Vesicouterine fistulae, despite being infrequent, are no longer a rare diagnosis and are most commonly secondary to lower segment caesarean section. With patient history and selected investigations diagnosis is relatively easy. The surgical repair of these fistulae is standard treatment, especially with delayed fistulae with achievement of total continence, and complete resolution of cyclic haematuria. Meticulous practice of obstetric and surgical principles during caesarean section can prevent the formation of these fistulae.

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in long anterior urethral stricture (> 2 cm long) through the midline perineal incision. Materials and Methods: From January 1998 to December 2003, 43 patients with long anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 months with uroflowmetry, retrograde urethrogram (RGU) and American Urological Association symptoms score (AUA symptoms scores). Successful outcome was defined as normal voiding with a maximum one attempt of VIU after catheter removal. Patients were further followed-up with uroflowmetry at 3 months interval and RGU every 6 months interval. Results: Mean stricture length was 4.8 cm (range 3 to 9 cm) and mean follow up was 48 months (range 12 to 84 months). Only five patients were found to develop stricture at anastomotic site, during follow-up. Two of them voided normally after single attempt of VIU. Other three patients (6.9%) required further open surgery or repeat VIU during follow up and were considered as failure. Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.

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The spectrum of adult renal tumors in this series is consistent with the other series of cases reported by different authors. Only few cases of the renal tumors were diagnosed incidentally among our patients which is just opposite to the rate of renal tumors diagnosed incidentally in the developed countries. Myofibroblastoma, a benign kidney tumor diagnosed in our series is probably the first reported case in the world.

Vesicovaginal Fistula (VVF), an abnormal communication between the urinary bladder and vagina, is one of the most distressing and embarrassing health problem for the ladies. The present observational study was planned to inquire into the demographic and aetiologic pattern of vesicovaginal fistula and the long-term success rate of its surgical management following different techniques of repair in a tertiary care centre of West Bengal, India. MATERIAL AND METHODSA total of 47 patients with vesicovaginal fistula presented at our hospital over a span of nine years, were observed during their course of treatment. The patients were evaluated with clinical history, physical examination, routine laboratory investigations, intravenous urogram and cystoscopy. Then the patients had undergone operation by vaginal or abdominal route. Patients were discharged from the hospital with per urethral catheter. On 21 st post-operative day, routine cystogram was done in every patient before catheter removal to exclude the failure of the operation. RESULTOf the observed 47 patients, 66% were tracked back to their obstetric causes and 34% patients could be linked up to gynaecological aetiology like a complication of hysterectomy or after brachytherapy for carcinoma of cervix. In 23.4% of patients, the repair of fistula was done by vaginal route, whereas in 76.6% cases by abdominal approach. Overall success rate of surgical repair was 87.3%, which is comparable to the success rate mentioned in literature. CONCLUSIONIn spite of a decline in the incidence of vesicovaginal fistula in the western world, it is still highly prevalent in the developing countries. Prolonged obstructive labour was found as the most common aetiology of this devastating condition in our region. Timely intervention with meticulous surgical technique is essential for an acceptable success rate in fistula repair surgery. However, improved obstetric care, institutional delivery, high literacy rate, prevention of early marriage-all are of paramount importance for the prevention of occurrence of this socio-medical problem.

Background: Benign prostatic hyperplasia (BPH) is the most common urological condition. The treatment of BPH depends on the severity of symptoms which aims to improve symptoms, lower the risk of progression and improve quality of life. The aim of this survey was to understand the prescription pattern of alpha blockers in the treatment of BPH among clinicians of India.Methods: A cross-sectional questionnaire-based survey was conducted between September to December 2018. Data regarding the management of BPH using α-blockers were filled by clinicians and collated for data analysis using appropriate statistical test.Results: Total of 1764 clinicians’ responses was collected and the result was analysed. According to the survey, 47.68% of clinicians felt that severity of the BPH symptoms is most common deciding factor for medical management of BPH. For the pharmacological management of BPH patients, around 58% of clinicians opted for α blockers monotherapy as a preferred option. Among α blockers, 65.14% of clinicians preferred tamsulosin as first line therapy for management of BPH patients. In this survey, 81.75% of clinicians believed that tamsulosin offers highest persistence rate among commonly prescribed α blockers. Looking at the switching to a second α-blocker, 75.45% of clinicians felt that tamsulosin shows the highest return rate following initiation of a second α-blocker. More than 90% of clinicians felt that favourable efficacy or tolerability of tamsulosin is due to its highest persistence and highest return rates.Conclusions: Tamsulosin is the most commonly preferred and prescribed α-blocker by Indian clinicians due to its favourable efficacy or tolerability.

BACKGROUND Erythroderma or exfoliative dermatitis is an inflammatory disorder, it covers > 90% of the body surface. Hebra proposed it first in 1868. Pre-existing dermatoses comprised majority of cases and these include psoriasis, spongiotic dermatoses, pityriasis rubra pilaris, lichen planus, pemphigus foliaceus etc. Erythroderma is a common clinical presentation of different diseases in this region. Aim-Erythroderma is a serious disease. Histopathological confirmation of causes is urgently required to optimise the therapy. MATERIALS AND METHODSClinically diagnosed 22 cases of erythroderma who presented to NBMC and H between December 2016 and July 2017 were evaluated and correlation of clinical diagnosis with histopathological features was studied. Results were then analysed. RESULTSMales were affected more than females and chronic spongiotic dermatitis was the most common cause. Erythroderma secondary to malignancy was not observed in this study. Majority (91%) of erythroderma cases clinically present as a chronic disease and t he most common presenting feature was itching (77.27%). Overall prognosis was good in our study with drug-induced cases. CONCLUSIONErythroderma secondary to pre-existing dermatoses is the major cause with insidious onset and geographic variation.

BACKGROUND Over the years, a number of methods have been tried to detect the presence of Mycobacteria in tissue samples. A number of previous literatures are available comparing the efficacy of fluorescent microscopy with Ziehl-Neelsen (ZN) stain for the detection of acid-fast bacilli (AFB) in tissue sections, but very few literatures are available on the efficacy of fluorescent method in imprint smears taken from skin biopsy over ZN method in tissue sections. Thus, the present study was undertaken with the following objective-to study the efficacy and advantages of using fluorescent microscopy in imprint smear from skin biopsies over ZN method in tissue sections for detection of mycobacteria in clinically suspected cases of leprosy and cutaneous tuberculosis.