Open Access Case Study

Significant Bilateral Calcification over a Neglected Ureteral Stent: About a Case Managed Endoscopically

Nedjim A. Saleh, Ghannam Youssef, Abdi El Mostapha, Nachid Abdellah, Ait Mahanna Hamza, Moataz Amine, Dakir Mohamed, Debbagh Adil, Aboutaieb Rachid

Asian Journal of Research and Reports in Urology, Page 9-13

Ureteral stents are integral parts of many procedures in endo-urology. Neglected stents can be associated with significant complications like serious encrustations, stone formation, recurrent urinary tract infections and hematuria. One of the known complications that poses a huge challenge to the urologist to manage is Calcification. The main risk factors for calcification of this stent are low education, time of use, sepsis, pyelonephritis, chronic kidney disease, recurrent or residual kidney stones, congenital and metabolic abnormalities, and malignant ureteral obstruction due to hyperuricosuria and chemotherapy. When removal by cystoscopy is not possible due to calcification, another procedure is required. We are reporting a case of significant bilateral double J-stent calcification in a 33-year-old patient who had kept bilateral double J stents placed for lithiasis for 3 years. Bilateral low back pain associated with hematuria was the main presenting complaints. biologically the renal function was normal. The CT scan revealed calcified bilateral double J probes along their entire length. The management was endoscopic in two sessions consisting of laser fragmentation of the calcifications and removal of the fragmented ureteral stent. Post-operative follow-up was simple.

Open Access Case Study

Zinner Syndrome with Chronic Refractory Lower Urinary Tract Symptoms: A Case Report

Anil Kumar Sah, Bipin Maharjan, Mahesh Bahadur Adhikari

Asian Journal of Research and Reports in Urology, Page 14-18

Zinner syndrome is a rare congenital urogenital anomaly characterized by unilateral renal agenesis, ejaculatory duct obstruction and ipsilateral seminal vesicle cyst due to developmental arrest in early embryogenesis affecting the caudal end of Mullerian duct. Here, we report a case of 27-year-old male, who presented with burning micturition, pain at base of penis, painful ejaculation and painful defecation for 10 years with history of recurrent urinary tract infection. Physical examination, transrectal ultrasonography, and pelvic magnetic resonance imaging (MRI) showed right renal agenesis, ipsilateral ejaculatory duct obstruction and right seminal vesicle cyst. He was found refractory to the conservative management of 6 months duration. Transurethral resection of veru with right ejaculatory duct and deroofing of the right seminal vesicle cyst was done with bipolar loop. The patient was symptomatically better during the follow-ups. The cases of Zinner syndrome have been addressed adequately but we had not found such cases from Nepal.

Open Access Original Research Article

Incidence Rate of Urosepsis Complication in Patient with Post DJ Stent Placement at Dr. Moewardi General Hospital Surakarta from January to March 2017: A Retrospective Study

Ihya U. Rahawarin, . Wibisono

Asian Journal of Research and Reports in Urology, Page 1-8

Background: Double J stent is a tool that is often used by the urologist to reduce and prevent upper urinary tract obstruction and to treat the injury in the ureter segment, with a mechanism to reduce urinary extravasation and accelerate ureter healing. Placement of Double J stent to the ureter has a meaning as implantation of a foreign object in the body that can cause various complications, especially infection. Placement of DJ stent allows the bacteria to colonize in the urinary tract that leads to systemic infection. Urosepsis is a form of non-traumatic emergency marked by systemic infection originating from the focus of infection in the urinary tract causing bacteremia and septic shock.

Objectives: To determine the incidence rate of urosepsis complication in a patient with post DJ Stent placement at dr. Moewardi General Hospital Surakarta from January to March 2017.

Methods: Descriptive retrospective study design by taking medical record data of a patient with post DJ Stent placement, then adjusted to the research criteria from January to March 2017.

Results: Male patients tend to develop urosepsis 1.3 times greater than female patients, with a percentage of 56%: 44%. Then, according to age criteria, patients with age > 50 years had a tendency 0.5 times greater than patients with age <50 years. (53%: 47%). Based on the length of installation found that patients with DJ stent placement > 1year tend to have sepsis 6.6 times greater than <1 year (87%: 13%).