Introduction:The correction of fossa navicularis strictures poses a distinct reconstructive challenge as it requires attention to cosmesis, in addition to urethral patency. Different graft and flap based repairs have been described with variable success rates. However, the ideal management remains unclear. The feasibility and efficacy of a single stage ventral onlay buccal mucosa graft urethroplasty (VOBMGU) for navicular fossa strictures (NFS) was evaluated in the present study.Subjects and Methods:All patients with NFS attending urology out-patient department from March, 2009 onward accepting VOBMGU were evaluated prospectively. Patients with minimum 1 year of follow-up were included for analysis. The technique involves opening the diseased stenosed meatus ventrally up to the corona. The diseased mucosa is excised leaving a midline strip of native urethral mucosa on the dorsal side. The buccal mucosal graft (BMG) is fixed on either side of this strip over a 24 Fr. silicone catheter. The glans wings are apposed in midline taking anchoring bites on the mucosal graft ventrally. Post-operatively patients were reviewed at 1, 3, 6 and 12 months and annually thereafter. Cosmetic acceptance and splaying of the urinary stream was assessed with individual questionnaires.Results:A total of six patients underwent VOBMGU. Average flow rate at 3 months post-operatively was 12 ml/s. The end result was cosmetically highly acceptable. There was no fistula in any of the cases. With a median follow-up of 37 months, only one patient had a recurrence of stricture in a proximal site.Conclusions:VOBMGU is a viable technique for reconstruction of NFS with promising short term results. However, long-term follow-up is necessary.

Retrocaval ureter (pre-ureteral vena cava) is an uncommon congenital anomaly that causes ureteral obstruction by external compression. Although right retrocaval ureter is a common entity, left retrocaval ureter is extremely rare. A left retrocaval ureter is usually associated with situs inversus or duplicated inferior venacava (IVC). An isolated left retrocaval ureter with single left-sided IVC is even rarer and only four cases have been reported in the literature. We present images of a case with isolated left retrocaval ureter with a single left-sided IVC without situs inversus.

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Objective: To choose appropriate size Amplatz sheath during percutaneous nephrolithotomy (PCNL) based on retrograde pyelogram. Material and methods:We performed standard PCNL in prone position in 20 patients. All these patients had placement of appropriate size of Amplatz sheath based on retrograde pyelogram images. All patients had nephrostomy tubes postoperatively. The preoperative and postoperative renal parameters, hemoglobin, mean operating time and mean hospitalisation stay were measured. Results:There was no significant difference between the pre-operative and postoperative hemoglobin and creatinine levels. Median operating time was 60.5 mins (45 to 98 mins). The median hospitalisation stay was 4.6 days (3 to 7 days). There was no intraoperative pelvic wall or infundibular injury. Conclusion:Choosing correct size of Amplatz sheath lowers the incidence of kidney hemorrhage and renal function impairment. Choosing the appropriate size of Amplatz sheath during percutaneous nephrolithotomy-a novel method IntroductionThe art of percutaneous nephrolithotomy (PCNL) has evolved over years in terms of technique and technology to improve the outcome, tide over the difficulties during the procedure and prevent complications. [1][2][3] The procedure has seen many advances in terms of miniaturisation, reducing radiation exposure and positioning. But, still it is not devoid of complications. In recent years, PCNL is performed with smaller sized Amplatz sheaths to avoid complications, and reduce morbidities. There is little evidence in the literature as to the selection of appropriate size Amplatz sheath to be used during PCNL.The present study discusses a technique which helps in determining the correct size Amplatz sheath to be used during the PCNL procedure. Material and methodsThis study was conducted between April 2015 and August 2015 in a tertiary care hospital where multiple number of patients with stone disease attend our department. We included 20 patients with pure renal pelvic calculi in our protocol, as this was our preliminary study. The mean stone size, preoperative blood and urine parameters and other patient demographics are given in Table 1. All patients underwent standard prone PCNL with stent and nephrostomy placement under general anaesthesia.During placement of ureteric catheter, a retrograde pyelogram (RGP) was done by instilling 10-15 mL of contrast material through catheter slowly under low pressure. The size of the desired calyceal infundibulum was noted. The infundibular diameter is the shortest distance between the edges of the fluoroscopic infundibular image nearer to the pelvis (Figure 1). Then serially starting from smaller to bigger size, Amplatz sheaths were placed over the back of the patient and fluoroscopic match was obtained between the infundibular diameter and appropriate Amplatz sheath. The size of the correct size Amplatz sheath was noted ( Figure 2).Initial access to the desired calyx was performed under the guidance of fluoroscopy. The access tract was serially dilated ov...

Introduction: Transurethral Resection of Prostate (TURP) is gold standard for management of Benign Prostatic Hyperplasia. Technological advances and refinements i n t his p rocedure h ave c ontributed t o improving safety and reducing morbidity and faster recovery. Here we compare the safety, efficacy an d complications of Monopolar vs Bipolar Transurethral Resection of Prostate (TURP) in patients with prostate gland larger than 50CC.