Longterm indwelling urethral catheter can cause several complications such as lower urinary tract infections, tissue damage, pain, hemorrhage and encrustation of catheter leading to blockage. A 55- year old male presented with suprapubic pain for three months owing to poorly draining Foley catheter. He had undergone surgery for bladder calculi two and half a years back. He had been discharged with Foley catheter. He did not show up at the hospital for two and half years. The catheter was never changed during this period. Plain X-ray abdomen revealed a large encrustation with radiopacity surrounding the foley's bulb. Open suprapubic cystostomy was performed. The intact Foley catheter with encrusted bulb was removed. His postoperative period was uneventful.Surgical removal is the only treatment of choice for unusual massive encrustations in long-term indwelling urethral catheter. Minimally invasive technique is getting popularity, however we performed open cystostomy and removal due to the lack of expertise and instruments in our hospital setting. Catheterization under aseptic condition, frequent catheter change, early treatment of urinary infection and proper patient education on catheter hygiene are few methods that can reduce the complications of longterm indwelling urinary catheter.

INTRODUCTION Surgical site infection (SSI) is a commonly encountered complication in any surgery and is commonly associated with appendicitis. Obesity has been associated with delayed wound healing and risk of infections and this research aims to validate the fact. MATERIAL AND METHODS Prospective observational study was carried out in Universal College of Medical Sciences, Bhairahawa, Nepal, from September 2017 to December 2018 on all cases of appendectomy meeting the inclusion criteria. RESULTS Of total 100 cases of acute Appendicitis, 35% cases developed superficial surgical site infection (SSSI). The development of SSSI in patients with subcutaneous fat thickness (SCFT) of greater that 2.5 cm, between 1.5 cm to 2.5 cm and less than 1.5 cm were 62.5%, 41.9% and 6.1% respectively. Similarly, 40% of patients in grade I obesity group, 63.6% of patients in pre-obese group and 31.1% of patients in normal BMI group developed SSSI.  On comparison between SCFT and BMI on a ROC curve, SCFT (0.785) has more AUC than BMI (0.762). CONCLUSION It has been observed that patients with increasing amount of SCFT at incision site had higher chances of developing SSSI. It could also be concluded that though both increased BMI and SCFT had increased frequency of occurrence SSSI, SCFT was more reliable in predicting the chances of SSSI as significant number of cases of SSSI were occurring in normal BMI and pre- obese group.