomes. Further studies may help to clarify if the reduction of reabsorption load mediated by UAS is really protective against a poor evolution to life-threatening conditions rather than any postoperative infectious complications.

Objective: To ascertain the safety and efficacy of percutaneous nephrolithomy in patients with previous open renal surgery. Study Design: Descriptive study. Place and Duration of Study: The Kidney Centre Postgraduate Training Institute, Karachi from January to December 2018. Methodology: Patients with previous open renal surgery underwent percutaneous nephrolithomy during study period (Group A). Equal number of percutaneous nephrolithomy patients without previous open surgery taken as controls (Group B). Safety was defined in terms of 'blood loss' as change in hemoglobin (HB) level and 'blood transfusion,' while efficacy was defined in terms of 'stone clearance' and were compared between both the groups. Results: There were a total of 87 patients. Both groups had comparative gender ratio [p = 0.858]. Mean age [p = 0.132] and BMI [p = 0.879] of patients in both groups was not significantly different from each other. Both groups showed no statistically significant difference in terms of values of stone size [p = 0.186], stone laterality [p = 0.437] stone location [p = 0.949], preoperative Hb [p = 0.095], postoperative Hb [p = 0.423] and change in Hb (indicating blood loss, p = 0.398). Puncture levels were significantly different among both groups (supracostal puncture in 18 and 36 patients; infracostal puncture in 63 and 51 patients in groups A and B, respectively, p = 0.006), while operative time [p = 0.787], calyx punctured [p = 0.051], double puncture [p = 0.787], nephrostomy tube [p = 0.288] were statistically not different among groups. Similar number of patients demonstrated residual stones [p = 0.773], along with residual stone sizes [Group A (0.5; 0.5) and Group B (0.65; 0.38)] [p = 0.445]. Intra-and postoperative complications like blood transfusion [p = 0.700] and fever [p = 1.000] along with hospital stay [p = 0.614] were comparable among groups. Conclusion: Percutaneous nephrolithomy is safe and effective in previously operated kidneys despite the possibility of calyceal anatomy distortion and scarring.