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Bladder cancer (BCa) is a common genitourinary cancer worldwide. It has been further classified into muscle invasive bladder cancer and nonmuscle invasive bladder cancer. Currently, the detection of BCa requires an unpleasant and expensive cystoscopy and biopsy, which is often accompanied by several adverse effects. Thus, a need is felt to develop novel diagnostic methods for initial detection and surveillance of the disease. Several urine-based tests have been approved by the Food and Drug Administration, USA, for the detection and surveillance of BCa, which are also commercially available. However, as of today, the sensitivity, specificity, and diagnostic accuracy of these urine-based assays are still suboptimal. To improve these, a number of novel molecular markers as well as multiple assays need to be introduced in clinical practice. At present, there is a growing need and evidence toward the use of minimally invasive “liquid biopsy” to identify biomarkers in BCa. DNA- and RNA-based markers in body fluids such as urine appear as promising potential markers in diagnostic, prognostic, predictive, and monitoring BCa. We report a nonsystematic review of the literature in regard to urinary biomarkers for BCa.

Introduction: Appearance or persistence of vesicoureteral reflux (VUR) and other obstructive complications after open reimplantation of ureters is well known and up to 7.5% of cases require reoperation. In this study, we have assessed children presenting with recurrent urinary tract infection (UTI) following open reimplantation for VUR. Materials and Methods: We retrospectively collected hospital data of 14 children referred to us for management of recurrent UTIs following open ureteric reimplantation for vesicoureteric reflux from January 2006 to December 2015. Results: Fourteen children presented to our center at a mean age of 31.85 ± 10.17 months. The mean serum creatinine was 0.77 ± 0.26 mg% (range 0.5–1.3). Urine culture was positive in all with Escherichia coli being the most common organism grown on culture. Two children had obstruction at the vesicoureteric junction, and the remaining twelve children had 14 ureteral units with VUR. Two children underwent reimplantation into Boari flap, five underwent open reimplantation, and the remaining seven underwent endoscopic Deflux injection. Repeat voiding cystourethrogram done within 1 year of surgery revealed no VUR in any child. Conclusions: Appearance or persistence of VUR and obstructive complications after open reimplantation surgery is a matter of great concern for the parents of these children as well as the treating pediatric urologists. Appropriately selected open/endoscopic treatment can help in resolving these complications.

Use of mid-urethral slings to treat stress urinary incontinence is based on the integral theory that the mid-urethra has an important role in the continence mechanism. Transobturator vaginal tape (TOT) involves passage of the sling transvaginally through the obturator foramen so as to avoid the pelvic organs and vasculature. In this report, we describe the operative steps of the transobturator approach.

Introduction: We retrospectively evaluated our experience with modified Cantwell-Ransley epispadias repair at our center to determine the complications and long-term results. Materials and Methods: We retrospectively reviewed the case records of 43 male children with a mean age of 9.13 ± 1.94 years who underwent primary epispadias repair at our center. The results of epispadias repair were assessed by both physical and endoscopic examination. All children who were old enough to opine as well as all parents/guardians were interviewed during the follow-up visits. Results: Urethrocutaneous fistulae occurred in 17.85% (5/28) children of the classic bladder exstrophy group and in 13.33% (2/15) children with penopubic epispadias. Postoperative cystoscopy done 12 weeks after repair revealed a smooth urethral tube in 81.39% (35/43) of children. With the patient in a standing position, the penis was dangling downward or in a horizontal position in 88.37% (38) of children, 85% of the patients ≥18 years of age were satisfied with both the functional and cosmetic outcome, as assessed by short form 36 and 93.02% (40/43) of the patients were continent during the daytime with voided volumes of more than 200 ml. Conclusion: In our experience, Cantwell-Ransley repair creates a functionally and cosmetically acceptable penis and produces a reliably tubularized neourethra with acceptable complication rates.

Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, occurring in 2-3% of the population. Littré hernia (LH) is the protrusion of MD through a potential abdominal opening in a sac. It results from improper closure and absorption of the omphalomesenteric duct. Protrusion of MD, along with coils of the intestine into the hernia sac may cause complications like obstruction, perforation, or fecal fistula. We report a very rare case of LH who presented with an irreducible mass in the left inguinal site, diagnosed preoperatively as incarcerated inguinal hernia in a 2-year-old boy.

Aim: To evaluate the role and efficacy of laparoscopic reduction of intussusceptions in children with failed initial hydrostatic reductions. Materials and Methods: This is a retrospective study of children who underwent laparoscopy for incomplete reductions following sonoguided hydrostatic reduction.Laparoscopy guided pneumatic reduction or laparoscopic reduction was done. Results: Hydrostatic reduction was successful in 76 (73.5%) of cases. Among 26 children in Laparoscopy group 8 showed completeness of reduction. Features of necrotic bowel were seen in 4 (15%) children requiring laparotomy. Among 14 children with incomplete reduction 3 (21%) children required pneumatic reduction under laparoscopic monitoring. 11 required laparoscopic reduction. None of the incomplete group with viable bowel required conversion to open surgery. No major complications were noted in any groups. The mean hospital stay was 1.8 days in hydrostatic group 4.2 days in laparoscopic group and 6.8 days in laparotomy group. No recurrence of intussusceptions noted. Conclusions: The role of laparoscopy in intussusceptions is evolving as a safe procedure and helps in avoiding laparotomy in large number of children with incomplete reduction. Non operative reduction is the gold standard in management of intussusceptions in children. Excellent results are obtained with either saline or pneumatic reductions. However, in few cases of, incomplete reduction or doubtful complete reduction with non operative technique poses problem for further management and may need laparotomy. Laparoscopy being less invasive has distinct advantage over open laparotomy. Use of Laparoscopy in the management of Intussusceptions is described in literature. We have analyzed our results of laparoscopic management of intussusceptions in children in our center.

Urethrocutaneous fistula (UCF) are common after hypospadias repair, but occurrence of congenital UCF without hypospadias is extremely rare and only about 35 cases are reported in the literature. The etiology is not established yet. We report a rare case of isolated congenital UCF in 1 year child managed by Snodgrass technique and review of literature regarding the etiology and management.

Introduction: We retrospectively evaluated our experience with modified Cantwell--Ransley epispadias repair at our center to determine the complications and long-term results. Materials and Methods: We retrospectively reviewed the case records of 43 male children with a mean age of 9.13 ± 1.94 years who underwent primary epispadias repair at our center. The results of epispadias repair were assessed by both physical and endoscopic examination. All children who were old enough to opine as well as all parents/guardians were interviewed during the follow-up visits. Results: Urethrocutaneous fistulae occurred in 17.85% (5/28) children of the classic bladder exstrophy group and in 13.33% (2/15) children with penopubic epispadias. Postoperative cystoscopy done 12 weeks after repair revealed a smooth urethral tube in 81.39% (35/43) of children. With the patient in a standing position, the penis was dangling downward or in a horizontal position in 88.37% (38) of children, 85% of the patients ≥18 years of age were satisfied with both the functional and cosmetic outcome, as assessed by short form 36 and 93.02% (40/43) of the patients were continent during the daytime with voided volumes of more than 200 ml. Conclusion: In our experience, Cantwell--Ransley repair creates a functionally and cosmetically acceptable penis and produces a reliably tubularized neourethra with acceptable complication rates. [ABSTRACT FROM AUTHOR]