Reza Falahatkar; Siavash Falahatkar; Ardalan Akhavan; Samaneh Esmaeili; Ehsan Kazemnezhad; Emad Moaied Abedi
Volume 25, Issue 7 , 2023
Abstract
Background: Transurethral ureterolithotripsy (TUL) is a common and highly efficient procedure for treating ureteral stones. The need for preoperative antibiotic prophylaxis to prevent post-TUL infections remains controversial.
Objectives: This study aimed to investigate whether the removal of preoperative ...
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Background: Transurethral ureterolithotripsy (TUL) is a common and highly efficient procedure for treating ureteral stones. The need for preoperative antibiotic prophylaxis to prevent post-TUL infections remains controversial.
Objectives: This study aimed to investigate whether the removal of preoperative antibiotic prophylaxis affects the rate of postoperative complications in patients undergoing TUL.
Methods: A total of 62 patients (aged 15-65 years) undergoing TUL between November 2021 and March 2022 were included in this controlled clinical trial. Patients were divided into two groups by the available gradual and sequential sampling methods: 33 had positive preoperative urine culture (UC), and 29 had negative preoperative UC. None of the patients in the two groups received preoperative antibiotic prophylaxis. Perioperative and postoperative outcomes, such as the operative time, stone-free rate, postoperative analgesic use, fever, urinary tract infection (UTI), and hospital stay, were reviewed in both groups.
Results: Patients with positive UC were significantly older than those with negative UC (P=0.018), and had a higher BMI (P=0.016). No significant differences were observed between the two groups in most perioperative variables or postoperative outcomes (P>0.05). In addition, patients in the positive UC group had significantly more underlying diseases than the other group (P=0.022). Postoperative symptomatic UTI was found in neither of the two groups. Fever was reported in 3 (9.1%) and 1 (3.4%) patients in the positive and negative UC groups, respectively, with no statistically significant differences between the two groups (P=0.616). In the matched logistic regression model, the effect of preoperative UC on postoperative fever was not significant (P=0.40).
Conclusion: The results of our study showed that prophylactic antibiotics can be eliminated at the discretion of the surgeon in patients without symptomatic positive UC.
Siavash Falahatkar; Nadia Rastjou Herfeh; Sahand Omidi; Samaneh Esmaeili
Volume 19, Issue 2 , February 2017, , Pages 1-4
Abstract
Introduction: Renomedullary interstitial cell tumor (RICT), or medullary fibroma, is a small tumor that is usually asymptomatic unless it attains a significant size; in rare cases, the tumor may be large and symptomatic. These benign tumors have a specific histology. Although they are usually incidental ...
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Introduction: Renomedullary interstitial cell tumor (RICT), or medullary fibroma, is a small tumor that is usually asymptomatic unless it attains a significant size; in rare cases, the tumor may be large and symptomatic. These benign tumors have a specific histology. Although they are usually incidental findings, it is necessary to be able to discriminate this lesion from other malignancies of the kidney, especially since its management represents a challenge during pregnancy. Numerous patients undergo an unnecessary radical nephrectomy to diagnose renal masses, which is considered hazardous for pregnant women. Ultrasound is the imaging procedure of choice followed by the magnetic resonance imaging (MRI) for assessing the urinary system in pregnant women. Histopathological examination is considered mandatory for the diagnosis of RICT to preclude an unnecessary nephrectomy.Case Presentation: In November 2015, a 31-year-old pregnant woman at gestational week 12 of her second pregnancy was referred to our private clinic in Rasht, Iran. She had microscopic hematuria; a mass measuring 39 × 33 mm in the upper portion of her right kidney was was detected by ultrasonography.Conclusions: A percutaneous renal mass biopsy was used, instead of nephrectomy, to diagnose the mass; immunohistochemical reports showed that the morphologic features were not compatible with an epithelial neoplasm and the paucicellular spindle cell tumor was compatible with renomedullary interstitial cell tumor. Patients with RICT can be successfully managed using a percutaneous renal mass biopsy and avoiding unnecessary nephrectomy.
