OBJECTIVE: This study evaluated postoperative complications of percutaneous nephrolithotomy (PCNL)and the influence of selected factors on the risk of complications using the modified Clavienclassification system in East Avenue Medical Center. PATIENTS AND METHODS: All patients who were treated with Percutaneous Nephrolithotomy (PCNL) atEast Avenue Medical Center from January to August 2017 were included. Complications wereevaluated by the modified Clavien classification system. RESULTS: Of the 45 patients with Clavien scores, 5 (11.1%) patients experienced one or morecomplications. Noted complications were fever, pneumothorax, hydrothorax and sepsis. Accordingto the modified Clavien classification, the majority had no complications and classified as Claviengrade 0. CONCLUSION The majority of complications after PCNL are minimal. Longer operative time and age> 59 are associated with the risk of more severe postoperative complications in PCNL.

Objectives: The goal to prevent increasing antibiotic resistance in urologic procedures has a significant impact on the choice of preoperative antibiotic prophylaxis. The efficacy of an old-new antibioticfosfomycin in TRUS-guided prostate biopsy was also evaluated. Methods: Included were patients who underwent TRUS-guided prostate biopsy from August 1, 2015- July 31, 2016. Patients who satisfied the inclusion criteria were included. Patients were asked to take a single dose of 3g oral fosfomycin 1-3 hours prior to the procedure. Urinalysis was taken pre biopsy and post biopsy (at least 7-10 days). Occurrence of afebrile and febrile UTI were noted. Patients were informed of the signs and symptoms that need to be reported to the investigators. Results: There were 74 patients enrolled in the study. The mean average age of patients was 66.5(±7). Majority of patients were having moderate lower urinary tract symptoms (40.5%) followed by patients with indwelling foley catheter (31.1%). Seventeen percent of patients had concomitant diseases like diabetes mellitus, cystolithiasis, nephrolithiasis, hypertension, etc. Pre biopsy, 51.4% of patients had asymptomatic urinary tract infection and 35% of these patients showed resolution of UTI post biopsy. The incidence of febrile UTI was 4%, 3.8% of patients with UTI pre biopsy and 50% of patients without UTI pre biopsy. Finally, the presence of afebrile and febrile UTI pre and post biopsy was statistically significant at 5% level of significance. Conclusion Single dose oral fosfomycin as prophylactic antibiotic in TRUS- guided prostate biopsy can be an alternative to reduce the rate of fluoroquinolone- resistant infections.
Fosfomycin ; Urinary Tract Infections

OBJECTIVE: To examine the ability of an antimicrobial agent Ciprofloxacin to diffuse through a Foley catheter retention balloon.
METHODS: The Utraviolet-Visible (UV-Vis) Spectophotometer (UV-1700 PharmaSpec) was utilized to detect the diffusion of the analyte (Ciprofloxacin) through end parameters such as peak absorbance and corresponding wavelengths.
RESULTS: On UV-Vis spectophotometer, the control sample of sterile water was analyzed and found to have the lowest peak absorbance value of only 0.003 at a wavelength of 343 nm. The peak absorbance values of subsequent samples, taken from the same environment (sterile water), since submersion of the catheter balloon, on day-3, day-8, day-15 had increasing peak absorbance values on their corresponding wavelengths.
CONCLUSIONS: In this study, the samples of sterile water from the outside environment of the submerged catheter yielded progressively increasing peak absorbance values on the succeeding days of submersion. Thereby, In lieu of this principle, one can infr the diffusion of the analyte throgh the catheter membrane, as reflected by the summary of peak absorbance value.

Ciprofloxacin ; Water ; Immersion ; Anti-infective Agents ; Diffusion ; Membranes ; Urinary Catheters

OBJECTIVE: This Study was designed to determine the five year biochemical progression free rate of patients with clinically localized prostate cancer stratified to low, intermediate and high risks groups who underwent permanent prostate brachytheraphy.

METHODS: Thirty six patients with a mean age of 67 years diagnosed with clinically localized prostate cancer were treated with Iodine-125 permanent prostate brachytherapy from November 2001 to December 2003. Prostate specific antigen (PSA) failure was defined as having more than +2 increase of serum PSA from the nadir, with PSA nadir set at 0.4 ng/ml. The biochemical recurrence-free rate for the overall and the stratified groups were then calculated.

RESULTS: Twelve patients were lost to follow up leaving twenty-four subjects in the study. The prescribe minimum dose was 145 grays. Median follow-up was 62 months. The over-all 5 year biochemical recurrence-free rate was 58%. Satisfying these patients into low, intermediate, and high group yielded a progression free rate of 80%, 42%, and 5%, respectively.

CONCLUSION: Permanent prostate branchytheraphy is an effective treatment for patients with clinically localized prostate cancers. This reported 5-year biochemical recurrence-free rate at East Avenue Medical Center (EAMC) is comparable with that reported by other centers.

Human ; Male ; Aged 80 And Over ; Aged ; Middle Aged ; Prostate-specific Antigen ; Brachytherapy ; Disease-free Survival ; Prostatic Neoplasms ; Disease Progression ; Radioimmunotherapy ; Iodine Radioisotopes