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  Citation statistics : Table of Contents
   1999| July-December  | Volume 15 | Issue 1  
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Fat-soluble vitamin profile in filarial chyluria : a preliminary study.
M Sridhar, DK Pal, ID Saxena, US Dwivedi, V NP Tripathi, PB Singh
July-December 1999, 15(1):18-20
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Randomized double-blind controlled clinical trial of serenoa repens versus placebo in the management of patients with symptomatic grade I to grade II benign prostatic hyperplasia (BPH).
NK Mohanty, RJ Jha, C Dutt
July-December 1999, 15(1):26-31
Full text not available    [CITATIONS]
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Acute abdomen of spontaneous bladder perforation.
DK Mittal, A Prasad, S Kumar, P Prasad
July-December 1999, 15(1):49-50
Intraperitoneal rupture of bladder in absence of trauma is extremely uncommon and usually associated with outlet obstruction or primary bladder-wall disease. The following case report illustrates the common mode of presentation but it is unusual in absence of an established etiology.
[ABSTRACT]   Full text not available    [CITATIONS]
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Urinary bladder with calculus : as contents of an inguinal hernial sac : a rare presentation.
MD Sanzgiri, NP Rangnekar, NI Ali, HR Pathak
July-December 1999, 15(1):50-51
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Central cavitatary effect : a radiological clue to a primary transitional cell carcinoma of the prostate.
A Mandlani, A Srivastava, A Kumar
July-December 1999, 15(1):52-52
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Malakoplakia of prostate : a case report.
AS Iyer, NU Ranadive, VD Trivedi
July-December 1999, 15(1):53-54
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Scrotal metastasis from transitional cell carcinoma of distal urethra.
AK Sharma, ND Perera, MT Vandal, R Bryan
July-December 1999, 15(1):55-57
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Kaposi's sarcoma of the testis.
AS Escandon, MA Pintos, AM Colino
July-December 1999, 15(1):57-58
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Diagnostic and therapeutic considerations in polyorchidism : a clinical curiosity in urology.
A Mandhani, R Kapoor, H SGT Rao, D Dubey
July-December 1999, 15(1):58-62
We hereby report a case of polyorchidism, which is a rare clinical entity (only 85 cases having been reported till date). The diagnosis of this condition, especially the role of ultrasonography and the management guidelines are presented along with a detailed review of its embryogenesis and the associated clinical anomalies. Polyorchidism is a rare congenital anomaly of testicular development and results from a division or duplication of the genital ridge. Majority of the cases show the epididymis of the supernumerary testis draining into that of the normal testis. Various anomalies are often associated with this condition. Ultrasonography is a useful tool in the diagnosis of polyorchidism. All supernumerary testes in ectopic sites should be excised to obviate malignant degeneration. Small atrophic supernumerary testes should be excised even if they are normally located. A supernumerary testis of a normal size should undergo ochiopexy to avoid torsion.
[ABSTRACT]   Full text not available   
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Complete penoscrotal transpostion : a case report.
AS Kanbur
July-December 1999, 15(1):62-64
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Maligrant periotoneal mesothelioma in an inguinal phi hernial Sac : an unusal presentation.
M Aggarwal, B Lakhkar, D Shetty, S Ullal, K Sasidharan
July-December 1999, 15(1):64-66
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The use of infant feeding tube as an alternative to nephrostent in pyeloplasty.
SS Samaiyar, US Dwivedi, PB Singh
July-December 1999, 15(1):67-68
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Infant feeding tube as an aid to optical internal urethrotomy.
SS Samaiyar, US Dwivedi, PB Singh
July-December 1999, 15(1):69-69
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An indigenously made device in the detection of nocturnal penile sigidity.
Prabhu GG Laxman
July-December 1999, 15(1):70-72
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Cohort study on circumcision of newborn boys and subsequent risk of urinary tract infection.
July-December 1999, 15(1):73-74
This population-based cohort study followed neonates in Ontario, Canada, prospectively to study the relation between circumcision and subsequent UTI risk. Eligible boys were born to residents of Ontario between April 1, 1993 and March 31, 1994. Hospital discharge data was used to follow-up boys until March 31, 1996. Computerised data from the Canadian Institute for Health Information of hospital discharges in Ontario were used for fiscal years 1993-94 to 1995-96 (April 1 to March 31 of the following year). Data are collected on all patients discharged from public, private and federal hospitals in Ontario, including acute-care and chronic-care hospitals and acute psychiatric hospitals. Therefore, all UTIs that necessitated hospital admission were included in this study. The data-base includes, for each patient on each hospital stay, demographic (birth date, sex and place of residence) and clinical data (admission date, discharge date, length of stay, codes from the International Classification of Diseases, 9th revision for discharge diagnoses). The cohort consisted of initially healthy infants. Multiple births were excluded from this study. Children circumcised after the first month of life were also excluded (2.9 percent). None of these children developed subsequent UTI during the 2-3 years of observation. Each child was followed up from birth to the first occurrence of UTI or to the end of March, 1996. The main outcome measure was hospital admission for UTI. The authors used ICD-9 codes to define UTI-infections of the kidneys (590), cystitis (595), urethritis (597), and other unspecified UTI (599). Cases of UTI necessitating hospital admission generally represent the most severe of the broad range of UTIs and are thus most relevant with respect to the balance of harm and benefit in terms of both cost and morbidity. Life-table method was used to calculate the cumulative probability of hospital admission for UTI, the log-rank statistic was used to compare the cumulative probabilities between the two cohorts, and Cox proportional-hazards regression to model the risks of hospital admission for UTI. Cases of UTI not resulting in hospital admission were not captured in this study. All data analyses were done with SAS software (version 6.11). Of 69100 eligible boys, 30105 (43.6 percent) were circumcised and 38995 (56.4 percent) uncircumcised. 888 boys circumcised after the first month of life were excluded. 29217 uncircumcised boys were matched to the remaining circumcised boys by date of birth. The 1 year probabilities of hospital admission for UTI were 1.88 per 1000 person years of observation (83 cases up to end of follow-up) in the uncircumcised cohort (p0.0001). The estimated relative risk of admission for UTI by first-year follow-up indicated a significantly higher risk for uncircumcised boys than for circumcised boys (3.7 [2.8-4.9]). 195 circumcisions would be needed to prevent one hospital admission for UTI in the first year of life.
[ABSTRACT]   Full text not available   
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Quality of life in advanced prostate cancer : results of a randomized therapeutic trial.
July-December 1999, 15(1):74-75
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An anatomical-functional and aetiological classification of lower urinary tract symptoms to facilitate understanding and diagnosis : storage insufficiency symptom trouble score (SI-STS) and emptying insufficiency symptom trouble score (EI-STS) for facilitating therapeutic decision making in obstructive BPH.
S Kumar
July-December 1999, 15(1):77-81
Limitations of the current usage of the term "lower urinary tract symptoms" and its classifications are briefly reviewed and an anatomical-functional and aetiological classification of lower urinary tract symptoms is proposed to facilitate understanding and diagnosis. Further, the limitations of available scoring systems for lower urinary tract symptoms as applied to therapeutic decision making in obstructive BPH are summarised and a storage insufficiency symptom trouble score (SI-STS) and emptying insufficiency symptom trouble score (EI-STS) are proposed for facilitating therapeutic decision making in obstructive BPH. A decision-making matrix is also presented for choosing appropriate treatment.
[ABSTRACT]   Full text not available   
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K Esuvaranathan
July-December 1999, 15(1):8-9
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Paediatric urolithiasis in western Orissa : a 10-year study.
LK Sahu, D Hota, JK Sahu, S Haldar, Silk
July-December 1999, 15(1):20-23
Only a very few reports are available in the world literature and almost no report are available in our country regarding urolithiasis in children. The incidence of urolithiasis is much more common in the western part of Orissa compared to other parts. This study was conducted during the last 10 years, i.e., from January 1998, to throw light on the different aspects of paediatric urolithiasis. The incidence was found to be high (8.41 percent) with a male preponderance (male: female, 29: 1). Children below 10 years of age were the common victims. This disease was found to be more common in lower socio-economic status group, which is used to cheaper non-vegetarian diet. In the absence of facilities for ESWL and endoscopic stone removal, open surgery was the choice of the treatment.
[ABSTRACT]   Full text not available   
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Antenatally detected pelviureteric junction obstruction : safety of conservative management by our protocol.
DK Gupta, M Bajpai, V VSS Chandrasekharan, M Srinivas
July-December 1999, 15(1):24-27
The present study was carried out by evaluate the safety and effectiveness of the selective conservative management of antenatally detected unilateral pelviureteric junction obstruction (ADPUJ) in children who were diagnosed to have unequivocal obstruction upon DTPA renograms performed at 6 weeks of age. The study comprised of 28 patients with ADPUJ. The selective conservative management was applied to the patients with unilateral ADPUJ who were asymptomatic, had split renal function (SRF) above 40 percent and had the anterior posterior diameter of the pelvis less than 20 mm at 6 weeks of life. 20 of the 28 patients fulfilled the above criteria and were followed up at 3-monthly intervals with unclear renograms and ultrasonography (US). Prophylactic antibiotics were not prescribed to these patients. The remaining 8 patients underwent pyeloplasty. None of the patients followed up without surgical intervention deteriorated enough to the SRF of 40 percent or below during the mean follow-up period of 30 months. Only 1 of these 20 patients had an episode of urinary tract infection. In conclusion, unilateral ADPUJ managed by selective conservative treatment is safe and these patients do not require any antibiotic chemoprophylaxis.
[ABSTRACT]   Full text not available   
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Optical internal urethrotomy under local anaesthesia.
NK Mohanty, M Khetan, AK Jha, RP Arora
July-December 1999, 15(1):28-31
Objective: Recurrence of urethral stricture after single internal urethrotomy is quite high, resulting in repeated urethrotomies. This results in a long waiting period for the patient to undergo urethrotomy under anaesthesia. Our aim was to perform urethrotomy under local anaesthesia so that hospital-stay-waiting-period is reduced to the minimum. Method: We analysed our patients between Jan '93 to Jan '98, who underwent repeated optical internal urethrotomy (O.I.U.) under local anaesthesia. A total number of 220 patients of stricture urethra underwent internal urethrotomy under local anaesthesia as a day care procedure using 2 percent Lignocaine jelly and intravenous Diazepam 10mg. Results: Our results revealed 35 percent (78 patients) had recurrence who underwent repeated urethrotomies (189) under local anaesthesia, number of urethrotomies depending on the etiology and length of the stricture. None of these patients were admitted in the hospital. Conclusion: We conclude that O.I.U. can safely be performed under local anaesthesia as a day-care procedure and the procedure is well tolerated by the patient without any hospitalisation and anaesthesia risk.
[ABSTRACT]   Full text not available   
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Modified cost reductive extraperi-toneal bladder neck suspension for anatomical stress urinary incontinence.
AK Hemal, S Ghosh, NP Gupta, SN Wadhwa
July-December 1999, 15(1):32-36
A pilot study was conducted in 5 female patients of anatomical stress urinary incontinence, who were repaired by cost reductive, modified extraperitoneal bladder neck suspension utilizing principles of Burch's colposuspension. All patients are showing good results except our first patient who occasionally leaks on stress although symptomatically improved substantially at follow-up of 12-24 months. The modified cost reductive technique of extraperitoneal bladder neck suspension is affordable and one can dispense with expensive disposable gadgets, thus providing the benefit of newer development at comparable cost to open surgery with additional advantages of low morbidity, shorter hospital stay and early recuperation with an excellent cosmesis.
[ABSTRACT]   Full text not available   
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Urodynamic assessment of patients with posterior urethral valves.
MD Sanzgiri, VV Maste, AD Mahajan, NP Rangnekar, RV Mahajan, HR Pathak
July-December 1999, 15(1):37-41
Objective : To identify the indications for urodynamic studies. To assess and categorise type of bladder dysfunction. To achieve a correlation between symptoms and urodynamic patterns. Patients and Methods : This is a prospective study carried out between August 1996 and January 1998 in a single tertiary referral urological unit including 72 patients with posterior urethral valves. These patients included 8 asymptomatic controls and 64 consecutive patients referred with symptoms of obstruction, incontinence or deteriorating renal function. All these patients were a minimum of 6 months post fulguration and did not have any radiological or endoscopic evidence of obstruction. The urodynamic evaluation was carried out on a DANTEC 5500 Urodynamic apparatus. The evaluation included a complete cystometric study and sphincter electromyography. Analysis: The urodynamic findings were recorded and analysed. The cystometric capacity, the compliance, the detrusor stability during filling cystometry, the detrusor contractility during the voluntary voiding phase and the EMG pattern were recorded. On the basis of these findings patients were categorised into broad urodynamic patterns. These patterns were then correlated with the presenting symptoms. Results : The majority of our patients were between 3 and 10 years of age (Table-1). Out of 72 patients, 8 were asymptomatic (controls), 35 presented with incontinence, 28 with obstructive symptoms and 1 with deteriorating renal function (Table-2). On clinical correlation it was observed that out of 28 patients who presented with incontinence 12 were low compliant out of which 8 had an unstable detrusor (presented with urge incontinence) and 16 were high compliant with a hypocontractile detrusor (presented with overflow incontinence). Of the 35 patients who had presented with obstructive symptoms all were hypocontractile (Table-6).All the asymptomatic patients had a normal urodynamic pattern. There were overall 4 different patterns of bladder dysfunction (not mutually exclusive); 10 were unstable, 25 were small capacity, 24 were low compliant and 40 were hypocontractile (Table-5).
[ABSTRACT]   Full text not available   
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Comparison of subinguinal microsurgical varicocelectomy (Goldstein's Technique) with inguinal varicocelectomy (Ivanissevich's Technique).
S Punekar, P Gavande, G Swami, A Soni, S Rao, JS Kinne
July-December 1999, 15(1):42-44
Introduction : Varicocele causing primary infertility can be dealt by open surgery, laparoscopy, venographic embolisation and microscopic surgery. Microscopic varicocelectomy by subinguinal incision is being compared with the more commonly performed traditional inguinal open varicoccelectomy. Material and Methods : Hundred males with primary infertility were divided randomly into two groups for inguinal and subinguinal varicocelectomy. Pre-operative and postoperative seminal parameters were compared. Both groups were analysed for post operative complications - iatrogenic hydrocele, testicular atrophy and recurrence of varicocele. Results : No significant difference was seen in improvement of seminal parameters and pregnancy rates between both groups. A significantly lower incidence of complications was noticed in subinguinal microscopic group.
[ABSTRACT]   Full text not available   
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Massive hematuria due to renal papillary necrosis.
G Gopalkrishnan, NS Kekre, BN Abhraham
July-December 1999, 15(1):45-46
Renal papillary necrosis (RPN) is a recognised complication in many medical conditions like sickle cell hemoglobinopathy, diabetes, analgesic abuse, and gout. Massive hematuria due to RPN has been reported in patients with sickle cell trait(1) but has not been described in those with other medical conditions. Two diabetic (type 2) males presented for evaluation of severe hematuria. Both patients had renal insufficiency, moderate to severe proteinuria and radiographic features of papillary necrosis. Complete radiological evaluation including computerized axial tomography (CT) and digital substraction angiography (DSA) failed to identify the source of bleeding. Cystoscopy at the time of hematuria localised the bleeding to the left kidney. Flexible ureteroscopy subsequently confirmed the bleeding to occur from the midpole papilla in one and the lower pole papilla in another. The bleeding points were coagulated with a bugbee electrode. Massive hematuria due to papillary necrosis in type 2 diabetes has not been reported earlier in literature.
[ABSTRACT]   Full text not available   
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Hydatid cyst of the adrenal gland.
NA Wani, OJ Shah, KA Wani, SS Nazir, KM Baba, JA Zargar
July-December 1999, 15(1):47-48
A hydatid cyst of adrenal gland in a 35-year-old female presenting as hypertension is described. The parasitology, characteristic diagnostic evaluation and surgical management for the entity resulting in curing of hypertension are briefly discussed.
[ABSTRACT]   Full text not available   
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The role of BCG in the treatment of superficial bladder cancer.
AM Kamat, DL Lamm
July-December 1999, 15(1):1-8
Intravesical therapy for superficial transitional cell carcinoma (TCC) of the urinary bladder (i.e. Ta, T1, and carcinoma in situ) is intended to treat existing or residual tumor, to prevent recurrence of tumor, to prevent progression of disease and to prolong survival of patients. Intravesical chemotherapy has resulted in a reduction in short-term tumor recurrence rates, but has had no positive impact on disease progression or prolongation of survival. Presently, BCG immunotherapy remains the most effective treatment and prophylaxis for superficial TCC and has a positive impact on tumor recurrence rate, disease progression and prolongation of survival. Proper attention to maintenance schedules, route of administration, dosing, strains and viability is essential to obtain the maximum benefits of BCG immunotherapy. This review highlights and summarizes the recent advances concerning BCG therapy in treatment and prophylaxis of TCC.
[ABSTRACT]   Full text not available   
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Safety and efficacy of endourology and SWL in paediatric calculus disease in a developing country.
A Mandhani, A Kumar, KV Sanjeevan, R Kapoor, M Bhandari
July-December 1999, 15(1):10-17
Objective : To assess the safety and efficacy of endourology and SWL in the management of paediatric calculus disease in a developing country. Patients and Methods : The study comprised of 110 patients of less than 15 years of age (range : 8 months to 15 years; mean: 9.9 years) who underwent treatment between June 1989 and July 1997 in a major urological centre in India. The clinical presentations, mode of therapy and the outcome were analysed retrospectively. There were stones in 120 units with 98 renal, 14 ureteric and eight vesical stones, Pain, urinary tract infection and haematuria were the frequent presenting complaints. Percutaneous nephrolithotomy (PNL) was undertaken for 27 renal stones. Shock wave lithotripsy (SWL) was given for 58 renal stones and one ureteric stone. Ureteroscopic retrieval (URS) was done for eight ureteric stones, percutaneous cystolithotomy (PCL) for four vesical stones. Open surgery was performed in rest of the 22 units. The youngest children who underwent PNL and PCL were each seven years old. The body size of these children was compared with the body size of the children of the West by standard nomograms to assess kidney size indirectly. Results : In PNL group, average stone size was 3.5 cm. Total clearance rate was 85 percent with re-look rate of 1.45 percent. However when SWL was combined with PNL total clearance rate was achieved in 96 percent of the patients. In SWL monotherapy, stones were of smaller size (av. 2.2 cm) which required mean of 2650 shocks in 3.14 sittings. Fragmentation rate was 85 percent with clearance rate of 76 percent, 88 percent of ureteric stones could be removed with ureteroscopy. All the 4 cases of PCL for bladder stones of size ranging from 2 to 6 cm were cleared completely. The most common indication for open surgery was parental insistence for a one go procedure due to financial constraints and concomitant surgical reconstruction for associated anomalies. The average size of an Indian child is smaller for age by one and a half to two years in their height and weight repectively.
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