Browsing by Author "M.P. Rao"

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A decade's experience with vesicovaginal fistula in India
(Springer London, 2007) Neeraj K. Goyal; U.S. Dwivedi; N. Vyas; M.P. Rao; S. Trivedi; P.B. Singh
A retrospective analysis of 252 cases of vesicovaginal fistulae was done to analyse its etio-pathology and management in an Indian population. After a thorough evaluation, different techniques of fistula closure were used for repair and the results were listed. The main outcome measures were the etiology of the fistula, need for tissue interposition and cure rate per repair as well as the overall cure rate. We compared our results with literature and concluded that simple and small fistulae should be repaired with layered closure. All complicated fistulae should be repaired with tissue interposition or tissue graft. This is the first study from India compiling 10 years of experience on vesicovaginal fistula. © International Urogynecology Journal 2006.
Dorsal onlay buccal mucosal graft urethroplasty in long anterior urethral stricture
(Brazilian Society of Urology, 2007) Biswajit Datta; M.P. Rao; R.L. Acharya; N. Goel; Vaibhav Saxena; S. Trivedi; U.S. Dwivedi; P.B. Singh
Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in long anterior urethral stricture (> 2 cm long) through the midline perineal incision. Materials and Methods: From January 1998 to December 2003, 43 patients with long anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 months with uroflowmetry retrograde urethrogram (RGU) and American Urological Association symptoms score (AUA symptoms scores). Successful outcome was defined as normal voiding with a maximum one attempt of VIU after catheter removal. Patients were further followed-up with uroflowmetry at 3 months interval and RGU every 6 months interval. Results: Mean stricture length was 4.8 cm (range 3 to 9 cm) and mean follow up was 48 months (range 12 to 84 months). Only five patients were found to develop stricture at anastomotic site, during follow-up. Two of them voided normally after single attempt of VIU. Other three patients (6.9%) required further open surgery or repeat VIU during follow up and were considered as failure. Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.
Prevention of bone mineral loss by zoledronic acid in men with prostate carcinoma receiving androgen deprivation therapy: A prospective randomized trial in an indian population
(2008) M.P. Rao; Abhay Kumar; Neeraj K. Goyal; Sameer Trivedi; Udai S. Dwivedi; Pratap B. Singh
Objective: To assess the efficacy of zoledronic acid in preventing bone mineral loss in locally advanced, non-metastatic prostate carcinoma in men receiving androgen deprivation therapy. Patients and Methods: Forty-one men with locally advanced, non-metastatic prostate carcinoma were randomly divided into 2 groups to receive zoledronic acid 4 mg intravenous infusion (n = 19) or a placebo (n = 22) every 3 months. The primary efficacy variables were measurement of bone mineral density (BMD) of the lumbar spine and urinary deoxypyridinoline at the baseline and at the end of treatment. The efficacy analysis was by mean and percent-age change of these variables from the baseline to the end of the treatment. Results: The mean BMD increased significantly to 1.18 g/cm 2 from a baseline value of 1.09 g/cm2 in the zoledronic acid group. In the placebo group, the mean BMD decreased to 0.99 g/cm 2 from a baseline value of 1.07 g/cm2. The percentage change of BMD of the lumbar spine from the baseline was an 8.15% increase in the zoledronic acid group and a 7.0% decrease in the placebo group. There was also a significant decrease of mean urinary deoxypyridi-noline values in the zoledronic acid group (p < 0.05) and a significant increase in the placebo group (p < 0.001). Conclusion: Long-term androgen deprivation therapy for prostate carcinoma patients leads to significant loss of bone density. Bisphosphonate treatment especially with the highly potent zoledronic acid should be considered in patients with a low BMD baseline because this drug not only prevents the decrease in BMD but also improves BMD. Copyright © 2008 S. Karger AG, Basel.
Transitional cell carcinoma of kidney with extension into renal vein and inferior vena cava: A report of two rare cases and review of the literature
(2004) Mufti Mahmood; U.S. Dwivedi; Vipul Tandon; N. Vyas; M.P. Rao; B. Dutta; P.B. Singh
We report two cases of transitional cell carcinoma (TCC) of the right kidney with extension into renal vein and inferior vena cava (IVC). Based on radiological findings, the patients were diagnosed having renal cell carcinoma with tumor thrombus in the vena cava pre-preoperatively. Radical nephrectomy with thrombectomy was performed. A literature review of 18 reported cases revealed that 14 cases (77.8%) were diagnosed as renal cell carcinoma preoperatively. TCC should be included in the differential diagnosis of renal tumors that can cause IVC thrombosis. Prognosis of TCC with vena cava thrombus is relatively poor compared to that of renal cell carcinoma with a large vein tumor thrombus.