Hypospadias is an common abnormality in males which the urethral opening is ectopically located on the ventrum of the penis as far down as in the scrotum or perineum. Classic hypospadias is characterized by the triad of ventral urethra defect, absence of dorsal prepuce and chordee. A megameatus with intact prepuce (MIP) is an unusual variant of an anterior hypospadias. It is characterized by a widely splayed coronal or subcoronal meatus, a deep glanular groove, a normally conformed prepuce, and no chordee. Here, we report a case of a 23-year-old male who was diagnosed as MIP clinically but found to be a hypospadias intraoperatively.

Introduction: Management of chyluria with initial conservative approach and then using endoscopic sclerotherapy is a mainstay approach. However, a wide range of sclerosants are available with differential success rates and complication rates. This study evaluated the safety and efficacy of a single-dose instillation of 1% povidone iodine for the treatment of chyluria. Materials and Methods: This was a prospective, observational study conducted on patients with chyluria who did not respond to conservative management with dietary restriction and diethylcarbamazine. The site of chyle efflux was identified by cystoscopy. A 6 Fr ureteral stent was inserted into effluxing side, diluted contrast was injected to delineate the pelvicalyceal system and the pyelolymphatic connection (arborization of the pelvicalyceal system), and a single-dose of 1% povidone iodine was instilled. Patients were observed for loin pain, fever, and disappearance of milky urine postinstillation and followed up at intervals of 3 months for a total duration of 1 year. Results: Of a total 50 patients included, 35 were men and 15 were women, with a mean age of 37 years. Pyelolymphatic connections were noted in 48% of the patients. All patients showed an immediate disappearance of milky urine. During 1-year follow-up, 92% of the patients were symptom-free till the last follow-up while only 8% of the patients experienced recurrence of chyluria which were treated with other treatment modalities. The mean duration of recurrence was 8 weeks. Conclusion: Single dose of 1% povidone iodine was effective in immediate clearance of milky urine and well tolerated in patients with chyluria during 1-year follow-up.

Adrenocortical oncocytomas are a very rare group of adrenal tumors. Unless functional, these tumors are incidentally diagnosed for clinical manifestations that are unrelated to the adrenal gland. The majority of these oncocytomas are benign and nonfunctional. Very few cases of uncertain malignant potential are reported. Here we present such a rare case of a 60 years old man presenting with voiding lower urinary tract symptoms but on contrast enhanced computed tomography (CECT) abdomen and pelvis a fairly large well defined heterogeneously enhancing retroperitoneal mass lesion with calcifications in the left anterior pararenal space (measuring 10.8×9.7×9 cm) was detected. On excision a well encapsulated solid mass of size approximately 12×10×9 cm was present in left suprarenal region. Histopathological examination confirmed the diagnosis of adrenocortical oncocytoma with uncertain malignant potential. As the incidence of adrenal oncocytoma is less, the knowledge regarding its clinical pattern, confirmatory imaging or histopathological diagnostic tools and chances of recurrence or turning malignant is limited.