Objectives:The objective of this study was measurement of urine flow parameters by a non invasive urodynamic test. Variation of flow rates based on voided volume, age, and gender are described. Different nomograms are available for different populations and racial differences of urethral physiology are described. Currently, there has been no study from the Indian population on uroflow parameters. So the purpose of this study was to establish normal reference ranges of maximum and average flow rates, to see the influence of age, gender, and voided volume on flow rates, and to chart these values in the form of a nomogram.Methods:We evaluated 1,011 uroflowmetry tests in different age groups in a healthy population (healthy relatives of our patients) 16-50 year old males, >50 year old males, 5-15 year old children, and >15 year pre-menopausal and post-menopausal females. The uroflowmetry was done using the gravitimetric method. Flow chart parameters were analyzed and statistical calculations were used for drawing uroflow nomograms.Results:Qmax values in adult males were significantly higher than in the elderly and Qmax values in young females were significantly higher than in young males. Qmax values in males increased with age until 15 years old; followed by a slow decline until reaching 50 years old followed by a rapid decline after 50 years old even after correcting voided volume. Qmax values in females increased with age until they reached age 15 followed by decline in flow rate until a pre-menopausal age followed by no significant decline in post-menopausal females. Qmax values increased with voided volume until 700 cc followed by a plateau and decline.Conclusions:Qmax values more significantly correlated with age and voided volume than Qavg. Nomograms were drawn in centile form to provide normal reference ranges. Qmax values in our population were lower than described in literature. Patients with voided volume up to 50 ml could be evaluated with a nomogram.

Introduction: In recent years there have been changes in management modality and a lower mortality with conservative management. We analyzed the result of emphysematous pyelonephritis (EPN) management by a review of the literature. Material and Methods: We made a retrospective study for the period from August 2005 to July 2009. Patients were evaluated by CT and subclassified based on CT. The patients managed in different modalities and their outcomes were compared. Results: A total of 28 patients were admitted with the diagnosis of EPN. The age range was 22–70 years. Five patients were managed conservatively, 17 patients underwent minimally invasive modalities (double J stent, pigtail drainage). Open drainage of the abscess was conducted in 2 patients, and 4 patients required emergency nephrectomy. Emergency nephrectomy is associated with a high mortality (75%). Conclusions: In the majority of cases, EPN was successfully treated by resuscitation and minimally invasive modalities. Percutaneous drainage should be part of the initial management strategy. This strategy is associated with a lower mortality than emergency nephrectomy.

Prostatic synovial sarcomas are exceedingly rare. To our knowledge, only six primary cases have been reported so far. We herein describe a primary synovial sarcoma of the prostate seen in a 25-year-old male patient, the youngest patient seen with this disease to date. He was referred to our department with the diagnosis of high-grade sarcoma of the prostate revealed by TRUS-guided biopsy. On admission he had a transurethral catheter for acute retention of urine. MRI revealed a solid prostatic tumor of 9.5 x 8 cm involving the rectum without any evidence of lymphatic or distant metastases. The patient underwent total pelvic exenteration and sigmoid end colostomy with ileal conduit. Histopathology revealed a synovial sarcoma of the prostate, immunoreactive to vimentin, Bcl-2 and cytokeratin. The patient is doing well at 18 months follow-up.

Post visual internal urethrotomy (VIU) bleeding is usually treated successfully with local compression. Angioembolization for post VIU bleeding has not been previously reported to the best of our knowledge. This is a case report of a 55-year-old man who was referred with persistent per urethral bleeding around a Foley catheter, three days following VIU. When standard methods of treatment were unsuccessful, the bleeding was controlled by embolizing the bulbourethral artery with polyvinyl alcohol (PVA) particles.

Routine investigations showed presence of pus cells in urine, mild anaemia with borderline leukocytosis on blood counts. ESR was elevated. Malarial parasite antigen test was negative. Blood glucose, serum electrolytes and liver enzymes were within normal range. Tests for viral markers 1 Department of Pathology, CK Birla Hospital, Jaipur. India 2 Department of Urology, CK Birla Hospital, Jaipur. India ABSTRACTAdrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours, that are usually asymptomatic and sometimes associated with endocrinological dysfunction.We present a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection, which was conservatively managed. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discharged after an uneventful postoperative period. Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.