Background; The abdominal masses in infants, neonate or child is a worrying sign that every clinician must be aware of as these masses can sometimes show malignant transformation. The outcome of this study would give an overview to the paediatric surgeons/ urologist about presenting spectrum of abdominal masses in children in our population which would enable them to manage these patients properly. Study Design: A Descriptive Cross-sectional Study conducted at Children Hospital, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS Islamabad and Urology department of Islam Medical College/ Teaching Hospital, Sialkot for the duration of one year from January 2022 to December 2022. Material & Methods: This descriptive cross sectional study include ninety four (n=94) patients of less than 12 years of age irrespective of either gender who presented with abdominal mass. Patients suspected of having abdominal mass were screened from the outpatient (OPD) and emergency departments. Results; Out of 94 children, sixty five (69.15%) children were males whereas twenty nine (30.85%) were females. The male to female ratio was 2.24:1. Thirty five (37.33%) children were less than 1 year old, Twenty six (27.66%) were between age 1 and 3 years, nineteen (20.12%) children were between age 3 to 7 years and fourteen (14.89%) of children were elder than 7 years of age. The mean age was 7.4 months ± 2.1 Standard Deviation (SD). Most of the masses are benign and cystic in nature, however, Wilms’ tumour and neuroblastoma are two conditions that need a vigilant monitoring as these are the two malignant tumours (22.34% : n=21) in children where they usually present with abdominal mass. Conclusion; In a nutshell, any child presented with abdominal symptoms in surgical department must be investigated and managed accordingly. Any delay in diagnosis may cause fatal outcome. Keywords: Abdominal mass, UPJO-ureteropelvic junction obstruction, VUR (vesico-ureteric reflux), Hydronephrosis.

In this study, our aim is “to study the determine the outcomes of transurethral nephroscope for the treatment of vesical stones using pneumatic lithoclast”. Material and Methods: The detailed study was conducted in Department of Urology, Islam Medical & Dental College/ Islam teaching/Central hospital Sialkot, from March 2019-March 2020 where we included  25 Male and 5 female who with  vesical stones greater then 4 cm that was fragmented using the through transurethral use of a nephroscope via 26F amlplatz sheath. We took history from medical cards and conducted physical examinations, lab tests, urine culture and ultrasonagraphy of urinary tract. Then using the x-ray KUB film  for stone clearance. We noted the mean age,  operation time, presenting symptoms, complications and the post operative status of the stone clearane, and conducted our analysis using SPSS version 20.  Result: The mean age ± SD was noted to be 48.79±12.499 years and male to female percentage being 89% to 11%. The mean stone size was 4.53±0.38 cm and mean operation time was 48.79±8.73 minutes. Thirty-one patients (31%) developed retention of urine and straining during micturition in (17%), dribbling of urine (15%) , hematuria (10%), frequent urination(10%) and abdominal pain was reported in 15% patients. Ninety-six  (96%) patients achieved the stone-free status and had no complications while only 1 patient had an intravesical bleeding. Conclusion: We conclude that treatment of large stone using a nephroscope via a transurethral  amplatz sheath  is an effective procedure and quick too.We also noticed that the Amplatz sheath helps in pneumatic lithotripsy is indeed an effective and safe procedure to be carry out in patients with large bladder stones.

Purpose: To present our experience with emergency ureteroscopic lithotripsy (URSL) on ureteral stones related with acute kidney injury (AKI). Place and Duration: In the Department of Urology for three years duration from January 2019 to January 2020. Material and methods: We retrospectively analysed 27 patients consisting of 54 ureteral units (UU) undergoing URSL. There were 9 females and 18 males with M: F of 2:1 The anuria cause was bilateral obstruction with calculi in 21 cases, and unilateral obstruction with calculi in 33 cases with contralateral nephrectomy. In the same session, bilateral ureteroscopy was performed for bilateral synchronous ureteral stones. The anuria duration ranged from 12hours to 3-days. After the procedure, all patients ureteral stent were systematically removed. The operation was accomplished 6-12 hours afterward hospitalization. After surgery; all individuals were followed for minimum one-month. Results: A total of 27 urgent URSL were performed in 9 (33.3%) females and 18 (66.7%) males with an average age of 51 (range 32 to 73). Percutaneous nephrostomy was performed in 2 (7.4%) patients and in 2 (9.5%) patients with bilateral stones, the ureteral units (UU), severely wedged distal hard stones. These patients were candidates for open surgery, ureterolithotomy, 6 to 8 weeks afterward the initial intervention (PCN+ URSL). The improvements in renal function as demonstrated by post-obstruction diuresis and serum creatinine were compared in the two groups of patients using the Fisher's exact test. In 20 (71.1%) patients, URSL proved to be an effective therapeutic approach for obstruction removal and stone removal. Repeat surgery was required in 3 (11.1%). In 3 (11.1%) patients, URSL caused significant damage to the mucosa with a guide wire in the area of the damaged ureteral calculus. Ureteral stenting was sufficient to treat this complication. Stone or fragment migration was observed in 5 (18.5%) patients, all of which were in the upper stone position, and this procedure was the main reason of failure. In the first 24 hours, mild macroscopic haematuria was detected which did not require treatment. Postoperatively, 6 (22.2%) patients had high fever. Body temperature reversed back to usual within four days after getting the high dose and intravenous injection of a third-generation cephalosporin antibiotic (ureteral stent culture for Escherichia coli and positive urine culture). Conclusion: Calculus anuria is a therapeutic emergency that necessitates timely analysis and decompression management. URSL is the appropriate technique for designated patients and can be accomplished securely and has a high achievement rate with insignificant incidence of morbidity. Key words: Ureteral stones, ureteroscopy; surgery; kidneys, anuria, abnormalities; outcome and treatment.

Objective: To compare the effectiveness of nifedipine and tamsulosin for expulsion lower ureteral stones with size ranging from 4mm-11mm. Study Design: A Randomized controlled trial. Methods: The study was held over a 2-year duration from January 2018 to December 2019 in the Urology department of Islam Medical College/ Teaching hospital Sialkot and Govt. Kot Khawaja Saeed Teaching Hospital Lahore. 72 total patients, 37 patients in each group, were selected for the study. The patients in A group were treated with alpha-1-blocker alone (tamsulosin), patients in B group were treated with calcium channel blockers (nifedipine 30-mg). Data on stone size, transit time, stone removal rate and control of pain were analyzed and collected. The mean ± SD of continuous variables was used to determine the percentage and frequency of categorical variables. The student’s t-test and Chi-square test were applied to compare numerical and categorical variables, correspondingly. Results: 72 total patients were involved and 36 patients in each group were analyzed after randomization. The patients mean age in A group was 36.40 ± 6.98 years, and in B group it was 38.01 ± 9.40 years correspondingly (p 0.76). The mean size of stone was 6.40 ± 1.82 mm in group A and in group B it was 6.51 ± 1.69 mm (p 0.80). Mean time of expulsion in A group was 8.40 ± 2.41 days and for group B; it was 6.71 ± 2.33 days (p <0.001). Patients receiving tamsulosin endured suggestively fewer attacks of pain related with patients receiving nifedipine treatment (p 0.017). Conclusion: The tamsulosin is safe treatment for appropriately sized lower ureteral stones as compared to nifedipine. The tamsulosin monotherapy have clear advantage over nifedipine but more detailed school studies are needed for efficacy and safety. Keywords: Tamsulosin, ureter, nifedipine.

Introduction: In Peyronie’s Disease, fibrous plaque is formed which has an excessive amount of collagen, fibroblastic proliferation and elastin framework alteration. Objective: To compare the effect of Intralesional Inj.Interferon alpha 2b (2 MU) against Intralesional Inj. Interferon alpha 2b (3 MU) on plaque size, penile deviation, erectile function and pain during erection in patients having Peyronie's disease Methods: It was comparative interventional/longitudinal study, conducted at Department of Urology, Kot Khawaja Saeed hospital, Lahore and Department of Urology, DHQ hospital Sheikhupura. Total 30 Patients of Peyronie's disease in Urology OPD were enrolled. Patients were randomized into two groups by online random number generator. Results: In Group-A, after therapy, mean plaque length was decreased from 9.9±2.4 to 8.8±2.1 mm and mean plaque width was decreased from 4.2±0.9 mm to 3.8±0.4 mm, mean penile curvature was decreased from 34.1°±8.4° to 26.2°±7.2°, mean IIEF score was improved from 35.1±11.4 to 46.2±10.6, and mean pain score was decreased from 4.2±1.1 to 3.4±0.7. In Group-B, after therapy, mean plaque length was decreased from 10.7±2.6 to 7.3±1.8 mm and mean plaque width was decreased from 4.3±0.7 mm to 3.0±0.3 mm, mean penile curvature was decreased from 35.4°±7.9° to 20.1°±6.3°, mean IIEF score was improved from 36.3±12.4 to 59.8±12.6, and mean pain score was decreased from 4.1±1.0 to 1.9±0.6. Conclusion: Intralesional inj. Interferon alpha-2b (3MU) is more effective than Intralesional inj. Interferon alpha-2b (2MU) for reducing plaque size, pain, and penile deviation, and for improvement in erectile dysfunction in patients with Peyronie's disease. Keywords: Peyronie’s disease, Interferon alpha 2b, Fibrous plaque