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B Lojanapiwat

Publications and source records attributed to B Lojanapiwat.

12 recordsLinked to original sources
PubMed2006

Colonization of internal ureteral stent and bacteriuria.

To demonstrate the infection rates, colonization rates following the internal ureteral stent placement; the correlation of indwelling time with the infection, bacterial colonization and the value of urine culture to identify colonizing bacteria One hundred and forty-eight stents of 146 patients were evaluated for the bacteriuria and colonization after internal ureteral placement average 8.6 weeks according to the indication. All patients were ambulatory and were examined in an outpatient clinic. Urine culture and 1 cm of proximal and distal ends was taken for culture for bacterial evaluation. The rate of colonization is 33, 50 and 54% when indwelling time is less than 4 weeks, 4-6 weeks and more than 6 weeks, respectively. Urine culture can detect colonization in 69%. Colonization was not found if the indwelling time was less than 2 weeks. Escherichia coli, Enterobacter and Pseudomonas spp. were the most common colonized organisms. Colonization is common if the indwelling time is more than 2 weeks, urine culture can detect colonization in about two to three of the patients. Even if the culture is negative, prophylactic antibiotic that cover gram-negative and gram-positive organisms should be administrated when the patients require further procedures.

Adolescent↗
PubMed2006

Previous open nephrolithotomy: does it affect percutaneous nephrolithotomy techniques and outcome?

BACKGROUND AND PURPOSE: The consequences of open nephrolithotomy are scar tissue around the kidney and in the retroperitoneum and distortion of the pelvicaliceal anatomy that may affect the techniques and outcome of percutaneous nephrolithotomy (PCNL). We compared the results and complications of patients undergoing PCNL who had and had not previously undergone open nephrolithotomy. PATIENTS AND METHODS: A total of 178 calculi in 175 patients who had previously had open nephrolithotomy (group I) and 178 calculi in 175 patients who had never had a renal operation (group II) were treated with PCNL. The average time between open nephrolithotomy and PCNL was 8.5 years (range 4 months-22 years). In both groups, PCNL was done by a standard technique with serial Amplatz dilator enlargement of the tract to 30F. Upper-pole access under fluoroscopic guidance was done in most patients. The operative time, success rate, hospital stay, and complications in the two groups were compared. RESULTS: The stone-free rates were 80.3% and 82.6% in groups I and II, respectively, and the rate of residual fragments < or =4 mm was 14.6% and 8.4%. The operative time, success rate, hospital stay, and complications did not differ significantly in the two groups. CONCLUSION: Percutaneous nephrolithotomy is effective and safe in patients who have previously had open nephrolithotomy with no more complications than are seen with PCNL of kidneys that have not been operated on.

Adolescent↗
PubMed2006

Upper-pole access for percutaneous nephrolithotomy: comparison of supracostal and infracostal approaches.

BACKGROUND AND PURPOSE: The advantage of upper-pole access for nephrolithotomy is direct access to most of the intrarenal collecting system and upper ureter. Upper-pole access can be achieved either supracostally and subcostally. Because of the anatomic location of the kidneys, the supracostal approach is associated with a higher rate of pulmonary complications. We compared the efficacy and safety of the supracostal and infracostal upper-pole approaches. PATIENTS AND METHODS: A total 464 patients were treated with percutaneous nephrolithotomy (PCNL) via the upper pole, of which 170 punctures (group I) were performed supracostally and 294 (group II) subcostally. In both groups, PCNL was done by the standard technique with fluoroscopic guidance. The operative time, success rate, hospital stay, and complications in the two groups were compared. RESULTS: Patients were stone free in 82.2% and 77.1% of the cases in groups I and II, respectively, and had stone fragments <4 mm in 10.7% and 14.7%, respectively. The operative time, success rate, and septic and hemorrhagic complications were not significantly different in the two groups. Hydrothorax was found in 26 patients (15.3%) of group I and 4 (1.4%) of group II. Only 9 patients (5.3%) in group I needed intercostal drainage. CONCLUSION: Percutaneous nephrolithotomy via the upper pole is effective using both supracostal and infracostal approaches, with acceptable rates of complications. The rate of pulmonary complications is higher with the supracostal approach. If the supracostal approach is indicated, it should be used with caution.

Adult↗
PubMed2005

The painful scrotum: an ultrasonographical approach to diagnosis.

Many disease processes, including inflammation, testicular torsion, testicular trauma, and testicular cancer, may have a similar clinical presentation as a painful scrotum. Differentiation of these disease processes is important for proper management. High-resolution ultrasonography (US) combined with colour Doppler ultrasonography (CDUS) is the imaging modality of choice in evaluating these patients. Gray-scale US helps to better characterise scrotal lesions. CDUS demonstrates testicular perfusion which aids in reaching a specific diagnosis. This pictorial essay is intended to review the causes, US appearances of disease processes causing the painful scrotum, and examination pitfalls of scrotal US.

Abscess↗
PubMed2005

Tuberculosis of the genitourinary tract: imaging features with pathological correlation.

The prevalence of pulmonary and extrapulmonary tuberculosis (TB) has been increasing over the past decade, due to the rising number of people with acquired immunodeficiency syndrome and the development of drug-resistant strains of Mycobacterium tuberculosis. The genitourinary tract is the most common site of extrapulmonary TB. Diagnosis is often difficult because TB has a variety of clinical and radiological findings. It can mimic numerous other disease entities. A high level of clinical suspicion and familiarity with various radiological manifestations of TB allow early diagnosis and timely initiation of proper management. This pictorial essay illustrates the spectrum of imaging features of TB affecting the kidney, ureter, bladder, and the female and male genital tracts.

Dilatation, Pathologic↗
PubMed2002

Intravesicle formalin instillation with a modified technique for controlling haemorrhage secondary to radiation cystitis.

OBJECTIVE: Intractable haemorrhage, secondary to radiation cystitis, is a serious complication of radiotherapy for pelvic malignancies. Formalin instillation is often effective for intractable haemorrhage unresponsive to other agents, but carries the risk of significant morbidity. The placement of formalin-soaked pledgets is a modified technique for the treatment of this complication. We compare the effectiveness and complications of both techniques. METHODS: Eleven patients with intractable haemorrhage secondary to radiation cystitis were treated by intravesicle 4% formalin instillation [Group I] and eight were treated by the endoscopic placement of 10% formalin-soaked pledgets on the bleeding points for 15 minutes [Group II]. RESULTS: Cessation of bleeding was 9 of 11 [82%] and 6 of 8 [75%] in Group I and Group II, respectively. One patient in Group II required two treatments, due to recurrent haemorrhage. Four major and several minor complications were found in Group I, and only three minor complications were found in Group II. CONCLUSION: Formalin instillation is effective in controlling severe bladder haemorrhage after radiation of the pelvis, but the complications secondary to the fixative properties are severe. Topical application of formalin-soaked pledgets is as effective in controlling the haemorrhage as conventional intravesicle formalin instillation, with fewer complications. This technique should be the initial treatment for this complication.

Administration, Intravesical↗
PubMed2001

Tubeless percutaneous nephrolithotomy in selected patients.

BACKGROUND: Placement of the nephrostomy tube is the last step after completion of percutaneous nephrolithotomy (PCNL). We were able to demonstrate in selected patients who had undergone PCNL that the use of an externalized ureteral catheter can reduce postoperative discomfort without complications. PATIENTS AND METHODS: A total of 37 patients underwent tubeless PCNL with an externalized 6F ureteral catheter for 48 hours. Inclusion criteria were use of a single access site where the renal unit was not obstructive, no significant perforation and bleeding, and no need for a second look. The stone burden was not taken into account. RESULTS: The procedure was performed successfully without major complications. The average length of hospitalization was 3.63 days: 25 patients stayed for 4 days, with the final day reserved for observation after removal of the catheter. The remaining 12 patients stayed only 3 days and could be discharged on the day the catheter was removed. The average intramuscular analgesic requirement was 38.57 mg of meperidine, and none of the patients needed a blood transfusion or required the emergency placement of a nephrostomy tube. CONCLUSION: In properly selected patients, tubeless PCNL with only an externalized ureteral catheter was found to be safe and just as economical as tubeless PCNL with the same outcome.

Adult↗
PubMed1999

Lower pole caliceal stone clearance after ESWL: the effect of infundibulopelvic angle.

Extracorporeal Shock Wave Lithotripsy (ESWL) represents the first choice therapy for renoureteral stone disease. Clinical controversy exists concerning the efficacy of ESWL for lower pole kidney stones. Nowadays, the factors that hinder the spontaneous passage of stone debris that results from ESWL of lower caliceal stone are the gravity-dependent position of the lower pole calices and particular features of the inferior-pole collecting system anatomy. We studied the influence of the lower infundibulo-pelvic in the success of ESWL of lower caliceal stones 10-20 millimeters in size in 50 patients with STORZ MODULITH SL-20 machine. At the mean follow-up of 6 months, only 44 per cent of the patients presenting with an infundibulo-pelvic angle of les than 90 degrees became stone free. On the other hand, 86 per cent of the patients presenting with an infundibulo-pelvic angle of greater than 90 degrees became stone free. Our data suggest that acute infundibulo-pelvic angle of the lower pole hinders the spontaneous passage of fragments after ESWL.

Humans↗
PubMed1999

Ureteric obstruction by shotgun pellet "pellet colic".

Acute renal colic from retained missiles is an unusual and interesting delayed complication of missile injuries to the abdomen. It must be considered in patients who present with symptoms of renal colic following gunshot and shotgun wounds with retained missiles. We report a case of acute ureteral obstruction secondary to a migrating intraluminal projectile 3 days after a shotgun wound to the back.

Child↗
PubMed1999

Preoperative laparoscopy in the management of the nonpalpable testis.

The purpose of laparoscopy in the management of the nonpalpable testis is to provide information regarding testicular presence and location to facilitate overall surgical management. Laparoscopy was performed at operation in 20 patients between 14 months to 21 years old (average 63 months), who had 22 nonpalpable testes. Of the testes 13 (59 per cent) were in the inguinal region or just proximal to the inguinal ring, 8 (36 per cent) were in a high intra-abdominal position and 1 (5 per cent) were absent. Anatomical localization of nonpalpable testes facilitated accurate planning of operative repair and the laparoscopy rendered exploration unnecessary in patients with intraabdominal vanishing testes syndrome, and laparoscopic orchiectomy is the treatment for the unilateral intraabdominal testes in patients more than 10 years old.

Adolescent↗
PubMed1994

Management of ureteral stenosis after renal transplantation.

BACKGROUND: Ureteral stenosis is the most common urologic complication of renal transplantation. Preferred management options for this complication vary among centers. Ureteral stenosis occurred in 24 (3.4 percent) of 692 consecutive renal transplants. The diagnosis was confirmed by antegrade pyelography after ultrasonography in all instances. An attempt was made to treat all patients by percutaneous stenting, usually with dilatation of the ureter, which was possible in 21 patients. In three patients, a wire could not be passed across the stricture and these patients were treated surgically. STUDY DESIGN: The patients were divided into two groups. Patients in group 1 (14 patients) presented within three months from the date of transplantation and patients in group 2 (seven patients) presented after three months. RESULTS: The site of stenosis was the ureterovesical junction in 80 percent of the patients and the uretero-pelvic junction in 20 percent. Urinary tract infection occurred in 70 percent of the patients in group 1 and 100 percent of patients in group 2. The success rate of percutaneous stenting was 71 percent (ten of 14 patients) in group 1, but only 29 percent (two of seven patients) in group 2. The failures were treated by repeated stenting (one patient in each group) or by operation. One allograft (7 percent) was lost in group 1 and two (28 percent) were lost in group 2. The average follow-up period was 38 months in group 1 and 56 months in group 2. There was no mortality in this series. CONCLUSIONS: Ureteral stenosis in the early postrenal transplant period can be safely and effectively treated by percutaneous dilatation and stenting, with few side effects and long-term success. This method is specially efficacious in patients who present within three months from the time of their transplant. In patients who have ureteric strictures developing after three months from transplantation, percutaneous stenting is of limited value and most patients require surgical correction.

Adult↗