Objective: Transrectal ultrasound guided biopy is the diagnostic of choice in detecting carcinoma of the prostate. The biopsy can be painful and many would refuse the procedure again without adequate analgesia.he combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids work synergistically in relieving pain. The investigators determined that the premedication of celecoxib and tramadol with 10ml intrarectal 2% lidocaine gel would significantly decrease the pain score of patients undergoing prostate biopsy compared to lidocaine gel alone.Methods: Thirty one patients who underwent 12-core prostate biopsy were randomly assigned into two groups. The control received 10ml 2% intrarectal lidocaine gel alone the experimental group was given celecoxib 400mg and tramadol 59mg 2 hours before biopsy plus intrarectal lidocaine gel. Immediately after biopsy, patients were asked to rate the pain score using visual analog scale (VAS).Results: A total of 15 patients assigned for cotrol group and 16 patients for the experimental group, showed similar characteristics in terms of age, prostate volume and prostate specific antigen (PSA) value. The overall mean pain score using visual analog pain scale was 4.1+/-1.7 in the experimental group compares to 5.5+/-1.9 in the control group with signifcant P value of 0.034 using chi-square test. There was a mean pain score decrease of 1.5 from the scale of 1 to 10 in the experimantal group compared to the cotrol.Conclusion: The addition of oral administration of celecoxib 400mg and tramadol 59mg 2 hours before intrarectal 10ml 2% lidocaine gel significantly reduced the pain exprienced by patients during ultrasound guided prostate biopsy as compared to lidocaine gel alone
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OBJECTIVE: Endoscopic surgery is one of the most common minimally invasive surgical techniques applied in the field of urology. The authors developed a mechanical adaptor for commercially available penlight-type LED light that can be used in common endoscopic procedures in urology.

MATERIALS AND METHODS: A four-piece light adaptor device made from medical-grade aluminum steel was crafted and functions as an adaptor for penlight-type LED light in one end and an endoscopic telescope on the other end. In order to determine its function and quality, it was compared to the conventional light source machine used in most endoscopic procedures. The specification of both light sources were compared in terms of light intensity and colour temperature through a light meter. This device was applied clinically by using it in a series of endoscopic procedures.

RESULTS: Application of the device in the endoscopic surgical procedures showed that it functioned well and appropriately. It was able to complete a full course of each operation undertaken.

CONCLUSION: This original an innovative device offers an alternative to the conventional light source equipment available commercially. Based on the authors experience we recommend the use of this adaptor for common endoscopic procedures done in minimally invasive surgery.

Human ; Male ; Female ; Endoscopy ; General Surgery ; Urology ; Minimally Invasive Surgical Procedures ; Inventions ; light ; Equipment and Supplies

A 19-year old man presented with acute onset of intractable hypertension with associated dizziness and nausea. Abdominal computed tomography revealed a 7.0cm x 6.27cm x 6.0cm suprarenal mass on the right. The patient was diagnosed to have pheochromocytoma and successfully underwent retroperitoneal laparoscopic adrenalectomy.

Human ; Male ; Young Adult ; Adrenalectomy ; Surgical Procedures, Operative ; Endocrine Surgical Procedures ; Laparoscopy ; Adrenal Gland Neoplasms ; Neoplasms ; Endocrine Gland Neoplasms

Objective: To determine the difference in urinary citrate level in Filipino stone formers as compared with non-stone formers in OPD patients seen at East Avenue Medical Center.Methodology: Forty males and females aged 20-70 years who were seen at the East Avenue Medical Center OPD Urology were randomly selected. Collection of the 24 hour urine was done. Urine specimens were sent to the same laboratory for examination and were processed using citrate lyase method.Results: The mean citrate levels seen between non-stone formers and stone formers showed significant difference with a P-value of less than 0.5. The results of the mean citrate difference in both sex and age showed no significant difference with a P-value of more than 0.5.Conclusion: Urinary citrate levels of stone formers are significantly lower than non-formers in our study. The levels of the urinary citrate are comparable to the foreign counterparts' results.
Citrate ; Urolithiasis

Treatment of urinary stone diseases requires radiographic imaging to optimize treatment selection. Non contrast helical computerized tomography (CT) has become the radiographic modality of choice in acute flank pains due to rapid and accurate determination of stone parameters. It was used by some groups to correlate treatment success, however, no specific recommendations have yet resulted from this series. Objective: To determine how non-contrast helical computerized tomography hounsfield unit (HU) measurement of surgically collected calculi correlates with in vitro stone breaking strength. Methodology: The specimens were obtained from patients who underwent open stone surgery at our institution from January 1, 2006 to September 30, 2006. Stones with sizes between 1-2 cm in their greatest dimension wer^ included in the study. In vitro measurement of the individual stone hounsfield unit values was done using the center's Neusoft CT C 3000 Spiral CT Scanner. Breaking strength of each stone was determined using Tinius Olsen low capacity Universal Testing Machine (UTM). Results were recorded and statistical analysis was performed using the Pearson correlation coefficient and linear regression from the commercially available SPSS statistical software. Results: A total of 38 stones were obtained from open stone surgery during the period covered in the study were included. Specimen sizes ranged between 1 to 2 centimers (cm) with an average size of 1.37 cm. The mean hounsfield unit of the stone specimen was at 588.34 HU and an average breaking strength of 57.54 Ib load. The Pearson correlation coefficient between the Hounsfield reading and that of breaking load is r = 0.406. This is indicative of a moderate yet significant (p-0.008) association between the two scores. A linear regression model may be fitted for these two scores with breaking load as dependent variable and hounsfield unit as predictor. A caveat on the model is its low adjusted R-square (16%). The resulting equation was: Estimated Breaking Load = 30.422 + 0.0461 (Hounsfield Unit). Conclusion: The breaking load of a urinary stone has a tendency to have a higher value as the Hounsfield score increases. Hounsfield unit is a predictor for stone's breaking strength but not a sufficient one.

Urinary Calculi ; Urolithiasis