Objectives. The aim was to compare demographics and pathological features of bladder carcinoma treated in a urology unit with findings of previous studies done in Sri Lanka. Materials and Methods. Data of newly diagnosed patients with bladder cancer in a tertiary referral centre from 2011 to 2014 were analysed. Data on bladder cancers diagnosed from 1993 to 2014 were obtained from previous publications and Sri Lanka Cancer Registry. Results. There were 148 patients and mean age was 65 years. Male to female ratio was 4.1 : 1. Urothelial carcinoma (UC) was found in 89.2% of patients. Muscle invasion was noted in 35% of patients compared to 48.4% two decades ago. In patients with UC, 16.5% were found to have pT1 high grade tumour. It was 5.3% from 1993 to 2000. Pure squamous cell carcinoma was found in 8.1% of patients while primary or de novo carcinoma in situ (not associated with high grade pT1 tumours) was seen in one patient only. Conclusions. The percentage of squamous carcinoma is higher among Sri Lankan patients while primary carcinoma in situ is a rarity. The percentage of muscle invasive disease has decreased while the percentage of pT1 high grade tumours has increased during the last two decades in Sri Lanka.

Background: Associated risk factors for renal cell carcinoma (RCC) include smoking, obesity, hypertension, and diabetes mellitus (DM). Studies on their role in Sri Lankan patients are sparse. The aims were to determine the risk factors for RCC in a cohort of Sri Lankan patients. Methods: A hospital-based case–control study was done in a teaching hospital from January 1, 2009, to December 31, 2015. The prospectively collected data included history of smoking, hypertension, DM, and body mass index (BMI). The controls were patients who were admitted after trauma and who required abdominal ultrasonography as part of routine assessment. The controls were accrued at a ratio of 1:2 and were age- and gender-matched. Chi-squared test was used, and P < 0.05 was considered statistically significant. Results: There were 178 patients with RCC. The mean age of patients with RCC was 56.9 years. Male to female ratio was 3.5:1. Forty-nine (27.5%) patients were < 50-year-old. 36.5% were asymptomatic and diagnosed incidentally by ultrasound scanning. Obesity (BMI > 30) (P < 0.01), DM (P < 0.05), and hypertension (P < 0.01) were significantly more common among the cases than in controls. There was no difference in the prevalence of smoking between the two groups (P > 0.5). Conclusions: Average age at the time of diagnosis of RCC in Sri Lankan patients is lower than the developed world, with a large proportion of patients being under 50 years. Obesity, hypertension, and DM are associated risk factors for RCC in Sri Lankan patients while smoking is not.

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The composition of renal stones varies widely among populations. The aim of our study was to determine the composition of staghorn renal stones using Fourier transform infrared (FTIR) spectroscopy in a cohort of Sri Lankan patients. Forty two staghorn calculi removed from kidneys of adult patients during open surgery were analysed. There were 32 men. Nineteen (45%) were calcium oxalate monohydrate (whewellite) stones. Stones containing a mixture of calcium oxalate and calcium hydroxyl phosphate (apatite) were found in 16 (38%). Only 4 (10%) staghorn calculi were coposed of struvite. Three (7%) were uric acid stones. So most staghorn renal stones in Sri Lanka are calcium oxalate. Contrary to the traditional view based on studies done in the western world, only 10% of staghorn calculi removed from patients in Sri Lanka are struvite or infection stones. This could be the reason for kidneys with staghorn calculi in Sri Lanka to retain their function.

ResultsStudy included 60 patients with average age of 72 years. Commonest presentation was acute urinary retention. Different variants of adenocarcinomas were the leading pathological phenotype while one patient had ductal carcinoma of the prostate. Only two patients had a PSA level less than 4ng/ml. Four patients had a PSA level less than 15ng/ml. Bilateral orchidectomy remained the leading method of treatment. One patient had negative histology on subsequent TURP.