Urethral foreign bodies are rare in daily practice, especially in adolescents with no evident history of mental illness. The presentation is usually delayed and a wide variety of objects may be implicated. Treatment by minimally invasive procedures (endoscopy), if possible, is preferred to minimize bladder and urethral injuries and psychiatric evaluation is mandatory to detect an underlying mental disorder. Despite the available literature on self-inserted urethral foreign bodies; the case we report here of urethral self-insertion of a sewing needle in a 14 year-old boy for autoerotic stimulation is very rare.

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Sequential therapy and repeat BCG therapy are among these options and our preliminary findings indicate a better efficacy for the combination treatment. Further prospective randomized trials are needed to find out if this regimen could really become a valid alternative for these patients.

more in tubeless Mini PCNL whereas pain score, analgesics requirement and hemoglobin drop are more in standard tubeless PCNL comparatively. Stone clearance in both groups is comparable and more than 95%.

above or below median site volume in the system.Multivariate regression was used identify predictive factors, and analysis of variance (ANOVA) was used to assess variation across different sites and surgeons.RESULTS: We identified 368 cases performed by 8 surgeons across 6 sites (3 HV sites, 3 LV sites). Median site volume was 100 cases. Most cases (304, 75.2%) were performed at HV sites. Mean case DIC, case length, and number DI's used varied significantly across sites (ANOVA p [ 0.000 for all three variables). Overall mean DIC was $975 ($388.8 e $1863), mean number of DI's used was 5.48 (3-9), and mean total case length was 78.7 minutes (28 e 187.8). On multivariate regression, only surgical site was a significant predictor of DIC (p [ 0.000), when adjusting for surgeon and high/low volume status (Figure 1). Site and surgeon were both significant predictors of number of DI's used (p[0.000), and case length (p [ <0.01).CONCLUSIONS: Procedural costs related to URS may vary between hospitals even when performed by the same surgeon. Further investigation into hospital practices with low DIC's is warranted in an effort to potentially identify opportunities for cost savings.