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Background: Open pyeloplasty is considered as the gold standard for the treatment of pelvi-ureteric junction obstruction. Laparoscopic pyeloplasty has added advantages with equivalent success rate and low complication rate. Objectives: The aim is to study our experiences in laparoscopic retroperitoneal and transperitoneal pyeloplasty. Methodology: Sixty-five patients with pelvi-ureteric junction obstruction were included in the study. The study was conducted between October 2016 and May 2019 at Kathmandu Medical College Teaching Hospital. Pelvi-ureteric junction obstruction was evaluated by ultrasound and intravenous or computed tomography urography. Clinical history, hospital stay, complications, success rate and functional outcome were analyzed. Statistical analysis was done using the Statistical Package for the Social Sciences,version 20.0 (SPSS Inc., Chicago, IL, USA). A p-value < 0.05 was taken as significant. Followup of the patients was carried out for six to twelve months clinically and radiologically. Results: Laparoscopic transperitoneal pyeloplasty was performed in 27 males and 8 females. Retroperitoneal pyeloplasty was performed in 30 cases (20 males and 10 females). The mean age was 20.26 ± 3.92 years for all cases. Operative time was longer in retroperitoneal group. There were four conversions in retroperitoneal group. Mean hospital stay was longer in retroperitoneal group with significant p-value<0.001. Success rate was almost similar in both groups with insignificant p-value of 0.46. Conclusion: Transperitoneal laparoscopic pyeloplasty group achieved better results than retroperitoneal pyeloplasty group in terms of hospital stay, complication and drain placement but with almost similar success rate.

Cysticercosis is a parasitic infection with CNS involvement in 60-90% of infested patients. The larval form of pork intestinal tapeworm (Taenia solium) is responsible for cysticercosis. Humans are the definitive hosts and usually harbor the adult tapeworm in small intestine as an asymptomatic infestation. Neurocysticercosis most commonly affects the brain parenchyma. Solitary and multiple cysts in brain parencyma is common but we came across a 24 year old lady patient with huge number of cysts which is relatively rare. The aim of this article is to report the rare case. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6450 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 44-45

Background: Nephrolithiasis represents a large portion in the fi eld of Urological pathology. Minimal invasive and non-invasive therapies have become more accessible and effi cient in the treatment of nephrolithiasis. Percutaneous nephrolithotomy (PCNL) is an effective minimal invasive modality of treating kidney stones. Objectives: To evaluate the outcome of standard percutaneous nephrolithotomy (PCNL) using two different stenting techniques i.e. externalized ureteral catheter placement compared with Double-J stent placement. Methods: This is a prospective study conducted from January 2012 to June 2013 at Kathmandu Medical College Teaching Hospital among patients undergoing percutaneous nephrolithotomy (PCNL). Fifty patients who underwent PCNL were divided into two equal groups: Group 1 (PCNL with Double-J stent placement) and Group 2 (PCNL with externalized ureteral catheter placement). Factors evaluated included stent-related symptoms, postoperative morbidity, and the cost. Morbidity was classifi ed according to the Modifi ed Clavien classifi cation. SPSS 20 was used for statistical evaluation. P value less than 0.05 was considered signifi cant. Results: Stent related morbidity were fever, dysuria, hematuria, burning micturition. Total of 16 stent related complications were seen in group 1 with four of the patients needing early surgical intervention to remove the Double J stent and injectable antibiotics for urinary tract complication due to indwelling stent. In Group 2, seven patients experienced postoperative complications, out of which six were managed conservatively and one patient had grade III A dysuria and hematuria, who underwent immediate stent removal and received injectable antibiotics. There was no reported sepsis and mortality in both groups. Stent was removed in 3-4 weeks' time in group 1 and 3-4 days in group 2. In Group 1, patients had to come one day prior for stent removal. Cost for DJ stent was signifi cantly higher in group I than group II. Conclusion: Standard PCNL with externalized ureteral catheter is as feasible as Double-J stenting. Less cost can be a huge relief to the patients in the third world developing country.

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