2. Case 1

3. Complaint:

4. HPI:
 The condition started 2 months ago when pt
started to complain of lt. dull aching loin pain,
not accompained with fever or rigors, not
accompained with nausea or vomiting.2 months
earlier pt. used to experience severe pain in
the area of both upper thighs with no
improvement on med. ttt.
• Irritative symptoms:
• BM, Frequency
• No Obstructive Symptoms:
• No History of PN, hematuria or SP.
• +ve History of Bilhariziasis.

5. Past History:
 Medical:
• Free
 Surgical
• Free

6. MRI Abdomen

7. MRI Abdomen

8. MRI Abdomen

9. MRI Abdomen

10. Bone Scan

11. Bone Scan

12. MRA Abdomen

13. Labs. :
 S. Creat. : 1.9 mg dl

14. Urine Analysis :

15. Case 2

16. Complaint:

17. HPI:
 The condition started 4 months ago when pt
started to complain of bilateral dull aching
loin pain, more on the left side not accompained
with fever or rigors, not accompained with
nausea or vomiting
• No Irritative symptoms
• No Obstructive Symptoms:
• No History of PN, hematuria, Bilhariziasis.
• +ve history of stone passage once 2 years ago.

18. Past History:
 Medical:
• HTN on inderal
 Surgical
• Tonsillectomy when she was 18
years old
• Cholecystectomy 4 years ago

19. Pelvi-Abd U/S

20. KUB

21. IVU

22. IVU

23. PACT without contrast

24. PACT without contrast

25. PACT without contrast

26. Labs. :
 S. Creat. : 0.8 mg dl

27. Urine Analysis :

28. Case 3

29. Complaint:

30. HPI:
 The condition started 7 months ago when pt
started to complain of right dull aching loin
pain, not accompained with fever or rigors, not
accompained with nausea or vomiting
• Irritative symptoms :
 BM, Frequency.
• No Obstructive Symptoms:
• No History of PN, hematuria or Bilhariziasis.
• +ve History of Stone passage

31. Past History:
 Medical:
• Free
 Surgical
• Free

32. Pelvi-Abd U/S

33. IVU

34. IVU

35. Labs. :
 S. Creat. : 0.9 mg dl

36. Urine Analysis :

37. Case 4

38. Complaint:

39. HPI:
 The condition started 1 yr ago when pt
started to complain of right dull aching loin
pain, not accompained with fever or rigors,
nausea or vomiting, releived with analgesics
• Irritative symptoms :
 BM, Frequency
• No Obstructive Symptoms:
• No History of PN, hematuria, Bilhariziasis or SP.

40. Past History:
 Medical:
• Free
 Surgical
 Lt. Varicocelectomy 3 yrs ago .
 Homorroidectomy 2 yrs ago .
 One session of ESWL at 7-8-2012 .

41. Pelvi-Abd U/S

42. Pre-ESWL Post-ESWL

43. IVU

44. IVU

45. Labs. :
 S. Creat. : 0.8 mg dl

46. Urine Analysis :

47. Case 5

48. Complaint:

49. HPI:
 The condition started one monthes ago when pt
first experienced a sudden red discolouration
of urine followed by acute retention of urine in
the same day. Pt. had a urethral catheter
applicated since then and received med. ttt. for
haematuria with significant improvement.
• Irritative symptoms :
 BM, Frequency
• No Obstructive Symptoms
• No History of PN, Bilhariziasis or SP.
• +ve History of haematuria ( single attack )

50. Past History:
 Medical:
• Hypertensive on Concor Plus 1x1
 Surgical
• Free

51. Pelvi-Abd U/S

52. PA-CT with cont.

53. PA-CT with cont.

54. PA-CT with cont.

55. CT Cystogram

56. Labs. :
 S. Creat. : 0.9 mg dl

57. Case 6

58. Complaint:

59. HPI:
 The condition started one month ago when pt
first experienced a sudden red discolouration
of urine. Pt. had a urethral catheter
applicated since then and received med. ttt. for
haematuria with significant improvement.
• Irritative symptoms :
 BM, Frequency
• No Obstructive Symptoms
• No History of PN, Bilhariziasis or SP.
• +ve History of haematuria ( single attack )

60. Pelvi-Abd U/S

61. Pelvi-Abd U/S

62. KUB

63. PA-CT without cont.

64. PA-CT without cont.

65. PA-CT without cont.

66. PA-CT without cont.

67. Renal Scan

68. Renal Scan

69. Labs. :
 S. Creat. : 2.1 mg dl
 PSA : 1.25 ng ml (total)

70. Urine Analysis :

71. Case 7

72. Complaint:

73. HPI:
 The condition started one month ago when pt
first experienced difficult painful
micturation.
• Irritative symptoms :
 BM, Frequency
• Obstructive symptoms :
 Weak intermittent stream, hesitancy,PMD
• No History of PN or haematuria.
• +ve History of Bilhariziasis & SP.

74. Past History:
 Medical:
• Free.
 Surgical
 Cystolithotomy 1991 .
 VIU 5 times starting from 2000.
 ESWL 5 times for bilateral renal stones. ??

75. Pelvi-Abd U/S

76. KUB

77. IVP

78. AUCG

79. AUCG

80. AUCG

81. Labs. :
 S. Creat. : 0.9 mg dl

82. Urine Analysis :

83. Case 8

84. Complaint:

85. HPI:
 The condition started 6 months ago when pt
first experienced painless swelling of both
scrotal compartments.
• Irritative symptoms : -ve
• Obstructive symptoms : -ve
• No History of PN ,Bilhariziasis, SP or
haematuria.

86. Past History:
 Medical:
• Free.
 Surgical
• Free.

87. Scrotal Duplex

88. Case 9

89. Complaint:

90. Pre-KUB

91. Post-KUB

92. Case 10

93. Complaint:

94. Pre-KUB

95. Post-KUB

96.  S. Creat. : 9.7 mg dl.
 Total GFR : 13 ml min.(before &
after).
 Pt. now is on regular dialysis.

97. Case 11

98. Complaint:

99. HPI:
 At age of 4yrs old ,MCA fr. Pelvis ( conserv. Management ) & diff.
during mict.  multiple VIU .
 At age of 7yrs old uretheroplasty pt micturate through urethra
till age of 22 yrs old .
 At age of 22 yrs old pt developed weak stream of mict.  VIU
 3 m later  pt developed weak stream of mict  D CX  post-
operative pt had supra-pubic cath & complained of bl/rectum &
micturation through rectum (fistula ) . 2 days later , pt underwent
repositioning of supra-pubic cath .
 2 yrs later, pt underwent fistula repair . Suprapubic cath was
removed with app of ureth cath  15 d after ureth cath was
obstructed & wrongly removed with false app of ureth cath  stool
was coming from urethra ( fistula reformation ) suprapubic cath
was applied
 6m later transient colostomy was done .

100. HPI:
 6m laterpt underwent uretheroplasty . Colostomy was closed after
6ms .
 1y later pt complained of diff in mict pt underwent D CX with
uretheral stent app . Pt did not come for follow up for 7 yrs  sever
infection around stent obstructing urethra supra-pubic cath was
app ( in 2009).
 In 2010, uretheral stent is removed surgically after failure of
endoscopic removal with formation of fistula bet urethra & perineal
skin . Pt is micturating through this fistula but now stream of mict
became weak.
 3 months ago, Diagnostic urethrocystoscopy revealed an opening
proximal to the vero, with no definitive fistilous tract, urethral
dilatation starting from the opening of the perineal fistula up to 26
FrenchAnd application of a urethral catheter 22 FR.
 Last urethral dilatation was done at 15-7-2012.

101. Past History:
 Medical:
• Free.
 Surgical
• As mentioned before.

103. Case 1

104. Complaint:

105. Pre-KUB

106. Post-KUB

107. Case 2

108. Complaint:

109. Combined Study (Pre)

110. Combined Study (Post)