BACKGROUNDBenign Prostatic Hyperplasia (BPH) is a common disease causing bothersome symptoms. The AUA Symptom Index or the identical IPSS is recommended for symptom assessment in each patient presenting with BPH. Though it has been validated it requires some explanation, especially for people with limited education. In this study, we evaluated the agreement and correlation between IPSS and UWIN to determine whether the reduced questionnaire could reliably be used instead of IPSS. MATERIALS AND METHODSA total of 300 patients with LUTS completed the IPSS and UWIN questionnaire. The patients feel about the two questionnaires, i.e. easy understanding, ability to fill without help, literacy of the patient, time taken, completeness of information were also recorded. Statistical analysis was performed; the scores of each participant on AUA-SS (range 0 to 35) and UWIN (range 0 to 12) were calculated and evaluated using Spearman's correlation coefficients. Bland-Altman plots were also used into determining whether UWIN and IPSS total scores were in agreement. RESULTSThe Spearman correlation coefficient was calculated for both the scores (Table 3), i.e. the IPSS and UWIN score and it was 0.913 (p <0.0001) which states that both the scoring system are in good correlation. Bland Altman plot of IPSS vs. UWIN showed that both the system were said to be in agreement if the values plotted are within the confidence limit. The pre-treatment IPSS and UWIN score were in good agreement for the 300 participants (Fig. 4). Similarly, the post-treatment IPSS and UWIN score were also in good agreement. The time taken for filling up the charts for IPSS score was average of 18 minutes (14-26 minutes). The time taken for filling up the charts for UWIN score was average of 10 minutes (8-18 minutes). CONCLUSIONSIn daily clinical practice the use of patient's questionnaires can be limited by questionnaire length and the burden that it places on the respondent to read, understand and answer all questions. Our study has shown that the UWIN scoring system for LUTS is equivalent to the gold standard IPSS.

Introduction and Objectives:Sepsis remains one of the dreaded complications of percutaneous nephrolithotomy (PCNL). To analyze prospectively the preoperative and intraoperative factors that predict the occurrence of systemic inflammatory response syndrome (SIRS) in patients undergoing PCNL so that we can aggressively manage those patients from the preoperative period itself and avert the dangerous complications.Materials and Methods:A prospective study was carried out between August 2012 and March 2013 including all patients who underwent PCNL. Patients with infected collecting system, synchronous ureteric stones, stents, or percutaneous nephrostomy drainage were excluded from the study. Patients were evaluated with physical examination, urine analysis, urine culture and sensitivity, complete blood count, renal function test, X-ray kidney, ureter, and bladder (KUB), and plain and contrast-enhanced computerized tomography KUB. Patients who developed any two or above of the following in the postoperative period were considered to have developed SIRS. (1) Temperature >100.4°F (38°C) or <96.8°F (36°C). (2) Pulse rate >90/min. (3) Respiratory rate >20/min. (4) White blood cell count >12,000/ml or <4000/ml.Results:Of the 120 patients who underwent PCNL 29 (24.1%) developed features of SIRS. On univariate analysis, gender, diabetes mellitus, bladder urine culture, and serum creatinine were found to be statistically insignificant. Blood transfusion (P = 0.009), no of access tracts (P = 0.001), pelvic urine culture (P = 0.04), stone culture (P = 0.003), stone size (P = 0.001), age (P = 0.019), and operative time (P = 0.004) were found to be statistically significant. On multivariate regression analysis stone size, no of access tracts, operative time, and stone culture were found to be statistically significant with regard to the occurrence of SIRS.Conclusion:Patients with above-identified risk factors must be aggressively treated to prevent the occurrence of sepsis postoperatively.

The ureteral calculus in general presents as acute colicky pain and the aim of treatment is to achieve complete stone clearance with minimal morbidity for the patient. Of the available treatment options for the management of lower ureteric stones, semirigid ureterorenoscopy with intracorporeal lithotripsy has the best results with little morbidity. However, ESWL is a safe and non-invasive technique with minimal morbidity. We have studied the outcomes of ESWL for distal ureteric stones and compared it with the ureterorenoscopy which is the current modality of choice. METHODSA total of 120 patients were included in the study. They were randomly divided into two groups by an independent observer into group A (70 patients) and group B (50 patients). The patients in group A were managed by supine transgluteal ESWL as described below and those in group B were managed by semirigid ureteroscopy. Patients were followed up at 15 days, 30 days and 90 days. Failure was defined as the presence of fragments of any size in the followup film 3 months after the final ESWL session. RESULTSThe demographic parameters and stone characteristics were comparable between the two groups. In our study, overall stonefree rate at three months was 93.8% (107/114). Clearance in the ESWL group was 89.4% (59/66) and in the URS group was 100% (48/48). This difference; however, was not statistically significant. However, there was an increased incidence of complications in the URS group, (24.2% vs. 39.6%), though most of the complications were mild requiring no active intervention. This difference was also not statistically significant (p=0.10). CONCLUSIONSupine transgluteal SWL for distal ureteric stones, the results are comparable with that of ureteroscopy with intracorporeal lithotripsy with specific advantages in carefully selected patients. It can be recommended as a non-invasive alternative for patients who are not fit or unwilling for surgery.