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Background Hydatid disease is an infectious disease that affects several organs. Isolated renal involvement is very rare. The treatment for renal hydatid cyst ranges from minimally invasive percutaneous aspiration techniques to laparoscopic and open techniques. We describe five cases of isolated renal hydatidosis with varied presentations who were treated successfully by various methods. Case presentation The presenting symptoms included flank pain (n = 5), mass abdomen (n = 2), and hydaturia (n = 1). In 4 patients, the diagnosis of a hydatid cyst was known preoperatively, but one patient with a preoperative diagnosis of a simple cyst was found to harbor hydatidosis intra-operatively. Eosinophilia as a marker for the active disease was present in 60% (3/5), while echinococcal serology was positive in only 25% (1/4). Two cases were approached laparoscopically, while three required an open approach. Two patients were treated with nephrectomy due to the high bulk of the disease, while the other three underwent renal preserving cyst excision. Conclusions The presence of eosinophilia in the preoperative workup may indicate an infective/active hydatid disease. Echinococcal serology is representative of past hydatid infection but cannot reveal about current disease status. Cysts with varied attenuations and residence in an endemic region may support a renal hydatid cyst diagnosis. A holistic approach including clinical history, laboratory parameters, and imaging is needed for diagnosis. Surgical treatment requires cyst excision, along with precautions to prevent spilling. Nephrectomy may be preferred in cases with minimal residual function.

Sarcomatoid differentiation of squamous cell carcinoma of the penis is a rare, high grade, and an aggressive tumour. Presentation is in the third to ninth decade of life. Glans penis is the most frequently affected part of the penis. This tumour is called a biphasic tumour as it contains both sarcomatoid and carcinomatous elements in varying proportions. A rapidly growing lesion has more of the sarcomatoid component with the slowly progressing tumour showing predominance of the carcinomatous component. This variant of squamous cell carcinoma of the penis is difficult to diagnose because of the morphological heterogeneity. A complete examination of the tumour in its entirety, along with the immunohistochemistry, is required to make a diagnosis. Correct diagnosis is essential as the prognosis is abysmal. Majority of the cases have an advanced disease at presentation. To the best of our knowledge, only 42 cases have been reported in the literature so far.

Female Urethral Stricture disease has been long neglected, the management of which has been often relegated to painful periodic urethral dilatations. However, of late, various techniques for female urethroplasty have been described and the technique of ventral inlay buccal mucosal graft urethroplasty (VIBMGU) is a newer iteration of female urethroplasty surgery. It can be routinely used as it is a simple technique with minimal dissection and has good outcomes. The strictured urethra is incised at 6 o’clock position and the buccal mucosa is placed over the periurethral bed. The catheter and the sutures placed give extrinsic compression for stabilization and engraftment of the graft onto the bed.

Introduction: The aim of the study is to present our initial experience with ventral-inlay buccal mucosal graft urethroplasty (VI-BMGU) in female urethral stricture disease (USD). Methods: Between May 2016 and June 2018, 12 women with USD underwent VI-BMGU. All women were evaluated preoperatively with the American Urological Association (AUA) symptom score, uroflowmetry, calibration with a 12 Fr catheter, and ultrasonography with postvoid residual (PVR) urine measurement. Intraoperative confirmation of stricture was done with a 6 Fr cystoscope. Postoperatively, the women were followed at 3, 6, and 12 months after surgery with AUA symptom score, uroflowmetry, and PVR estimation. Increase in AUA symptom score, maximum flow rate (Qmax)

Introduction: There are very few studies in the literature describing retrograde intrarenal surgery (RIRS) in preschool children. We have evaluated the feasibility, stone-free rate, and complications of RIRS in children

Introduction: Laparoscopic or robotic-assisted laparoscopic radical prostatectomy (RALP) is a frequently used approach for localized carcinoma prostate. For intermediate and high-risk cancers, extended pelvic lymph node dissection (e-PLND), is often performed. Conventional e-PLND involves piecemeal retrieval of lymphatic tissue. We describe a novel technique of laparoscopic e-PLND, which involves en-masse removal of pelvic lymph nodes from each side, based on an overlying peritoneal scaffold. Materials and Methods: Fifteen cases of intermediate and high-risk carcinoma prostate underwent laparoscopic radical prostatectomy (LRP) with peritoneal scaffold based e-PLND within a period of 1 year. We describe the surgical techqniue and outcomes in terms of operative time and lymph nodes retrieved. Results: The mean operating times for peritoneal scaffold lymphatic dissection was 48 min (38-64). The total number of lymph nodes retrieved was 18 (14-22). There were no cases with postoperative lymph collection or hematoma. Conclusion: The peritoneal scaffold technique of e-PLND is a novel technique, which involves having a peritoneal scaffold to bind and hold all the lymphatic tissues together in its anatomical orientation during dissection. This enables complete retrieval of specimen during LRP and RALP.

Introduction: With safe obstetric practices now globally available, most vesico-vaginal fistulas (VVF) presenting in recent times are secondary to various gynecologic surgeries. Most of them are supra-trigonal in location. Laparoscopic repair of VVF is gaining ground as an alternative to open repair of VVF. In this study, we describe our initial experience with a novel technique of laparoscopic VVF repair involving a limited transverse cystotomy for access and a single-layered barbed suture closure of bladder. Materials and Methods: Twenty cases of supra-trigonal VVFs following gynecologic surgeries were taken up for repair by our novel technique. The mean age of the patients was 32 years and the mean VVF size was 1.5 cm. Results: The mean operative time was 54 min. Estimated mean blood loss was 30 ml and the mean postoperative stay was 2.5 days. None of the patients had any recurrence with a mean follow-up of 14 months. Conclusion: The limited transverse cystotomy approach has advantages in decreasing the operative time, improving ease of laparoscopic suturing, allowing an automatic separation of suture lines and allowing for an easier anterior dissection of the bladder to reduce tension on the suture line if necessary. Further this approach provides excellent results in select patients of supra-trigonal VVF in terms of continence and postoperative bladder overactivity.

Introduction: A precise puncture of the renal collecting system is the most essential step for percutaneous nephrolithotomy (PCNL). There are many techniques describing this crucial first step in PCNL including the bull's eye technique, triangulation technique, free-hand technique, and gradual descensus technique. We describe a novel puncture guide to assist accurate percutaneous needle placement during bull's eye technique. Methods: The mini access guide (MAG) stabilizes the initial puncture needle by mounting it on an adjustable multidirectional carrier fixed to the patient's skin, which aids in achieving the “bull's eye” puncture. It also avoids a direct fluoroscopic exposure of the urologist's hand during the puncture. Sixty consecutive patients with solitary renal calculus were randomized to traditional hand versus MAG puncture during bull's eye technique of puncture and the fluoroscopy time was assessed. Results: The median fluoroscopy screening time for traditional free-hand bull's eye and MAG-guided bull's eye puncture (fluoroscopic screening time for puncture) was 55 versus 21 s (P = 0.001) and the median time to puncture was 80 versus 55 s (P = 0.052), respectively. Novice residents also learned puncture technique faster with MAG on simulator. Conclusion: The MAG is a simple, portable, cheap, and novel assistant to achieve successful PCNL puncture. It would be of great help for novices to establish access during their learning phase of PCNL. It would also be an asset toward significantly decreasing the radiation dose during PCNL access.

We report for the first time a "giant megaureter" causing symptomatic compression of the contralateral ureter in a 15-year-old girl. Extrinsic compression of the ureter by a contralateral giant hydronephrotic kidney, although rare, has been reported most commonly because of congenital pelviureteric junction obstruction. In this case, the possible etiology of megaureter, the differential diagnosis, and the clinical implications are discussed.

Introduction: The correction of fossa navicularis strictures poses a distinct reconstructive challenge as it requires attention to cosmesis, in addition to urethral patency. Different graft and flap based repairs have been described with variable success rates. However, the ideal management remains unclear. The feasibility and efficacy of a single stage ventral onlay buccal mucosa graft urethroplasty (VOBMGU) for navicular fossa strictures (NFS) was evaluated in the present study. Subjects and Methods: All patients with NFS attending urology out-patient department from March, 2009 onward accepting VOBMGU were evaluated prospectively. Patients with minimum 1 year of follow-up were included for analysis. The technique involves opening the diseased stenosed meatus ventrally up to the corona. The diseased mucosa is excised leaving a midline strip of native urethral mucosa on the dorsal side. The buccal mucosal graft (BMG) is fixed on either side of this strip over a 24 Fr. silicone catheter. The glans wings are apposed in midline taking anchoring bites on the mucosal graft ventrally. Post-operatively patients were reviewed at 1, 3, 6 and 12 months and annually thereafter. Cosmetic acceptance and splaying of the urinary stream was assessed with individual questionnaires. Results: A total of six patients underwent VOBMGU. Average flow rate at 3 months post-operatively was 12 ml/s. The end result was cosmetically highly acceptable. There was no fistula in any of the cases. With a median follow-up of 37 months, only one patient had a recurrence of stricture in a proximal site. Conclusions: VOBMGU is a viable technique for reconstruction of NFS with promising short term results. However, long-term follow-up is necessary.