Modern physiotherapy technologies in medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction

This article discusses the issues of medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Objective of the study: scientific substantiation of the use of selective chromotherapy in medical rehabilitation of children with megaureter with concomitant neurogenic bladder dysfunction. Materials and research methods: clinical observations and special studies were carried out in dynamics in 40 children, aged 1 to 7, with megaureter after ureteral surgery. Of these, 20 children made up the main group (received selective chromotherapy, blue spectrum); 20 children — the control group (without physiotherapy). Based on the studies carried out, a beneficial effect of medical rehabilitation with the inclusion of selective chromotherapy in children with megaureter and concomitant neurogenic bladder dysfunction was revealed. The inclusion of selective chromotherapy in the program of medical rehabilitation of children with megaureter contributed to a decrease in the activity of inflammation in the renal parenchyma (decrease in proteinuria, leukocyturia). Selective chromotherapy had a positive effect on the urodynamics of the lower urinary tract (reduction in the number of urgent urges and episodes of urinary incontinence, decreased frequency of urination, improved uroflowmetry indicators). The effectiveness of medical rehabilitation with the inclusion of selective chromotherapy was 80.0 %, while in the control group — 40.0 %.

COMPARISON OF THE EFFICACY (IN TERMS OF STONE EXPULSION) OF TAMSULOSIN VERSUS NIFEDIPINE IN DISTAL URETERIC STONE

ABSTRACT:INTRODUCTION: In western prosperous countries, a great research has been done on these two medicines in urolithiasis. Extent of disease is varying from developing countries to developed countries, specially due to late identification of diseases, late in examination which enhances the consequences of disease in ureteral stone or in any other disease. OBJECTIVES: To compare the efficacy (in terms of stone expulsion) of tamsulosin versus nifedipine in victims with distal ureteral stone. MATERIAL AND METHOD: All of 86 patients with distal ureteric stone, 20 to 50 years of both genders were included. Patients with proximal ureteric stricture, gross hydronephrosis, previous ureteral surgery and solitary kidney were excluded. After informed, written consent, all selected cases were divided in two groups by lottery method. In group A patients, tamsulosin was given while in group B patients, nifedipine was given. All patients were followed weekly by the researcher till 4 weeks and ultrasonography in both groups was done by the one consultant radiologist for evaluation of efficacy. RESULTS: Mean age was 32.29 ± 6.81 years. Out of these 86 patients, 53 (61.63%) were male and 33 (38.37%) were females with. Mean size of stone was 6.69±1.49 mm. Stone expulsion was seen in 37 (86.05%) patients in group A (tamsulosin group) and 25 (58.14%) patients in group B (nifedipine group) with p-value of 0.004. CONCLUSION: This survey concluded that efficacy (in terms of stone expulsion) of tamsulosin is better as compared to nifedipine in distal ureteric stone

Management of recurrent ureteral stricture: a retrospectively comparative study with robot-assisted laparoscopic surgery versus open approach

Background Management of recurrent ureteral stricture is challenging. Consensus on the best surgical choice has not been demonstrated. In this study, we aim to report our experience in treating recurrent ureteral stricture and demonstrate whether robot-assisted procedure for redo ureteral surgery is as effective as open procedure while remaining less invasive. Methods We retrospectively assessed 41 patients (22 robot-assisted surgeries and 19 open surgeries) who underwent consecutive robot-assisted and open procedures for redo ureteral surgery from January 2014 to 2018 in our institution. Perioperative outcomes, including demographics, operative time, estimated blood loss, complications, pain scores, success rate and cost, were compared between two groups. Results There was no significant intergroup difference in terms of age, body mass index, gender composition and American Society of Anesthesiologists scores. A total of 31 patients underwent redo pyeloplasty and ten underwent redo uretero-ureterostomy. Compared with open group, robot-assisted group showed shorter operative time (124.55 min vs. 185.11 min, p < 0.0001), less estimated blood loss (100.00 mL vs. 182.60 mL, p = 0.008) and higher cost (61161.77¥ vs. 39470.79¥, p < 0.0001). Complication rate and pain scores were similar between two groups. Median follow-up periods were 30 and 48 months for robot-assisted and open group respectively. Success rate in the robot-assisted (85.71%) and the open group (82.35%) was not significantly different. Conclusions Robot-assisted surgery for recurrent stricture after previous ureteral reconstruction is as effective as open procedure and is associated with shorter operative time and less estimated blood loss.

An Unusual Case of Retained DJ Stent

Double J stents are an integral part of urological practice today. Ureteral stenting is done as an adjunct to ureteral surgery and for managing ureteral obstruction. Every urological surgery doesn't require DJ stenting and their use must be strictly restricted to selected cases. Retension is a common complication of ureteral stents and is mostly due to encrustations on a forgotten DJ stent. Here we report a case of retained DJ stent which was placed during open nephrolithotomy. It was neither forgotten nor encrusted, but was embedded in the renal parenchyma. As per our knowledge this is the first case of its kind to be reported in medical literature.

Placement of subcutaneous ureteral bypasses without fluoroscopic guidance in cats with ureteral obstruction: 19 cases (2014–2016)

Objectives The purpose of this study was to describe the perioperative and postoperative complications as well as short-term and long-term outcomes in cats with ureteral obstructions treated by placement of a subcutaneous ureteral bypass (SUB) device without imaging control. The second objective of this study was to compare cats treated by SUB device with cats treated by traditional surgical intervention. Methods Data were obtained retrospectively from the medical records (2014–2016) of cats that underwent SUB placement (SUB cats) and cats that underwent traditional ureteral surgery (C cats). Results Nineteen SUB devices were placed without fluoroscopic, radiographic or ultrasonographic guidance in 13 cats. Fifteen traditional interventions (ureterotomy and neoureterocystostomy) were performed in 11 cats. Successful placement of the SUB device was achieved in all cats with only one major intraoperative complication (kinking of the kidney catheter) and one minor intraoperative complication (misplacement of the kidney catheter). Eleven SUB cats recovered from the surgical procedure; two SUB cats and three C cats died during the anaesthesia recovery period. Postoperative SUB complications included anaemia (n = 2), urinary tract infection (UTI) (n = 4), non-infectious cystitis (n = 5) and SUB device obstruction (n = 1). Postoperative traditional surgery complications included anaemia (n = 7), UTIs (n = 6), non-infectious cystitis (n = 1), re-obstruction (n = 4) and ureteral stricture (n = 1). Median postoperative duration of hospitalisation (3 days) was significantly shorter for SUB cats than for C cats ( P = 0.013). Ten SUB cats (76.9%) and four C cats (40%) were still alive at a median follow-up of 225 days and 260 days, respectively. Owners were completely (90%) or mostly (10%) satisfied with the SUB device placement. Conclusions and relevance SUB device placement appears to be an effective and safe option for treating ureteral obstruction in cats, and this study has shown that fluoroscopic guidance is not essential in all cases.