The International Continence Society (ICS) defines Incontinence of urine as involuntary loss of urine. Objective: To determine the frequencies of different types of incontinence of urine and their impact on quality of life of Pakistani women. Method: Descriptive observational study was conducted at outpatient department of five centers. Three validated questionnaires were used for quality-of-life assessment, International Consultation Incontinence Questionnaire Short Form (ICIQ-SF), Medical Outcome Study 36 items Short Form (SF-36) and King's Health Questionnaire (KHQ). Result: The study included 436 women. The most frequent type of incontinence of urine was mixed (n=281, 64.45%) followed by stress incontinence (n=129, 29.59%) and urge incontinence (n=26, 5.96%). The women suffering from mixed type of incontinence of urine had maximum effect on quality of life both general and specific. Conclusions: All types of incontinence of urine had an effect on quality of life but the mixed type had more impact.

Kidney transplantation (KT) is the most successful treatment for end-stage renal disease patients. But objective data about patients' willingness to undergo kidney transplant is still lacking in Pakistan. Objective: To assess barriers to KT and identify factors which could influence the willingness regarding KT among hemodialysis dependent patients.  Methods: This cross-sectional study carried out at Dialysis Unit, Dept. of Urology and Kidney transplantation Lahore General Hospital, Lahore on 100 hemodialysis dependent patients by completion of structured questionnaire about their knowledge and attitudes toward KT and how satisfied they were with dialysis. Results: The mean age of the patients was 42.8 ± 10.6 years with 55% male and 45% female patients. The percentage of patients who were willing to get a kidney transplant was 60%. The main reason of unwillingness to undergo KT was lack of donor (83.3%). Motivating factors in patients to choose KT were vascular access constraints 75%, studies or work difficulties 70%, fluid and dietary restrictions account for 63.3%. The percentage of patients who wanted a deceased kidney for transplant was 50%, whereas the percentage of patients who preferred a living kidney for transplant was 25% (17 % relatives and 8% non-relatives) and 25% of patients had no preference. Conclusion: Willingness to get kidney transplant is relatively low in Pakistan. Lack of donor, fear of surgery and financial problems are the main barriers for KT in ESRD patient

Background: Persistence of urinary incontinence after an attempted vesicovaginal fistula (VVF) repair leads to frustration for the patient as well as for the surgeon. Optimal approach for the surgery, stage and use of additional measures to strengthen VVF repair is controversial. However, it has been found that interposition of some sort of tissue has provided more promising results. Objective: To compare the outcome of Vesicovaginal fistula repair by omental transposition and peri-vesical fat emplacement in terms of recurrence and maximum bladder capacity. Study Design: Randomized control trail. Settings: Urology department of Lahore General Hospital, Lahore Pakistan. Duration: Study period was 1 year. Methodology: Overall 40 patients with VVF were added in the research, split into two identical groups, each consisting of 20. In group 1, omental transposition and in group 2, peri-vesical fat emplacement was done. After 6, 12 and 24 weeks, all the patients were assessed for recurrence. The complications like wound infections, urgency, urge incontinence and paralytic ileus were also noted. The data was collected in a specially designed proforma. Results: In this study 40 patients fulfilling the inclusion criteria were included, 20 patients in each group. The success rate was 19/20 (95%) in Group-1, only one case had recurrence. While in group 2 all the cases were successful. Conclusion: It is concluded that both the techniques of Vesicovaginal fistula repair, either with omental transposition or peri-vesical fat emplacement are equally good in terms of recurrence and maximum bladder capacity.

Background: Urolithiasis is a common urological disease in Pakistan. Calculusrenal failure is a urological emergency that required immediate intervention to prevent furtherdeterioration of renal function. Objectives: The purpose of this study is to present clinical profileof calculus renal failure patient and to report our experience of management of such patients.Study Design: Descriptive Cross sectional study. Setting and Period: Department of urologyServices Hospital from July 2015 to December 2016 were included. Materials and Methods:Patients of all ages of either sex who presented with calculus renal failure. The patients withobstructive uropathy due to causes other than stone disease were excluded. Demographicinformation along with detailed history recorded. Baseline investigations included Completeblood counts, serum creatinine, serum electrolytes and ultrasound for KUB. For stone positionXray KUB in every case & CT in selected cases performed. Functional status of individual kidneywas assessed by renal scan with differential GFR. After initial emergency treatment, all patientswere subjected to definite treatment depending upon stone location and functional status ofkidney. Results: A total of 68 patients were recruited for this study. The mean age of the patientswas 48.8 + 14.13 with range 23-90. 52(76.5%) of the patients were male and 16(23.5%)were females. Most common presentation was lumber pain 46 (67.6%) followed by anorexia 42(61.8%). The average presence of the symptoms was 17.70 days. At initial management of thecondition contained, 16(23.5%) of the patients managed by peritoneal dialysis /Hemodialysis,10(14.7%) by unilateral PCN, 16(23.5%) by Bilateral PCN, unilateral JJ stenting done in 8(11.8%)while bilateral JJ stenting in 07 (10.9%), 6(8.8%). 10(14.7%) patient were managed with URS/Lithoclast therapy without any prior diversion. Renal function in 08 patients (11.8%) did notimproved after initial management and they remained on maintenance dialysis. Conclusion: Intime diagnosis and early proper treatment improves the outcome.