1.Lumbar Transforaminal Injection of Steroids versus Platelet-Rich Plasma for Prolapse Lumbar Intervertebral Disc with Radiculopathy: A Randomized Double-Blind Controlled Pilot Study
Anuj GUPTA ; Harvinder Singh CHHABRA ; Vishwajeet SINGH ; Daram NAGARJUNA
Asian Spine Journal 2024;18(1):58-65
Methods:
In this single-center double-blind randomized controlled pilot study, 46 patients were recruited and randomized by the lottery method. The Visual Analog Scale (VAS) for leg pain, modified Oswestry Disability Index (mODI), and Short-Form 12 (SF-12) were assessed at 1 week, 3 weeks, 6 weeks, 6 months, and 1 year.
Results:
Both groups were comparable in terms of demographics, preprocedure VAS scores, mODI, and SF-12 scores (p=0.52). At the 1-week follow-up, the steroid group had significantly better improvement than the PRP group (p=0.0001). At the 3-week follow-up, both groups showed comparable outcomes; however, the PRP group had better symptom improvement. At 6 weeks and 6 months, the PRP group had better outcomes (VAS, p<0.0001; ODI, p=0.02; SF-12, p=0.002). Moreover, 17 and 16 patients in the steroid and PRP groups underwent repeat LTI with steroids or surgery because of pain recurrence during follow-up. At 1 year, no difference in outcomes was observed.
Conclusions
PRP may be a useful alternative to steroids for LTI in lumbar radiculopathy. Although improvement was delayed and 1-year outcomes were comparable, the 6-week and 6-month outcomes were better with PRP than with LTI. Multiple PRP injections may be beneficial because of its autologous nature. However, further studies with a larger number of participants, longer follow-up, and repeat LTIs are warranted to draw definite conclusions.
2.Response to the Letter to the Editor: Lumbar transforaminal injection of steroids versus platelet-rich plasma for prolapse lumbar intervertebral disc with radiculopathy: a randomized double-blind controlled pilot study
Anuj GUPTA ; Harvinder Singh CHHABRA ; Vishwajeet SINGH ; Daram NAGARJUNA
Asian Spine Journal 2024;18(3):489-490
3.Tricholithobezoar: An Unusual Late Complication of Neourethral Reconstruction in Aphallia.
Vishwajeet SINGH ; Deepak Sharanappa NAGATHAN ; Rahul Janak SINHA ; Dheeraj Kumar GUPTA
Korean Journal of Urology 2013;54(5):345-347
An 18-year-old man born with aphallia had undergone phallic reconstruction in childhood followed by total urethral reconstruction with a buccal mucosal graft and groin-based pedicle (Singapore) flap urethroplasty at 13 years of age. The patient presented with obstructive voiding symptoms lasting 6 months followed by acute urinary retention. The results of a voiding cystourethrogram showed a filling defect in the distal urethra that had been reconstructed by use of the skin flap. On urethroscopy, a 3 cmx2 cm sized tricholithobezoar was seen in the distal urethra. Pneumatic lithotripsy followed by bulbar urethrolithotomy was performed in the same operation to extract the bezoar. The remaining hairs were mechanically epilated. The patient has been doing well for 6 months of follow-up.
Bezoars
;
Follow-Up Studies
;
Hair
;
Hair Removal
;
Humans
;
Lithotripsy
;
Skin
;
Transplants
;
Urethra
;
Urinary Retention
4.Leiomyosarcoma, a Nonurothelial Bladder Tumor: A Rare Entity With Therapeutic Diversity.
Dheeraj Kumar GUPTA ; Vishwajeet SINGH ; Rahul Janak SINHA ; Vijay KUMAR ; Deepak Sharanappa NAGATHAN ; Satya Narayan SANKHWAR
Korean Journal of Urology 2013;54(6):409-411
A 22-year-old young woman presented with dysuria and lower urinary tract symptoms that had persisted for 6 months. She was diagnosed with a tumor near the bladder neck. Transurethral resection was done under anaesthesia. The histopathological examination with immunohistochemical staining showed the tumor to be a low-grade leiomyosarcoma. Adjuvant chemoradiation was given, and the patient has been doing well for 12 months of follow-up. Nonurothelial tumors of the bladder are rare and consensus is lacking regarding their definitive treatment. Furthermore, little is known about the natural history and prognosis of this type of bladder sarcoma. We present a minimally invasive treatment for this relatively rare tumor in which bladder preservation was achieved with no evidence of local or distant recurrences during the follow-up to date.
Consensus
;
Dysuria
;
Female
;
Follow-Up Studies
;
Hematuria
;
Humans
;
Leiomyosarcoma
;
Lower Urinary Tract Symptoms
;
Natural History
;
Neck
;
Prognosis
;
Recurrence
;
Sarcoma
;
Urinary Bladder
;
Urinary Bladder Neoplasms
5.Leiomyosarcoma, a Nonurothelial Bladder Tumor: A Rare Entity With Therapeutic Diversity.
Dheeraj Kumar GUPTA ; Vishwajeet SINGH ; Rahul Janak SINHA ; Vijay KUMAR ; Deepak Sharanappa NAGATHAN ; Satya Narayan SANKHWAR
Korean Journal of Urology 2013;54(6):409-411
A 22-year-old young woman presented with dysuria and lower urinary tract symptoms that had persisted for 6 months. She was diagnosed with a tumor near the bladder neck. Transurethral resection was done under anaesthesia. The histopathological examination with immunohistochemical staining showed the tumor to be a low-grade leiomyosarcoma. Adjuvant chemoradiation was given, and the patient has been doing well for 12 months of follow-up. Nonurothelial tumors of the bladder are rare and consensus is lacking regarding their definitive treatment. Furthermore, little is known about the natural history and prognosis of this type of bladder sarcoma. We present a minimally invasive treatment for this relatively rare tumor in which bladder preservation was achieved with no evidence of local or distant recurrences during the follow-up to date.
Consensus
;
Dysuria
;
Female
;
Follow-Up Studies
;
Hematuria
;
Humans
;
Leiomyosarcoma
;
Lower Urinary Tract Symptoms
;
Natural History
;
Neck
;
Prognosis
;
Recurrence
;
Sarcoma
;
Urinary Bladder
;
Urinary Bladder Neoplasms