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Bapir R, Qader D, Gharib D, Tahir S, Abdullah A, Asaad H, Ahmed S, Ali H, Abdullah H, Ahmed S, Hussein Kakamad F, Aghaways I. Delayed Presenting Gastric Duplication Cyst Mimicking a Left Adrenal Cyst in a Young Female: A Case Report with a Literature Review. Case Rep Gastroenterol 2024; 18:153-160. [PMID: 38524872 PMCID: PMC10959546 DOI: 10.1159/000537972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Gastric duplication cyst (GDC) is a rare congenital anomaly of the gastrointestinal tract. Though GDC is often misdiagnosed, misidentification as an adrenal cyst has rarely been reported. Herein, we report a case of GDC in a young female mimicking an adrenal cyst. Case Presentation A 17-year-old female presented with chronic epigastric pain, nausea, and intermittent vomiting. Physical examinations revealed mild tenderness in the epigastric region. Esophagogastroduodenoscopy showed no abnormality. Ultrasound, contrast-enhanced computed tomography scan, and MRI of the abdomen and pelvis showed an oval-shaped left adrenal cystic lesion measuring 33 × 26 mm. Preoperative blood investigations and hormonal assessments were normal. Laparoscopy showed that the cyst originated from the greater curvature of the stomach. The left adrenal gland was normal. After an intraoperative consultation with a gastrointestinal surgeon, a wedge resection of the cyst was performed. Histopathology confirmed the gastric duplication cyst. Conclusion GDCs are rare congenital malformations that may become symptomatic during adulthood. They can mimic adrenal cysts and lead to misdiagnosis.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaimani, Iraq
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Deedar Qader
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Dana Gharib
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | - Soran Tahir
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Ari Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Sulaimani Teaching Hospital, Sulaimani, Iraq
| | - Hoshmand Asaad
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | | | - Hemn Ali
- Smart Health Tower, Sulaimani, Iraq
| | - Hiwa Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Sasan Ahmed
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Fahmi Hussein Kakamad
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
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Bapir R, Aghaways I, Ali RM, Fakhralddin SS, Ali RM, Rashid RJ, Abdullah AM, Ali MBA, Mohammed KK, Abdullah HO, Kakamad FH. Spermatocytic tumor of the testis: A case report and mini‑review of the literature. Med Int (Lond) 2023; 3:51. [PMID: 37810904 PMCID: PMC10557091 DOI: 10.3892/mi.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
Spermatocytic tumors are a rare type of testicular cancer, comprising <1% of all testicular malignancies. This type of cancer typically affects males in their 60s and 70s and rarely metastasizes; however, it poses a threat to the health of affected individuals if left untreated. The present study describes the case of a 68-year-old male patient with this type of tumor, including a presentation of his initial symptoms, treatment and subsequent monitoring. A male patient, aged 68 years, visited the authors' clinic with an asymptomatic mass in the right testicle. The mass had been progressively increasing in size for a duration of 5 years following a history of blunt injury. During the examination, a noticeable, painless enlargement was detected in the right testis, whereas the left testis appeared to be in a normal state. Tumor markers were within normal limits. Imaging revealed a complex mass (11x8x7 cm) almost replacing the right testis, with no detectable lymph nodes. A right radical orchidectomy was performed under spinal anesthesia. A histopathological examination revealed a spermatocytic tumor. The post-operative period was uneventful, with no metastasis detected in the CT scans. The patient was discharged with instructions for regular follow-up appointments. The case presented herein highlights a rare spermatocytic tumor in a 68-year-old male. The early detection and treatment of testicular tumors, regardless of age, are crucial for a good prognosis.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rawa M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Saman S. Fakhralddin
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rebaz M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Oncology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Rezheen J. Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Radiology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Ari M. Abdullah
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | | | - Karukh K. Mohammed
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower (Raparin branch), Sulaimani, Kurdistan 46001, Iraq
| | - Hiwa O. Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
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Bapir R, Hama Hussein KF, Baba HO, Muhialdeen AS, Tahir SH, Abdalla BA, Mohammed SH, Salih AM, kakamad FH, Aghaways I. Coexistence of acute pancreatitis and an obstructing upper ureteral calculus: does a calculus cause pancreatitis? a case report. Ann Med Surg (Lond) 2023; 85:3158-3162. [PMID: 37363548 PMCID: PMC10289531 DOI: 10.1097/ms9.0000000000000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/14/2023] [Indexed: 06/28/2023] Open
Abstract
Acute pancreatitis is an inflammatory disease that can affect both the peripancreatic tissues and distant organs. There are few reports of acute pancreatitis caused by endourological procedures. However, an obstructing ureteral calculus causing acute pancreatitis is very rare. Case presentation A 36-year-old male patient presented with epigastric, and right loin pain with decreased urine output for 3 days. On physical examination, he had central abdominal and right flank tenderness. An abdominal ultrasound showed mild to moderate ascites, a hyperechoic pancreas, a small (26×77 mm) left kidney with increased echogenicity, right renal hypertrophy with moderate hydronephrosis, and a dilated upper ureter due to a 10 mm obstructing stone with a perirenal fluid collection. The diagnosis of acute pancreatitis with an obstructing right upper ureteric stone was established. Under spinal anesthesia, an emergency ureteroscopy with laser fragmentation of the stone was performed, and a JJ stent was inserted. He developed postobstructive diuresis and his renal function was improved with a rapid decline of pancreatic enzymes as well. Clinical discussion Two theories explain the presentation of acute pancreatitis by ureteral obstruction. First, the obstructed severe hydronephrotic kidney compresses the duodenum and head of the pancreas, obstructing the distal part of the common bile duct and triggering the elevation of pancreatic duct pressure, bile reflux, trypsin activation, and pancreatic autodigestion. The second theory states that acute pancreatitis develops when urine is extravasated from an obstructed kidney into the adjacent tissues, irritating the uncinate process of the pancreas. Conclusion Although mentioning ureteral obstruction as a cause of pancreatitis is scarce, the clinician should be aware that in each case of ureteral obstruction, the emergence of acute pancreatitis is a possible complication.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Madam Mitterrand Street
- Department of Urology, Surgical Teaching Hospital
| | - Karokh F. Hama Hussein
- Smart Health Tower, Madam Mitterrand Street
- Kurdistan Center for Gastroenterology and Hepatology
| | - Hiwa O. Baba
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | - Aso S. Muhialdeen
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | - Soran H. Tahir
- Smart Health Tower, Madam Mitterrand Street
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Berun A. Abdalla
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
| | | | - Abdulwahid M. Salih
- Smart Health Tower, Madam Mitterrand Street
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. kakamad
- Smart Health Tower, Madam Mitterrand Street
- Kscien Organization, Hamdi Str, Azadi Mall
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
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Bapir R, Kakamad FH, Aghaways I, Abdullah AM, Hassan MN, Abid AAM, Hasan SJ, Salih KM, Hamasalih HM. Para‑testicular arteriovenous malformation: A case report and mini‑review of the literature. Med Int (Lond) 2023; 3:28. [PMID: 37323126 PMCID: PMC10265326 DOI: 10.3892/mi.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
Arteriovenous malformations from para-testicular structures are very rare, with only a limited number of cases reported in the literature. The present study reports a rare case of para-testicular arteriovenous malformation. A 6-year-old boy presented with painless swelling in the scrotum for 6 months. Upon examination, a non-tender and non-pulsatile cystic swelling was observed in the right hemi-scrotum below the testis. A scrotal ultrasound revealed a separate cystic lesion with a normal texture and the vascularity of both testes. Under general anesthesia, via a small scrotal incision, a cystic, blood-filled mass was excised. The results of a histopathological examination were suggestive of vascular malformation. The case described in the present study aims to shed light on vascular malformations. A number of vascular malformations are incorrectly referred to as hemangiomas, and numerous patients undergo inappropriate therapy due to this misclassification. Although para-testicular arteriovenous malformation is a very rare condition, it should be included in the differential diagnosis of para-testicular lesions.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ari M. Abdullah
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Department of Pathology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Marwan N. Hassan
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- Kscien Organization for Scientific Research, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ayoob Asaad Mohammed Abid
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
- College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Sabah Jalal Hasan
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Karzan M. Salih
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Hussein M. Hamasalih
- Department of Scientific Affairs, Smart Health Tower, University of Sulaimani, Sulaymaniyah, Kurdistan 46000, Iraq
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Bapir R, Shabur B, Aghaways I, Tahir S, Abdullah H, Ahmed R, Rashid R, Ali R, Abdalla B, Kakamad F. Synchronous Kaposi sarcoma and renal cell carcinoma in an elderly male patient (a very uncommon reported entity): A case report. Med Int 2023; 3:16. [PMID: 37021299 PMCID: PMC10068030 DOI: 10.3892/mi.2023.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Based on the literature, there are only three reports available to date on synchronous Kaposi sarcoma (KS) and renal cell carcinoma (RCC), at least to the best of our knowledge. The present study reports a rare case of synchronous classic KS and clear cell RCC. A 69-year-old male presented with painful, purplish nodular lesions on the dorsal aspect of his hands and feet. He had no chronic medical illnesses or prior surgical interventions. An excisional biopsy of one of the lesions revealed a nodular dermal lesion with numerous vascular channels and interlacing spindle cells. A 2.5 cm-enhancing mass was found in a contrast-enhanced computed tomography scan of the abdomen, suggesting RCC or metastasis. A partial nephrectomy was performed, and the histopathological findings were consistent with clear cell RCC. The patient responded well to paclitaxel and topical imiquimod (5%), and the skin lesions disappeared. Both KS and RCC are vascular tumors, and their pathogenesis is commonly affected by an angiogenic factor known as vascular endothelial growth factor (VEGF). A complete response of KS was observed after sorafenib, an inhibitor of VEGF receptors, was administered for the treatment of metastatic renal cancer. This reinforces the fact that there is a common therapeutic and pathogenetic pathway between these two neoplasms. Synchronous KS and clear cell RCC are rare findings. Their simultaneous appearance may be triggered by the common enhancing angiogenic factor, VEGF.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Bana Shabur
- Department of Oncology, Hiwa Oncology Hospital, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq
| | - Soran Tahir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Hiwa Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Ronak Ahmed
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Rezheen Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Razhan Ali
- Department of Cardiothoracic Surgery, Shar Hospital, Sulaimani, Kurdistan 46000, Iraq
| | - Berun Abdalla
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
| | - Fahmi Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq
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Fateh SM, Arkawazi LA, Tahir SH, Rashid RJ, Rahman DH, Aghaways I, Kakamad FH, Salih AM, Bapir R, Fakhralddin SS, Fattah FH, Abdalla BA, Mohammed SH. Renal cell carcinoma T staging: Diagnostic accuracy of preoperative contrast-enhanced computed tomography. Mol Clin Oncol 2023; 18:11. [PMID: 36761384 PMCID: PMC9892965 DOI: 10.3892/mco.2023.2607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/19/2022] [Indexed: 01/13/2023] Open
Abstract
Renal cell carcinoma (RCC) accounts for 1-2% of all malignancies and is the most common renal tumor in adults. Imaging studies are used for diagnosis and staging. Tumor-Node-Metastasis staging strongly affects prognosis and management, while contrast-enhanced computed tomography (CECT) is regarded as a standard imaging technique for local and distant staging. The present study aimed to evaluate the accuracy of CECT for the preoperative staging of RCC by using surgical and pathological staging as the reference methods. This single-center prospective study was conducted between October 2019 and November 2021. The preoperative abdominal CT scans of patients suspected of having RCC were reviewed. Imaging data were collected, including tumor side and size, and perinephric fat invasion. Intraoperative notes were recorded, including the operation type, perinephric fat invasion, renal vein (RV) or inferior vena cava (IVC) tumor extension, and surrounding organ invasion. pathological data were collected on tumor size, RCC type, presence of clear margins, presence of renal capsule or perinephric fat invasion, renal sinus or pelvicalyceal system (PCS) invasion, segmental or main RV extension, and the involvement of Gerota's fascia and nearby organs. Preoperative CECT revealed that 42 out of 59 tumors had a greater maximum diameter than the pathological specimen, with an overall disparity of 0.25 cm. The specificity of CT for the detection of tumor invasion of the perinephric and renal sinus fat and PCS was 95%, and the sensitivity ranged from 80 to 88%. CT had an 83% sensitivity and a 95 specificity in detecting T4 stage cancer, with a 100% specificity for adrenal invasion. The concordance between radiographic and histological results for RV and IVC involvement was high, with specificities of 94 and 98%, and sensitivities of 80 and 100%, respectively. Overall accuracy for correct T staging was 80%. In conclusion, CECT is accurate in the local T staging of RCC, with high sensitivity and specificity for estimating tumor size and detecting extension to nearby structures and venous invasion.
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Affiliation(s)
- Salah M. Fateh
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Lusan A. Arkawazi
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Soran H. Tahir
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Radiology Center, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Rezheen J. Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Hiwa Cancer Hospital Centre, Sulaimani Directorate of Health, Sulaimani, Kurdistan 46000, Republic of Iraq,Radiology Center, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Dalshad H. Rahman
- Department of Surgery, Shar Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Fahmi H. Kakamad
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq,Correspondence to: Dr Fahmi H. Kakamad, College of Medicine, University of Sulaimani, Doctor City Building 11, Apartment 50, Madam Mitterrand Street, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Abdulwahid M. Salih
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Urology, Surgical Teaching Hospital, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Saman S. Fakhralddin
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Fattah H. Fattah
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Republic of Iraq,Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq
| | - Berun A. Abdalla
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Republic of Iraq,Kscien Organization, Sulaimani, Kurdistan 46000, Republic of Iraq
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Bapir R, Hawrami T, Aghaways I, Ali R, Hiwa D, Hussein D, Kakamad F, Salih A. A huge retroperitoneal ganglioneuroma in a middle‑aged patient: Report of a diagnostically challenging case with review of the literature. Oncol Lett 2022; 24:449. [DOI: 10.3892/ol.2022.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/03/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Rawa Bapir
- Department of Urology, Surgical Teaching Hospital, Pathology Lab, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Tahir Hawrami
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Ismaeel Aghaways
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Rawa Ali
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Dilan Hiwa
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Dlsoz Hussein
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Fahmi Kakamad
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
| | - Abdulwahid Salih
- Scientific Affair Department, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq
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Aghaways I, Ibrahim R, Bapir R, Salih RQ, Salih KM, Abdulla BA. The role of inflammatory serum markers and ureteral wall thickness on spontaneous passage of ureteral stone < 10 mm: A prospective cohort study. Ann Med Surg (Lond) 2022; 80:104198. [PMID: 36045783 PMCID: PMC9422225 DOI: 10.1016/j.amsu.2022.104198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. There is a widespread discussion on the preferred initial treatment method, whether medical or surgical, and each has its pros and cons. In this study, we aimed to assess the role of both ureteral wall thickness around the stone and inflammatory markers in guiding the decision-making process. Methods In this prospective study, 161 patients who presented with ureteric colic and were diagnosed with ureteral stone with NCCT were included. UWT around the stone was measured, and the NLR and PLR were calculated. The patients were given a single daily dose of tamsulosin 0.4 mg for 4 weeks with weekly follow-up to determine SSP or failure. Results Of the 161 patients with a mean age 40.12 ± 12.36 SD, 55.9% had a spontaneous stone passage. Receiver operating characteristics showed a cut off value of 2.45 mm UWT of non SSP patients with an 83% sensitivity and 86% specificity. Moreover, there was a significant correlation between higher NLR, PLR and increased UWT (Pearson correlation of 0.314 and 0.426 respectively). The combined higher NLR, PLR and increased UWT were associated with failure of SSP (p-value <0.001). Conclusion Many factors play a role in decision making for management of ureteral stones. Our study concludes that patients with high NLR, PLR, and UWT around the stone have lesser chance of SSP using MET. Their rise can be used as predictors to decide early intervention. Ureteral stone is a worldwide disease and accounts for 20% of all urolithiasis. Impacted ureteral stones occupy the majority of emergency department visits due to urolithiasis. The role of inflammatory serum markers and UWT around the stone on spontaneous passage are controversial.
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Affiliation(s)
- Ismaeel Aghaways
- Department of Surgery, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
| | - Rebaz Ibrahim
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
| | - Rawa Bapir
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- U-merge Ltd. (Urology in Emerging Countries), London, UK
- Corresponding author. Doctor city, building 4, apartment 23, Sulaymaniyah, Iraq.
| | - Rawezh Q. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
| | - Karzan M. Salih
- Iraqi Board for Medical Specialties, Department of Surgery, Sulaymaniyah Center, Sulaymaniyah, Iraq
| | - Berwn A. Abdulla
- Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaymaniyah, Kurdistan, Iraq
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9
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Fakhralddin SS, Bapir R, Babarasul MH, Ibrahim ZB, Aghaways I. Typical leiomyoma of the scrotum: A rare case report. Int J Surg Case Rep 2020; 67:142-145. [PMID: 32062120 PMCID: PMC7021516 DOI: 10.1016/j.ijscr.2020.01.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/20/2020] [Accepted: 01/25/2020] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Scrotal leiomyomas are benign tumors arising from the dartos layer of the scrotal wall. The exact cause of this tumor is not yet clear. Malignant transformation to leiomyosarcomas has been reported. CASE PRESENTATION A 52-year-old male who complained of a painless lump on the right side of the scrotum that lasted 12 years. Physical examination revealed a single, firm, and non-tender, mobile lump on the anterior aspect of the right scrotum. Both testes were normal and no inguinal lymph nodes could be palpated. Ultrasound scan of the scrotum showed a 40 mm × 20 mm hypoechoic, poorly vascular lesion in the scrotum. Under spinal anesthesia, the mass has been excised. Histopathological and immunohistochemical findings were consistent with the diagnosis of scrotal leiomyoma. DISCUSSION Leiomyomas may originate from any location in the genitourinary system where there is smooth muscle. Scrotal smooth muscle tumors can be categorized into Leiomyomas, atypical or symplastic leiomyomas, which are not hypercellular and lack mitotic activity, and leiomyosarcomas. Ultrasound is the first-line imaging investigation in patients with suspected scrotal masses. Typical leiomyomas and atypical ones behave similarly. Therefore, they are managed only with surgical excision, while leiomyosarcomas need a wide 3-5 cm margin resection. Both recurrence and malignancy have been described. Close follow-up is required to detect recurrence. CONCLUSION Scrotal leiomyoma is a rare benign mesenchymal tumor of the middle-aged men. The current report describes the clinical and histopathological characteristics to help reduce erroneous diagnoses of this rare tumor.
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Affiliation(s)
| | - Rawa Bapir
- Shaheed Shawkat Haji Musheer Hospital/Said Sadiq, Sulaymaniyah, Iraq; U-merge Ltd., (Urology in Emerging Countries), London, United Kingdom(1).
| | | | | | - Ismaeel Aghaways
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Iraq
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Aghaways I, Bapir R, Hawrami TA, Thahir NM, Al Kadum Hassan MA, Salih Hassan KM. Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report. Int J Surg Case Rep 2019; 59:31-34. [PMID: 31102837 PMCID: PMC6525288 DOI: 10.1016/j.ijscr.2019.04.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/04/2019] [Accepted: 04/22/2019] [Indexed: 11/30/2022] Open
Abstract
Bladder injury is an uncommon complication of cesarean delivery with an incidence ranging from 0.0016% to 0.94%. Delayed blabber rupture post CD may present with urinary ascites and elevated serum creatinine mimicking acute kidney injury. Cystography is the diagnostic imaging of choice with the reported accuracy of 85%–100%. Surgical repair is the treatment of choice for intraperitoneal bladder injury. Conservative management with intraperitoneal and urethral catheter may succeed in properly selected cases.
Introduction Bladder injury is an uncommon complication of cesarean delivery (CD) with an incidence ranging from 0.0016% to 0.94%. The risk factors are emergency CDs, subsequent CDs, trial of normal delivery after CD and whether adhesions are present or not. The presentation is either immediate intraoperative event or delayed bladder rupture and urinary ascites. Case presentation A 35-year-old female presented with considerable abdominal distension, shortness of breath, oliguria, straining to void and elevated levels of blood urea and serum creatinine 11 days after an uneventful Caesarean delivery. Abdominal ultrasound showed marked ascites. Immediate resuscitation was done, a urethral catheter and percutaneous intraperitoneal pigtail catheter were inserted confirming urinary ascites. Next day cystoscopy was performed and revealed a perforation at the posterior wall of the bladder. She was kept on conservative treatment with adequate urine diversion through both urethral and intraperitoneal catheter. Her condition improved and responded well. Discussion To the best of our knowledge this presentation of delayed intraperitoneal bladder rupture post CD is the second case reported in literature. Although surgical repair is regarded as the treatment of choice for intraperitoneal bladder injury, conservative treatment may succeed in properly selected cases. Non-operative managements include indwelling transurethral Foley catheter alone, percutaneous peritoneal drain alone or combined Foley catheter and percutaneous peritoneal drain for complete urinary drainage. Conclusion Delayed urinary bladder rupture is a very rare complication of cesarean delivery. Non-operative treatment can be a viable alternative to surgical repair in carefully selected patients.
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Affiliation(s)
- Ismaeel Aghaways
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Sulaymaniyah, Kurdistan Region, Iraq
| | - Rawa Bapir
- Sulaymaniyah Surgical Teaching Hospital, Urology Department, Sulaymaniyah, Kurdistan Region, Iraq; Shaheed Shawkat Haji Musheer Hospital, Urology Department, Said Sadiq/Sulaymaniyah,Kurdistan Region, Iraq.
| | - Tahir A Hawrami
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Sulaymaniyah, Kurdistan Region, Iraq
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Hama amin Said S, Abdalla RY, Aghaways I, Abdullah AM. Xanthogranulomatous orchitis: Review of the published work, and report of one case. Urol Case Rep 2019; 27:100908. [PMID: 31687347 PMCID: PMC6819949 DOI: 10.1016/j.eucr.2019.100908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 05/02/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022] Open
Abstract
Xanthogranulomatous reaction is rare begin disease affects many different organs, in clinical practice it is well known to affect kidney and gallbladder, but also affect male genital organs including (Testis, epididymis, and spermatic cord), we report a case 70-year old, diabetic patient presented with right scrotal swelling, had history of prior TURP, tumor markers was within normal range, ultrasound shows multiple hypo echoic lesions with moderate hydrocele, exploration done: pus found within tunica vaginalis, and destructed testicular tissue with necrosis, culture revealed (E.Coli), histopathology showed xanthogranulomatous orchitis.
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Said SHA, Al Kadum Hassan MA, Ali RHG, Aghaways I, Kakamad FH, Mohammad KQ. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding. Arab J Urol 2017; 15:24-29. [PMID: 28275514 PMCID: PMC5329700 DOI: 10.1016/j.aju.2016.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/11/2016] [Accepted: 12/04/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To evaluate factors contributing to bleeding after percutaneous nephrolithotomy (PCNL) and ways of managing this complication, as bleeding is a serious sequela that requires prompt management. PATIENTS AND METHODS The demographic and procedural data of 200 patients, who underwent unilateral PCNL during a 20-month period, were prospectively collected. Preoperative, operative, and postoperative details were recorded. The preoperative variables analysed included: age, sex, body mass index (BMI), the presence of hypertension, diabetes mellitus, serum creatinine, degree of hydronephrosis, previous ipsilateral open renal surgery, stone size and complexity. The operative variables analysed included: number of tracts, operative time, size of Amplatz sheath, type of anaesthesia, and complications such as calyceal and pelvic perforation. RESULTS The variables of age, sex, BMI, diabetes, hypertension, and a preoperative creatinine level of >1.4 mg/dL had no significant effect on blood loss (all P > 0.05). However, the rate of bleeding was significantly higher (P ⩽ 0.05) in patients who had a history of previous open renal surgery, intraoperative pelvicalyceal perforations, and Guy's Stone Score (GSS) grade 3 and 4 complex stones; however, absence of hydronephrosis, larger stone size, operative time (>83 min), more than one puncture, and size of the Amplatz sheath (26-30 F) did not maintain their significance in multivariate analysis. CONCLUSION According to our present results stone complexity (GSS grade 3 and 4), history of ipsilateral renal stone surgery, and occurrence of intraoperative pelvicalyceal perforation are alarming variables for post-PCNL bleeding.
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Affiliation(s)
- Shakhawan H A Said
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
| | | | - Rawa H G Ali
- Department of Urology, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
| | - Ismaeel Aghaways
- Department of Surgery, University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Iraq
| | - Fahmi H Kakamad
- Department of Cardiothoracic Surgery, Sulaymaniyah Surgical Teaching Hospital, Sulaymaniyah, Iraq
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Aghaways I, Anwer Wahid S, Ali RHG, Sabir F, Kakamad FH. Migration of an intrauterine device to the left inguinal region, the first reported case. Int J Surg Case Rep 2016; 28:68-70. [PMID: 27689521 PMCID: PMC5043400 DOI: 10.1016/j.ijscr.2016.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 12/29/2022] Open
Abstract
An intrauterine contraceptive device (IUD) is a long acting, highly effective, economic and reversible method of contraception. Common complications include failed insertion, pain, vasovagal reactions, infection, menstrual abnormalities and expulsion. Although uncommon, uterine embedment and perforation may occur. The current paper reported the first case of migrated IUCD to inguinal cannel.
Introduction A large number of complications are reported with the use of IUD. Migration to inguinal region has not been mentioned in literature. We report a rare case of migrated IUD to inguinal canal. Case report A 25-year-old lady presented with a painfull mass in the left inguinal region. Diagnostic work up showed migrated IUD to inguinal region. Operation was done and the impacted IUD with surrounding granuloma was retrieved. Discussion When the string of the IUD is no longer visible at the external os of the cervix, radiological scan must be performed, this should begin with a sonographic examination and plain abdominal radiography may be used to localize the IUD. Conclusion IUD Migration may occur to unusual area and perforation can be misdiagnosed as non-witnessed expulsion.
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Affiliation(s)
- Ismaeel Aghaways
- University of Sulaymaniyah, Faculty of Medical Sciences, School of Medicine, Department of Surgery, Iraq
| | | | | | - Falah Sabir
- Sulaymaniyah Surgical Teaching Hospital, Urology Department, Iraq
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Aghaways I, Ahmed SM. Endourologic Intervention for Management of Infertility in a Man with Zinner Syndrome Resulting in a Natural Pregnancy. J Endourol Case Rep 2016; 2:71-3. [PMID: 27579422 PMCID: PMC4996586 DOI: 10.1089/cren.2016.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ipsilateral renal agenesis associated with seminal vesicular cysts is an uncommon finding. Zinner syndrome is a rare variant of wolffian duct anomalies with a triad of seminal vesicle cyst, ipsilateral renal agenesis, and male fertility problems due to ejaculatory duct obstruction (EDO). CASE PRESENTATION A 28-year-old man with 6 years history of primary infertility presented with left-side lower abdominal pain. A palpable cystic mass was found on digital rectal examination. Semen analysis revealed low volume ejaculate azoospermia. Abdominal ultrasonography revealed a single right kidney and transrectal ultrasonography showed an evidence of left EDO. Transurethral resection of the ejaculatory duct was performed. Semen analysis after 2 weeks showed normal sperm count (23M) and acceptable progressive motility (24%). Eight weeks later, his wife was pregnant with a 7-week viable fetus. CONCLUSION Although not a common disease, a careful physical examination and thorough semen analysis interpretation should guide clinicians to diagnose a surgically treatable syndromic cause of male infertility.
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Affiliation(s)
- Ismaeel Aghaways
- Urology Unit, Department of Surgery, School of Medicine, University of Sulaimani , Sulaimani, Iraq
| | - Shyaw M Ahmed
- Urology Unit, Department of Surgery, School of Medicine, University of Sulaimani , Sulaimani, Iraq
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Kachrilas S, Popov E, Bourdoumis A, Akhter W, El Howairis M, Aghaways I, Masood J, Buchholz N. Laparoscopic varicocelectomy in the management of chronic scrotal pain. JSLS 2016; 18:JSLS-D-13-00302. [PMID: 25392634 PMCID: PMC4154424 DOI: 10.4293/jsls.2014.00302] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives: To evaluate the usefulness of laparoscopic varicocelectomy in the management of chronic scrotal pain. Methods: Between 2009 and 2011, 48 patients in total were treated with laparoscopic varicocelectomy for dull scrotal pain that worsened with physical activity and was attributed to varicoceles. All patients were followed up at 3 and 6 months and biannually thereafter with a physical examination, visual analog scale score, and ultrasonographic scan in selected cases. Results: The mean age was 38.2 years (range, 23–54 years). The mean follow-up period was 19.6 months (range, 6–26 months). Bilateral varicoceles were present in 7 patients (14.6%), and a unilateral varicocele was present in 41 (85.4%). The varicocele was grade 3 in 27 patients (56.3%), grade 2 in 20 (41.6%), and grade 1 in 1 (2.1%). The mean preoperative visual analog scale score was 4.8 on a scale from 0 to 10. The mean postoperative visual analog scale score at 3 months was 0.8. After the procedure, 42 patients (87.5%) had a significant improvement in the visual analog scale score (P < .001); 5 (10.4%) had symptom improvement, although it was not statistically significant; and 1 (2.1%) remained unchanged. During follow-up, we observed 5 recurrences (10.4%) whereas de novo hydrocele formation was identified in 4 individuals (8.3%). Conclusion: Laparoscopic varicocelectomy is efficient in the treatment of symptomatic varicoceles with a low complication rate. However, careful patient selection is necessary because it appears that individuals presenting with sharp, radiating testicular pain and/or a low-grade varicocele are less likely to benefit from this procedure.
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Affiliation(s)
| | - Elenko Popov
- Endourology and Stone Services, Barts Health NHS Trust, London, England
| | | | - Waseem Akhter
- Endourology and Stone Services, Barts Health NHS Trust, London, England
| | | | - Ismaeel Aghaways
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimaniya, Iraq
| | - Junaid Masood
- Endourology and Stone Services, Barts Health NHS Trust, London, England
| | - Noor Buchholz
- Endourology and Stone Services, Barts Health NHS Trust, London, England
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Aghaways I. Digital rectal examination and urethral catheterization by medical students: comparative study. ZJMS 2013. [DOI: 10.15218/zjms.2013.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ngai HY, Salih HQ, Albeer A, Aghaways I, Buchholz N. Double-J ureteric stenting in pregnancy: A single-centre experience from Iraq. Arab J Urol 2013; 11:148-51. [PMID: 26558073 PMCID: PMC4442953 DOI: 10.1016/j.aju.2013.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES To evaluate the safety and effectiveness of ureteric stenting with a JJ stent in pregnant women, to relieve renal obstruction and intractable flank pain. PATIENTS AND METHODS All pregnant patients presenting with intractable flank pain, with or without complications, to a tertiary national teaching hospital in Kurdistan/Iraq, and necessitating ureteric stenting with a JJ stent, were prospectively assessed for this study between March 2008 and March 2010. RESULTS In all, 30 pregnant patients presented with intractable flank pain necessitating JJ ureteric stenting during the 25 months. Intractable flank pain (23 patients, 77%) was the most common indication for ureteric stenting, followed by flank pain with clinical sepsis (six, 20%). All pregnant women had hydronephrosis on ultrasonography (US), and 12 (40%) had evidence of coexisting renal stones on US. All ureteric stents were inserted successfully. The mean (range) indwelling time was 47.4 (3-224) days. Radiologically, 14 (47%) and 15 (50%) had complete resolution of the hydronephrosis on follow-up US in late pregnancy and in the early postnatal period, respectively. Two-thirds of patients had a clinical improvement immediately (15, 50%) and soon after (five, 17%) surgery. Stent encrustation (three, 10%), stent migration (three, 10%) and stent irritation (five, 17%) were reported as complications. The post-natal evaluation confirmed that half the patients had urinary calculus disease. CONCLUSION Ureteric stenting during pregnancy can be safe, with no intraoperative imaging and even under local anaesthesia. It provides good symptom relief and has a low complication rate. We therefore advocate it as a first-line treatment in pregnant women with therapy-resistant flank pain.
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Affiliation(s)
- Ho-Yin Ngai
- Department of Urology, Queen Elizabeth Hospital, Hong Kong, China
| | | | - Ayad Albeer
- Department of Urology, Medical City Hospital, Baghdad, Iraq
| | | | - Noor Buchholz
- Department of Urology, Bartshealth NHS Trust, The Royal London Hospital, London, UK
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