Journal of Research in Urology
Year:2018 | Volume:2 | Issue:3 |Papers Count:5

Background & Objective: Retrocaval ureter is a rare congenital abnormality. Surgical repair would be necessary in the setting of functional or anatomic stenosis. Various techniques for laparoscopic repair of RCU were reported recently. The aim of present study is to describe our experience and techniques during laparoscopic pyelopyelostomy, as a new challenging technique, for Retrocaval ureter in 4 cases. Methods: One woman and three men with the mean age of 36. 5 years (range 16 to 48) referred to our department with the diagnosis of Retrocaval ureter. With transperitoneal laparoscopic approach, dilated renal pelvis was mobilized and transected at distal portion; ureter was replaced anterior to inferior vena cava. Patency of the retrocaval segment was confirmed by passing a 10Fr Nelaton catheter. Pyelo-pyelostomy was performed in running manner with intracorporeal suturing, over an antegrade inserted Double-J stent that was removed 4 weeks later. Follow up intravenous urography was performed 3 and 12 months after operation. Results: Mean operative time was 105 minutes (range 90 to 120). Recovery was uneventful in all patients. Follow up intravenous urography revealed patent anastomosis without stenosis and also significant improvement in hydronephrosis that accompanied by complete resolution of patient’ s symptoms. Conclusions: Laparoscopic pyelo-pyelostomy without excision of retrocaval segment is a safe, reliable and less time-consuming technique in management of Retrocaval ureter and can be the procedure of choice if retrocaval segment is not grossly stenotic.

Background and Objective: Labor pain has some adverse effects, which can be significantly reduced after delivery without pain. In the present study, we assumed that the elimination of labor pain effectively leads to favorable pregnancy outcome in women with kidney transplantation. Methods: Among the kidney recipients in Ekbatan and Shahid Beheshti hospitals in Hamadan, whose kidney transplantation was carried out from 1994 to 2016, 17 women were selected, aged 17-35, who decided to get pregnant at least one year after surgery. 7 cases were cesarean delivery and other painless deliveries. Results: None of the people who had painless labor had history of abortion or the risk of it. Either of them was exposed to pregnancy toxicity. Administration of immunosuppressive drugs did not increase during this period. All patients had normal bleeding during labor. There were no abnormalities in the newborns. Weight gain in infants with an average of 5300 grams was significant. During one year of follow up, none of the expected complications including increased serum creatinine, urinary tract infection, or high blood pressure occured, and the survival of the kidney transplant was similar to that of other non-pregnant participants. In general, all participants were reluctant to give birth. Conclusion: Relaxation delivery is based on epidural anesthesia, like delivery in non-transplanted individuals.

Background & Objective: Chronic renal failure (CRF) is an irreversible violation of renal function. The aim of this study was to determine the epidemiologic pattern of patients with this disease and related factors in hemodialysis patients of Shahid Ayatollah Ashrafi Esfahani Hospital in Tehran in 2017. Methods: This retrospective cohort study was conducted on 359 patients referring to the hemodialysis department of Shahid Ayatollah Ashrafi Esfahani Hospital who had undergone continuous hemodialysis for at least three months. Information was gathered through the medical history contained in the patient records of the hemodialysis department, and, in cases where necessary, additional interviews were conducted. Data were analyzed by descriptive and inferential statistics using Stata software version 14. Results: Of 359 patients in the study, 230 (64. 07%) were male with mean and SD (58. 04 ± 1. 09), of which 49. 86% were in the age range> 60 years old and only 3/90% of the patients were under the age of 30 years. 193 (53. 76%) were illiterate and 233 (64. 90%) were employed. Frequency (percentage of frequency) in terms of the most commonly known possible causes of the patients were respectively: hypertension 91 (25. 35%), hypertension and diabetes combined 84 (23. 40%) and diabetes 78 (21. 73%). 106 (29. 53%) patients, were diagnosed with other types of illnesses. Conclusion: Considering the hypertension and diabetes as the main causes of chronic renal failure, using appropriate methods can prevent the occurrence of the two diseases; the course of these patients will prevent the end stages of renal disease and will work to increase their longevity.

Background &Objective: The inadequacy of dialysis is one of the determinants of inability in hemodialysis patients. Due to the lack of clarity of the adequacy of dialysis in hemodialysis patients in Shahid Ayatollah Ashrafi Esfahani Hospital in Tehran, and since there has not been a similar study in this area, this study was the first study to evaluate the adequacy of dialysis in patients undergoing hemodialysis in the hospital. It was conducted in 2016. Methods: This is a descriptive cross-sectional study. In which all patients who were already hemodialysis at the center and who had been undergoing hemodialysis for more than three months were chosen using non-sampling method and entered the study. Data were collected through a checklist and researcher-made questionnaire. Dialysis adequacy was calculated through KT/V parameters and (URR) urea reduction ratio. The data were then analyzed using Stata software version 14. Results: Approximately fifty percent of the patients in the study had incomplete hemodialysis. As only 48(22. 75%) of patients with KT/V index were more than 1. 2 and in 41 (19. 43%) of patients with URR index more than 65%, indicating good hemodialysis adequacy. The mean KT/V index was 0/0± 96/29 and the lowest and highest were respectively 0. 07 and 1. 69 respectively. The mean URR index in the samples was 0/53± 0/13 and the lowest and the highest was 0. 14 and 0. 82. Conclusion: According to the dialysis index, a high percentage of patients in this hospital have inadequate hemodialysis, which needs to be reviewed and corrected.

Background and Objective: Acute Kidney Injury is a state which is defined as the accumulation of all waste products of metabolism, such as Urea and Creatine which causes an increase in mortality every year. In this study, etiology and epidemiology of AKI in patients who hospitalized were investigated from 2013 to 2017 in Shahid Beheshti hospital. Methods: This research is analytical, descriptive and cross-sectional in which patients with AKI, ARF, GN, ATN, AIN, Pre-Renal, Post-Renal Azotemia were studied. After a complete study of the mentioned cases, all essential data are recorded in the checklists, and analyzed using SPSS 16. Results: The mean age of patients was 65. 82 ± 34. 76 years. 64. 8% were male and 32. 5% were female. The percentage of prerenal and postrenal azotemia was 55. 2, 22%, and 22%, respectively. The most common risk variables was hypertension. There was a significant correlation between acute renal failure and the history of previous disease of kidney stones, prostate enlargement, heart disease and respiratory disease. Conclusion: It is better that everyone with underlying medical conditions such as hypertention, kidney stones, heart disease and diabetes to be evaluated for renal function annually.