Urography Research Articles

Lower pole obstructive megaureter of duplex kidney: an exception to the Weigert-Meyer rule

Introduction. Anatomical features of the urinary tract in patients with duplicate kidneys are described using the Weigert-Meyer rule, since the orifice of the upper ureter has an ectopic location (inferomedial) and the orifice of the lower ureter has an orthotopic location (superolateral). However, there are rare cases of violation of this rule, complicated by obstructive megaureter, ectopic ureteral orifice, the presence of ureterocele.Objective. To report the rare clinical case of a lower pole obstructive megaureter as a violation of the Meyer-Weigert rule in the patient with complete ureteral duplication and to describe the use of ureteroureterostomy as an effective and safe method of surgical correction of the presented anomaly.Clinical case. We present a case of the infant (5 months old) with a lower pole obstructive megaureter. This pathology was identified through intravenous urography and voiding cystourethrography. Laparoscopic proximal end-to-side ureteroureteroanastomosis was chosen as a surgical treatment. Postoperative control intravenous urography showed the effectiveness (a reduction in the lower pole collecting system of the duplex kidney was revealed) and the safety of this method of correction.Conclusion. There are only several clinical cases about exceptions to the Weigert-Meyer rule reported in literature, and most of them are about adult patients. The main surgical method of treatment in such cases is heminephrectomy. To our knowledge, this is the only reported case of using ureteroureterostomy in the patient with a lower pole obstructive megaureter. This technique has shown its effectiveness and safety for restoring the patency of the urinary tract, confirmed during the control postoperative examination.

Circadian as a prognostic factor for radiation responses in patients with cervical cancer: A nested case‑control study.

The radiation response of cervical cancer is thought to be enhanced by the levels of melatonin due to its roles in the circadian cycle and cancer growth. In the present study, the roles of circadian rhythms and melatonin levels as prognostic factors for predicting the radiation response in patients with cervical cancer were examined. In this nested case‑control study, patients with good and poor responses to radiotherapy were assessed in terms of the time‑of‑day radiation treatment was administered and further influencing factors. The radiation time was determined, as the subjects were either irradiated in the morning (06.00‑10.00am) or afternoon (04.00‑06.00pm). Data on tumour size and other biological parameters were collected and analysed by binary logistic regression. Among the 56patients examined, most subjects had good radiation responses. Most patients were <50years old with an initial body weight of >50kg, no pain prior to radiation, low erythrocyte sedimentation rates, normal intravenous urography results, moderate or good differentiation on pathology and histo‑pathologically non‑keratinised cells. According to the multivariate analysis, the irradiation time as a surrogate of the circadian cycle (morning vs. afternoon), the initial haemoglobin(Hb) level and the clinical tumour size were significant predictors of the radiation response. The circadian cycle, tumour size and Hb levels may affect the radiation response in patients with cervical cancer. In addition, the morning group had better 5‑year overall survival, but it was not significant, possibly due to the small cohort size. Further research is required to identify more relevant prognostic factors using different radiotherapy techniques [National Clinical Trial (NCT) no.NCT05511740, registration date, 08/20/2022].

The Report of a Surgical Residual Langas Inside the Renal Pelvis 16 Years after Surgery “Case Report”

Background &amp; Objective: Gossypiboma is the meaning of a residual foreign body such as gas in the abdomen following surgical operation, which is a rare complication of surgery. Residual of a foreign body causes mass, fistula, abscess and, obstruction after surgical operation. Computed tomography (CT) scan is a very useful method in the diagnosis of Gossipiboma. In patients who referred with abdominal pain and unexplained manifestations after surgery, Gossypiboma should be considered.&#x0D; Case presentation: A retrospective case study was performed in the year 2020 in a patient with a history of open kidney stone surgery in Hospital of Zabol. A 60-year-old male patient who referred with complaint of neck pain to an orthopedic doctor, which due to a history of kidney stone, the doctor orders an ultrasound of the kidneys. In the ultrasound, a number of stones are observed in the right kidney of this patient. After performing CT scan and Intravenous pyelography (IVP), a foreign body is identified inside the renal pelvis. In the following, the history taken from the patient, the history of open kidney stone surgery during 16 years ago in this patient is determined. During this period, the patient did not have any symptoms, including infection or pain in the mentioned area.&#x0D; Conclusion: In patients with a history of surgery who are referred with abdominal pain or mass, the residual foreign body should be included in the list of differential diagnoses.

Intrathoracic ectopic kidney: Surgical intervention and its consequences

Intrathoracic ectopic kidney is a very rare form of ectopic kidney. It is usually asymptomatic and diagnosed incidentally during chest investigations. A 3-year-old boy was admitted to our center with respiratory distress and fever recurrent since birth. An abdominal ultrasound, chest X-ray, intravenous pyelogram, and computed tomography revealed a right-sided intrathoracic ectopic kidney. A thoracotomy approach was used. The right intrathoracic ectopic kidney was reduced to the abdominal cavity and a diaphragm fold was performed. Subsequently, severe hydronephrosis and obstruction as a result of ureteral folding required repeated surgical intervention.

Laparoscopic transperitoneal ureterolithotomy is an effective and safe method for >15 mm impacted ureteral stones in elderly patients: single center 10-year experience.

The aim of our study is to investigate the efficacy and safety of laparoscopic ureterolithotomy operation in elderly patients with large and impacted ureteral stones. Between January 2011 and July 2021, 66 elderly patients with impacted, > 15 mm upper and middle ureteral stones underwent laparoscopic ureterolithotomy in our center. The data for all patients were evaluated retrospectively. The mean age of the patients was 65 ± 5.43 years. The mean stone size was 20.2 ± 2.5 mm. The mean operation time was 93.6 ± 13.2 minutes. Among patients, 16 (24.2%) had history of unsuccessful shock wave lithotripsy and 12 (18.1%) patients had history of ureterorenoscopy. Stone-free rate was 95.4% in all patients. Modified Clavien grade 1 complications were seen in 18 patients (27.2%), but no significant perioperative and postoperative complications were observed. Urinary extravasation lasting 5, 7 and 9 days was observed in 5 patients (7.5%) who were treated conservatively. The mean hospital stay was 3.4 ± 1.52 days. The patients were asymptomatic at the 6th week post-op follow-up, and no stones were seen on direct X-ray and abdominal ultrasonography. Intravenous urography and non-contrast tomography (NCCT) taken 3 months later did not show any obstruction or stenosis in the ureter. Laparoscopic ureterolithotomy can be considered as the first treatment option for elderly patients with impacted and large ureteral stones, thanks to its high success and acceptable complication rates.

Ratlarda intravenöz kontrast madde uygulamasının göz içi basıncı, göz yaşı miktarı ve oksidatif stres üzerine etkileri

Although iodinated radiocontrast agents, which are frequently used in radiological procedures such as indirect radiography, angiography, intravenous urography and computed tomography, are generally safe, they can cause serious side effects. In this study, it was aimed to investigate the effect of intravenous ionic high osmolar contrast agent administration on intraocular pressure, tear amount and oxidant and antioxidant parameters of eye tissue. Study groups consisted of 2 groups, Group 1 (Control) and Group 2 (Urographin), and a total of 16 Wistar albino female rats were used. On the first day of the experiment, 6 ml/kg of physiological saline was administered intravenously to the control group, and the same dose of contrast agent was administered to group 2. Intraocular pressure and tear amounts were measured at 1, 6, 12, 24 and 48 hours after intravenous administration. After measurements were made at the 48th hour of the experiment, all rats were euthanized and their eye tissues were removed. In order to reveal the oxidative damage and antioxidant activity in the eye tissue, malondialdehyde and reduced glutathione levels, catalase and glutathione peroxidase enzyme activities were measured spectrophotometrically. Schimer tear test (STT-1) strip was used for tear amount measurements, and rebound tonometer Tonovet® was used as tonometer for intraocular pressure measurements. No statistically significant difference was found between the control and urographin groups in terms of intraocular pressure and tear amounts in the measurements performed at 1,6,12,24 and 48th hours after urographin administration. It was observed that the same application significantly increased the malondialdehyde level (P&amp;lt;0.005) in the eye tissue. There was no significant difference between the groups in terms of reduced glutathione level and catalase and glutathione peroxidase enzyme activities in eye tissue. It was evaluated that intravenous contrast agent administration causes oxidative stress in the eye tissue and this may have a long-term ocular effect

A Unique Urine Isolating Drape Technique for on Table Pyeloscopy Post Radical Cystectomy for a Suspected Upper Tract Lesion With an Obliterated Ureteric Orifice

A 72-year old male undergoes a transurethral resection of a 1.5 cm bladder tumor occluding the left ureteric orifice which was found to be a high grade pT2 urothelial carcinoma with an obliterated left ureteric orifice. In the workup before the procedure a CT intravenous pyelogram revealed a filling defect in the left lower pole and renal calyx. An MRI scan did not demonstrate any filling defects. Here are the CT and MRI scans below.

A STUDY OF URINARY TRACT ABNORMALITIES: ROLE OF LOW DOSE MDCT UROGRAPHY

Introduction: Computed Tomography (CT) urography is more accurate in detection of renal masses, urinary tract tumors, inflammatory lesion, calculi and other causes of urinary tract obstruction compared with intravenous urography. The standard single bolus MDCT Urography protocol comprises three to four phases, consists of non-contrast, corticomedullary, nephrographic and excretory phases. A major disadvantage is a high radiation dose, which is 8-10 times higher than an IVP examination. In comparison, an split-bolus, dual-phase technique scans the urinary system in the non-contrast and combined nephrographic-excretory phases. This study aimed to compare the total CT radiation dose of patient and image quality in standard MDCTU protocol and low dose MDCTU protocol. Methodology: In this hospital based prospective study total 100 patients (50 tests and 50 controls) were compared for radiation dose and subjective image quality assessment between standard dose MDCTU protocol [non contrast scan at 120kvp , followed by contrast enhanced corticomedullary phase and excretory phase] and low dose MDCTU protocol (non contrast scan (at 80 kvp), followed by contrast enhanced synchronus corticomedullary phase and excretory phase acquisition by using split bolus contrast administration technique) . Result: In the standard dose MDCTU protocol in unenhanced and enhanced phase, patients received mean net effective dose of 18.83 mSv and in the low dose protocol, patients received mean net effective dose of 9.06 mSv with significant 52% dose reduction (P value &lt;0.001). In Standard dose protocol in unenhanced phase, optimal resolution in 82% patients, moderately grainy/poor resolution in 14% and significantly grainy/very poor resolution in 4% patients. In low dose protocol, optimal resolution in 64% patients, mild to moderately grainy/poor resolution in 22% and significantly grainy/very poor resolution in 14% patients with no significant difference in image quality in both protocol (P value&gt;0.05). In low dose protocol, mild to moderately grainy/poor resolution images (22%) of unenhanced phase reviewed together with normal dose good qualitysynchronus corticomedullary and excretory phase images to diagnosis the almost same spectrum of pathology like standard dose protocol. Conclusion: In low dose MDCT Urography radiation dose reduction of approx 50% is possible with no significant difference in image quality in line to ALARA principle (As low as reasonably achievable), facilitating diagnosis of urological pathologies.

Effective dose for kidney-ureter-bladder plain radiography, intravenous urography, and abdominal computed tomography scan: A phantom study

Abdominal colic pain or hematuria is suspected to be caused by urinary tract stones. Commonly used X-ray examinations include kidney-ureter-bladder plain radiography (KUB), intravenous urography (IVU), and abdominal computed tomography (CT). In this study, a high-sensitivity thermoluminescent dosimeter (TLD) was embedded in a Rando phantom to directly measure organ dose and evaluate effective dose. During each experiment, 139 TLD measurement points that cover almost all organs (as recommended by the ICRP 103 report) were examined. Red bone-marrow and remainder tissues have a high tissue weighting factor (0.12), and they are widely distributed. In the phantom, 34 TLDs and 31 TLDs were embedded in the red bone-marrow and remainder tissues to improve the accuracy and representativeness of organ doses. The detailed organ dose distributions for KUB, IVU, and abdominal CT are presented. The effective doses for KUB and IVU were 0.22 and 1.51 mSv, respectively, and those for two abdominal CTs were 8.21 and 9.27 mSv. This experiment presents a conversion factor of 0.0177 mSv·mGy−1 cm−1 for the abdominal CT examination, which differs from most of the conversion factors obtained through the Monte Carlo simulation method.

Assessment of the effective radiation dose and radiogenic effect in intravenous urography imaging procedures

The pathology of the urinary system is usually investigated using Intravenous Urography (IVU). The study objectives are to quantify patients’ radiation dose and radiation induced malignant tumors risk during IVU examination. The radiation doses during IVU and the subsequent risks from exposure are studied, using data from 50 patients imaged in one hospital. The demographic data given as (mean ± std) was as follows:The age of patients was 39 ± 14 years; height of patients was 1.7 ± 0.1 m, the mass was 69 ± 10 kg and the body-mass-index was 24.3 ± 4.1 kg m−2. The physical exposure parameters recorded were: kVp: 74.04 ± 3.1, mAs: 33.64 ± 4. Moreover, the average number of films per procedure was 5.72 ± 1.49. The entrance-surface air kerma (ESAK) was 2.1 ± 0.64 mGy, and the mean effective dose was 0.131 ± 0.04 mSv. Calculation of the overall cancer risk yielded 5.9 × 10−6 procedures. ESAK (mGy) and effective dose values obtained in this study were comparable with reported studies as shown in the text. The effective and cancer risk are around ten times lower during IVU procedures than for example, contrast enhanced computed tomography urography (CTU) examination. Reduction of doses received by patients to meet the values of the diagnostic reference levels without compromising the quality and clarity of the images is highly recommended. KetwordsRadiation dosimetry; IVU; Radiology; Cancer risk; medical imaging.

Videourology Abstracts

Journal of EndourologyVol. 36, No. 6 AbstractsFree AccessVideourology AbstractsPublished Online:7 Jun 2022https://doi.org/10.1089/end.2022.29124.vidAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail A Unique Urine Isolating Drape Technique for On-Table Pyeloscopy to Exclude Suspected Upper Tract Urothelial Carcinoma During Radical CystectomyZein Alhamdani, MD,1 Sean Ong, MBBS,2 Nathan Lawrentschuk, MBBS PhD FRACS (Urology),3 and Dixon Woon, MBBS (Hons), DMedSc, FRACS (Urology)11Department of Surgery, University of Melbourne, Austin Health, Heidelberg, Australia.2Department of Surgery, University of Melbourne, Parkville, Australia.3Department of Urology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.Clinical History: A 72-year-old man undergoes a transurethral resection of a 1.5 cm bladder tumor completely obliterating the left ureteral orifice (UO). A radical cystectomy was performed as the tumor was found to be a high-grade pT2 urothelial carcinoma. A computed-tomography intravenous pyelogram phase clearly demonstrated a filling defect in the left lower pole and renal calix; however, an magnetic resonance imaging postcontrast failed to detect the same filling defects, possibly secondary to inadequate filling as the obstruction progressed.Physical Examination: Physical examination was unremarkable and vital signs were within normal parameters.Diagnosis: The history raises high clinical suspicion for an upper tract urothelial carcinoma. At a multidisciplinary team meeting, some surgeons advocated for a radical nephroureterectomy, others a unique drape technique that facilitates on-table pyeloscopy.Intervention: To investigate the upper tract filling defect, retrograde pyeloscopy was not possible because of the obliterated left UO. Our novel technique is the first described to facilitate on-table pyeloscopy with an open ureter that diverts ureteral fluid into a pouch instead of the abdomen after radical cystectomy when upper tract access is not otherwise possible. The diversion of ureteral fluid from the abdominal cavity minimizes the catastrophic theoretical risk of tumor seeding1–5 that has been known to happen along percutaneous nephrostomy tracts.6Follow-up/Outcomes: The filling defect was most likely caused by a fungal ball seen on pyeloscopy, and as there were no signs of malignancy observed this patient was saved from a potential nephroureterectomy.Patient consent statement: “I give full informed consent to the research team for this research project including recording of the operation for the purposes of research and publication of a video and any written materials.”http://online.liebertpub.com/doi/full/10.1089/vid.2022.0018

Different Diagnostic Findings in patients with Gross Hematuria on Computed Tomography Urography

Background: In urine, the presence of abnormal quantity of RBCs is Hematuria. Computed Tomography Urography ability for assessing urothelium and renal parenchyma within particular examination also provides insight into morphological and functional urinary system which may help the physician in better treatment and management of their patients. Aim: To evaluate different diagnostic findings into patients presenting with gross Hematuria on CTU. Methodology: A descriptive study was conducted at Shalamar Hospital Lahore. Data of 113 participants were designated done suitable sample method. For analysis of data 24 SSPS version was used. Results: Out of total number of 113 patients, comprising Out of total number of 113 patients, 33 (29.2%) were females and 80 (70.8%) were males. Out of 113 patients, 42 (37.2%) pateints had gross haemutria, 40 (35.4%) had macroscopic haemtuira and 31 (27.4%) had no haemturia. 25 (22.1%) patients had nephrolithiasis and 88 (77.9%) had not nephrolithiasis. 20 (17.7%) patients had PUJ calculus and 93 (82.3%) had PUJ calculus. 14 (12.4%) patients had urinary tract masses and 99 (87.6%) patients had not urinary tract masses. Out of 113 patients, 58 (51.3%) patients had no calculus and 10 (8.8%) had calculus at distal pole, 30 (26.5%) had calculus at mid pole and 15 (13.3%) had calculus at proximal pole. Mid ureter is the most frequent site for urolithiasis. 27 (23.9%) patients had prostatic abnormalities and 86 (76.1%) patients had not prostatic abnormalities. Conclusion: This study concluded that the utility of CTU is now widely recognized as well as has grown to be the Imaging of choice to evaluate of asymptomatic Hematuria. In our study gross Hematuria are most common in males. The most common site for cause of Hematuria was ureteric calculi and least common site was nephrolithiasis. Keywords: Hematuria, Intravenous Urography, Urolithiasis, pelvic ureteric junction.

URINALYSIS AS PREDICTOR OF UPPER-TRACT URINARY STONE ON COLIC PAIN PATIENTS: SINGLE-CENTER COHORT STUDY

Objective: There was no study in our country especially in our hospital that studied correlation between urinalysis and upper tract urinary stone on colic pain patients, so we conducted the study. Material &amp; Methods: We_collected patients' data with colic abdomen from January 2018 to January 2020 then divided into hematuria and non-hematuria group respectively. We excluded patients with lower-tract urinary stones, DJ-stent insitu, BPH, and malignancy. All patients had urinalysis and abdominal ultrasound, then continued with non-contrast abdominal CT-Scan or Intravenous Urography. Retrospective and prospective cohort study was performed to collect data: age, sex, serum ureum and creatinine, urinalysis results (pH, specific gravity, nitric, leucocyte, erythrocyte, crystal, and bacteria), stone number, site, and size, then analysed the relationship between urinalysis results with upper-tract urinary stone incidence using point biserial correlation. Results: We found 235 colic patients, 115 and 120 patients in hematuria and non-hematuria group respectively. Male patients were higher, 137_(58.3%). The highest incidence was in the range 41-50 years-old_(30.6%), mean 46.5313,53 years-old. Stone incidence was 55.7% in all colic patients. Stone was proven 78.3% and 34.2% in hematuria and non-hematuria group respectively. There was significant association between upper-tract urinary stone and haematuria compared to non-haematuria patients (p&lt;0.05). Relative-risk (RR) was 2.29, CI_95%. Conclusion: Hematuria increases two-folds probability of upper-tract urinary stone. It is necessary to expand population data and follow-up center to make this representative

Diagnosis and Management of Vesicouterine Fistula (Youssef’s Syndrome): A Case Report

Background. Vesicouterine fistula (VUF) is a rare pathological communication between the uterus or cervix and the bladder. Youssef's syndrome is an atypical presentation of a patient with a vesicouterine fistula, characterized by a triad of cyclic hematuria, amenorrhea, and absence of urinary incontinence. Because of this atypical presentation, the patient may go undiagnosed and patient management will be delayed.&#x0D; Case presentation. A 39-year-old woman complained of hematuria. The patient underwent a second caesarean section in 2008 and a few weeks after the procedure the patient complained of leakage of urine from her vagina. Six months later the patient complained hematuria on her menstrual cycle and amenorrhea, with absence of urinary incontinence. Ultrasound examination found adhesions between the uterus and vagina, and irregular bladder mucosa. Patient underwent cystoscopy with endometriosis were suspected on vesicovaginal repair scars and a bladder biopsy was also performed with the results of no endometrial stroma and glands then followed by hysteroscopy. Hysteroscopy result showed a 20 mm diameter hole with irregular margins. Subsequently, the patient was treated with hysterorrhaphy laparotomy and fistula repair.&#x0D; Conclusion. One type of vesicouterine fistula is Youssef's syndrome, which is a complication following a lower segment caesarean section with undiagnosed bladder injury. The diagnosis can be confirmed by cystoscopy, intravenous pyelography, hysterosalpingogram, sonography, and other types of imaging tests. Management of patients with VUF can be conservative, medical, or surgical.

The urinary lithiasis – a challenge of contemporary medicine, under the sign of scientific achievements

The efficacy of various diagnostic imaging methods in determining the morphofunctional features of the affected kidney, the characteristics of kidney stones and its complications, as well as the sensitivity and specificity of conventional imaging methods (ultrasonography, simple KUB radiography, intravenous urography), functional (isotopic renography and dynamic renal scintigraphy) and complex (computed tomography and densitometric tomography associated with infrared spectroscopy) were assessed. Comparison of imaging data with the results of macroscopic evaluation of affected kidneys by stones during surgery allowed to specify the diagnostic contribution of each method with determining its influence on the selection of any applied treatment method. The article assesses an analysis of the main aspects related to diagnosis, the selection criteria for medical-surgical treatment, but especially the surgical techniques, selected from case to case, individualized with the introduction and implementation of numerous diagnostic procedures, treatments, prophylaxis, and metaphylaxis, during the years 2010–2021. The current study of kidney stone disease is complex scientific research, with a multilateral character, which is determined by the multitude of the examined aspects.

Complex beam diagnostics of nephroptosis in adults

The informativity of the ultrasonic examination, intravenous excretory urography, radioisotopic renography in the diagnosis of nephroptosis is studied. It is shown that the combined use of radiation methods makes it possible to establish the nephroptosis degree, to reveal the disorders of uro- and hemodynamics and to determine the choice of treatment tactics.

Intravenous Pyelogram (IVP)-Based Guy’s Stone Score (GSS) Utility for Prediction of Outcomes of Upper Pole Access Percutaneous Nephrolithotomy (PCNL)

Background: Renal stone disease is a very common disease, and its lifetime prevalence is 1 - 15%, with a gradual rise in incidence and disease prevalence. There are significant financial implications of its management. Nowadays, for big (typically &gt; 2 cm) renal and upper ureteric stones, PCNL is widely regarded as the first-line treatment. Because most of the intrarenal collecting systems can be accessed by superior calyceal puncture in PCNL, good stone clearance can be achieved. The “Guy’s Stone Score” is a useful technique for categorizing the complexity of PCNL. Objectives: This study aimed to evaluate the role of Guys Stone Score based on KUB and intravenous urography to predict the success rate, grading, and complexity of PCNL, which are performed via the upper pole access. Methods: The present prospective, non-randomized observational study was undertaken in the Department of Urology and Renal transplantation, SCBMCH, Cuttack, from 1st November 2017 to 31st October 2019. A total of 104 patients were enrolled in the study in whom PCNL was performed through superior calyceal puncture, based on preoperative intravenous pyelogram. The Guy's Stone Score was calculated, and the complexity of the procedure was graded using radiological studies, then the outcome was determined accordingly. Results: In this study, 59.6% of the patients had immediate success among them 29.0% had grade 3, and 6.5% had grade 4 GSS. Moreover, 38.4% of the patients had clinically significant residual fragments among them, 75.0% had grade 4, and 20.0% had grade 3 GSS.23% of the patients underwent REDO-PCNL and 11.5% of the patients underwent accesory/ancillary procedure of ESWL. Conclusions: The present study shows that an intravenous pyelogram-based Guy’s Stone Score (GSS) is an easy-to-use tool in predicting the early success rate and potential difficulties and complications in PCNL performed through superior calyceal puncture.

The clinical outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi

To evaluate efficacy and safety of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi. We retrospectively analyzed 784 patients who underwent FURSL between January 2015 and October 2020 in our unit. All patients were preoperatively evaluated with urine analysis, serum biochemistry, urinary ultrasonography, non-contrast computed tomography and intravenous urography. The procedure was considered as successful in patients with complete stone disappearance or fragments < 4 mm on B ultrasound or computed tomography. The operative parameters, postoperative outcomes and complications were recorded and analyzed respectively. The average operative time and postoperative hospital stay were 46.9±15.8 min and 1.2±1.1 days, respectively, among 784 patients. In addition, 746 patients were followed up and 38 patients were lost. In these patients, 700 (93.8%) cases met the stone removal criteria and 46 cases (6.2%) did not meet the stone removal criteria who need further treatment. The stone free rate (SFR) is 92.5%after 1-3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever (58/784, 7.4%), gross hematuria (540/784, 68.9%) and lpsilateral low back pain (47/784, 6.0%). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear. The complications are few and the safety is high. However, there are certain limitations to the efficacy in treating larger stone and lower calyceal calculi.

Analysis of the Application Value of X-Ray Digital Tomographic Fusion Technique in Urinary System Diseases.

Objective To explore the application value of the X-ray digital tomographic fusion technique in the diagnosis of urinary system diseases. Methods 500 patients with suspected urinary diseases in our hospital were examined by three methods: X-ray digital tomographic fusion imaging (DTS), intravenous pyelography (IVP), and abdominal plain film (KUB), and the image quality before and after tomographic fusion was objectively evaluated. The image quality could be divided into three grades: excellent, good, and poor. Results The image excellent rate of DTS (88%) was higher than that of IVP (27.5%). The sensitivity of DTS in the diagnosis of renal cyst and space occupying of the bladder was higher than that of IVP (P < 0.05). The accuracy rate of DTS in the diagnosis of urinary calculi was 93.33%, higher than 63.3% of KUB (P < 0.001). The accuracy rate of DTS in the diagnosis of ureteral stricture was 90%, higher than 65% of IVP (P=0.03). The accuracy of DTS in the diagnosis of hydronephrosis was higher than that of IVP and KUB (P < 0.05). Conclusion In the examination of urinary system-related diseases, high-definition images can be obtained by timely using sectional fusion technology. Compared with conventional IVP, space occupying lesions such as the bladder and kidney can be displayed more clearly with the help of the tomographic fusion technique, which is helpful to improve the possibility of finding lesions and is of great significance in clinical application.

Sonographic features of radiologically non-functioning kidneys on intravenous urography (IVU) in Kano Metropolis, Nigeria

Background: Despite technological advancement in uro-radiology, renal ultrasonography remains the imaging modality of choice for evaluating various pathological conditions affecting urinary tract (GIT) system.Aim: This study was aimed at evaluating sonographic features of radiologically nonfunctional kidneys in Kano metropolis, Nigeria.Methods: A prospective study involving 94 each of disease and control group were conducted in Kano metropolis from January 2019 to January 2021. Renal scans were performed using a digital ultrasound imaging system; model DP-8800Plus fitted with a 3.5MHz curvilinear transducer. The maximum length, width, and thickness were measured. The renal echogenicity was assessed and graded. Data was analyzed using SPSS Version 22.0Results: The mean values of the right and left renal volumes among adult patients was 400.5 ± 527.3 cm3 and 177.6 ± 174.3 cm3 respectively. For pediatric patients it was 272.3 ± 308.6 cm3 and 241.6 ± 228.7 cm3 for the right and left kidney respectively. The renal parenchymal echogenicity of the right kidney among adult patients were sored as grade II 2 (5.3%), grade III 27 (71%), and grade IV 9 (23.7%), while that pediatric patients were Grade 0 (11.1%), and 8 (88.9%) as grade III. The adults left kidney were scored grade II 2 (6%), and 16 (47%) each as grades III and IV, while the pediatric group scored 3 (25%) as grade II, and 9 (75%) as grade III.Conclusion: Increased renal volume, shrunken kidney, increased renal parenchymal echogenicity, and severe hydronephrosis were strong sonographic indicators of nonfunctional kidneys.