Objectives To ascertain the necessity for the use of nephrostomies and ureteric stents after paediatric pyeloplasties. Patients and methods Seventy children with a pelviureteric junction obstruction underwent a dismembered pyeloplasty between March 1983 and March 1991 at The Bristol Royal Hospital for Sick Children. A nephrostomy and stent were not used routinely except for the first few months of the survey. Indications for their use were: surgery on a single kidney, an inflamed renal pelvis or a revision pyeloplasty. Urinary catheters were only used for those patients with proven or suspected vesicoureteric reflux. Results Thirteen patients had a nephrostomy and stent inserted (Group 1) of whom three patients (23%) developed complications. Fifty‐seven patients had only a wound drain inserted (Group 2) of whom nine (16%) developed complications. The hospital stay of 12.1 days for patients in Group 1 was significantly longer than the 5.4 days for Group 2 (P value <0.05). Long‐term radiological and/or radio‐isotopic follow‐up showed improvement in function and/or drainage in 95% of both groups. Conclusions These findings support the concept that paediatric pyeloplasties can be safely performed at any age without the insertion of a nephrostomy tube or stent and that hospital stay is therefore significantly reduced.

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Prostate Specific Antigen (PSA) is a non-invasive biomarker in the management of prostate adenocarcinoma. Due to its low specificity, its diagnostic role is controversial in prostate adenocarcinoma. Gleason score is considered as most powerful predictor of prostate carcinoma. PSA in combination with Gleason grading system improves the detection of pathological stage of prostate adenocarcinoma. Objective: To determine the degree of correlation between pre biopsy serum PSA level and Gleason score in patients diagnosed with prostate adenocarcinoma. Methods: Retrospective cross sectional study was conducted in Chemical Pathology and Histopathology department, Sheikh Zayed Hospital, Rahim Yar Khan between July 1, 2021 and September 31, 2022. A total of 51 histopathologically confirmed cases of prostate adenocarcinoma with documented Pre biopsy PSA level and Gleason score were included in the study. Serum PSA level correlation is compared with Gleason score, Gleason Pattern and Gleason Grade. p-value ≤0.05 taken as significant. Results: Mean age for prostate carcinoma patients was 65.71±10.062 years. Mean pre biopsy serum PSA level in study subjects was 40.31±37.52ng/ml. Of the total 51 study subjects, 27 (52.94%) were having Gleason score 7 suggestive of moderately differentiated tumor. Among these, 15(55.6%) were having serum PSA level between 10.01-50.00ng/ml. Statistically significant good correlation of serum PSA with Gleason score, Gleason pattern and Grade was established with p value <0.05. Conclusion: It was concluded that there is good degree of positive correlation between pre biopsy PSA level and Gleason score in patients with Prostate adenocarcinoma

Background and Aim:Prostate histological enlargement known as Benign Prostatic Hyperplasia (BPH) is the major challenge for aging men with substantial burden on the health care system. It is associated with incomplete emptying sensations and impedance in flow due to symptoms of the lower urinary tract. Patient of higher body mass index (BMI) or obese have larger prostate volume (PV) and increase in lower urinary tract symptoms (LUTS) compared to normal BMI patient as reported by many researchers. The current study aim was to correlate the association between obesity and prostate volume in BPH patients. Materials and Methods: This cross-sectional was conducted on 140 BPH patients with 45 years to 75 years age range admitted in the department of Urology, DHQ Teaching Hospital, Dera Ismail Khan for six months duration from July 2020 to December 2020. BMI of each individual was calculated using height and weight measurements. Measuring tape was used to measure waist circumference (WC) while Prostate volume (PV) was measured with Transrectal Ultrasound (TRUS). Demographic and clinical parameters such as diabetes, smoking, prostate specific antigen (PSA) and hypertension were recorded on pre-designed proforma. Outcome variables were BMI and prostate volume. Results:Patients were divided into three categories based on BMI namely Obese, overweight and normal. Mean value for age and BMI was 61.34±5.324 and 26.89±4.13 respectively. Mean PV of Obese, overweight and normal BMI were 61.34±7.5, 59±3.10 and 50.91±8.5 cm3 respectively. The PV average score was 58.42±6.53 cm3. The mean value for waist circumference (WC) and PSA were 97.20 and 5.10±3.23 with 1.2-5.9 range respectively. The correlation between PV and BMI as well as between WC and PV, diabetes, smoking and hypertension shown no significance (p value=0.195). However, PSA and PV correlation give significant (p value 0.001-0.009) correlation. Conclusion:Central obesity plays a key role in developing and promoting BPH. The highest prevalence of BPH was found in patients with BMI >30kg/m2 while lowest in men of BMI <23 kg/m2. The current study found higher frequency of BPH among patients with WC >90 cm and lowest in men of WC <90 cm. A positive correlation was found between WC, BMI and PV. Individual quality of life affected by LUTS caused by severe risk of BPH due to increase in obesity. Balance diet and physical exercise help in maintaining the healthier BMI among obese and aged men. Keywords: Benign prostate hypertrophy, Bladder outlet obstruction, Prostate volume