Ureterocalycostomy can be performed in patients in whom desired methods of treating secondary PUJ (Pelvi-Ureteric Junction) obstructions either failed or could not be used.In our study, one child and two adults in whom one redo-ureterocalycostomy and two ureterocalycostomies were performed for severely scarred PUJ. The causes for secondary PUJ obstruction were post-pyelolithotomy in one case, post-pyeloplasty and ureterocalycostomy for PUJ obstruction in the second patient and the third patient had long upper ureteric stricture post-ureteropyeloplasty due to tuberculosis. In all these cases ureterocalycostomy proved to be salvage/final resort for preserving functional renal unit.

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Introduction: Acute Scrotum is an emergency with vast number of differential diagnoses with potential to have short and long term complications. Low salvage rates are often secondary to misdiagnosis and delayed presentation. Late presentation remains the greatest cause of orchiectomy.Many studies had been conducted, on whether every patient of acute scrotum should be explored or not on solely clinical grounds. Objective: The purpose of this study was to study the etiology, age incidence, the differential diagnosis and complications in patients with acute scrotum. Methods: The present prospective observational study was carried out at a tertiary care centre from August 2015 to November 2017 amongst 102 patients diagnosed and admitted for acute scrotum.   Results: Out of 102 patients acute scrotum majority 74 (72.54%) had epididymitis and/or orchitis, 6 (5.88%) testicular torsion, 20(18.6%) pyocoele. In final diagnosis, we got 20 patients of pyocoele but only 17 patients were diagnosed clinically, while 3 patients were earlier diagnosed as epididymo-orchitis. Out of 6 patients of testicular torsion, in 3 patients we were able to save testis and bilateral orchiopexy was done. Out of 20 patients of pyocoele, 3 patients were complication of epididymo-orchitis and 2 of testicular torsion. In 8 patients with gangrenous testis orchiectomy was performed. Conclusion: Overlap exists between testicular torsion and other conditions of acute scrotum in the younger population. The clinical manifestations, physical examination findings, and laboratory test results are helpful in distinguishing the etiology; however, ultrasonography and color Doppler help in the diagnosis and immediate treatment for testicular torsion.

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INTRODUCTIONPuerperium is defined as the period of about six weeks after childbirth during which the mother's reproductive organs return to their original non-pregnant condition. Perianal problems, including Constipation, Hemorrhoids and Fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, this study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it.METHODSThis was a prospective observational cohort study done over the span of 3 years on 902 puerperal ladies. A self structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. RESULTSThe Total prevalence of all the perianal problems in puerperium encountered in this study, out of 902 subjects, was 36.3% [327 subjects]. The Perianal problems encountered were Fissure in 185 patients [20.5%] followed by Haemorrhoids in 110 patients [12.2%], Perianal episiotomy infections in 25 patients [2.8%] and Perineal tears in 7 patients [0.8%]. On comparative analysis, Positive family history, macrosomia, past history of perianal diseases, second stage of labour >50 minutes showed a higher prevalence in Perianal disease Group as compared to the Healthy group. Out of these, Positive family history of perianal diseases [p=0.015], past history of perianal diseases [p=0.016] were statistically significant. The percentage of multipara with Hemorrhoids was more as compared to primipara [p=0.01], patients who had a past history of any perianal disease have higher chance of Hemorrhoids during puerperium [p=0.00]. Patient with constipation in pregnancy have higher chance of hemorroids in pregnancy [p=0.00]. Patients who had a past history of any perianal disease, had higher chance of fissure during puerperium [p=0.00]. 27.74% of study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22% and this was statisticallty significant [p=0.02]. CONCLUSIONConstipation, haemorrhoids, anal fissures are the most common perianal problems in postpartum period causing significant reduction in life quality of those afflicted with them.

Introduction Puerperium is defined as the period of about 6 weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition. Perianal problems, including constipation, hemorrhoids, and fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, the present study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it. Methods This was a prospective observational cohort study done over the span of 3 years on 902 puerperal women. A self-structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. Results The total prevalence of all the perianal problems in puerperium encountered in the present study, out of 902 subjects, was 36.3% (327 subjects). The perianal problems encountered were fissure in 185 patients (20.5%) followed by hemorrhoids in 110 patients (12.2%), perianal episiotomy infections in 25 patients (2.8%), and perineal tears in 7 patients (0.8%). On comparative analysis, positive family history, macrosomia, past history of perianal diseases, and second stage of labour > 50 minutes showed a higher prevalence in the perianal disease group as compared with the healthy group. Out of these, positive family history of perianal diseases (p = 0.015) and past history of perianal diseases (p = 0.016) were statistically significant. The percentage of multipara with hemorrhoids was more when compared to primipara (p = 0.01), patients who had a past history of any perianal disease have a higher chance of hemorrhoids during puerperium (p = 0.00). Patients with constipation in pregnancy have higher chance of hemorrhoids in pregnancy (p = 0.00). Patients who had a past history of any perianal disease had higher chance of fissure during puerperium (p = 0.00). A total of 27.74% of the study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22%, which was statistically significant (p = 0.02). Conclusion Constipation, hemorrhoids, and anal fissures are the most common perianal problems in postpartum period causing significant reduction in the quality of life of those afflicted with them.

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