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Introduction: Various nephrolithometric scoring systems have recently emerged to predict the outcomes of percutaneous nephrolithotomy (PCNL). However, there is no consensus upon an ideal tool. The current study aimed to assess the correlation between Guy’s stone score (GSS) and PCNL outcomes. Method: This was a hospital-based observational study of 2-year duration. All patients electively undergoing PCNL for renal stones during the study period were included. Based on the imaging findings, the stones were categorized as simple (GSS I & II) and complex (GSS III & IV). The association between GSS and duration of the procedure, the number of percutaneous tracts needed, stone-free rate (SFR), and the severity of complications based on modified Clavien classification and postoperative stay were assessed. Results: Total number of the patients studied were 100 (n = 100), and most of the patients were in the category of GSS II (51%). Post-extrapolation of χ2 to Pearson’s test, GSS demonstrated a significant association with duration of surgery, the number of percutaneous tracts needed, the severity of complications, and SFR. Conclusions: Preoperative assessment of stone complexity by using GSS effectively correlated with SFR as well as other PCNL outcomes. Hence, we recommend utilizing this predictive tool for standardized documentation, preoperative planning, and better patient counseling.

Objective: To compare intraoperative and post-operative outcomes between mini-percutaneous Nephrolithotomy (miniPCNL) and Retrograde intrarenoscopy (RIRS) groups. Materials and methods: A total of 66 patients were alternatively allocated to undergo miniPCNL (33patients, group A) and RIRS (33patients, group B) groups. All patients were evaluated by history, laboratory investigations, X-ray Kidney ureter bladder (KUB), Ultrasonography and computerized tomography (CT) scan to determine stone number, location and size. Operative time, stone free rate, duration of hospital stay and complications were compared between both groups. Results: Demographic parameters were comparable between two groups. Stone free rate was similar in both groups. Mean duration of procedure was less for miniPCNL when compared to RIRS with P < 0.0001. Duration of post-operative stay for miniPCNL was longer when compared to RIRS with P < 0.0001. Complications like intra operative bleeding, post-operative fever and blood transfusion were similar in both groups. The RIRS group patients experienced reasonably less pain postoperatively as per Visual analogue scale (VAS) score when compared to miniPCNL group with P < 0.0001. Conclusion: Though RIRS and miniPCNL have good and comparable stone free rate with low complication rates, favourable pain score and less hospital stay makes RIRS a preferred option over miniPCNL.

Tamsulosin, a third-generation uroselective α1A adrenergic receptor blocker (antagonist), has been approved for the treatment of signs and symptoms of benign prostatic hyperplasia for more than two decades. Apart from this approved use, more recent evidence has been published regarding the off-label use of tamsulosin in various other urological conditions. However, further research is needed regarding the use of tamsulosin in these indications. This review highlights the possible therapeutic uses of tamsulosin for the management of various urological conditions.

Introduction: Renal cell carcinoma (RCC) is known to invoke both immunological and inflammatory responses. While the neutrophils mediate the tumor-induced inflammatory response, the lymphocytes bring about the various immunological events associated with it. The neutrophil-to-lymphocyte ratio (NLR) is a simple indicator of this dual response. We investigated the association between preoperative NLR and histopathological prognostic variables of RCC intending to find out whether it can be of value as a red flag capable of alerting the clinician as to the biological character of the tumor under consideration. Methods: Preoperative NLR and clinicopathological variables, namely histological subtype, nuclear grade, staging, lymphovascular invasion, capsular invasion, tumor necrosis, renal sinus invasion, and sarcomatoid differentiation of 60 patients who underwent radical or partial nephrectomy, were analyzed to detect the association between the two. Results: We found that mean preoperative NLR was significantly higher in clear-cell carcinomas (3.25 ± 0.29) when compared with nonclear-cell carcinomas (2.25 ± 0.63). There was a linear trend of NLR rise as the stage of the disease advanced. A significant rise in preoperative NLR was noted in tumors with various high-risk histopathological features such as tumor size, capsular invasion, tumor necrosis, and sarcomatoid differentiation. Conclusion: Preoperative measurement of NLR is a simple test which may provide an early clue of high-risk pathological features of renal cell cancer.

Introduction: Visual Prostate Symptom Score (VPSS) was introduced to overcome the drawbacks of the International Prostate Symptom Score (IPSS). However, this score also has potential for improvement. Materials and Methods: The primary objective of this study was to evaluate the utility of VPSS in patients with benign enlarged prostate (BEP) after uroflowmetric validation of the stream component. The secondary objective was to improve VPSS by adding a new severity grading and to assess if the "new upgraded VPSS" can replace IPSS in terms of ease of completion without assistance and the time taken. Results: Of 115 patients, 42.60% of them were of thea age group between 61– 70 years; mean ± standard deviation age was 64.75 years ± 8.042 (range 48– 90 years). Nineteen (16.52%) patients, who had education level ≥10th grade completed IPSS without assistance.. One hundred and eight (93.91%) patients completed VPSS without assistance (P = 0.000). None of those (0/6) with no formal education (but able to read and write) could complete the IPSS without assistance, whereas 66.67% completed the VPSS without assistance. Six minutes and two minutes was the average time taken to complete IPSS (4– 10 min) and VPSS (1– 3 min), respectively. Responses to different variables of VPSS were statistically significant (P < 0.001) compared to the IPSS. Correlation between the severity grading of the two scores was statistically significant (P < 0.001), with a statistically significant positive correlation between VPSS and IPSS (r = +0.582, P < 0.001). The new severity grading system developed on par with the IPSS, improvising the existing VPSS, showed statistically significant positive correlation to the IPSS (r = +0.587, P < 0.001). Conclusions : VPSS correlated well with IPSS. The "new improvised VPSS" developed by incorporating severity grading is a potential tool that can replace IPSS by overcoming its limitations.

Use of exogenous estrogens in manipulating the androgenestrogen equilibrium was one of the earliest therapeutic strategies developed to treat prostate cancer which followed close on heels the discovery of hormone dependence of this tumor. Despite its well-documented benefit, estrogen therapy fell out of favor with the advent of other forms of androgen deprivation therapy (ADT) as the former registered a higher incidence of cardiovascular complications and poorer overall survival. Clearer understanding of the mechanism of action of estrogen coupled with the adoption of alternative routes of administration has triggered a renewed interest in estrogen therapy. Since then, many studies have not only proved the therapeutic benefit of estrogens but also explored the ways and means of minimizing the dreaded side effects deterring its use. Further, the fact that estrogen therapy offered a clear advantage of reduced cost of treatment over other treatments has led many countries to readopt it in the treatment of advanced prostatic cancer. We reviewed the published data on the use of estrogens in CRPC, which may affect its revival as an efficacious treatment option having minimal side effects, with modified dosage and route of administration. Estrogen therapy would be a less expensive option having equivalent or even better therapeutic effect than ADT in advanced carcinoma of prostate.

The histological finding of persistent mesonephric duct remnants in the uterine cervix and vagina is uncommon and is usually an incidental finding in tissues excised for other reasons. Herein we present a case of lobular mesonephric hyperplasia in a 45 year old woman who presented with vaginal bleeding and difficulty passing urine.

A case of leiomyosarcoma of the urinary bladder occurring in a middle aged lady with immunohistochemical confirmation is presented for its rarity with emphasis on grading of smooth muscle neoplasms of the urinary bladder.