Syed Raziuddin Biyabani

UNUSUAL PRESENTATIONS OF HYDATID DISEASE OF THE URINARY TRACT

Echinococcosis is an infestation caused in humans by the larval form of tenia echinococcus (E. granulosis). Humans are accidental intermediary hosts. Although the liver and lungs are commonly affected, renal infestation occurs in only 2% to 3% of all cases of hydatid disease. 2 Because of its uncommon occurrence in many parts of the world and infrequent involvement of the urinary tract, genitourinary hydatid disease may cause considerable diagnostic difficulty and management challenges for the radiologist and urologist. We report 3 cases to highlight the unusual presentation of hydatid disease of the urinary tract.

Incidental prostate cancer: the importance of complete prostatic removal at cystoprostatectomy for bladder cancer

Patients with invasive bladder cancer could be at a higher risk for a second malignancy such as an unsuspec- ted prostate cancer. We report a case of muscle-invasive transitional cell carcinoma of the urinary bladder with incidental adenocarcinoma of prostate, and review the literature to highlight the importance of complete prostatic removal to prevent residual disease.

Epidemiology of Stone Disease in Pakistan

Urinary tract stones are a common affliction across river, desert, and mountainous regions of Pakistan. A third of the stones have a single component. The commonest stone is composed of oxalate, with phosphate and uric acid as additional components. Calcium oxalate monohydrate is more abundantly present than the dihydrate. Phosphate stones comprise only about 7 % of all stones, and struvite is uncommon. Populations in the north have a greater proportion of pure and predominantly oxalate stones. Rural areas in the south have phosphate stones. The government of British India documented the frequent occurrence of stone in this region from the nineteenth century. The commonest stone was vesical. Noted stone transitions include (1) the marked increase in the discovery of renal stones, (2) the disappearance (except in pockets) of the idiopathic adult vesical stone, and (3) the decrease in children in the proportions of stones that are vesical. Late presentation for treatment and consequent renal destruction are still frequent.

Management of Urinary Bladder Calculi

The most common cause of bladder stones in the adult is bladder outlet obstruction from mechanical or neurogenic causes. Pediatric bladder stones, on the other hand, are likely due to nutritional factors. Open surgery for bladder stones has almost completely been replaced by endoscopic methods. Yet, it remains an effective modality of treatment in low-resource countries.

Shock Wave Lithotripsy, Endourological Intervention, and Hemostatic Defects

Extracorporeal shock wave lithotripsy and minimally invasive procedures for the management of urolithiasis are currently considered safe and effective. Yet, treatment-related hemorrhagic complications are common and at times dreadful. The risk of such complications is increased by the widely prevalent use of antiplatelet and anticoagulant medications as well as when operating on patients having inherited or acquired bleeding disorders. This chapter describes the perioperative management of these situations and depicts real-life scenarios of management of such cases.