Purpose:The purpose of the study was to evaluate the presentation and management of posthysterectomy ureteral injuries.Patients and Methods:Fourteen patients with ureteric injuries after hysterectomy for benign diseases were evaluated. The diagnosis was done based on clinical presentation, intravenous urogram, computed tomography, cystoscopy, and retrograde pyelogram (RGP) depending on the clinical situation.Results:Sixteen iatrogenic ureteric injuries in 14 patients over a 2-year period were evaluated. Hysterectomy was the cause of injury in all the cases, 12 abdominal and 2 were vaginal. Two patients presented with anuria, one had ureteric, and bladder injury with hemoperitoneum underwent emergency laparotomy and bilateral ureteral reimplantation. Another patient underwent RGP followed by stenting on the right side, left side unable to put stent so percutaneous nephrostomy (PCN) was done followed by antegrade stenting later. Two patients presented with septicemia and pyonephrosis were managed initially with PCN followed by balloon dilatation and JJ stenting. RGP and retrograde stenting was done in seven of the remaining ten patients and ureteric reimplantation in three patients.Conclusion:Patient with ureteric injury should be evaluated and intervened at the earliest. Patients presenting early, within 2 weeks after hysterectomy have higher chances of success with endourological procedures, obviating the need for open surgery.

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Percutaneous nephrolithotomy (PCNL) has been an excellent option for the management of kidney stones. There have been many complications in regards to solid organ injury during PCNL. Here we discuss an interesting case of 45-year-old woman, who underwent PCNL for right renal staghorn calculus, and had an accidental puncture of the gall bladder. Post operatively, the patient was conservatively managed and recovered well. A small number of cases has been reported until now in literature.

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IntroductionWe present a prospective randomized study to compare the efficacy of tamsulosin and silodosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia, planned for trial without catheter.Material and methodsPatients with acute urinary retention secondary to benign prostatic hyperplasia (total 160) were catheterized and randomized into two groups: Group A: tamsulosin 0.4 mg (80 patients) and Group B: silodosin 8 mg (80 patients). After three days, the catheter was removed, and patients were put on trial without catheter. Patients with a successful trial without catheter were followed up after two weeks and one month, taking into account the international prostate symptom score (IPSS), post void residual volume (PVR), and peak flow rate (PFR). Statistical analysis of the data was performed.ResultsBoth group A (tamsulosin) and group B (silodosin) had similar results of trial without catheter (group A: 67.50%, group: B 60%). In follow up, three patients in group A and four patients in group B had retention of urine, requiring recatheterization. These patients were withdrawn from the study. No significant differences were present between group A and group B patients in regard with IPSS, PVR and PFR measured at the time of successful trial without catheter and during follow up at two weeks and one month.ConclusionsEfficacy for trial without catheter of tamsulosin was slightly higher than silodosin, but comparable. No statistical difference between tamsulosin & silodosin treated groups were found in regard with IPSS, PVR and PFR.

We present a case of spontaneous retrograde migration of mid ureteric calculus into the kidney. A 55 year old male, who presented with left flank pain, was diagnosed with a left mid ureteric calculus on ultrasound abdomen. X ray KUB and CT KUB confirmed the same. Intervention was planned as he did not respond to Medical Expulsive Therapy. On day three, he developed urinary intermittency followed by pain relief. We suspected the calculus to have spontaneously passed out and an X ray KUB was done to confirm it. To our surprise, the same calculus was seen in the kidney instead of ureter. A repeat CT KUB confirmed that the calculus has up migrated into the lower calyx of the kidney.

Adenocarcinoma of prostate typically involves axial skeleton and has been infrequently reported in unusual sites like orbit. It is noteworthy that upto 1989, only 28 cases of occulo-orbital metastases of prostate cancer (PC) had been reported in the literature. PC is mostly known to metastasize to the bony skeleton. The lack of skeletal metastasis does not exclude the possibility of visceral/ distant metastasis, and serum PSA levels usually do not correlate with the extent of metastatic disease. Here in, we report a rare case of unilateral orbital metastasis from PC.

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