Ashok N. Biradar

Para-meatal urethral cyst with bladder calculi: A case report and review of the literature.

Para-meatal urethral cyst or median raphe cyst of the glans penis is a benign cystic lesion uncommonly encountered in prepubertal age group. Approximately, about 50 cases have been reported till date in the world literature. Herein we report a case of para-meatal urethral cyst concurrent with urinary bladder calculi.

Extensive nephroureteric calcification presenting with renal failure: A rare case report

The diagnosis of renal Tuberculosis (TB) can be hypothesized in the setting of non-specific bacterial cystitis associated with a therapeutic failure or a urinalysis with a persistent leukocyturia and absence of bacteriuria. Renal TB is an important cause of kidney disease, mainly in tropical areas of the globe, which can lead to end-stage renal disease if not diagnosed early and treated correctly. We report a case of a 58 year man with a past history of pulmonary TB treated for six months with extensive nephroureteric calcification presenting with renal failure.

Female urethral anomalies in pediatric age group: Uncovered

Female urethral anomalies such as epispadias and hypospadias have been rarely reported in the literature. Clinical diagnosis of female urethral anomalies is significant for management. Diagnosis may be missed leading to mismanagement of the clinical condition. Herein, we report a case of female epispadias and hypospadias managed by us at Tertiary Care Center.

Conservative management of accidental gall bladder puncture during percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) has been an excellent option for the management of kidney stones. There have been many complications in regards to solid organ injury during PCNL. Here we discuss an interesting case of 45-year-old woman, who underwent PCNL for right renal staghorn calculus, and had an accidental puncture of the gall bladder. Post operatively, the patient was conservatively managed and recovered well. A small number of cases has been reported until now in literature.

Make the technology count.

Good judgment comes from experience and experience comes from bad judgment – Rita Mae Brown In spite of advances in imaging techniques, PCNL continues to be a blind procedure. Gallbladder puncture during PCNL has been a described complication, sometime resulting in biliary peritonitis and even mortality [1]. Very few cases concerning conservative management of gallbladder puncture during PCNL have been reported in literature to date [2]. It is important to document the solid organ injury and maintain a registry of this. Voilette and Denstedt have given a major contribution by introducing standard protocol for documentation of PCNL complications [3]. A structured apprenticeship program is required to train fellow residents [4]. Recent advances in imaging, establishment of advanced training centres, and development of simulators have decreased the incidence of complications significantly by improving technical skills. However, complications continue to plague even the most experienced surgeons. The occurrence of complications can be decreased only by gaining more experience and by learning from past mistakes. The two–dimensional information provided by X–ray/ultrasound guided tracking does not provide an assessment of calyceal depth during needle puncture [5]. Neuronavigation (i.e. stereotactic surgery) has been a promising step in the field of neurosurgery [6]. Application of stereotactic surgery in the field of endourology may help in obtaining real time imaging and 3–D localization of the pelvicalyceal system, thereby reducing the complications significantly.