Prof. Adeebul Hassan Rizvi speaks on management of pediatric urolithiasis

Print

Prof. Surgeon Hameed Memorial lecture at Surgicon 2013

Prof. Adeebul Hassan Rizvi speaks on
management of pediatric urolithiasis

KARACHI: Prof. Adeebul Hassan Rizvi the founder of Sindh Institute of Urology and Transplantation (SIUT) delivered the Prof. Surgeon Hameed Memorial lecture during the Surgicon 2013 and the topic of his presentation was Management of pediatric urolithiasis: from minimally invasive to renal transplantation. To begin with Prof. Adeeb Rizvi paid rich tributes to late Prof. Surgeon Hameed who he said was my mentor. Prof. Adeebul Hasan Rizvi was of the view that everything is possible in Pakistan if you want to manage a case. He then discussed at length the history of changing concept of this disease and said that Hippocrates had described four diseases of kidney. Almost 50% of his writings are full of warnings. Avicenna was the first person to describe relationship between urine and stones. Thick and ropy urine stone will be soft. MaCnison described the causation of stones in India in 1931 which was published in British Medical Journal. He opined that it is the diet and infections which were the main cause of kidney stone formation in India.

Prof.Adeebul Hassan Rizvi delivered Prof. Manzar Saleem Memorial
lecture at the Surgicon 2013. Picture shows Prof. Zakiuddin G. Oonwala
Patron of Surgicon 2013 presenting him a mementoe on this occasion.
Prof. Saleem Khan President SSP is also seen in the center.

Giving details of paediatric stone diseases at SIUT, Prof. Adeebul Hassan Rizvi said that from 1998-2012 they have examined 15,093 patients. As regards the spectrum of stone diseases, we have seen stones in abnormal kidney, infection destruction of kidney. He then discussed the evaluation protocol and the management protocol for pediatric stone diseases at SIUT starting from open surgery to minimal surgery, management protocols for special stones and stones in infancy. In 1985, it was open surgery in 100% of cases which reduced to 65% in 2002, 30% in 2010 and 28% at present and it will remain at it. He then talked about the era of minimally invasive surgery, ESWL which was used in 158 cases and the results were published. We started PCNL in 1997 with adult equipment and have managed more than two thousand patients so far. Now we have got miniature instruments and managed fourteen hundred cases and it gives much better results, he added.
With URS we have done over one hundred cases with a stone clearance rate of over 95.5%. We have managed 1498 cases with PUCL and thirty five cases with PCCL. He also talked about management of special stones. We had forty patients with stone with primary oxalosis, they were in end stage renal disease and we lost two patients. At present all facilities for management of these kidney stones are available at SIUT under one roof. Continuing, Prof. Adeebul Hassan Rizvi said that once you start dealing with stones, there is no end to it and you have to continue looking after these cases. We had sixty eight patients with End Stage Renal Disease. We did four hundred fifty paediatric renal transplants and mean age of the patients was 14.2 years. The latest figures show that the number of paediatric renal transplants at SIUT was over five hundred. An analysis of risk factors showed that it includes low weight and short in height, less water intake, less potassium. He was of the view that for proper understanding of stone diseases there are many studies which are going on at present. He concluded his presentation by talking about pre urinary risk factors, urinary risk factors, clinical psychological risk factors as regards prevention of stones but we do not know where we stand at present, he added.
Earlier Prof. Asadullah Khan read the Citation for late Prof. Surgeon Hameed and said that he was an accomplished surgeon, trained a large number of surgeons and retired as Prof. and Head of the Dept. of Surgery from JPMC.