Iatrogenic Urethral Injuries: A Comprehensive Guide to Prevention and Best Practices in Catheterization | Chapter 8 | Newer Frontiers IN Urology

Catheterisation is required for 12–16% of inpatients at any given time. The paramedical support crew, junior medical officers, or trainee intern doctors are typically the ones carrying out this treatment. Urethral catheter insertion is a common procedure done in hospital-admitted patients. Iatrogenic urethral injuries are one of the common preventable complications related to urological procedures. Patients with urethral injury present with frank bleeding from the urethra. The bleeding may sometimes be so severe that it may even occasionally present with urosepsis or hemodynamic instability. We describe a case of iatrogenic urethral injury post-catheterisation, following which the patient returned to the ER in shock with an incorrectly positioned catheter. The patient was resuscitated and managed with suprapubic diversion and a perineal compression tamponade. The patient recovered well and voided normally eventually. An orientation program outlining the techniques for catheterisation and the precautions to be taken before inflating the balloon and during catheter insertion is crucial to minimizing this potentially preventable morbidity since most catheterisations are performed by interns, the paramedical support team, or nursing staff. It is advisable to provide education to patients who require self-catheterisation due to detrusor underactivity or stricture urethra self-calibration. Patients who are paraplegic, and need regular bladder emptying have to exert greater caution, especially if the urethra is insensate. A few learning points are to be borne in mind before insertion of the catheter, which if properly followed, can minimize catheterisation-associated morbidity and ensure patient wellness. In order to reduce iatrogenic urethral injuries caused by catheterization, it is the duty of the urologists and senior surgeons to instruct the junior nursing staff and interns on urethral catheterization practices.

 

Author (s) Details

Pradhyumna Koushik
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Nakul Aher
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

Sriram Krishnamoorthy
Department of Urology & Renal transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH8

Renal Leiomyosarcoma with Mixoid Component: Case Report and Literature Review | Chapter 11 | Advanced Concepts in Medicine and Medical Research Vol. 1

 Primary leiomyosarcoma is an intensely rare entity establishing only 0.5–1% of all invasive renal tumors. It is commonly diagnosed after histological test because it does not have any distinguishing diagnostic countenance clinically and radiologically. At times, it is difficult to differentiate leiomyosarcoma from the sarcomatoid renal container carcinoma even all the while histological examination as both tumors have pivot-shaped atypical containers. Moreover, some epithelial tombstones can be present in pure smooth influence sarcomas, while some smooth muscle tombstones are positive in carcinomas. An intensely uncommon condition is leiomyosarcoma that develops in the renal stomach. A patient with an obstructive grain-related abandoned renal colic was admitted to ward with a filling defect in the renal stomach, which was originally misdiagnosed as a blood clot. After visual test of the renal pelvis and a examination of the exophytic lesion, leiomyosarcoma was determined expected the cause. Laparoscopic radical nephrectomy was performed, histological and immunohistochemical examination rooted the lesion expected a leiomyosarcoma with mixomatoid component. No adjuvant situation was performed, and the patient remains active 6 years later surgery without repetition. Herein we provide literature review, consideration of the diagnosis and situation scenario of the patient with renal stomach leiomyosarcoma with mixomatoid component.

Author(s) Details:

Krivoborodov G. G.,
Department of Urology and Andrology, Pirogov Russian National Research Medical University, Ministry of Health, Russia and Russian Clinical and Research Center of Gerontology, Russia.

Bolotov A. D.,
State Budgetary Institution of Healthcare of Moscow (City Clinical Hospital no 1 Named after N.I. Pirogov), Russia.

Efremov N. S.,
Department of Urology and Andrology, Pirogov Russian National Research Medical University, Ministry of Health, Russia and Russian Clinical and Research Center of Gerontology, Russia.

Please see the link here: https://stm.bookpi.org/ACMMR-V1/article/view/12315

Renal Arteriovenous Malformation | Chapter 6 | New Horizons in Medicine and Medical Research Vol. 11

 Due to the high morbidity of the condition, renal arteriovenous malformations (AVMs) or arteriovenous fistulas (AVFs) represent a significant category of entities requiring diagnostic evaluation. Hematuria seldom has this aetiology. It is crucial to carefully assess radiographic results and the kind of AVM in order to administer safe and efficient care. The basic forms of AVM, clinical manifestations, imaging techniques, and therapeutic options are highlighted in this book chapter.

Author(s) Details:

Shruti P. Gandhi,
Department of Radiology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC),Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad - 380016, Gujarat, India.

Kajal Patel,
Department of Radiology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC),Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad - 380016, Gujarat, India.

Vaidehi Pandya,
Department of Radiology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC),Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad - 380016, Gujarat, India.

Manish Raval,
Department of Vascular Surgery, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC),Dr. H.L. Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad - 380016, Gujarat, India.

Please see the link here: https://stm.bookpi.org/NHMMR-V11/article/view/7141

Acute Glomerulonephritis: A Study of Histo-Clinical Correlation of Patients at Tertiary Care Centre, India | Chapter 7 | Highlights on Medicine and Medical Science Vol. 15

The abrupt development of hematuria, proteinuria, and red blood cell casts is known as acute glomerulonephritis. Hypertension, edoema, and decreased renal function are frequently present in this clinical presentation. Acute glomerulonephritis can occur as a result of a primary renal disease or as a side effect of other illnesses.

The goal of this research was to look at the clinical and histological correlations of acute glomerulonephritis in hospitalised patients.

Materials and Methods: This was a two-year prospective study conducted at GMC Jammu from January 2012 to January 2014.

The study enlisted the participation of 80 patients. A total of 80 individuals with clinically suspected acute glomerulonephritis were hospitalised (AGN). Nine individuals had a positive response to medical treatment. A total of 56 patients had their kidneys biopsied. On further investigation, 10 patients were identified with chronic glomerulonephritis based on renal biopsies and were ruled out. Acute glomerulonephritis was identified in 46 cases after renal biopsies.

On histological examination, patients with clinical manifestations such as edoema, hematuria, and hypertension have more evidence of acute glomerulonephritis. The most common entity is PSAGN.

Author (s) Details

Vinod Kumar
Department of Medicine, GMC Doda, JK, India.

Ritu Bhagat
Department of Pathology, GMC Doda, JK, India.

Ahmer Javid Azad
Department of Medicine, GMC Doda, JK, India.

View Book :- https://stm.bookpi.org/HMMS-V15/article/view/2468

Post-Transurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Case Report with Review of Literature | Chapter 10 | Research Trends and Challenges in Medical Science Vol. 1

Review of Literature  | Chapter 10 | Research Trends and Challenges in Medical Science Vol. 1

Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-yearold male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical pseudo aneurysm. CT angiography showed pseudo aneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities.

Author (s) Details

Dr. Vivek Vasudeo
Department of Urology, Sardar Patel Medical College, Bikaner 334001, Rajasthan, India.

Dr. Samir Dhingra
Department of Cardio Thoracic and Vascular Surgery, PSRI Heart Institute, New Delhi, India.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/181