Background The prevalence of urolithiasis is on a rising trend in tropical and sub-Saharan African countries. The treatment options and data on the surgical outcome are limited in our country. This study was designed to assess the clinical presentation, surgical management and outcome of patients operated on for urolithiasis. Patients and Materials A retrospective study of all patients admitted and operated for urolithiasis at St. Paul’s hospital millennium medical college (SPHMMC) from July, 2016 to December, 2017 was conducted. Factors associated with surgical outcome were identified with binary logistic regression. Results Urolithiasis constituted 247 (30.0%) of 824 urologic admissions. Of these, 202 (Male:Female = 2:1) patients were investigated. The mean age was 37.1 ± 14.4 years (range, 10–85 years). The mean duration of illness was 16.7 ± 18.7 months and the commonest presenting symptom was isolated flank pain (97, 48.0%). A majority of the patients (186, 92.1%) had upper tract stones of which 96 (51.6%) were renal stones. More than two-thirds (164, 81.2%) of the patients had complications at presentation, and hydronephrosis (148, 73.3%) was the major one. Half of the patients (104, 51.5%) were treated with endoscopic procedures, 88 (43.6%) with open stone surgery and in 10 (4.9%) patients both were performed. Nephrectomy was done to 15 (7.4%) patients. Intraoperative and postoperative complications were noted in 16 (7.9%) and 26 (12.9%) patients, respectively. These complications were higher in patients with comorbid illness (AOR = 2.44; 95% CI 1.12–5.31; p = 0.024). Complete stone clearance was achieved in more than half of the clients (114, 61.0%). Multiple stones (AOR = 8.33; 95% CI 2.53–27.43; p < 0.0001) and endoscopic procedures (AOR = 4.17; 95% CI 1.57–10.71; p = 0.003) had significant association with incomplete stone clearance. Conclusion Patients’ presentation in this review was not different from studies elsewhere. Endoscopic procedures are emerging in our set up; however, it was significantly associated with incomplete stone clearance. Strategies to improve outcome (stone clearance) need to be implemented accordingly.

A case of chronic granulomatous disease with hydronephrosis and renal calculi is presented. This is to our knowledge the first such case to be reported. The calculi were successfully ablated by extracorporeal shockwave lithotripsy.

Background: Ureteroscopy is a major diagnostic and therapeutic technique for lesions of the ureter and intrarenal collecting system. Methods: A retrospective chart review was done at St. Paul’s Hospital Millennium Medical College, Ethiopia to determine the outcome of  ureteroscopy and factors affecting it. The study period was from January 2018 to April 2018. Multivariate analysis was done to determine factors  affecting stone clearance and success rate. Result: One hundred six patients who underwent semirigid ureteroscopy were included in the study. The male-to-female ratio was 1.8:1. The mean  age of the patients was 36.4 years (±12.6). Ninety-six (90.6%) patients were found to have ureteric stones, while 9(8.5%) patients had a ureteric  stricture. Ureteroscopy therapeutic interventions for stones were successful in 89 (92.7%) patients. The mean procedure time and postoperative  hospital stay were 44 minutes (±23.7) and 2.5 days (±2.5) respectively. Intraoperative complications (ureteric avulsion, hemorrhage, and ureteral  perforations) occurred in 6(5.7%) patients. The stone clearance rate was 54.7% (52). The site of obstruction was passed in 93 patients making the  success rate of the procedure 87.7%. The absence of intraoperative complications was significantly associated with success rate. Patients with  intraoperative complications have low success rate (20%) compared to patients without complications (92.3%), p=0.42. Conclusion: Semirigid  ureteroscopy had a good success rate, especially for stones in the distal ureter and if there is no flexible ureteroscope, it is an acceptable alternative.

Crossed fused renal ectopia is a rare congenital anomaly of renal embryogenesis. The majority of such anomalous kidneys are supplied by a single renal artery and drained by two separate ureters. However, drainage by a single common ureter is an unusual variant. Here, we present a 17-year old male with a pelvic pancake kidney drained by a single ureter with associated acute obstructive uropathy diagnosed with ultrasonography and computed tomography urography (CTU). We describe the anatomical peculiarity and diagnostic evaluation of the case.