Aims. The aim of the study is to present our experience with the management of ureteral avulsions following semirigid ureteroscopy for ureteral stones. This is one of the largest series reported so far. Methods and Materials. It is a retrospective and observational study done at Sri Ramachandra Institute of Higher Education and Research over the last 18 years. Results. There were seven cases of ureteral avulsion following semirigid ureteroscopy. All patients were males with a mean age of 35.7 years. All had impacted stones, with proximal ureteric location in 6 patients and distal ureteric location in 1 patient. Five cases had two-point avulsions with loss of entire ureter. Two cases had one-point avulsion: one distal ureteric and the other mid-ureteric. Of the five cases with whole length ureteral avulsion, four were managed by classical ileal replacement of ureter and the the fifth case was managed by ileal replacement of ureter by the Yang–Monti technique. Of the two cases with one-point avulsion, one was managed by uretero-neocystostomy and the other by uretero-ureterostomy. All the patients had successful outcome. Conclusions. Even though rare, ureteral avulsion can potentially happen especially when dealing with impacted ureteric stones. Being conscious of the possible occurrence of this serious complication during any difficult ureteroscopy and exercising utmost care during the procedure are important preventive measures. However, this catastrophe can be successfully managed by either immediate definitive repair or in a staged manner.

Urolithiasis is a very common problem, and the challenges that it has posed has been instrumental in devising various means to tackle the stone burden. With better access, visualization and stone fragmenting techniques, end urological procedures have become a mainstay in treatment of stone despite the vast evidence supporting nonstented ureteroscopies, worldwide many urologists still prefer to place stents in majority of uncomplicated stone removal procedures in a bid to improve drainage, stone eases. Ureteric stents are associated with a wide spectrum of symptoms thereby producing considerable morbidity ranging from 80 to 98% and the discomfort caused varies from p Alpha adrenergic receptor like α1A and α1D have been documented to be distributed the in the lower urinary tract and the distal ureter and the use of alpha adrenergic receptor blockers like Tamsulosin are shown considerable promise in treating the stent related symptoms. Hence this study, was done in an effort to determine the effect of Tamsulosin in improving double-J stent related symptoms and quality of life following ureteral stent placement. This is a prospective study conducted from February 2013 to January 2014 at Government Stanley Hospital. A total of 180 patients were enrolled in this study after following the exclusion and inclusion criteria. Patients were prospectively randomized by random-number chart into two groups. Patients those of whom are prescribed non-selective α adrenergic receptor blockers like Tamsulosin following stenting, seem to benefit significantly because not only did they experience much lesser symptoms and bother, but they also improved over their symptoms with which they presented at admission. This would concur to the explicit influence these group of α adrenergic receptor blockers have over the lower urinary tract and gives them a definite role in treating patients afflicted with stent related morbidity.

Gastrojejuno appendicular fistula is a rare condition. To our knowledge it has not been reported previously in the literature. We report the first case of a gastrojejuno appendicular fistula occurring in a patient who had previous gastroenterostomy for ulcer disease. He presented to us with recurrent episodes of abdominal pain and bilious vomiting. An endoscopy revealed intense gastritis with bile reflux. He was diagnosed as alkaline gastritis and put on medication. As there was no relief of his symptoms; it was decided to do a biliary diversion. At laparotomy there were extensive adhesions which was gently separated. Patient had an anticolic anastomosis and a long tubular structure was seen fistulating to the stoma site. It was traced and found to be the appendix. The gastrojejunal stoma was opened and the fistulous mouth was identified and cannulated following, which a retrograde appendicectomy was performed and a cuff of intestine around the fistula was excised. The Stoma was closed in a single layer. A Braun's enteroenterostomy was done to correct the alkaline reflux. The patient is symptomatically better and is gaining weight. The pathogenesis of alkaline gastritis. appendicular fistula and gastrojejunocolic fistula is discussed.