Papers by Mohammad Alomar
PubMed, Jun 1, 2023
Staghorn calculi (SC) are defined as large kidney stones that fill the renal pelvis and at least ... more Staghorn calculi (SC) are defined as large kidney stones that fill the renal pelvis and at least one renal calyx. They represent 10-20% of all renal stones in developing countries and require prompt diagnosis and management. Massive SC (over 5 cm) are treated exclusively via open surgery, despite percutaneous nephrolithotomy (PCNL) being the gold standard treatment for large stones. Descriptions of PCNL for massive SC are very limited in the literature. Case presentation: We report a case of a 63-year-old male who presented with chronic abdominal pain, hepatosplenomegaly, and normal renal function. He was later diagnosed with polycythemia vera. Computed tomography of the abdomen revealed massive, bilateral staghorn stones measuring 7.3×5.5 cm and 1.8×4.5 cm on the right and left, respectively. Additionally, the right stone was found to be compressing the inferior vena cava (IVC). The patient was promptly scheduled for right-sided PCNL and the target of 80% stone fragmentation was successfully attained. Discussion: We present the first case of a stone of such size in the Middle East, as well as the first known case of a renal stone compressing the IVC. Unlike previous reports, the stone was successfully fragmented via PCNL - a procedure that has not been described for stones of such size. Conclusion: This report highlights that ultrasound-guided PNCL without any other intervention is sufficient for the successful treatment of giant SC. Greater research is needed on the potential utility of using ultrasound-guided PCNL for the fragmentation of stones sized over 5 cm.
Cureus
Percutaneous nephrolithotomy (PCNL) is a difficult treatment for treating kidney stones, especial... more Percutaneous nephrolithotomy (PCNL) is a difficult treatment for treating kidney stones, especially when there are orthopedic or skeletal abnormalities. Here, in a 19-year-old male, we describe a two-step PCNL with a case of caudal regression syndrome (CRS) and a pelvic kidney, with an extremely deformed neurogenic bladder on intermittent catheterization. Our conclusion is that PCNL may be done safely with minimum morbidity in patients with caudal regression syndrome by utilizing adult equipment for heavy stone burdens, allowing full and rapid stone removal.
Annals of Medicine and Surgery
Journal of pediatric surgery case reports, 2021
Caudal duplication syndrome is a very rare anomaly and poses a major challenge for surgeons. The ... more Caudal duplication syndrome is a very rare anomaly and poses a major challenge for surgeons. The term caudal duplication syndrome is used to describe the association between hindgut duplication, duplication of the genitourinary, and malformations of the spinal cord and vertebrae. A 5-year-old girl is reported with complete duplication of the entire large bowel, cecum, appendix, about 2 cm of the terminal ileum, bladder, urethra, vagina, uterus, and vertebral body deformities. After an extensive evaluation phase, a laparotomy was performed and the duplicated colon was excised completely without removing the adjacent native colon.
Since the introduction of minimally invasive procedures for managing renal stones, the presence o... more Since the introduction of minimally invasive procedures for managing renal stones, the presence of small residual fragments became an issue with debatable approaches.
Dental, Oral and Craniofacial Research
The advancement of new technologies for the creation of biomaterials has been inspired by the dem... more The advancement of new technologies for the creation of biomaterials has been inspired by the demand for materials, capable of bearing new specifications and applications. Ceramic materials based on alumina (Al2O3) and zirconia (ZrO2) is used as material of choice for fixed dental prosthesis due to their excellent properties, such as strength, corrosion resistance and biocompatibility. Full coverage zirconia-based ceramic crowns with knife edge preparations can offer a good esthetic result with minimum tooth preparation combining strength and could be considered as a treatment option in selected clinical cases. All-ceramic frameworks are fabricated from zirconium oxide and veneered in the layering technique. Additional advantages of the zirconia based all ceramic restorations are the esthetic characteristics, the biocompatibility and durability. They also show increased abrasion resistance, color and contour stability, appropriate translucency and excellent tissue response due to minimal plaque accumulation.
This case report describes a two-step percutaneous nephrolithotomy (PCNL) in a 22-year-old male w... more This case report describes a two-step percutaneous nephrolithotomy (PCNL) in a 22-year-old male who had severe kyphoscoliosis and a malrotated kidney. The operation was performed with the patient under general anesthesia and in the left lateral decubitus position. All stones were successfully removed. No complications occurred during surgery, and the patient recovered well. Regardless of the posed challenges for kidney stone treatment in patients with spinal deformities, PCNL is not only a minimally invasive but also a safe and effective treatment option when done under correct positioning. The success rate is high, and the morbidity rate is low. According to the literature, only 125 cases of PCNL implications in kyphoscoliosis patients have been reported in emerging case reports and case series.
The Egyptian Journal of Hospital Medicine
Introduction: renal stone is an important health problem in the world and is the most common dise... more Introduction: renal stone is an important health problem in the world and is the most common disease in urinary tract system. It is particularly a common problem in areas of hot climate like Saudi Arabia. Knowledge and lifestyle attitude of individuals towards renal stone plays a role in delivering optimum management. Aim: to determine the public awareness of renal stones causes, symptoms and management amongst Saudis. Patients and Methods: the data of this quantitative cross-sectional study was collected from participants from two regions in Saudi Arabia. Participants were given a self-administered questionnaire written in Arabic from October 2017 till November 2017. Individuals under the age of 18, tourists, medical staff and people unable to read Arabic were excluded. Data were analyzed using SPSS. Results: four hundred and seven participants with a mean age of 35 filled the questionnaire. About half of them had experienced renal stones either personally or in a direct family member. 91.4% of them are aware that increased water intake decreases the formation of renal stones. As for symptoms of urinary stones, 65.36% of them thought that pain and other urinary symptoms would occur when having urinary stones. Radiology imaging was the most chosen mode of diagnosing urinary tract stones especially amongst participants above the age of 35 (p-value= 0.002) with surgical intervention as the best treatment according to the participants. 57.2% of the participants believe that drinking parsley water prevents the formation of renal stones. Individuals who experienced renal stones before were more knowledgeable about the commonest type of renal stones (p-value= 0.005) and the quantity of recommended daily fluid intake (p-value= 0.008). Conclusion and Recommendation: this data indicates that the participants are to some degree aware of some aspects of renal stone prevention, symptoms and modes of diagnosis and treatment. Individuals who experienced renal stones were more knowledgeable in some aspects. Further emphasis on public awareness of renal stones is recommended.
World journal of urology, Jan 16, 2017
Urolithiasis is a significant worldwide source of morbidity, constituting a common urological dis... more Urolithiasis is a significant worldwide source of morbidity, constituting a common urological disease that affects between 10 and 15% of the world population. Recent technological and surgical advances have replaced the need for open surgery with less invasive procedures. The factors which determine the indications for percutaneous nephrolithotomy include stone factors (stone size, stone composition, and stone location), patient factors (habitus and renal anomalies), and failure of other treatment modalities (ESWL and flexible ureteroscopy). The accepted indications for PCNL are stones larger than 20 mm(2), staghorn and partial staghorn calculi, and stones in patients with chronic kidney disease. The contraindications for PCNL include pregnancy, bleeding disorders, and uncontrolled urinary tract infections. Flexible ureteroscopy can be one of the options for lower pole stones between 1.5 and 2 cm in size. This option should be exercised in cases of difficult lower polar anatomy and ...
Clinics, 2015
To evaluate the intra-and postoperative outcomes of patients undergoing laparoscopic radical neph... more To evaluate the intra-and postoperative outcomes of patients undergoing laparoscopic radical nephrectomy with intact specimen extraction through a Pfannenstiel transverse suprapubic incision. METHODS: Prospective follow-up of 26 laparoscopic transperitoneal radical nephrectomies for suspected renal tumors in which the kidneys were extracted via a Pfannenstiel lower abdominal transverse incision. RESULTS: The mean operating time was 152.3 (80-255) minutes, and the mean blood loss was 90 (20-300) ml. The mean extraction time was 20.4 (12-35) minutes. The mean weight of the removed specimen was 631.5 (190-1505) grams, and the mean longest diameter of the extracted specimen was 17.4 (9-25) cm. The mean extraction incision size was 10.7 (7-16) cm. No open surgical conversions were necessary. Pain control was excellent, with minimal intravenous morphine equivalent narcotic use by patients: 15.7 (0-31) mg in the recovery room, 33.8 (0-127) mg on the first postoperative day and 8.7 (0-60) mg in the first week after discharge. The patients experienced a short duration to full ambulation and normal dietary intake. Postoperative followup visits were recorded for at least six months. The patients reported a high cosmetic satisfaction rate of 97.7% (60-100). No late postoperative complications were observed related to the extraction site. CONCLUSIONS: The operative specimen can be extracted via a low transverse Pfannenstiel incision during radical laparoscopic nephrectomy. This incision ensures the extraction of large specimens while preserving the aesthetic and functional advantages of laparoscopy without increasing the cancer risk. The absence of muscle cutting maintains the integrity of the abdominal wall and elicits minimal pain. No postoperative incisional hernias or keloid formations were observed.
The Canadian journal of urology, 2005
Aggressive angiomyxoma is a rare locally invasive non-metastasizing soft tissue neoplasm that is ... more Aggressive angiomyxoma is a rare locally invasive non-metastasizing soft tissue neoplasm that is most commonly located in the female pelvis and perineum. We report a case of aggressive angiomyxoma arising from the epididymis of a young male, which was treated by radical orchiectomy.
Urology Annals, 2015
The aim was to highlight the advantages and the feasibility of treating ureteral stump syndrome (... more The aim was to highlight the advantages and the feasibility of treating ureteral stump syndrome (USS) by different minimally invasive procedures. Materials and Methods: Four patients with USS who were treated by different minimally invasive surgery approaches depending on their presentation and findings on radiologic investigations. Results: Three patients had complete resolution of their symptoms, whereas the fourth patient had persistence of urinary tract infection. Conclusion: Minimally invasive surgery is a valid treatment option for patients with USS with possible less morbidity than conventional open surgical excision.
Journal of Endourology, 2013
Management of stones in the ectopic pelvic kidney can be very challenging. Treatment of each pati... more Management of stones in the ectopic pelvic kidney can be very challenging. Treatment of each patient should be individualized. We describe a new approach that is CT-guided transgluteal percutaneous nephrolithotripsy (PCNL). A 19-year-old male presented with symptomatic right ectopic pelvic kidney stones. He was treated with CT-guided transgluteal PCNL. The patient was stone free at postoperative day 1. No major complications were observed, and the patient was discharged home on postoperative day 2. CT-guided transgluteal PCNL is a safe and effective option for selected patients with ectopic pelvic kidney stones.
Clinics, 2015
To evaluate the intra-and postoperative outcomes of patients undergoing laparoscopic radical neph... more To evaluate the intra-and postoperative outcomes of patients undergoing laparoscopic radical nephrectomy with intact specimen extraction through a Pfannenstiel transverse suprapubic incision. METHODS: Prospective follow-up of 26 laparoscopic transperitoneal radical nephrectomies for suspected renal tumors in which the kidneys were extracted via a Pfannenstiel lower abdominal transverse incision. RESULTS: The mean operating time was 152.3 (80-255) minutes, and the mean blood loss was 90 (20-300) ml. The mean extraction time was 20.4 (12-35) minutes. The mean weight of the removed specimen was 631.5 (190-1505) grams, and the mean longest diameter of the extracted specimen was 17.4 (9-25) cm. The mean extraction incision size was 10.7 (7-16) cm. No open surgical conversions were necessary. Pain control was excellent, with minimal intravenous morphine equivalent narcotic use by patients: 15.7 (0-31) mg in the recovery room, 33.8 (0-127) mg on the first postoperative day and 8.7 (0-60) mg in the first week after discharge. The patients experienced a short duration to full ambulation and normal dietary intake. Postoperative followup visits were recorded for at least six months. The patients reported a high cosmetic satisfaction rate of 97.7% (60-100). No late postoperative complications were observed related to the extraction site. CONCLUSIONS: The operative specimen can be extracted via a low transverse Pfannenstiel incision during radical laparoscopic nephrectomy. This incision ensures the extraction of large specimens while preserving the aesthetic and functional advantages of laparoscopy without increasing the cancer risk. The absence of muscle cutting maintains the integrity of the abdominal wall and elicits minimal pain. No postoperative incisional hernias or keloid formations were observed.
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Papers by Mohammad Alomar