Summary Ketamine consumption in on the increase as a recreational abuse substance. It is reported to cause lower urinary tract symptoms (LUTS), and published accounts of its deleterious effects are increasing. We reviewed the available literature regarding the urological impact of ketamine abuse and its management. Twenty‐two publications were found in total after a search of all databases including Pubmed, Medline and Google Scholar using the words ‘ketamine’, ‘bladder’ and ‘cystitis’ with no limits imposed. There are approximately 110 cases reported in the literature in the form of case series, case reports and letters. The effect of ketamine abuse on the bladder is universally similar; however, there is no uniform method adopted in reporting the symptoms, diagnosis and management. Very little is known regarding the pathogenesis of its effects on the urinary tract. Patients with severe irritative LUTS, a positive history of ketamine abuse and the absence of any other aetiology should be considered to have ketamine‐induced vesicopathy. Effort must be made to elicit the history of drug abuse in those with no found cause of LUTS, especially in the young. Presently, ketamine cessation is the only effective treatment modality to prevent deterioration of the renal function and indeed offer the possibility of symptom resolution. Management akin to that formulated for interstitial cystitis patients would appear to offer the greatest opportunity for effective treatment.

Multiple myeloma is characterized by clonal proliferation of plasma cells usually of the B cell type. The skeletal manifestations are usually osteolytic lesions whose differential diagnosis includes primary and secondary bone tumor. This tumor is characterized by the presence of abnormal paraprotein 8 in blood and urine. However, one to five per cent of the cases do not have any protein. Hence they are termed nonsecretory. It often poses a diagnostic dilemma when it is presented to orthopedic surgeons with no clear features of the disease. Our case report exemplifies such a diagnostic dilemma. A high index of suspicion must be borne in mind when excluding multiple myeloma as a cause of pain, pathological fracture or lytic lesion.

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Introduction: Memokath 051® represents a nickel-titanium stent that has been used to treat patients with incurable ureteral strictures. In the current study we present our experience in using this technique. Materials and Methods: Between 2003 and 2008, 19 metallic stents were placed in 13 patients. All of them had been previously treated by using JJ stents or dilatation. The etiology was benign in 10, while in 3 patients malignancy was involved. The mean age was 60.7 years. Mean stricture length was 3.2 cm while the median stent length was 6 cm. No severe complications were noticed postoperatively. Mean follow-up was 14.3 months. Results: Six patients (46%) experienced a satisfactory result after first insertion. Stent migration was observed in 6 patients and in 3 it was replaced successfully. One patient was offered a simple nephrectomy due to a poorly functioning kidney. Eventually, 10 of 13 patients (77%) had a successful outcome after the final stent insertion. Conclusion: Memokath stents suggest a possible alternative in treating chronic/recurrent ureteral strictures. Their most important disadvantage seems to be migration. Their role in endourological practice remains to be validated.

Bardet-Biedl syndrome is an autosomal recessive disorder with obesity, polydactly, retinitis pigmentosa, hypogenitalism, intellectual impairment and varying degree of renal abnormalities. Fewer than ten cases of paediatric renal transplantation for BBS have been reported in literature so far. This is the only case report of BBS transplant urolithiasis which was dealt with percutaneous nephrolithotomy and has been stone free for seven years. This is a complex case with a rare genetic disorder, renal transplant, renal stone, ileal conduit, long loop and inversely placed kidney. This case exemplifies the need for multidisciplinary management of complex cases and emphasises PCNL as the safe method.