Testicular germ cell tumours are the most common malignant tumours seen in adult males in the 20-40 years age group. The cure rate of these tumours is quite high even with the presence of metastasis. But many patients present quite late in the course of the disease, often with complications. We present the case of a young male who presented with mixed germ cell tumour consisting of the unusual combination of seminoma, yolk sac tumour and mature teratoma. Though mixed germ cell tumour is a common entity, presence of seminomatous and non-seminomatous components is quite unusual.

Introduction: Urogenital fistula is a physically, socially and psychologically devastating condition. Although advances occurred in the understanding of etiology, pathogenesis, diagnosis, and management, it still poses challenges to the treating surgeon because of the controversies regarding the optimum time of repair and the ideal surgical approach. The objective of our study was to review cases of urogenital fistulae referred to our department over a 4-year period, with respect to etiology, types, management and outcome. Material and methods: This was a retrospective observational study between January 2013 to January 2017 which reviewed patient charts undergoing Genitourinary fistula repair at our Institute SVIMS, Tirupati for etiology, site, size and number of fistulae, clinical presentation, diagnostic modalities, and management. Results: A total of 49 women underwent genitourinary fistula repair at our institute between January 2013 to January 2017. The mean age of the patients was 39 years (19-58). Out of 49 cases, 35 cases were vesicovaginal fistulae (VVF), 3 fistulae were ureterovaginal, two fistulae were both VVF and ureterovaginal,7 fistulae were urethrovaginal and one vesicouterine fistula. Conclusion: Genitourinary fistulas are socially debilitating. High rates of successful fistula closure can be achieved irrespective of etiology by following sound surgical principles of fistula repair.

Introduction: Urethral stricture description is not standardized. This makes surgical decision-making less reproducible and increases the difficulty of objectively analyzing urethroplasty literature. Wiegand and Brandes 2 developed the UREThRAL stricture score to codify anterior strictures. The objectives of this study were to evaluate urethral stricture score in management of anterior urethral strictures. Material and methods:This was a prospective observation study, which included all patients operated for stricture urethra between March 2015 to march 2017 after applying exclusion criteria. The UREThRAL STRICTURE SCORE for each patient was calculated. The obtained USS was related to the surgical procedure, intraoperative complexity, complications that patient underwent for any significant correlation. Results:A total of 94 patients were included in study. A total of 26 (27.66%) patients underwent VIU while 26 (27.66%) and 42 (44.68%) of patients underwent anastomotic urethroplasty and BMG urethroplasty respectively with a overall success rate of 76.60%. Mean UREThRAL Stricture Score of 94 patients was 9.617 with a range of 5 -21. Conclusion:This study confirms the validity of UREThRAL stricture score in predicting surgical complexity for anterior urethral strictures with higher USS score patient requiring more complex surgery.

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