Inflammatory pseudo tumor of the tunica is rare and typically presents as long standing, painless scrotal mass. A 23-year-old man had palpable, multiple, hard scrotal masses for 3 months. Laboratory investigations were normal (including LDH, AFP, HCG). Radical inguinal orchiectomy done. Macroscopically the testis and epididymis were normal, with multiple gray nodules surrounding the testis and epididymis, attached to the tunica albuginea and vaginalis, had smooth surface, partly whorled cut surface. Histologically, the nodules were well circumscribed, consisting of fibrous tissue, with infiltration by plasma cells and mononuclear inflammatory cells, giving the diagnosis of plasma cell granulomas.

Urinothorax is the presence of the urine in the pleural space. This condition is very rare and occurs due to unrelieved obstruction of urinary flow. A 20-year-old female presented 7 days after cesarean section with tachypnea, and generalized abdominal pain. There was absent air entry over the left hemithorax. CT scan showed massive left pleural effusion and a stone obstructing the renal pelvis with hydronephrosis and peri-renal collection. The pleural fluid had high fluid creatinine level suggesting urine collection. Ureteroscopy done and double J catheter inserted. The effusion became loculated, thoracotomy and pleural decortication done.

Background: The tubularized incised plate urethroplasty has well been depicted for the hypospadias management, however, few studies have measured its complication on hypospadias. The current study aimed to compare the tubularized incised plate urethroplasty procedure in circumcised and uncircumcised patients on different locations of distal hypospadias. Subject and Methods: Between 9-July-2012 and 9-March-2014, 81 male patients aged 6 to 108 months (mean age 42.10 ± 25.72), including33 circumcised and 48 uncircumcised boys with distal hypospadias were recruited into the study and underwent tubularized incised plate for the first time. The complications included fistula, meatal stenosis, surgery failure or success, penile skin necrosis, and final outcome were obtained after six month follow-up of the patients. Results:The study revealed that mean surgery duration was60.00±8.18 minutes. The study did not show that surgery in different locations (p=0.872), overall outcome (p=0.153) and specific outcomes including fistula (p=0.261), meatal stenosis (p=0.337), and penile skin necrosis (p=0.299), and successful rate of operation (p=1.000) have a significant difference in circumcised and uncircumcised patients. Conclusion: The procedure is an effective, safe, and proper clinical technique to treat hypospadias in circumcised and uncircumcised patents. The study showed that the technique can be done in both group of patients successfully. Duhok Med J 2017; 11 (1): 61-68.

Background: Urolithiasisis a common health problem in our society. Extracorporeal Shock Wave Lithotripsyhas been practiced successfully for treating renal and upper ureteric stones. Few studies, however, have looked on its effectiveness in the treatment of lower ureteric stone. Objective: To evaluate the effectiveness of ESWL in the management of upper and lower ureteric stones in Duhok. Patients and Methods:The study was planned and conducted from January 2013 to June 2014 on 294 patients(16-80 years)with ureteric calculi admitted for the initial Extracorporeal Shock Wave Lithotripsytreatment. All patients were underwent lithotripsy with shock wave 1220 to 4000 at the rate of 60-90 impulses per minute in the same place using the Siemens lithotripter. The outcome was evaluated on the 3rdand 7thdays by x-ray and ultrasound and a second Extracorporeal Shock Wave Lithotripsy session was conducted for those have an incomplete clearance of ureteric stone. Results: Out of the 294 patients, 74.1% were male, 55.8% had left-sided stone and remaining 44.2% had right-sided stone, and 34.4% had stone located in lower ureter. The mean age of the patients was 37.2 (±10.9) years, while the mean stone size was 7.98 (±1.18) mm. The Extracorporeal Shock Wave Lithotripsy has successfully removed the stone from 256 (87.1%) patients and the success rate was significantly higher for lower ureteric and small size stones. The success rate for both sides and genders were comparable in the study. Out of the rest 38 (12.9%) patients who did not obtain the success of stone minimization from the first Extracorporeal Shock Wave Lithotripsy session; 33 of them had stone clearance in the second session while, the rest of 5 patients need surgical intervention. Univariate logistic regression showed that small stone size was the only significant predictor for stone clearance after the first session. Conclusion: The current study confirmed that the Extracorporeal Shock Wave Lithotripsy technique is the safe and effective method for upper and lower ureteral calculi comminution.