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Nephroureterectomy Definition, Steps, Recovery, Indications, Complications

Nephroureterectomy as the name indicates is the surgery related to kidney. It is an invasive surgical procedure which is performed to remove ureter, bladder cuff, kidney and renal pelvis of patient. This surgery is performed in patient with transitional cell cancer.  Renal pelvis, ureter, bladder and kidney can also be removed with an open procedure but nephroureterectomy is recommended over open procedure. It has following benefits.


  • Recovery time is short in nephroureterectomy. 
  • Hospital stay is reduced and heals faster. 
  • Patient returns to his routine life very quickly. 
  • Patient feels less pain in nephroureterectomy. 
  • Nephroureterectomy leaves no scars or less scarring with small sized incisions. 

Nephroureterectomy Definition, Steps, Recovery, Indications, Complications

Nephroureterectomy Steps


There are some steps regarding pre-procedure, during procedure and after procedure. Before procedure, patient is asked to take liquid diet from previous night. Patient is also asked to stop taking any kind of medications before surgery. During surgery, anesthesia is given to the patient. A small incision is made and a camera is inserted inside the body through incision. The organs to be removed are separated from the surrounding nerves and then removed via that incision. After procedure, the patient is moved to the recovery room and then monitored for the side effects.

Nephroureterectomy Recovery


Nephroureterectomy is considered preferable instead of open procedure because of it's fastest recovery rate. The patient gets recover fast and start responding to the regular activities. The recovery time is shorter. Patient return to normal activities within days. After discharge from hospital, the patient is asked to avoid weight lifting and other activities for at least 2 weeks. And in some cases it may extend up to six weeks. Patient is asked to walk and do exercise for faster response. Most of the patients get completely recover within 4 weeks and can join their work again with same passion.

Nephroureterectomy Indications


Nephroureterectomy is performed basically for the cancer treatment. The cancer spreading in the renal pelvis, bladder, kidney and ureter. This procedure is performed to remove organs containing transitional cancer cells. The organs like kidney, ureter and bladder are covered with a lining of transitional epithelial cells. Nephroureterectomy is performed to remove this epithelial lining of transitional cancer cells from organs and it is also performed for upper urinary tract infection. These two conditions require nephroureterectomy because it is localized and requires little time for surgery. It is recommended because of it's fast recovery process after surgery and no scarring.

Nephroureterectomy Complications


Where there are various benefits of this surgery over open surgical procedure, there are some risks and complications also associated with this. As an incision is made to remove the organs from body. After surgery, the incision may turn in to a wound and may cause infection causing late recovery. So proper care is required for the incisional region. During surgery, the surrounding organs may become damage due to the incision. So a professional surgeon is required for the surgery. Last but not least, patient may develop incisional hernia because of negligence about the care of incision.
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Infusaport Catheter Placement, Pictures, Complications, Care, Insertion, Removal

Infusaport infusion is similar to infusion. An infusaport is a small device which is used to give  medications direct into the patient’s blood circulation.. This port is used for taking more than one medication and nutrients in one way. This port is mostly used in chemotherapy treatment because patient needs frequent medications in chemotherapy. This port is used when medications are used over a long period of time. Infusaport also used to take number of blood samples for blood tests. Infusaport consist of 2 parts, port and catheter. Port is made of metal and plastic, having chamber of medications.


Infusaport Catheter Placement


This port is placed under the skin through minor surgery. Most common area used for the insertion of port are placed in the chest but can also placed in the arm. This port is placed in deep sleep, so that patient does not feel pain. Second, it may also be placed by numbing the specific area where the port should be placed, patient may also wake up and relax to take multiple medications. After the port is placed , patient may go home. The port can be felt under the skin. After placement, it will not hurt.

Infusaport Catheter Placement, Pictures, Complications, Care, Insertion, Removal

Infusaport Catheter Insertion


Insertion of infusaport catheter is done in operation theater, when patient undergo sedation or on general anesthesia. Before giving multiple medications, small catheter is attached to the reservoir and is placed under the skin also with hollow tube catheter placed inside the veins present in chest area. X-rays are used to check the position of the catheter. Heparin is injected to avoid clots formed in catheter. Chest X-ray is performed right after the insertion. After insertion , it can be used multiple times with a specialized needle. It should only be operated by specialized doctors or trained nursing staff.

Infusaport Catheter Complication


Pain is usually associated after the insertion, but gradually decrease with time. Infections occur and are treated  by antibiotics but it may also result in removal of catheter. Bleeding may start during insertion but it may be stopped by applying pressure. Blood clots formation in catheter is very common, due to this new port should be inserted. Sometime the end of catheter breaks off, this results in removal of catheter. Sometimes yellow or green drainage starts from port site. Swelling and warm feeling may also felt at port site. Sometimes entry of needle in lungs cause damage to outer lining.

Infusaport Catheter Care


When port is not used, Patient should take shower or bath but keep the dressing dry. Dressing should be present over the wound till the healing process isn't complete. Sterile dressing will be used strictly around the port to avoid infection. When healing process will complete patient may come to normal life activities. Port can be used for a long time but When patient does not used port for a long time not taking medicines, should be removed. Catheter should be flushed with heparin to avoid blood clots in the tube. Port can be used at home or in hospital.

Infusaport Catheter Removal


Port should not be removed if they are not infected or not used for a long time. For the removal, adequate anesthesia is applied and given to soft tissues making sure that the skin over the veins and tissues is well anesthetized. The skin over the port site i.e. area of entrance into the veins is prepared by povidone-iodine and alcohol making the area sterile. Sterile wipes and towels must be used to keep area clean & free from infection . Pull the catheter with enough tension so that the catheter release without damaging tissues. Do not apply much tension that the catheter breaks.
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Epididymectomy Recovery, Complications, Swelling, Success Rate

It is a surgical procedure which involves removal of epididymis. Epididymis is the duct which is responsible for carrying sperms in it. It is present right behind the testicles in male. These ducts are 2 in number behind each testicle. This procedure is used rarely and it is recommended only as a last option for the pain. It is advised to perform as a last option for chronic scrotal pain. When the antibiotics are of no use anymore. Then this surgical procedure is recommended. In this procedure an incision is made on the scrotum and remove the both ducts.


Epididymectomy Complications


There are various risks and complications which are associated with epididymectomy. These complications and risks include bleeding,  scarring of tissues, pain, infection (transfusion infection, wound infection or dehiscence), any injury to the surrounding tissues of wound, procedure may fail, pulmonary embolism, deep venous thrombosis and last but not least long term stay in intensive Care unit ICU. In addition to this, there are also some complications related to the anesthesia given to patient. These complications include damaging of airways, pneumonia, cracked teeth, aspiration, malignant hyperthermia, bleeding in spinal canal and nerve damage.

Epididymectomy Recovery, Complications, Swelling, Success Rate

Epididymectomy Swelling


Epididymectomy is a rarely performed surgery because it is the last option advised in case of chronic scrotal pain. After epididymectomy, swelling may occur at the region of surgery. The swelling is normal if it exists for about one month. But if swelling persists for more than one month then it is not normal. There could be an infection behind this swelling. If the swelling is due to the surgery, then there will be no pain . But in case of an infection, the swelling may cause pain in scrotal region. Surgeon also prescribe some medications to subside swelling.

Epididymectomy Success Rate


Epididymectomy is a simple but risky surgery. This is recommended just in case of severe scrotal pain which becomes unbearable. The success rate varies from 10 percent to 80 percent. Because of the number of complications associated with it, epididymectomy is recommended only if the chronic scrotal pain is localized. But if it start spreading from scrotum to the surrounding areas, then epididymectomy is not recommended because it can be prove fatal for health. The severe complications related to it are mayocardial infarction, stroke, pulmonary thrombosis etc. So the success rate varies according to these complications.

Epididymectomy Recovery


The epididymectomy is a risky procedure and patient have to follow some instructions for fast recovery. Patient may feel burning sensation and pain while urinating and this may remain for about 3 to 4 days. Like wise patient is advised to avoid sexual intercourse till 5 days or 1 week after surgery. So almost 2 weeks are required for complete recovery. Patient may also feel irritability during urination in case of placement of stent in urethra. Patient have to follow medications to avoid any further communications. Medications should be continued for the advised time for fast relief and recovery.
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Pseudomeningocele Symptoms, Causes, Complications, Treatment

It is an abnormal condition in which cerebral spinal fluid starts accumulating and shows contact with the space containing cerebral spinal fluid around brain and spinal cord. Pseudomeningocele is different from meningocele because in meningocele, the cerebrospinal fluid is surrounded with dura matter but in pseudomeningocele, cerebrospinal fluid is not surrounded with any membrane. In pseudomeningocele, the cerebrospinal fluid is present in the cavity i.e. within soft tissues. Pseudomeningocele can occur as a result of a surgery of brain or spinal cord. It can also occur as a result of brachial plexus avulsion injury. The treatment of pseudomeningocele is conservative.


Pseudomeningocele Symptoms


The symptoms of pseudomeningocele varies according to the region attached. It may affect various parts of body because of its contact with spinal cord. It may cause pain in back, sciatic pain and headache. It may also cause pain in neck region. Patient feels nausea. Patient may vomit again and again. Other symptoms include tinnitus and a palpable mass in the cavities. In most cases, the pseudomeningocele is asymptomatic and does not show any symptoms. It shows symptoms only in chronic or severe cases. Pain is the commonest symptom it shows in various regions of body.


Pseudomeningocele Causes


Pseudomeningocele is a condition similar to meningocele. The only difference is in their compositions. Both the conditions may have same causes. Some of the common causes include spinal surgery, brain surgery and any kind of injury in brain or spinal cord. Pseudomeningocele is considered as uncommon complication of spinal cord surgery. Injuries leading to pseudomeningocele includes brachial plexus avulsion injury. This injury accelerates the accumulation of cerebrospinal fluid in the cavities or we can say soft tissues without dural matter. These are the only reported causes of pseudomeningocele till yet. This condition is still under investigation for more causes and complications.

Pseudomeningocele Complications


Pseudomeningocele is itself an uncommon complication of brain or spinal surgery. But it also leads to many complications like chronic meningitis, cosmetic deformity. This condition may become life threatening if it is not treated on time. Patient may feel impingement. Some neurological deficits may occur. Cyst formation is the rarest complication. The cysts are life threatening posterior fossa cyst. If this condition is left untreated, it may lead to chronic meningitis and may prove fatal for health. Pseudomeningocele is still under investigation for the collection of further complications and causes behind it.

Pseudomeningocele Treatment


Pseudomeningocele is treated with a surgical procedure. Surgery is the only treatment option for pseudomeningocele. Neurosurgical repair is necessary. Pseudomeningocele is treated via combined treatment protocol which involves extirpation of pseudomeningocele and repair of damaged dural matter. A subarachnoid catheter is used to drain excessive cerebrospinal fluid from cavities or soft tissues. The drainage is safe and effective. This method is used to drain cerebrospinal fluid in case of giant pseudomeningocele. The surgery is the only option to remove excessive amount of cerebrospinal fluid from brain and spinal cord cavity. And surgery should be performed under the supervision of trained physician.
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Gartner Duct Cyst Symptoms, Causes, Treatment | Gartner Duct Cyst vs Bartholin

Gartner's duct cyst is the vaginal cyst which is formed on the Gartner's duct. It is benign in nature. The Gartner's duct is vestigeal remnant of the mesonephric duct (the wolffian duct). The Gartner's duct cyst is mostly mixed up with vaginal inclusion cyst but it is a different thing. Gartner's duct cyst appears on the lateral walls of vagina. These benign cysts are asymptomatic in nature and do not cause pain. These cyst appear in adolescence and cause pain during menstruation. These cysts also cause problem and pain in inserting a tempon. These cysts may grow and become big causing problems.


Gartner's Duct Cyst Symptoms


Gartner's duct cyst are usually asymptomatic. These cysts show no symptoms and can only be diagnosed via physical touch. These cysts cause no pain. But during menstruation these cysts cause pain and patient also feel pain while inserting a tempon. These cysts are benign in nature. Upon touching, patient feels a small lump which is protruding from vaginal lateral wall. These cysts cause pain during sexual intercourse. Usually these are small in size but these may grow bigger and cause further problems. Patient should consult doctor immediately after she feels lumps in her vagina.

Gartner Duct Cyst Symptoms, Causes, Treatment  Gartner Duct Cyst vs Bartholin

Gartner's Duct Cyst Causes


There are many causes behind the formation of Gartner's duct cyst. These cyst can be formed as a result of fluid accumulation in the Gartner's duct. These cyst may form due to any injury or cut during delivery of a baby. Fluid buildup in the glands is another reason. Some non cancerous benign tumors in vagina may also lead to formation of Gartner's duct cyst. These are the main reasons of formation of Gartner's duct cyst. These cysts does not show any visible symptoms other than pain. These cysts are sometimes difficult to differentiate from other kind of cysts. .

Gartner's Duct Cyst Treatment


When we talk about treatment, mostly the benign Gartner's duct cyst subside on it's own. If these cysts are showing no symptoms, then the patient is asked to wait and watch whether it subside on it's own or not. Sitz bath is technique mostly used to break cysts. The patient is asked to sit in warm water for about 3 to 4 days and then the progress is checked. This therapy is not suitable for all patients. If these cysts cause secondary infection then antibiotics are prescribed to clear infection. If antibiotics are of no use, then surgical procedure is required.

Gartner's Duct Cyst V/S Bartholin


Gartner's duct cyst and bartholin are mostly similar but the only difference is between their location. The Gartner's duct cyst is the vestigeal remnant of mesonephric duct i.e. wolffian duct. The Gartner's duct cyst are formed on the lateral side of vaginal wall. In case of bartholin, small projections are formed below the level of pubic symphysis. These cysts are formed on the posteriolateral wall of the vagina. Most of the features of these two types of cysts are same but the location differentiate them from each other.
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Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Commissural dysphasia and white motor dysphasia are the other names of transcortical motor aphasia. It is a speech disorder which occurs due to damage in anterior superior frontal lobe. It specifically occurs in language control center of hemisphere (frontal lobe). Usually left hemisphere of brain is involved in controlling language center. In this disease, patient can't speak openly I.e. there is reduced speech output.

It is difficult for patient to maintain his speech and initiation. Watershed region of brain is not involved in the direct harm of language production and comprehension center. Executive functions of language are affected if frontal lobe is damage.

Transcortical Motor Aphasia Symptoms



Transcortical motor aphasia is a speech disorder in which patient cant speak properly. He cannot even start a conversation and further maintain it. Executive functions of language are affected which mainly involve Grammer (Syntex) control, patient can't narrate a story or any thing he wants to and language response center is not properly activated. Other symptoms involve:

  • Patient find it hard to compose a sentence and elaborate it properly. 
  • Patient gets confused and cannot select right words during his speech. 
  • Starting a conversation is a hardest task for patient suffering from transcortical motor aphasia. 


Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Transcortical Motor Aphasia Causes


Transcortical motor aphasia occurs due to damage in the frontal lobe of brain. Frontal lobe specifically left hemisphere contains language control center. Usually damage in anterior superior frontal lobe is responsible for transcortical motor aphasia. This damage occurs due to cerebrovascular problem I.e. infarction. Prefrontal cortex is the part which involves ideation and initiation of verbal speech. So when damage occurs, it becomes difficult to initiate a conversation. Damage in anterior superior frontal lobe does not affect major language network, Broca's and Wernicke area and arcuate fasiculus. Only infarction is not the reason, damage can also occur due to stroke.

Transcortical Motor Aphasia Treatment


Treatment of transcortical motor aphasia involves speech therapy. Its treatment mainly focus on patients strong hearing conversation and skills of repetition and correcting the reduced speech output of patient. Treatment also covers maintenance of speech and initiation of speech including language. Participation approach to aphasia is a treatment  strategy which have greater success rates. In this treatment strategy, patient is asked to focus on his skills he required to talk with people. He is allowed to talk with people in real life situations like talking to nurse about anything he wants to.

Transcortical Motor Aphasia Speech Therapy


A speech and language pathologist is required for treating transcortical motor aphasia. In this therapy some pictures are provided to patient and ask him to elaborate every single thing or event happening in this picture. Pathologist also provide a vocabulary booklet so that he can easily choose words to start his speech. Other than pictures, pathologist also ask some questions related to current affairs, patients past life, general knowledge and about his experiences. He also ask patient about some cooking recipes like baking a cake and cookies. Repetitive questioning helps in improvement of patients speech.
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Navicular Stress Fracture Test, Symptoms, Causes, Treatment

Navicular stress fracture occurs in foot. It is the most common stress fracture which usually occurs in athletes. Athletes who do jumping and sprinting are at hit list. Navicular is the tasral bone present in foot ankle. It is rightly placed just above the heel bone. Navicular stress fracture results from repetitive strains and continuous use of navicular bone. Guys at gym due to wrong training or weight lifting at wrong angle may suffer from navicular stress fracture. The exact mechanism of injury is not known but it is considered that fracture occurs because of compression of navicular bone within other bones around it due to stress.


Navicular Stress Fracture Symptoms


As navicular bone is present in foot, so symptoms of navicular stress fracture are associated with it. Patient feels unbearable pain in mid foot area. The pain is localized. If patient does not stop exercising or sports, the pain may get worse. Upon applying weight on foot, pain may radiate along the arch of foot and then disappears on rest. Pain will start again as training resumes. Along with pain, patient also feel tenderness in foot if pressure is applied on the top of thumb I.e. N spot.

Navicular Stress Fracture Test, Symptoms, Causes, Treatment

Navicular Stress Fracture Causes


The following factors can cause navicular stress fracture.


  • If patient starts athletic activity at a very high level. He does not let his bones and muscles to relax, that's why stress increases and as a result fracture occurs.
  • Patient does not relax for sufficient time and body remains under stress so it leads to navicular stress fracture.
  • Biomechanical abnormality.
  • Relative osteopenia.
  • Wrong fitting of equipment.
  • Training under Non professional trainer
  • Due to weight lifting at wrong angle or wrong training is the common cause.
  • The exact mechanism of navicular stress fracture is not known yet.


Navicular Stress Fracture Treatment


There is poor blood supply in navicular bone, so treatment is difficult. A good blood supply is needed to heal it completely. Casting is preferred usually to treat stress fracture in navicular bone. Patient have to rest for atleast 6 weeks because even slow walking absorbs navicular bone. The success rate of casting is 85 to 90 percent. Other methods of treatment invovle use of bone stimulator. It helps a lot in bone healing but it does not effect healing time. Walk during casting is strictly prohibited because even a little walk will increase healing time up to 25 percent.

Navicular Stress Fracture Test


At initial stage, X rays may show nothing but Magnetic resonance imaging or bone scan will clearly show fracture at navicular bone. Navicular drop test is performed to assess fracture specifically in navicular bone. In this test, the height of navicular bone is checked while patient stand in front of physician. 1st height of navicular bone is checked at rest, and it is again checked after applying stress on both foot. So the difference in measurement is known as navicular drop. Greater than 10 mm is considered in excessive foot pronation.
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