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Biomedical subjects

M S Ansari

Publications and source records attributed to M S Ansari.

At least 19 recordsLinked to original sources
PubMed2007

National survey on orthotopic neobladder.

OBJECTIVE: A national survey was conducted among the urologists in India to find the preference for urinary diversion after radical cystectomy for muscle invasive carcinoma of the urinary bladder, percentage of neobladder reconstruction, segment of the bowel used, complication rate, need for self-intermittent catherisation on follow up and the survival. MATERIAL AND METHODS: A detailed questionnaire was mailed to all members of the urological society of India (USI) to find out their preference for urinary diversion following radical cystectomy for muscle invasive carcinoma urinary bladder. For the neobladder reconstruction, they were asked for the type of bowel segment used, complication rate, reoperation rate, need for intermittent clean catheterisation on follow up and 5-year survival. RESULTS: A total of 24 institutions responded to the mailed questionnaire. Of all institutions 12 (50%) did not prefer the orthotopic neobladder (ONB) reconstruction. Among the institutions carrying out neobladder reconstruction, majority perform ileal conduit in more than 50% of the cases. Ileum (66.66%) or ileocaecal (16.66%) segment was the choice of bowel segment for most of the urologists. Only three institutions used sigmoid colon. The complications encountered were wound infection (5-25%), burst abdomen (5%), urinary fistulas (3-25%), faecal fistulas (2-5%), bladder neck stenosis (5-15%) and ureterointestinal anastomosis stenosis (5-25%). The reoperation rate was 5-15% with a perioperative mortality of 0.5-3%. Around 10-100% (average 50%) of the patients require intermittent clean catherisation. Only seven institutions could provide 5-year survival rate data. Of these three institutions reported more than 50% and four institutes less than 50% 5-year survival. CONCLUSION: Ileal conduit still remains the urinary diversion of choice following radical cystectomy for muscle invasive carcinoma of the bladder among most of the urologists in India. Orthotopic neobladder reconstruction is practiced only in selected centres. Wound infection, urinary leak and obstruction at ureterointestinal anastomosis are the main complications. Clean intermittent cathaterisation is required at an average of 50% of the patients to ensure complete emptying of the neobladder.

Health Surveys↗
PubMed2006

Extensive balanitis xerotica obliterans (BXO) involving the anterior urethra and scrotum.

We describe an unusual case of balanitis xerotica obliterans (BXO) involving the entire anterior urethra and the scrotum that had presented as a palpable nodular scrotal mass with obstructive voiding symptoms in middle aged man. He was managed by a staged urethroplasty. We report the first such case of BXO involving the scrotum resulting in a nodular mass that has not been described and reported till date.

Adult↗
PubMed2006

Laparoscopic ureteral reimplantation with extracorporeal tailoring for megaureter: a simple technical nuance.

PURPOSE: We describe a novel technique of extracorporeal tailoring for megaureter to perform laparoscopic extravesical transperitoneal ureteral reimplantation. We present our initial results with this procedure. MATERIALS AND METHODS: Three cases of megaureter were operated on laparoscopically. The 3-port technique was used (all 5 mm in 2 cases, and 2, 5 mm and 1, 10 mm in 1). The colon was reflected medially to expose the retroperitoneal course of the ureter. The ureter was gently dissected circumferentially down to the bladder. It was ligated close to the bladder and divided proximal to it. The free ureteral end was delivered out through the ipsilateral 5 mm port. The lower end was tailored over an 8Fr feeding tube. A 6Fr Double-J stent was placed. Later the whole assembly was carefully replaced in the abdomen. A Lich-Gregoir type extravesical reimplantation was done. RESULTS: Mean operating time was 220 minutes (range 210 to 240), which included 15 to 20 minutes to exteriorize the ureter, complete extracorporeal tailoring and replace the stented ureter in the abdomen. Mean blood loss was 40 ml. Cystourethrogram at 3 months did not demonstrate any reflux. Renal scan showed preserved renal function in all 3 cases, with prompt drainage in 2 and delayed drainage in 1. At a mean followup of 12 months all 3 patients were asymptomatic. CONCLUSIONS: Extracorporeal tailoring for obstructing megaureter is an easy and safe procedure that makes laparoscopic ureteral reimplantation simpler and quicker to perform.

Adolescent↗
PubMed2005

Suture foreign body granuloma masquerading as renal neoplasm.

Foreign body granulomas and pseudotumors due to retained surgical linen are well known in surgical practice. These lesions usually correspond to the actual size of residual foreign body and have characteristic presentation according to the anatomy involved. Renal suture granuloma is a rare postoperative complication of renal surgery due to persistence of sutures used to close the pelvicalyceal system/nephrotomy incisions and usually present as incidentally detected small mass lesions. This case of a suture foreign body granuloma presenting with hematuria, large peripheral mass lesion and characteristic computed tomography picture of renal cell carcinoma confounded the diagnosis and underwent laparoscopic radical nephrectomy. In retrospect, such lesions warrant the use of selective needle biopsy and intraoperative frozen section confirmation to clinch diagnosis. Mass lesions occurring in a previously operated kidney should have granuloma as a differential diagnosis.

Adult↗
PubMed2005

Retroperitoneoscopic decortication of symptomatic renal cysts.

PURPOSE: To determine the safety and efficacy of retroperitoneoscopic decortication of symptomatic renal cysts. PATIENTS AND METHODS: A total of 24 patients with symptomatic 6- to 14-cm (mean 10.9-cm) simple renal cysts, right sided in 13 and left sided in 11, underwent retroperitoneoscopic decortication for pain relief at our center between January 1997 and December 2002. The diagnosis was based on an ultrasonogram and contrast-enhanced CT. Symptom severity, assessed using a visual analog pain scale, averaged 7.2/10 (range 6.5-9). The mean duration of symptoms was 4 months. Operative and follow-up data were collected prospectively and analyzed for symptomatic and objective evidence of improvement. RESULTS: The mean operating time was 95 minutes, and no major complications were observed. The average hospital stay was 2.9 days (range 2-7 days). At a mean follow-up of 2.8 years (range 1.5-5 years), pain relief was reported by 22 patients (change of pain score from 7.2 to 1.4). One patient had worsening of pain at 6 weeks postoperatively. Asymptomatic recurrence of the cyst was seen in two patients on the follow-up ultrasound scans. CONCLUSIONS: Retroperitoneoscopic renal-cyst decortication is a safe, minimally invasive, and efficacious procedure for the treatment of painful renal cysts, with a durable response.

Adult↗
PubMed2005

Laparoscopy-assisted percutaneous nephrolithotomy (PCNL) in previously operated ectopic pelvic kidney.

A 35-year-old man with a left ectopic pelvic kidney and a prior history of open pyelolithotomy presented with recurrent multiple stones in the pelvic kidney. Complete clearance of calculi was achieved by laparoscopy-assisted PCNL (percutaneous nephrolithotomy). To the best of our knowledge this is the first report of laparoscopy-assisted PCNL in a previously operated ectopic pelvic kidney.

Adult↗
PubMed2005

Lycopene and prostate cancer.

Despite being one of the most common malignancies, the preventable measures for prostate cancer remain poorly defined. Dietary intake of tomatoes and tomato products containing lycopene have been shown in cell culture, animal, epidemiologic and case-control studies to be inversely associated with the risk of prostate cancer. Its unique structural and biologic properties enable lycopene to prevent free-radical damage to cells caused by reactive oxygen species, thus acting as a potent antioxidant. Although some studies have provided contradictory results, these should not be considered incongruous to the many larger studies which have shown reliable results in favor of prostate cancer. Further research involving large randomized case-control trials would confirm the potential anticancer effect of this molecule, which might provide new dimensions not only to the prevention but also the treatment of prostate cancer.

Anticarcinogenic Agents↗
PubMed2004

Spinning top urethra and lower urinary tract dysfunction in a young female.

Spinning top urethra (STU) denotes a particular urethral configuration that is a dilated posterior urethra mainly seen in young girls or women. STU deformity arises secondary to detrusor instability, leading to a rise the intravesical pressure against a closed sphincter. We describe a case of spinning top urethra in a 30-year-old woman who presented with lower urinary tract symptoms and left flank pain.

Adult↗
PubMed2004

Radical cystectomy in septuagenarian patients with bladder cancer.

INTRODUCTION: Clinical results of radical cystectomy performed on elderly bladder cancer patients over 70 years old were assessed to determine whether age is one of the critical points for the application of this type of surgery. MATERIALS: From January 1992 to December 2002, 41 radical cystectomy performed in septuagenarian population were compared with 197 performed in patients less than 70 years of age. RESULTS: The early and late complication rate for septuagenarians was 29.7% and 12%, compared with 26.9% and 9.6% for patients younger than 70 years respectively. The overall mortality rate for septuagenarians was 4.9%, compared with 8.6% for patients younger than 70 years. There was no significant difference between the two groups with regard to pathologic stage or length of hospital stay. The 5-year overall survival rate for septuagenarians was 53% compared with 59% for patients younger than 70 years. CONCLUSIONS: When indicated after adequate preoperative assessment and optimization of the patient, radical cystectomy is a safe procedure in the septuagenarians and patient should not be denied surgery dependent on chronologic age.

Aged↗
PubMed2004

Penile amputation and emasculation: hazards of modern agricultural machinery.

We report a case of 20-year-old farmer with penile amputation and emasculation secondary to crushing injury inflicted by agricultural machinery. His entire penis, scrotum and both the testis had been avulsed after falling onto a rotating axel wheel of an electronically driven thrashing machine. After resuscitation the wound was thoroughly washed with saline, hemostasis achieved and a perineal urethrostomy was made from the remnant urethra.

Accidents, Occupational↗
PubMed2004

Renal cell carcinoma presenting as solitary foot metastasis.

Skeletal metastases from genitourinary tract are common, but metastatic tumors involving the hand and foot are rare. We herein present a case of 55-year-old man who presented with painful swelling of right foot and no urological complaints. Investigations revealed left renal mass and fine needle aspiration cytology from the swelling revealed findings consistent with metastatic clear cell carcinoma.

Bone Neoplasms↗
PubMed2004

Holmium laser core-through urethrotomy for traumatic obliterative strictures of urethra: initial experience.

OBJECTIVES: To determine the safety and efficacy of holmium laser core-through urethrotomy (HolCTU) for the treatment of post-traumatic obliterative stricture of the urethra. METHODS: From June 2002 to March 2003, 29 men underwent the core-through procedure. All the patients had obliterative strictures of the bulbomembranous urethra. The length of the stricture was 2.5 cm or less, with good alignment between the two urethral ends. The holmium laser was used to vaporize the obliterative fibrotic tissue. The procedure was guided by a metal sound introduced through the suprapubic tract. Catheter removal and voiding cystourethrography were done at 6 weeks after the procedure and urethroscopy 1 month after catheter removal. RESULTS: At a mean follow-up of 15 months (range 10 to 19), the results were excellent in 19 (65.51%) of 29 patients. Nine (31.03%) had acceptable results; these patients failed to maintain good flow after HolCTU and required internal urethrotomy/endoscopic dilation once or twice for stabilization (maximal flow rate 15 mL/s or greater). Failure was seen in 1 patient (3.44%) who had recurrent obstruction despite repeated internal urethrotomy and finally required formal transpubic urethroplasty. The mean operating time was 40 minutes (range 30 to 90), with mean hospital stay of 8 hours (range 6 to 48). No perioperative complications occurred, except in 1 patient who developed small extravasation of fluid locally. All the patients were continent, and potency status was unaffected by HolCTU. CONCLUSIONS: HolCTU is a safe and simple treatment for obliterative urethral strictures. The procedure is less morbid than open repair with a slightly greater failure rate.

Accidents↗
PubMed2004

Squamous cell carcinoma of the renal pelvis manifesting after percutaneous nephrolithotomy for long standing calculus.

Squamous cell carcinoma of the renal pelvis is a rare neoplasm and is usually associated with long standing stone disease. The disease is aggressive in nature and usually has a poor prognosis. We report a case of renal lithiasis who underwent successful percutaneous nephrolithotomy (PCNL) for renal pelvic calculus, and eight months later presented with a large invasive squamous cell carcinoma in the same location.

Carcinoma, Squamous Cell↗
PubMed2004

Renal stone masquerading as an occult renal cell cancer (incidental RCC).

We report an unusual case of 40-year-old adult man who presented as a case of urolithiasis but was found to be harboring an incidental renal cell adenocarcinoma. He underwent an uneventful radical nephrectomy. The literature regarding incidental renal cancer and it's association with urolithiasis has been reviewed and discussed.

Adenocarcinoma↗
PubMed2004

Spontaneous nephrocutaneous fistula--2 unusual case reports with review of literature.

We report two unusual cases of spontaneous nephrocutaneous fistulas. They were discovered to be the cases of neglected calculous disease in a poorly functioning kidney and tuberculous pyelonephritis respectively. A timely nephrectomy cured their debilitating condition and prevented further morbidity. We have discussed the etio-pathogenesis, clinical and diagnostic approach towards the cases of nephrocutaneous fistula. The literature regarding nephrocutaneous fistula has been reviewed and discussed. A stepwise algorithm has been proposed to manage cases of nephrocutaneous fistulas.

Cutaneous Fistula↗
PubMed2004

Distribution of dopamine D2-like receptors in the human thalamus: autoradiographic and PET studies.

The distribution of dopamine (DA) D(2)-like receptors in the human thalamus was studied using in vitro autoradiographic techniques and in vivo positron emission tomography in normal control subjects. [(125)I]Epidepride, which binds with high affinity to DA D(2) and D(3) receptors, was used in autoradiographic studies to determine the distribution and density of D(2)-like receptors, and the epidepride analogue [(18)F]fallypride positron was used for positron emission tomography studies to delineate D(2)-like receptors in vivo. Both approaches revealed a heterogeneous distribution of thalamic D(2/3) receptors, with relatively high densities in the intralaminar and midline thalamic nuclei, including the paraventricular, parataenial, paracentral, centrolateral, and centromedian/parafascicular nuclei. Moderate densities of D(2/3) sites were seen in the mediodorsal and anterior nuclei, while other thalamic nuclei expressed lower levels of D(2)-like receptors. Most thalamic nuclei that express high densities of D(2)-like receptors project to forebrain DA terminal fields, suggesting that both the thalamic neurons expressing D(2)-like receptors and the projection targets of these neurons are regulated by DA. Because the midline/intralaminar nuclei receive prominent projections from both the ascending reticular activating core and the hypothalamus, these thalamic nuclei may integrate activity conveying both interoceptive and exteroceptive information to telencephalic DA systems involved in reward and cognition.

Adult↗