Objective:To present the outcome of dorsal onlay urethroplasty in 73 patients for stricture urethra over a period of eight years.Materials and Methods:Seventy-three patients of stricture urethra have undergone dorsal onlay urethroplasty from July 1998 to February 2006. Age distribution: 14-58 years. Etiology: Trauma 20/73 (27.39%), Balanitis Xerotica Obliterans 2/73 (2.73%), Iatrogenic 26/73(35.61%), Infection 3/73 (4.10%), Idiopathic 22/73 (30.13%). Site: Penobulbar-25/73, bulbar-38/73, membranous-8/73 and long length-2/73. Suprapubic catheter was inserted preoperatively: 21/73 patients. Preputial / distal penile skin was used in all patients. Buccal mucosa was not used in any patient. Hospitalization was for four to five days. Catheter was removed after 21 days. All patients had their first endoscopic checkup after three months. Subsequently they were followed up by uroflometry. Routine imaging of urethra for follow-up was not carried out.Results:63/73 (86.30%) patients had satisfactory outcome not requiring any further treatment, 8/73 (10.95%) developed anastomotic stricture (3/8-optical internal urethrotomy, 5/8 dilatation alone). 2/73 (2.75%) developed external meatal stenosis. None had urinary fistula and required repeat urethroplasty. Follow-up ranged from three months to eight years.Conclusion:Dorsal onlay urethroplasty using preputial/distal penile skin is a satisfactory procedure. Preputial/distal penile skin is devoid of hair and fat and hence an ideal graft material. Even in circumscribed patients distal penile skin can be harvested. Long-term follow-up is required in judging results of patients with stricture urethra.

Androgen blockade (surgical or medical castration) is a standard procedure for patients with metastatic carcinoma prostate. Sub-epididymal orchiectomy involves removal of testis leaving behind epididymis. This epididymal stump over a period gives a pseudo testicular feel within the scrotum. We present a prospective randomized study to assess the functional utility of this procedure and compare it with total orchiectomy in terms of achieving castrate levels. From July 2005-Jan 2008, 60 patients with metastatic carcinoma prostate were alternately randomised and allotted to two groups, 30 underwent sub-epididymal orchiectomy (group A) and remaining 30 (group B) underwent total orchiectomy. Age: 56-80 years. Serum PSA: 55-268 ng/ml. Preoperative serum testosterone: Group A-300-650 ng/ml and group B-320-640 ng/ml. Postoperative serum testosterone: group A-2-18 ng\ml and group B-7-15 ng\ml on day 7 after surgery. Operating time-26-40 mins for group A and 20-34 mins for group B. Follow up-6 weeks and 3 months. At 3 months patients were asked to grade appearance of scrotum for asthetic value on a scale of 1-100 using visual analogue score. Postoperative serum testosterone reached castrate levels in seven days (both groups). Duration of surgery in both groups was comparable. Complications-wound infection in 1 patient (group A) & 1 scrotal hematoma (group B). Satisfaction score for group A (83.5 ± 9.7) was significantly (p < 0.05) better (95%CI-18.58-28.42), compared to that of group B (60 ± 9.4) by using't' test. Sub epididymal orchiectomy is comparable to total orchiectomy in terms of achieving castrate levels with similar operating time. It has significant advantage in terms of mental satisfaction to patients. It is a simple and safe procedure that can be conveniently performed in an outpatient clinic setting using pure local anaesthesia.

Aiming for sensing balloon catheters which are able to provide intraoperative information of the vessel stiffness and shape, the present study uses finite element analysis (FEA) to evaluate the interaction between high-compliant elastomer balloon catheters with the inner wall of a non-cylindrical-shaped lumen structure. The contact simulations are based on 3D models with varying balloon thicknesses and varying tissue geometries to analyse the resulting balloon and tissue deformation as well as the inflation pressure dependent contact area. The wrinkled tissue structure is modelled by utilizing a two-layer fibre-based Holzapfel-Gasser-Ogden constitutive model and the model parameters are adapted based on available biomechanical data for human urethral vessel samples. The balloon catheter structure is implemented as a high-compliant hyper-elastic silicone material (based on polydimethylsiloxane (PDMS)) with a varying catheter wall thickness between 0.5 and 2.5 µm. Two control parameters are introduced to describe the balloon shape adaption in reaction to a wrinkled vessel wall during the inflation process. Basic semi-quantitative relations are revealed depending on the evolving balloon deformation and contact surface. Based on these relations some general design guidelines for balloon-based sensor catheters are presented. The results of the conducted in-silico study reveal some general interdependencies with respect to the compliance ratio between balloon and tissue and also in respect of the tissue aspect ratio. Further they support the proposed concept of high-compliant balloon catheters equipped for tactile sensing as diagnosis approach in urology and angioplasty.

The knee joint is one of the most important voluntary organs of the human body. Modelling and simulating it under various stress and strain conditions can help us understand its mechanical behavior to a better extent. We have attempted to model the knee joint and analyze it under varying loads to get an indication about the fatigue life of the joint. The study of the normal knee under cyclic loading helps us know more about the life of the assembly. Fatigue analysis can help us understand the cause of various knee joint disorders. It would enable us to design better ways to tackle the problems faced by patients suffering from such disorders. Moreover this prototype can be used as a reference for comparing the various treatments recommended to the patients, enabling us to find the best treatment for such disorders.