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Ureterocystoplasty is a novel operation well suited for patients having small capacity urinary bladder with unilateral poorly functioning kidney and megaureter. The megaureter is detubularized and used for urinary bladder augmentation. The ureter lining has advantage of being non-secretory and free from the metabolic complications of enterocystoplasty. This operation is mainly done in children. This is one of the very few from the Asian subcontinent which describes the short term results of ureterocystoplasty in an adult patient. We report a case wherein ureterocystoplasty was performed in an 18-year male presented with a small capacity neurogenic bladder with a grossly dilated and tortuous left ureter and a non-functioning left kidney. Left ureter was detubularized and used for augmentation after left nephrectomy. Blood supply to the left ureter was preserved during the dissection. After the operation, the bladder capacity increased adequately and he is doing well at a followup of 1 year. Ureterocystoplasty works well in the adult patients also and the bladder capacity increases adequately following this procedure.

Fistula following circumcision and at times accompanied by disfigurement of the glans penis is a common problem in our country, where a large number of circumcision is performed by untrained professionals. These complications may have profound negative psychological impact on the growing child. Herein, we report the successful closure of such fistula using buccal mucosa, which occurred following circumcision (for phimosis) in a 15 year old boy. This resulted in the disfigurement of the glans penis with a distal urethral fistula. The fistula was managed by dorsal onlay buccal mucosa graft urethroplasty (BMGU). The patient has excellent cosmesis at 6 months followup with a good urinary stream. This technique can give better results than those, where skin grafts or local flaps are used for fistula closure. BMGU is a versatile technique with good long term results. The cosmesis and functional results are satisfactory and help in improving the self esteem and sexual function in the years to come.

Chronic prostatitis / chronic pelvic pain syndrome (NIH-type II and type III prostatitis) are common cause of chronic pelvic pain. The exact etiology of these entities are unknown. They are associated with varying degree of voiding and sexual dysfunction. Consensus regarding treatment of these pain syndromes is lacking. Review of literature suggest a therapeutic role of alpha adrenergic receptor blockers in the management of NIH-type II and type III prostatitis. A trial of alpha-blocker is reasonably inexpensive and appropriate for most patients suffering from NIH-type III prostatitis and NIH-type II prostatitis. A general consensus is that if a patient agrees to a trial of alpha-blocker therapy which subsequently shows a good response then it should be continued for at least 6 months for a proper therapeutic effect. This review analyses the role of alpha-blockers in this disease/syndrome; discusses the possible mechanism of action through which these drugs provide relief and also highlights some of the important trials which have paved way for this particular treatment option in this intriguing disease /syndrome.

Chronic testicular pain represents a management dilemma to clinicians and remains a very frustrating clinical problem. In nearly 25% of patients there is no obvious cause for idiopathic chronic orchialgia. Chronic testicular pain may occur at any age but the majority of patients are in 20-30 years of age group. The desired goal of the treatment is to allow the patient return to routine activity without significant use of analgesics. There is very little published material, in urology, about the etiology and treatment of idiopathic chronic orchialgia but situation is not bleak since many treatment options do exist which can allow the patient enjoy life with mechanisms for coping with pain. A multidisciplinary team approach is required, so that the patient can benefit from the different treatment options available at present.