Urology Commons^™

Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman

Section of Urology

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.
Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray …

Making Tough Decisions, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

This article focuses on the aspect of critical thinking in making tough decisions in life. Advances in urology have resulted in a range of therapies for many urologic diseases and disorders. Patients need information about each treatment, and the time to fully consider the effect of a given therapy on their overall health. Keep in mind that patients who are empowered to make decisions about their health care are more likely to comply with the treatment plan. Likewise the author urges readers to use their critical thinking skills to solve the clinical problems they are confronted with daily.

Expression Of Ps2 In Prostate Cancer Correlates With Grade And Chromogranin A Expression But Not With Stage, Hammad Ather, Farhat Abbas, Nuzhat Faruqui, M Israr, Shahid Pervez

Department of Pathology and Laboratory Medicine

Background: The biological potential of prostate cancer is extremely variable. Particular interest is focused on markers not expressed in normal prostatic tissues. pS2 protein expression has been demonstrated in a range of malignant tissues in an oestrogen-independent pathway. Recently, it has been demonstrated that pS2, in prostate cancer, is closely associated with neuro-endocrine differentiation. In the present study, we have analyzed, the potential of Neuro-endocrine and pS2 (TFF1) expression in human prostate cancer determined by immunohistochemistry, in primary adenocarcinoma of the prostate and attempted to correlate this with the clinico-pathologic features of the patient and neuroendocrine expression.

Methods: Ninety-five malignant …

Isolated Congenital Bilateral Absence Of Vas Deferens (Cbavd): A Rare Anomaly And Diagnostic Dilemma, M Moazzam, Syed Raziuddin Biyabani, C K. Jadoon

Section of Urology

No abstract provided.

Incidental Diagnosis Of Diseases On Un-Enhanced Helical Computed Tomography Performed For Ureteric Colic, Nazim A. Ahmad, M Hammad Ather, Jeffrey Rees

Section of Urology

Background: Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT) for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic.Methods: Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological …

The Prevalence Of Silent Kidney Stones: An Ultrasonographic Screening Study, Buchholz Niels-Peter, Farhat Abbas, R Khan, Jamsheer J. Talati, M Afzal, I Rizvi

Section of Urology

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi.
Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis.
Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in …

Optimization Of Low Pre-Operative Hemoglobin Reduces Transfusion Requirement In Patients Undergoing Transurethral Resection Of Prostate, Hammad Ather, Nuzhat Faruqui, F. Abid

Section of Urology

Objective: To identify factors that influence peri-operative hemorrhage in view of reducing the need for transfusions in patients undergoing trans uretheral resection of prostate (TURP).
Methods: All patients undergoing TURP between January 1997 and December 1999 were identified using lCD 9CM coding and indexing system. Overall 430 patients were identified, however, 384 charts were included and reviewed for demographics, pre and intra-operative data and post-operative morbidity. Patients were divided into two groups on the basis of presence of significant hemorrhage.
Results: Overall 384 patients were analyzed. Nineteen patients had hemorrhage - group I whereas 365had no significant hemorrhage …

Needed: Urologic Nursing Mentors For New Grads, Karen A. Karlowicz

Ellmer School of Nursing Faculty Publications

Presents the accomplishment felt after a completion of intense course of study. Inundation of nursing graduates; Assessment of nursing education programs; Tips to develop the role as urologic nurse.

Post-Chemotherapy Residual Mass In Stage Iic Seminomatous Testicular Tumor, N A. Ahmad, S R. Biyabani, Farhat Abbas

Section of Urology

Introduction

The management of patients with residual masses following chemotherapy for advanced seminoma remains a difficult problem with no clear guidelines. While most patients with advanced seminoma achieve a complete or partial response with cisplatin based chemotherapy¹, a significant number will reveal a residual mass on follow up CT scan or MR imaging^2,3. Management options for post chemotherapy residual mass in a case of seminoma include close observation, radiation therapy and excisional surgery. While 80 to 85% of residual masses represent either fibrosis or necrotic tissue needing no further therapy, 10 to 15% may contain viable …

Symptomatic Granulomatous Prostatitis Following Bacillus Calmette-Guerin Immunotherapy For Bladder Cancer, M A. Noor, S R. Biyabani, I A. Burney, J Talatia

Section of Urology

No abstract provided.

Role Of Imaging In The Evaluation Of Renal Trauma, M H. Ather, M A. Noor

Section of Urology

No abstract provided.

Faecal Empyema, R Layeeque, S Hussain, M Arshad, Farhat Moazam

Section of Urology

No abstract provided.

Early Surgical Results With Intent To Treat By Radical Retropubic Prostatectomy For Clinically Localized Prostate Cancer, Farhat Abbas, Kamran Siddiqui, Syed R. Biyabani, Jamsheer J. Talati, S. H. Hasan

Section of Urology

Aims: To evaluate the early cancer control rates, morbidity and mortality in men undergoing radical retropubic prostatectomy (RRP) for clinicallylocalized adenocarcinoma prostate.
Methods: Patient's characteristics, operative data, progressive-free survival rates, morbidity and mortality were analyzed for 23 men with clinical T1-2 prostate cancer who underwent surgery with an intent to treat by RRP between December 1997 to July 2001.
Results: Patient's mean age was 63 +/- 6.2 years (range 51 to 76 years) with American Society of Anesthesiology (ASA) status I in 4%, II in 65% and III in 31%. Two third of the patients had lower urinary tract obstructive …

Niche Market And Customer Analysis For The Introduction Of A Potential New Pharmaceutical Product In Peninsular Malaysia, Jeyalakshmi Rajan

Student Works (2000-2009)

Benign Prostatic Hyperplasia (BPH) is a non-cancerous condition in which the number of prostate cells increases, causing the gland to enlarge. Nearly all men develop BPH If they live long enough and about half would develop symptoms of BPH. Company A's product is one of three drugs competing for the BPH market. In view of the slow growth of its product, Company A was considering launching a new formulation. Thus, a customer and market evaluation was essential to understand the market and develop relevant marketing strategies for such a launch. The major objectives of this study were to: (a) determine …

Problem Based Learning, Jamsheer J Talati

Section of Urology

No abstract provided.

A Critical Step In The Operative Management Of Non-Functioning Asymptomatic Incidentaloma, M H. Ather, S Altaf, A Memon

Section of Urology

No abstract provided.

A Noninvasive Test For Vesico-Ureteric Reflux In Children, R. A. Mevorach, B. Cilento, S. Zahorian, C. Badgett, R. Walker, A. Atala, S. Iannello, M. Meyer

Electrical & Computer Engineering Faculty Publications

Objective To report the development and testing of a device for the noninvasive diagnosis of vesico‐ureteric reflux (VUR) which avoids the need for urethral catheterization (currently required to reliably determine the presence of VUR), and which thus avoids the anxiety of parents and patients that causes many families to refuse such evaluation.

Patients and methods Fifty‐four children (49 girls and five boys, mean age 7.2 years, range 4–14) previously evaluated as having VUR volunteered to participate; no child was symptomatic at the time of the study. Refluxing units were known to be present by voiding cysto‐urethrography (within 1 year, mean …

Fluoroscopic Placement Of Double-Pigtail Ureteral Stents., Gregory L. Chen, Demetrius H. Bagley

Department of Urology Faculty Papers

Purpose: Double-pigtail ureteral stent is placed cystoscopically after ureteroscopy. We describe a technique for fluoroscopic placement of ureteral stents and demonstrate its use in a non-randomized prospective study.Materials and methods: Double-pigtail stents were placed either fluoroscopically or cystoscopically in 121 consecutive patients. In the fluoroscopic method, the stent was placed over a guide wire using a stent pusher without the use of cystoscopy. Conversely, stents were placed through the working channel of the cystoscope under vision. The procedure, stent length, width, type, method, ureteral dilation, and use of a retrieval string were noted.Results: A wide range of stent sizes were …

Surgical Management Of Penile Cancer: Report Of Two Cases, M Amjad Noor, Muhammad Hammad Ather, M Nasir Sulaiman, Farhat Abbas

Section of Urology

No abstract provided.

Genitourinary Tuberculosis: A Profile Of 55 In-Patients, N P. Buchholz, S Salahuddin, R Haque

Section of Urology

Objective: To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment.
Method: We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan.
Results: The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery …

Ultrasonographic Renal Size In Individuals Without Known Renal Disease, Niels-Peter Buchholz, Farhat Abbas, Syed Raziuddin Biyabani, Qaiser Javed, Jamsheer Jehangir Talati, Masood Afzal, Imtiaz Rizvi

Section of Urology

Objective: In order to establish some preliminary data of our population, we determined the ultrasonographic kidney dimensions in individuals withoud known renal disease. We assessed whether age, sex, side, body mass index (BMI) and presence or absence of diabetes mellitus and hypertension affect the renal size.
Methods: Ultrasonographic kidney measurements were performed on 194 adult patients without known kidney lesions. Measurements included length, width, cortical thickness and estimation of renal size which was obtained by multiplying the first three variables. The effect of age, gender, side, height, weight, BNll, hypertension and diabetes mellitus was statistically analyzed.
Results: The mean kidney …

Bone And Renal Stone Disease In Patients Operated For Primary Hyperparathyroidism In Pakistan: Is The Pattern Of Disease Different From The West?, Syed Raziuddin Biyabani, Jamsheer J Talati

Section of Urology

Objective: To document the clinical presentation of primary hyperparathyroidism (PHPT) in a developing country and note differences from the West.
Setting: A tertiary care teaching hospital.
Method: The records of 37 patients operated for PHPT between January 1986 and December 1997 were reviewed. Symptoms, laboratory parameters and histopathology results were analyzed.
Results: Surgery for PHPT accounted for 0.055% of 67,566 operative procedures performed in the Department of Surgery during the 12 year period. The mean age of our patients was 38.4±13.2 years (range 17 to 73 years). Ninety percent of patients were less than 60 years old and 51% less …

Acute Urinary Retention: A Primary Manifestation Of Chronic Lymphocytic Leukemia And Organ Confined Prostate Cancer, Muhammad Hammad Ather, Amanullah Memon

Section of Urology

No abstract provided.

Molecular And Cellular Biology Of Prostate Cancer, El-Nasir Lalani, Marc Elie Laniado, Paul David Abel

Department of Pathology and Laboratory Medicine

Prostate cancer is an enigmatic disease. Although prostatic-intraepithelial neoplasia appears as early as the third decade and as many as 80% of 80 year old men have epithelial cells in their prostate that fit the morphological criteria for cancer, only about 10% of men will ever have the clinical disease and less than 3% will die from it. There have been no significant proven interventions which have altered the natural history of the disease since hormone down regulation was introduced in the 1940s and new research has been poorly supported. There is however an urgent need to develop new criteria …

Ureteroscopic Lithotripsy., Demetrius H. Bagley

Department of Urology Faculty Papers

There is a wide array of endoscopic lithotriptors presently available. Each of these has its own advantages and disadvantages. No single lithotriptor is suitable for all applications and none can meet the goal of fragmenting all calculi while remaining harmless to tissue.

Biofilm Mediated Calculus Formation In The Urinary Tract, Robert J. C. Mclean, David J. Stickler, J. Curtis Nickel

Cells and Materials

Mineralization and subsequent calculus formation is a common complication of biofilm infections. In the urinary tract, these infected calculi often arise from infections by urease-producing bacteria. Ammonia, liberated by bacterial urease activity, increases urine pH, resulting in the precipitation of Ca and Mg as carbonateapatite {Ca₁₀(PO₄,CO₃)₆(OH,CO₃)₂} and struvite (NH₄MgP0₄·6H₂O). These minerals become entrapped in the organic matrix which surrounds the infecting organisms and ultimately grow into mature calculi. When the causative organisms grow on urinary catheters and stents, the resulting mineralization can …

Feasability Of Preventing Encrustation Of Urinary Catheters, J. M. Bibby, A. J. Cox, D. W. L. Hukins

Cells and Materials

Colonization of urinary catheters by bacteria which produce urease leads to an increase in urine pH, followed by deposition of the minerals struvite and hydroxyapatite. Adhesion of these encrusting deposits can be reduced, but not prevented, by using catheters with a smooth surface finish. Chemical methods for preventing encrustation are not completely satisfactory. A better way of preventing encrustation would be to prevent colonization of the catheter by bacteria. This might be achieved by controlled release of antimicrobial agents directly into the urine from the catheter itself. Preliminary experiments have demonstrated the feasibility of controlled release from solid silicone. However, …

Some Observations On The Structure Of Encrusting Biofilms Of Proteus Mirabilis On Urethral Catheters, C. Winters, D. J. Stickler, N. S. Howe, T. J. Williams, N. Wilkinson, C. J. Buckley

Cells and Materials

A physical model of the bladder has been used to study the process of urinary catheter encrustation. Techniques have been devised for the preparation of sections through these encrustations in situ on the luminal surfaces of catheters and for mapping the distribution of calcium and magnesium in the biofilms. Transmission electron microscopy on these sections showed struvite-like crystals lying in the matrix and in direct contact with the catheter surface. Calcium phosphate ("bioapatite") was distributed throughout the film and many of these amorphous particles appear to have cells at their cores. Freeze-substituted sections of biofilms also showed electron dense materials …

Renal Angiomyolipoma: An Uncommon Tumour, Zafar Nazir, Jamsheer J. Talati

Section of Urology

No abstract provided.

The Binding Of Urinary Components And Uropathogens To A Silicone Latex Urethral Catheter, G. Reid, C. Tieszer, R. Foerch, H. J. Busscher, A. E. Khoury, H. C. Van Der Mei

Cells and Materials

The adhesion of uropathogens to urethral catheters initiates the infectious process which causes morbidity in a large patient population. Catheters were examined by X-ray photoelectron spectroscopy after use in three patients and following incubation in vitro with human urine, urea and creatinine, and found to have adsorbed a conditioning film containing carbon, nitrogen and in some cases phosphorous, calcium and sodium containing components. The binding of three strains of uropathogenic bacteria to the catheter surface was significantly influenced by the suspending fluid composition.