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Extramedullary plasmacytoma is a rare malignant neoplasm typically arising outside the bone marrow of patients who show no clinical evidence of multiple myeloma. Kidney is a rare site for plasmacytoma. We present here a case of primary renal plasmacytoma confirmed on histo-pathology of the specimen and immuno-histochemistry studies. Patient was treated with radical nephrectomy followed by radiotherapy. The case is presented due to its rarity.

Context and Aim: Prostatic abscess is an unusual condition. The prevalence of prostatic abscess is about 0.5% of all prostatic diseases. The purpose of the study is to present and discuss the role of transrectal ultrasound (TRUS) in the management of prostatic abscess. Settings and Design: Retrospective study. Materials and Methods: We retrospectively reviewed the medical records of all eight patients diagnosed and treated for prostatic abscess in the last threeyears. TRUS was used for diagnosis in all cases. Four patients had TRUS guided aspiration for management of prostatic abscess. Data collected regarding etiology, clinical features, investigations and treatment was compared with the available literature. Results: The age of patients ranged from 18-65 yrs (mean 47.12 yrs). Out of the eight patients, six were diabetics. TRUS revealed one or more hypoechoic areas within the prostate in all the patients. Successful treatment of prostatic abscess with TRUS guided needle aspiration was done in all fourpatients in whom it was used. Mean hospitalization time was 9.4 days, and most frequent bacterial agent was S. aureus. Conclusions: TRUS is useful in diagnosis as well as in guidance for aspiration of such abscesses. TRUS guided needle aspiration is an effective method for treating prostatic abscess. Most of the patients are diabetics and usually grow Staphaureus. So an antibiotic with staphylococcal coverage should be used empirically.

Emphysematous pyelonephritis (EPN) is an acute necrotizing parenchymal and peri-renal infection caused by gas-forming uropathogens. The predisposing factors are diabetes mellitus and ureteric obstruction. E. coli is the most frequently identified pathogen. The overall mortality is 43%. Computerized tomography (CT) is the imaging procedure of choice in determining the extent of infection and guiding management. Management of EPN has evolved from aggressive surgical intervention to conservative management. Although there are reports of improved renal function after medical therapy combined with relief of obstruction, most of the patients still require neph-rectomy. We present a case of EPN and also evaluate the radiological features, prognosis, and current management of this disease.

Background: Ureteropelvic junction obstruction (UPJO) causes hydronephrosis and progressive renal impairment may ensue if left uncorrected. Open pyeloplasty remains the standard against which new technique must be compared. We compared laparoscopic (LP) and open pyeloplasty (OP) in a randomized prospective trial. Materials and Methods: A prospective randomized study was done from January 2004 to January 2007 in which a total of 28 laparoscopic and 34 open pyeloplasty were done. All laparoscopic pyeloplasties were performed transperitoneally. Standard open Anderson Hynes pyeloplasty, spiral flap or VY plasty was done depending on anatomic consideration. Patients were followed with DTPA scan at three months and IVP at six months. Perioperative parameters including operative time, analgesic use, hospital stay, and complication and success rates were compared. Results: Mean total operative time with stent placement in LP group was 244.2 min (188-300 min) compared to 122 min (100-140 min) in OP group. Compared to OP group, the post operative diclofenac requirement was significantly less in LP group (mean 107.14 mg) and OP group required mean of (682.35 mg). The duration of analgesic requirement was also significantly less in LP group. The postoperative hospital stay in LP was mean 3.14 Days (2-7 days) significantly less than the open group mean of 8.29 days (7-11 days). Conclusion: LP has a minimal level of morbidity and short hospital stay compared to open approach. Although, laparoscopic pyeloplasty has the disadvantages of longer operative time and requires significant skill of intracorporeal knotting but it is here to stay and represents an emerging standard of care.

Tubularized free preputial graft for hypospadias repair had been tried in the past and discarded due to high incidence of graft shrinkage causing stricture formation. We have tried to revive the technique using onlay method thus avoiding stricture formation. The technique was used in 33 subjects (Group A) and compared with 33 subjects in control group (Group B) in whom other techniques of urethroplasty were used. The study was a randomized controlled trial. The mean length of the free preputial graft was 22.06 + 4.68 mm (16-35 mm) and breadth was 9.0 + 1.32 mm (7-11 mm). Fistulae developed in 3 patients in group A out of which one healed spontaneously. In group B, 6 patients had fistula formation. Complications developed in 18% cases in group A and 50% cases in group B. There was significant difference between the cosmetic results (p < 0.05) with 58% excellent results in group A and 27% in group B. Free preputial graft onlay urethroplasty has better functional and cosmetic results.

Xanthogranulomatous pyelonephritis (XGPN) represents an unusual suppurative gra-nulomatous reaction to chronic infection, often in the presence of chronic obstruction from a calculus. We present a case of XGPN in a horse shoe kidney in an adult. Hemi-nephrectomy of the involved side was followed by clinical improvement. The case highlights the importance of early hemi-nephrectomy in XPGN with horse shoe kidney.

Byline: Ritesh. Mongha, Shrinivas. Narayan, Anup. Kundu We report a rare case of echinococcosis, primarily involving the right kidney and ureter, presenting with gross hydatiduria. We also present the salient [...]