Despite the high success of dismembered pyeloplasty (Anderson–Hynes) for the management of pelvi-ureteric junction obstruction (PUJO), outcomes in children with excessively dilated renal pelvis remain insufficiently defined clinically. We aimed at evaluating the functional outcome of dismembered pyeloplasty in an excessively dilated renal pelvis-defined as Antero-posterior diameter of renal pelvis more than 50 mm- and comparing the results with those of non-excessively dilated renal pelvis in the pediatric population. This prospective comparative study, conducted at a tertiary-care pediatric hospital, included 43 pediatric cases presenting with PUJO, with 46 renal units indicated for surgical intervention. Patients were divided into: Group 1: included 23 cases with 23 renal units with non-excessively dilated renal pelvis, and Group 2: included 20 patients with 23 renal units with excessively dilated renal pelvis, both underwent Dismembered pyeloplasty. Primary outcomes were defined as resolution of clinical symptoms, improvement of anteroposterior pelvic diameter (APD), and parenchymal thickness (PT). Secondary outcome included absence of postoperative complications as graded according to Clavien-Dindo classification, functional improvement on renal nuclear scan, and the rate of secondary surgical intervention. Male: female ratio was 3.8:1, mean age at presentation for group 1 was 11.8 ± 12.9 months vs. 16.5 ± 14.2 months for group 2 (p = 0.242). Preoperative anteroposterior pelvic diameter (APD), operative time, and reduction rate were significantly higher in Group 2 compared with Group 1 (P < 0.05). Postoperative APD of Group 2 remained significantly higher at 6 and 12 months postoperatively (P < 0.005), whereas Group 1 showed a marked reduction over time. No significant differences were observed between groups in Parenchymal Thickness (PT) at any follow-up point. Preoperative APD, age at presentation, and preoperative isolated glomerular filtration rate (GFR) were significantly associated with surgical success (P < 0.005), while age at surgery, preoperative creatinine level, and PT were not. Group 2 showed a significantly lower success rate and a higher incidence of postoperative complications in the form of postoperative fever (30.4
Abstract Background Priapism is a serious urological complication of sickle cell disease (SCD) that may result in permanent erectile dysfunction if not promptly treated. Although it often begins in childhood or adolescence, paediatric data in Nigeria remain limited. Objective To determine the prevalence, clinical characteristics, and determinants of priapism among male children with SCD attending the University of Benin Teaching Hospital (UBTH), Benin City. Methods A hospital-based cross-sectional study was conducted between July and September 2025 among 120 male children aged 1–18 years with confirmed SCD. Eligible participants were consecutively recruited during routine clinic visits. Sociodemographic, clinical, haemoglobin phenotype, and haematologic data were obtained using structured questionnaires and medical record review. Anaemia severity was classified according to World Health Organization criteria. Associations were assessed using Chi-square tests, independent t-tests, and multivariable logistic regression. Statistical significance was set at p < 0.05. Results Sixteen participants had experienced priapism, giving a prevalence of 13.3% (95% CI: 8.3–20.6%). Most episodes occurred in the early morning (75%), and all episodes lasted ≥ 4 hours, with 87.5% persisting between 4 and 11 hours. On multivariable analysis, age ≥ 10 years (adjusted OR [aOR] = 3.98; 95% CI: 1.01–15.72; p = 0.048) and severe anaemia (aOR = 4.52; 95% CI: 1.38–14.81; p = 0.012) were independent predictors of priapism. Hydroxyurea use demonstrated a non-significant protective trend (aOR = 0.34; 95% CI: 0.10–1.12; p = 0.076). Conclusion Priapism affects approximately one in eight male children with SCD at UBTH. Adolescents and children with severe anaemia appear to be at increased risk. The finding that all reported episodes lasted ≥ 4 hours underscores the burden of ischemic priapism in this cohort. Routine counselling, early identification of high-risk patients, and strengthened adherence to guideline-based acute management may help reduce long-term complications.
Abstract Background Prostate cancer (PCa) is the most commonly diagnosed cancer in men worldwide. This cohort study evaluates agreement between clinical and pathological T and N staging in PCa, examining patterns of understaging and overstaging and associated clinical factors. Method This retrospective study included 97 patients who underwent radical prostatectomy at King Hussein Cancer Center (2006–2021). Data collected included age, diagnosis date, PSA, clinical and pathological T and N stages, Gleason score, PI-RADS score, lesion characteristics, extracapsular extension, and prostate volume. Concordance between clinical and pathological staging was assessed, and associations with clinical and radiological predictors were analyzed. Patients were categorized as correctly staged, understaged, or overstaged for T stage; only clinical understaging was observed for N stage. Analyses were performed using IBM SPSS Statistics 26.0. Results Ninety-seven patients (mean age 67.7 years; mean PSA 20.9 ng/mL) were included. Clinical and pathological T staging agreed in 61.9% of cases, with 28.9% understaged and 9.3% overstaged (κ = 0.41, p < 0.001). N-stage concordance was 94.8%, with 5.2% understaging (κ = 0.79, p < 0.001). In exploratory regression analysis, larger prostate volume was associated with both T-stage understaging (OR = 1.04, p = 0.04) and overstaging (OR = 1.06, p = 0.04), while PSA, lesion size, Gleason grade, and PI-RADS score were not significantly associated with T-stage discrepancy. Given the small number of N-stage discrepancies, predictor analysis was not performed. Conclusion Clinical and pathological concordance was fair for T stage and substantial for N stage. T-stage discrepancies were linked to larger prostate volume and cT3b status, while N-stage errors were rare and limited to understaging. Improved standardization and advanced imaging may enhance staging accuracy in prostate cancer.
Rezūm water vapor therapy is typically recommended for prostates < 80 mL. We report the case of a patient with a prostate measuring 297 mL by transrectal ultrasound (TRUS) who achieved catheter independence and marked symptom improvement following Rezūm therapy. Despite the exceptionally large gland size, the procedure was feasible and resulted in improvements in IPSS and Qmax, and a reduction in PSA at one-year follow-up. This case suggests that Rezūm may be a feasible minimally invasive option for carefully selected patients with extremely large prostates.
Abstract Background Stone retropulsion during ureteroscopic lithotripsy (URSL) adversely affects stone-free rates and may increase the need for auxiliary procedures, particularly in upper and mid-ureteric calculi. Mechanical anti-retropulsion devices such as Stone Cone and NTrap are commonly used to prevent proximal migration of stone fragments. Objective Primary objective: Stone-free rate at one month, defined as absence of residual calculi > 2 mm on non-contrast CT-KUB. Secondary Objective: Operative time,Intraoperative and postoperative complications (Clavien–Dindo classification),Requirement of auxiliary procedures and Duration of hospital stay. Materials and methods In this prospective randomized study, 56 patients with upper or mid-ureteric calculi were randomized into two groups (n = 28 each) using sealed envelope method. Group A underwent URSL using NTrap, while Group B underwent URSL using Stone Cone. The primary outcome was stone-free rate (SFR), defined as absence of residual calculi >2 mm on non-contrast computed tomography at one month. Secondary outcomes included operative time, intraoperative and postoperative complications, need for auxiliary procedures, and duration of hospital stay. The radiologist assessing the primary outcome was blinded to group allocation. Results The mean stone size was 11.08 ± 2.5 mm, and mean stone density was 1028 ± 331 HU. Operative time was comparable between groups (55.7 ± 21.1 vs. 56.2 ± 20.6 minutes). The SFR was 85.7% in the NTrap group and 96.4% in the Stone Cone group (p = 0.160) Although the observed rate was numerically higher with Stone Cone, no statistically significant between-group difference was detected. Complications were minimal and predominantly minor in both groups. Auxiliary procedures were required in four patients in the NTrap group and one patient in the Stone Cone group. Conclusion Both Stone Cone and NTrap are safe and effective anti-retropulsion devices during URSL. Although Stone Cone demonstrated a higher stone-free rate, the difference was not statistically significant. These findings support the use of either device based on surgeon preference, local availability, cost, and provide a basis for future adequately powered multicentre trials.
