The absence of complications, high patient satisfaction, and ability to be used in the outpatient setting make the holmium:YAG laser an attractive alternative in the treatment of recurrent superficial cancer of the bladder.

points * septic arthritis in an adult often has a predisposing factor * group B streptococcal septic arthritis in a woman should raise the possibility of a genitourinary source Organisms isolated from septic joints in pregnancy include Pseudomonas aeruginosa, Staphylococcus aureus, Mycoplasma hominis and our case of group B streptococcus.

Objective: We evaluate the discomfort and efficacy of instilling 2% lignocaine gel (Instillagel) versus smearing water-soluble gel (Aquagel) around the flexible cystoscope and external urethral meatus in men undergoing flexible cystoscopy for the first time and the overall efficacy of lignocaine gel in completion of the procedure. Materials and Methods: A total of 140 patients divided into two groups, were randomized for this study: group A (n = 70) received approximately 11 ml of 2% lignocaine gel (Instillagel) intraurethrally for approximately 15 min, while in group B (n = 70) approximately 10–15 ml of water-soluble gel (Aquagel) was smeared around the scope and external urethral meatus. Total completion time for each procedure was recorded. Primary outcomes were pain during instillation of lignocaine, during insertion of scope and cystoscopy. Pain was recorded by the patient using a 100-mm nongraphic rating visual analogue scale. Secondary outcome included procedure time and cost analysis. Results: The majority of patients in both groups reported mild pain with VAS 3 or less throughout the whole procedure. No significant difference was noted in the two groups at any stage of the procedure. Use of lignocaine gel added approximately 10 min to the procedure time. Conclusions: In our study there was no significant difference in patient discomfort between instilling lignocaine gel and smearing of Aquagel in completion of flexible cystoscopy. However, application of lignocaine gel added extra time, effort and cost to the procedure.

This study compares the safety and efficacy of mechanical cystolithotripsy (MCLT) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of vesical stones. In the last four years we have treated 144 bladder lithiasis patients with MCLT (86; group A) and ESWL (58; group B). All patients in group A were treated under spinal anaesthesia while 47 patients in group B needed intravenous sedation. The early complication rates in groups A and B were 19.7 and 6.8%, respectively. The corresponding mean hospital stay was 60 and 18 hours. ESWL should be considered as an effective, safe and least invasive alternative to MCLT in the therapeutic options for vesical lithiasis.

To our knowledge only a few cases of renal milk of calcium have been reported. We have encountered 5 such patients. The diagnosis depends upon the demonstration of halfmoon-shaped calcification in the lateral decubitus or upright roentgenograms. This condition should be differentiated from a renal calculus to avoid unwarranted surgery or extracorporeal shock wave lithotripsy.