Aim: To explore the association between urinary stone cultures and infectious complications following PCNL. Materials and Methods: An observational case–control study was conducted in patients undergoing PCNL. The assessment included demographic parameters, medical history, urinalysis, and urine culture and blood testing. Pre-operatively, urinary stone samples were collected for cultures. Post-operatively, patients were observed for infectious complications such as fever and/or SIRS. Patients were divided into two groups based on the presence or absence of infected renal calculi. Patient characteristics, stone factors, and intra-operative and post-operative findings were studied in relation to stone culture. Descriptive statistics was used to present the data and the SPSS software was used for analysis. Results: From December 2023 to March 2025, a total of 126 patients were included in the study. A total of 16 patients (12.6%) had a positive stone culture. Statistical significance was found upon the comparison of stone culture with gender (p = 0.046), chronic kidney disease (p = 0.002), pre-operative urine culture (p = 0.001), pre-operative haemoglobin (g/dL) (<0.001), pre-operative S. creatinine (mg/dL) (p = 0.038), stone volume (mm3) (p = 0.012), CROES score (p = 0.023), SIRS (p = 0.001), and AKI (p = 0.021). Conclusions: Infected renal calculi identified by positive stone cultures were strongly associated with infective complications such as fever and SIRS following PCNL. E. Coli was the dominant bacteria present in both bladder urine and renal stone culture. The occurrence of infectious complications despite the administration of pre-operative antibiotics highlights the antibiotic resistance patterns noted among the cultured bacteria. The pre-operative factors identified to be associated with a positive stone culture could potentially be used for predicting infected stones, thereby improving outcomes.
Introduction: Various nephrolithometry scoring systems have been introduced to assess the outcomes of percutaneous nephrolithotomy (PCNL) and postoperative complications. Previous studies have incorporated various variables to determine factors influencing postoperative acute kidney injury (AKI). Using separate scoring systems or nomograms to predict postoperative outcomes and AKI is cumbersome. Our study aims to find if stone scoring systems can be used to predict AKI following a PCNL procedure. Materials and methods: A prospective observational study was conducted at Kasturba Hospital and Medical College from December 2023 to June 2024. All patients undergoing PCNL were included in the study. Scores were calculated for all patients pre-operatively using various nephrolithometry scoring systems. Patients were divided into two groups based on the presence or absence of AKI following PCNL. The various stone scoring systems were assessed for their ability to predict AKI following PCNL. Results: Out of the 90 patients in the study, 15 (16.66%) developed AKI, and 75 (83.33%) had no AKI following PCNL. Statistical significance was found in stone size ( p < 0.001), stone location ( p = 0.011), Staghorn ( p < 0.001), Guy’s Score ( p = 0.001), STONE score (0.002), CROES Score ( p = 0.001), Amplatz size ( p = 0.012) and energy source ( p = 0.01). No statistical significance was found when comparing sex, comorbidities, number of stones, the severity of HN, puncture location and number, intraoperative hypotension, operative time, and duration of hospital stay. Conclusion: Nephrolithometry scoring systems, in addition to assessing postoperative outcomes such as stone-free rate and complications, can also be used to predict the occurrence of AKI. The use of a limited number of scoring systems to assess all the postoperative outcomes will help simplify and facilitate their use in routine clinical practice.
Background: Delayed graft function (DGF) is a frequent early complication after deceased donor kidney transplantation (DDKT), leading to prolonged hospitalization, increased risk of acute rejection, and reduced graft survival. Reliable and easily measurable preoperative biomarkers for DGF prediction remain limited. This study aimed to evaluate the predictive value of pre-operative Absolute Eosinophil Count (AEC) and Albumin-to-Globulin Ratio (AGR) for DGF in DDKT recipients. Methods: A retrospective analysis was conducted on all DDKT procedures performed at our institution between January 2018 and December 2023. Patients were divided into two groups: Group 1 (DGF) and Group 2 (non-DGF). DGF was defined as the requirement for hemodialysis within the first seven postoperative days. Demographic, clinical, and laboratory data—including pre-operative AEC and AGR—were collected and compared between groups. Statistical analysis was performed using appropriate parametric and nonparametric tests. Receiver operating characteristic (ROC) curves were generated to assess the individual and combined predictive performance of AEC and AGR for DGF. Results: A total of 38 patients underwent DDKT, comprising 27 males (71.05%) and 11 females (28.95%), with a mean age of 43.3 ± 9.41 years. Fifteen patients (39.47%) developed DGF. The mean AEC and AGR were significantly lower in the DGF group compared to the non-DGF group (AEC: 0.20 ± 0.16 vs. 0.40 ± 0.35, p = 0.04; AGR: 1.43 ± 0.22 vs. 1.66 ± 0.39, p = 0.02). ROC analysis demonstrated that both AEC (p = 0.04) and AGR (p = 0.04) were significant predictors of DGF. Combining both parameters resulted in a higher area under the curve (AUC), improved sensitivity, and enhanced negative predictive value (NPV) compared to either marker alone. Conclusions: DGF occurred in nearly two-fifths of DDKT recipients in this cohort. Patients with lower preoperative AEC and AGR were more likely to develop DGF, suggesting that these easily available hematological and biochemical indices can serve as potential preoperative predictors of early graft dysfunction. Future multicentric prospective studies are warranted to validate these findings and explore their integration into DGF risk prediction models.
Introduction: Upper Urinary Tract Small Cell Neuroendocrine Ca are extremely rare carcinomas with less than 40 reported cases in literature. Case: 92 years old male with left flank pain and diagnosed to have an enhancing renal pelvic mass, which on histopathological examination was noted to have a predominant small cell carcinoma component. Conclusion: This case report attempts to shed a light on the patients with small cell neuroendocrine carcinoma of the upper tract with its silent and aggressive nature.
Fungal bezoars are extremely rare in the urinary bladder, and there is limited literature regarding the modality of management. We report a case, where the piecemeal removal of a vesical fungal bezoar was performed using Ho:YAG LASER. A 60-year-old man presented with lower urinary tract symptoms and on evaluation was diagnosed with vesical calculus. On cystoscopy, a white-colored, smooth contoured ball was identified in the bladder. The effective endourological modalities for the removal of fungal bezoar require mention in the literature. This case report demonstrates the possibility and efficiency of Ho:YAG LASER in the endourological retrieval of fungal bezoar in the bladder. The rarity of the diagnosis results in difficulty in prompt management.
Mycotic aneurysms of the transplant renal artery (TRA) are rare but life-threatening complications following renal transplantation, often resulting in graf