Introduction: Fracture penis is uncommon and often a result of sexual trauma. Diagnosis remains clinical and early surgical management is advocated. Herein, we share our experience of 20 such cases. Materials and Methods: Twenty fracture penis patients presented between August 2014 and April 2017 were included. Patients' data were retrieved retrospectively using case sheets and followed by outpatient department visits and telephonically. Eighteen patients had penile exploration while two patients were managed conservatively. Erectile and voiding functions were assessed by asking single question to the patient, which was limited to only two options in the form of normal and abnormal. All patients were followed up for a minimum of up to 6 months. Results: The patients were aged between 20 and 60 years (mean 37.7 years). Mean timing of presentation was 28.8 h (range 2 h to 7 days). Mean follow-up was 22.5 months (6–42 months). There were no long-term postoperative complications. Eighteen patients had coital trauma, one unmarried patient had a history of manipulation of erect penis, while one patient had a fall-on erect penis. Three patients had associated urethral injury. All patients had almost the same potency as preoperatively, but for one who had erectile dysfunction for a short period recovered spontaneously on tablet sildenafil. No patient had long-term voiding dysfunction, penile curvature, or sexual dysfunction. Conclusion: History and clinical examination clinch the diagnosis. Considering it as a urological emergency, radiological imaging is not required routinely. Early surgical repair preserves the potency and voiding functions.

Background:The treatment of STAG HORN calculi has varied from combination of percutaneous nephrolithotomy (PCNL) and shockwave lithotripsy (SWL) or sometimes open surgery. The goals of treatment of a STAG HORN stone are complete stone clearance with minimal morbidity. Although excellent stone-free rates are universally reported in the literature, complication rates vary widely, especially related to the need for blood transfusion. Subjects and Methods: From January 2015 to December 2018, 1400 patients underwent PCNL out of which 392 patients had stag horn stones. Our study included stag horn stones that were present in the renal pelvis and branched into two or more major calyces. All procedures were performed under general or spinal anesthesia by the same surgical team. Results: 392 patients (144 women and 248 men) with mean age of 44.2 (range 8yr-72yr) years having partial/complete STAG HORN calculi were treated at our center S.P. Medical college, Bikaner from period of January 2015 to December 2018. 10 patients (10.2%) had pre existing renal insufficiency with a mean (range) serum creatinine of 3.0 (1.5-4.2) mg/dl. Conclusion: PCNL using multiple tracts is safe and effective and should be the first option for renal STAG HORN calculi. It must be done by experienced endourologists in a specialized centre with all the facilities for stone management and treatment of possible complications.

Transcaval ureter is a rare condition caused by abnormality in the embryogenesis of the inferior vena cava (IVC). It results from a segmental duplication of the IVC which creates a venous ring that encircles the right ureter. Here, we report a case of a 42-year-old female who presented to us with a history of right flank pain for 2 years. Ultrasonography, intravenous urogram, and contrast-enhanced computed tomography (CECT) scan of the abdomen suggested it to be a retrocaval ureter. On exploration, contrary to the report of imaging, the ureter was found to transverse in between two segments of IVC and thus on table, a diagnosis of the right transcaval ureter as the cause of obstruction was made. The patient underwent segmental ureteral resection followed by ureteroureterostomy. Follow-up CECT scan was done to document two segments of IVC and thus confirm our intraoperative finding.

Introduction: Perineal urethrostomy (PU) is a valid single stage option with maximum success to manage complex anterior urethral strictures. Aims: To evaluate the functional outcome of permanent PU using the Blandy technique in older patients or PU with staged reconstruction in young patients with severely diseased distal urethra. Materials and Methods: This is a retrospective analysis of 124 patients. They underwent Blandy's PU with or without Johanson stage 1. Exclusion criteria included patients with posterior urethral strictures or bladder neck contractures. Results: Mean age of patients was 54 years. Strictures due to catheterisation or instrumentation were most common – 85 (68.54%). Out of 124 patients, 71(57.3%) of them were posted for PU with Johanson stage 1 and 53 for PU only (42.7%) according to patients’ choice. In patients age below 50 years, PU (N=10), PU with Johanson stage 1 (N=40) and Johanson stage 2 (N= 8) patients had mean Qmax of 20.2ml/s (17-24), 20.7ml/s (16-26), 16.375ml/s (14-18) respectively. In patients age> 50 years, PU (N=43), PU with Johanson stage 1 (N=31) and Johanson stage 2 (N= 4) patients had mean Qmax of 16.41ml/s (11-24), 17.25ml/s (11-25) and14.75 ml/s (12-17) respectively.For patients with only PU, 8/53 patients (15.09%) required secondary intervention (stomal dilatation N=6 and TURP N=2) while in PU with Johanson stage 1 patients, 10/71(14.08%) required secondary intervention (Stomal dilatation N=6, 8.45% and TURP N= 4, 5.6%). 112/124 (90.32%) were considered successful. Conclusion: Since most of patients have suffered for years, PU provides results in one stage.

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