Giant Hydronephrosis in the adult can reach elephantoid proportions, containing several liters of fluid. It can be associated with rare renal neoplasms. We present a 27 year old man with progressive painless abdominal distention whose imaging investigations (ultrasound and CT scan) disclosed a left GH. This was successfully removed en-bloc by simple nephrectomy via a midline laparotomy. Obstruction was at the UPJ, the mass contained 13.5L of fluid and histopathologic examination revealed Angiomyolipoma of the kidney and pelvis. This is a rare discovery in a rare pathology.

The Soci et e Internationale d'Urologie (SIU) offers training scholarships for young doctors with basic surgical or urologic qualifications. The SIU scholarships involve training in a recognized urology center of excellence located in the candidate's geographical region. These SIU-accredited centers provide an excellent environment for learning and, in many instances, hands-on experience, so that candidates may acquire knowledge and skills that they will be able to transfer to their own setting of practice. In this series of short communications, SIU scholars write about the impact that these training opportunities facilitated by the SIU had on their quality of care and career development. Information about applying for an SIU scholarship is available at http://www. siu-urology.org/. I started my SIU scholarship training at the University College Hospital (UCH) in Ibadan, Nigeria on September 12, 2012, with great delight and anticipation. I was delighted because I considered it a privilege to be part of an institution that is not only the first tertiary health care facility in Nigeria, but also noted for excellent, prompt, and accessible health care in the West African subregion. As such, I was confident that I would have a worthwhile and rewarding experience during the 6-month program. I was introduced to Prof. O. B. Shittu, the Head of the Urology Division, who also doubles as the Head of the Department of Surgery. I was then directed to Prof. E.O. Olapade-Olaopa, the Director of the SIU training program and was warmly welcomed. The division has 3 professors of surgery and/or urology, 2 consultant urologists with different areas of specialization and interest, 3 senior registrars, and 1 SIU scholar. The division operates as a united family with members being very resourceful, proactive, and painstaking in caring for patients. The division is well structured with intense clinical and academic activities that span throughout the week. Ward rounds are done daily, with consultant teaching rounds on Wednesdays and Fridays. Other activities include outpatient consultation clinic, minor procedure clinic, theater sessions, grand rounds, journal club meetings, mortality and morbidity meetings, a joint urology and radiology conference, and a joint urology and pathology conference. I enjoyed wide exposure through active participation in surgical procedures such as anastomotic and substitution urethroplasty, radical nephrectomy, nephrolithotomy, pyeloplasty, retropubic prostatectomy, nephroureterectomy, hypospadias repair, epispadias repair, vesicovaginal fistula repair, and radical cystectomy.

Background Isolated scrotal gunshot injuries are uncommon. Even more so when they are self-inflicted. The extent of the injury is determined by the caliber of the weapon. Established management protocols when followed yields excellent results. Case presentations We present two male patients, aged 41 and 51 years old, who sustained gunshot injuries to the scrotum following accidental discharges from hand guns stored in their trouser pockets. The first (41 years) sustained grade 5 American Association for Surgery of Trauma (AAST) left testicular injury and was managed by unilateral orchidectomy. The second (51 years old) sustained bilateral grade 4 AAST testicular injuries and had both testes salvaged by primary repair after meticulous debridement. Conclusion Isolated scrotal gunshot injuries can occur when low velocity guns are placed adjacent to the genitalia and accidentally discharged. The testes are endangered and can be devitalized requiring orchidectomy or salvaged by meticulous debridement and primary repair when viability is not compromised.

Background: Prostate cancer is a global health problem affecting men in their advancing years. Both prostate and hypertension incidence increases with age. Human and animal studies have attempted to explain an association between the two disease entities. The interplay of androgen activity has been strongly suggested. The aim of this study was to evaluate the prevalence of hypertension among prostate cancer patients. Materials and methods: One hundred and nineteen (119) patients with prostate cancer were studied. Information retrieved from their case notes included biodata, clinical, laboratory, imaging and prostate biopsy results. Hypertensive men were selected based on preceding history of hypertension or absence of such history for non-hypertensives. Results: mean age of patients was 68.68±8.38 years ranging from 48 to 91 years. Non–hypertensives were slightly older than hypertensive men (Table 1). Mean Gleason score was 7.97±1.15 and mean prostate specific antigen (PSA) was 56.20±37.30 ng/ml. Most men were in their 8th decade of life (table 2i).The prevalence of hypertension was 43.7%. Most of them had prostate specific antigen in excess of 10.0ng/ml and Gleason score of 9. Hypertensive men were also associated with slightly higher Gleason score and prostate specific antigen values. Conclusion: Evaluation of hypertensive men should include a full urological assessment to diagnose those at increased risk of prostate cancer bearing in mind documented high prevalences associated with both disease conditions.

Background: Previous studies had documented a causal relationship between diabetes mellitus (DM) and benign prostatic hyperplasia (BPH) through hyperinsulinaemia and increased serum levels of insulin-like growth factor-1 (IGF-1). These growth factors contribute to prostatic enlargement and may cause lower urinary tract symptoms (LUTS) and increase symptom severity in BPH patients. This study was aimed at associating DM with clinical parameters of BPH. Materials and Method: This was a retrospective study of one hundred and sixteen (116) BPH patients carried out over a year period. Their clinical, laboratory and imaging study results were retrieved from their case files. Eligible patients were taken through a structured questionnaire during their clinic visits. This questionnaire assesses severity of LUTS in BPH patients called the International Prostate Symptom Score (IPSS) and quality of life scale. All data were entered into a structured proforma and analyzed using the statistical package for social sciences (SPSS) version 20.0 software. Diabetic patients were selected based on the clinical history of diabetes mellitus (DM). Results: One hundred and Sixteen (116) patients aged between 43 and 82 years with a mean age of 63.10±8.89 years were studied. Diabetic patients were older than non-diabetics. They also had higher clinical parameters of BPH namely; higher prostate volume (PV), higher symptom scores both voiding and storage and a poorer quality of life from symptom-bother. Conclusion: Diabetic men have higher prostate volume which can precipitate LUTS, cause BPH progression and symptom severity.