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In our part of the world, many patients present with hypospadias in adult age, where results are often poor and associated with increased complications. This study was conducted to assess the factors affecting outcome of single stage hypospadias surgery in adults.This study included patients (12 years) undergoing hypospadias repair in single stage. Preoperative factors were assessed and outcome parameters including early complications (within 1 month) and late complications (after 1 month) were studied and statistically analyzed.Of the 31 patients included (mean age 20.8 6 7.87 years), 38.7% had a history of previous surgery. Mean glans width was 17.54 6 1.78mm. Postoperatively, the median hospital stay was 5 days (range: 4- 10 days), and the median catheter duration was 21 days (range: 7-21 days). Overall complication rate was 54.83% at 6-month follow-up. Early complications comprised of infection, skin necrosis, and dehiscence of suture line. Late complications included urethrocutaneous fistula, glans dehiscence, and urethral stricture. On performing univariate logistic regression, glans width, urethral plate width and shape, and history of previous surgery were significant risk factors of postsurgery complications. On multivariate logistic regression, glans width was an independent significant risk factor (odds ratio: 0.197).Several factors are associated with significant complications in adult hypospadias single stage repair. Among the various risk factors, glans width is an independent significant risk factor affecting outcome.

The major disadvantage of radical perineal prostatectomy (RPP) is the difficulty to perform pelvic lymphadenectomy via the same incision. Open retropubic, mini laparotomy, and transperitoneal laparoscopic pelvic lymphadenectomy as an adjunct to open RPP have been tried but need change in patient position and separate incision, thereby decreasing the acceptability of this procedure. Open RPP followed by a lap perineal pelvic lymphadenectomy via the same perineal incision is a hybrid technique that is aimed to decrease morbidity of lymphadenectomy.Patients of low and intermediate risk localized carcinoma prostate with a Partin score of5% were taken for this procedure. After completing prostatectomy part of RPP, lap perineal pelvic lymphadenectomy was performed via same incision using single incision laparoscopic surgery port.We performed this new hybrid technique in eight patients. Bilateral lymph node dissection required an additional mean time of 35 minutes. A total of 68 nodes were retrieved from eight patients with a median number of eight nodes (range: 6-12). None of our cases had any complications related to lymphadenectomy. Bilateral lymph node dissection was feasible in seven patients, and in one patient, it could be done on one side only.Sandwiching lap perineal pelvic lymphadenectomy between prostatectomy part of RPP and urethra-vesical anastomosis (by open approach) is a safe, reproducible, and feasible approach to pelvic lymphadenectomy compared to lymphadenectomy from other routes with simultaneous reduction in the operative time, patient morbidity, and discomfort. Ease of doing lymphadenectomy from same incision can increase the acceptability of this excellent procedure.

To gain insights on the diverse practice patterns and treatment pathways for prostate cancer (PC) in India, the Urological Cancer Foundation convened the first Indian survey to discuss all aspects of PC, with the objective of guiding clinicians on optimizing management in PC. A modified Delphi method was used, wherein a multidisciplinary panel of oncologists treating PC across India developed a questionnaire related to screening, diagnosis and management of early, locally advanced and metastatic PC and participated in a web-based survey (WBS) (n = 62). An expert committee meeting (CM) (n = 48, subset from WBS) reviewed the ambiguous questions for better comprehension and reanalyzed the evidence to establish a revote for specific questions. The threshold for strong agreement and agreement was ≥90% and ≥75% agreement, respectively. Sixty-two questions were answered in the WBS; in the CM 31 questions were revoted and 4 questions were added. The panelists selected answers based on their best opinion and closest to their practice strategy, not considering financial constraints and access challenges. Of the 66 questions, strong agreement was reached for 17 questions and agreement was achieved for 22 questions. There were heterogeneous responses for 27 questions indicative of variegated management approaches. This is one of the first Indian survey, documenting the diverse clinical practice patterns in the management of PC in India. It aims to provide guidance in the face of technological advances, resource constraints and sparse high-level evidence.

Polyurethane double-J ureteral stents are widely used in the field of urology. Postoperatively, patient education about the ureteral stent and making sure it is removed at the prescribed time is an utmost necessity. Forgotten ureteral stent is not only disastrous for the patient but also fraught with serious medico-legal implications for the urologist. Herein, we present four cases of long-term retained part of ureteral stent with its varied presentation and subsequent management.

Osteochondroma or exostosis is the most frequent bone tumour which appears in adolescence and rarely can be responsible for vascular complications. It may present with thrombosis, embolism, arteriovenous fistulae, or the development of pseudo aneurysms. We report a case of a patient with multiple osteochondromas complicated by development of pseudo aneurysm. A simultaneous surgical treatment of both lesions was performed with favourable post operative outcome.