Objective: To compare the outcomes of percutaneous nephrolithotomy (PCNL) in patients with renal stones with high (≥700) versus low (<700) HU. Patients and Methods: A total of 200 patients having age 18 to 60 years, with diagnosis of unilateral renal stone disease, having stone size 2 to 4 cm in diameter on non-contrast computed tomography (NCCT) of Urology Unit of Ibn e Sina Hospital and Research Institute Multan were included. The study duration was May-2021 to July-2021. NCCT was done pre-operatively in every patient to measure Hounsfield units (HU). Post-procedural X-ray KUB was done 2 weeks after the surgical procedure to determine the stone clearance in every patient. Results: Mean age was 45.79±11.17 Years. Mean duration of disease of patients included in this study was 8.78±8.59 months. Mean stone size in patients included in this study was 3.11±0.61 cm. On comparison of stone clearance rate between the patients having high-HU versus low-HU, stone clearance was found in 61 (72.6%) patients having low HU value and in 105 (90.5%) patients having high HU value (p-value 0.001). Conclusion: HU-value ≥700 is a significant predictor of success rate of percutaneous nephrolithotomy (PCNL) in patients having renal stone disease. Keywords: Renal Stone Disease, Percutaneous nephrolithotomy, Hounsfield units (HU).
Objective: To determine the frequency of encrustations of ureteral stents in a tertiary care hospital of Pakistan. Patients and Methods: In this study we included 150 patients of Urology Unit of Ibn e Sina Hospital and Research Institute Multan, Pakistan in whom ureteral stents implantation was done. The study duration was April-2020 to July-2020. Patients with ureteral stents having renal stone, ureteric stone, ureteral stricture, pelviureteric junction obstruction (PUJO), trauma or malignant disease as primary pathology and duration of implantation >2 weeks to <2 years were included. Results: Mean age of patients included in this study was 46.46±12.26 years. Mean duration of stent placement was 11.96±6.01 weeks. There were 97 (64.7%) male and 53 (35.3%) female patients. There were 72 (48%) patients with renal stone disease, 32 (21.33%) patients with ureteric stone, 11 (7.33%) patients with pyeloplasty, 22 (14.67%) patients with partial nephrectomy and 13 (8.67%) patients with obstruction sec. to malignancy were included in this study. Stent encrustation was diagnosed 52 (34.67%) patients. Conclusion: After implantation, ureteral stent encrustation is still a cause for concern for urologists. Because its encrustation management may involve additional urologic procedures. In present study, stent encrustation was found in 62 (32.29%) patients. Keywords: Double-J stents, stent encrustation.
Objective: To compare the stone clearance rate in patients treated with percutaneous nephrolithotomy (PCNL) versus open surgery for the management of staghorn renal calculi. Materials and Methods: In this comparative study, a total number of 200 patients who presented in urology department of Ibn e Sina Hospital and Research Institute Multan with the diagnosis of staghorn stones were included. The study duration was October-2021 to January-2022. Group I: Patients underwent PCNL and Group II patients underwent open surgery for removal of stones. Stone clearance was two weeks of primary procedure. Results: Mean age was 45.53±10. 37 years in PCNL group versus 44.36±10.80 years in open surgery group (p-value 0.44). There were 64% male patients in PCNL group and 62% male patients in open surgery group (p-value 0.77). There were 19% patients who had bilateral stone in PCNL group and 23% in open surgery group (p-value 0.48). Complete staghorn stones were diagnosed in 70% patients in PCNL and in 73% patients in open surgery group (p-value 0.64).Stone clearance rate was 76% patients in PCNL group and 62% patients in open surgery group (p-value 0.032). Conclusion: In patients who have staghorn stones, percutaneous nephrolithotomy (PCNL) is preferable to open surgery in terms of the rate of stone clearance. Keywords: Open surgery, Staghorn stones, percutaneous nephrolithotomy.
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