Undescended testes (UDT) is a common congenital anomaly in male children. Accurate localization is critical for effective surgical planning. MRI, including Diffusion Weighted Imaging (DWI), offers potential advantages. To evaluate MRI, particularly with DWI sequences, in identifying non-palpable undescended testes and to compare imaging findings with intraoperative outcomes in Indian pediatric patients. This retrospective study included 32 patients. MRI (T1, T2, DWI sequences) findings were compared with intraoperative observations. Diagnostic accuracy and statistical measures were computed. MRI correctly localized 29 of 32 testes. Testes appeared hypointense on T1, hyperintense on T2, and showed restricted diffusion on DWI. Sensitivity: 96.7%, Specificity: 100%, PPV: 100%, NPV: 66.7%, Accuracy: 96.9%. The Chi-square test yielded a p-value of 0.001. MRI with DWI significantly aids in UDT localization. Despite limitations, it remains a valuable preoperative tool.

Extracorporeal shock wave lithotripsy (ESWL) is widely recognized as a safe, non-invasive treatment with minimal side effects. This procedure does not require anesthesia, making it an effective option for lower ureteral stones. This study aimed to assess the effectiveness of ESWL in treating distal ureteral stones ranging from 5 to 15 mm in size and to identify factors influencing the treatment outcomes. This was a prospective hospital-based analytical cross-sectional study conducted in the Department of Urology, tertiary care facility, Jaipur. Data collection for the study was started in September 2023 and completed in November 2024. A total of sixty one patients diagnosed with distal ureteral stones and undergoing ESWL treatments were enrolled in this study. The data was analyzed using SPSS 25.0 version. The average age of the participants was 49.52 ± 10.99 years, with approximately two-thirds being male. The mean stone size was 9.93 ± 2.95 mm, and the average stone density was 765.10 ± 205.88 HU. The overall success rate of the procedure was 85.2% (n = 52/61). Treatment success was significantly associated with age, stone size, and BMI (p < 0.05), but not with the patient's sex or stone laterality (p > 0.05). In the multivariate analysis, the patient's BMI was identified as the only significant predictor of treatment success. ESWL is a successful, non-invasive, and practical therapeutic option for lower ureteric calculi with no significant side effects. It is an effective procedure for small size ureteric calculi up to 15 mm size, ESWL could therefore be used as the main form of treatment.

We describe a modified technique for laparoscopic radical cystectomy (LRC) utilizing a mini-laparotomy incision for conduit formation and compare outcomes with the conventional technique. This retrospective single-centre study included patients with bladder cancer undergoing LRC at a tertiary care centre between September 2019 and December 2024. Patients were divided into conventional LRC (CLRC) and modified LRC (MLRC) groups. Statistical analysis was performed using chi-square and Student's t-test (p < 0.05 considered significant). A total of 228 patients were included (CLRC: 58; MLRC: 170). Operative time was significantly longer in MLRC (253 vs 246 min, p = 0.0018). However, mean blood loss (370 vs 543 ml, p < 0.001), incision size (8.5 vs 14.5 cm, p < 0.001), time to oral intake (3.5 vs 3.8 days, p < 0.001), and hospital stay (10.8 vs 11.6 days, p < 0.001) were significantly reduced. Two early postoperative deaths (Clavien-Dindo Grade V) occurred in CLRC. At 2-year follow-up, recurrence (7.1% vs 10.3%) and mortality (1.2% vs 5.2%) were comparable between groups. The modified technique is feasible and reproducible. Despite longer operative time, it significantly reduces postoperative morbidity with comparable short-term oncological outcomes.

To evaluate the association between tumor location and progression or recurrence after initial transurethral resection of bladder tumor (TURBT) in patients with high grade (HG) T1 urothelial carcinoma. This retrospective cohort analysis included patients diagnosed with HG-T1 bladder cancer from 2020 to 2024. Patients were stratified by tumor location: anterior/posterior wall, lateral walls, bladder neck, trigone, dome. Residual disease or upstaging at restaging TURBT was assessed via follow-up restaging TURBT. Associations were tested using chi-square, univariate, and multivariate models. A total of 80 patients with high-grade T1 urothelial carcinoma were included. The median age was 73 years (range 45-89) and 92.8% (77) were male. The mean tumor size was 2.6 cm, and 91.3% of tumors were completely resected. Tumors were most commonly located in the lateral wall (36.3%) and posterior wall (31.3%). Worsening on restaging TURBT was most frequent in posterior wall (48.4%) and bladder neck tumors (50%). Lateral wall tumors worsened in 37.0%, anterior wall in 23.1%, and none from the trigone. Posterior wall tumors showed higher odds of worsening versus dome tumors in univariate analysis (OR 2.50, p = 0.34), though not statistically significant. Multivariable analysis adjusting for clinical and tumor factors also found non-significant increased odds for posterior wall tumors versus lateral wall and dome (OR 1.26, p = 0.71). Posterior wall and bladder neck tumors showed the highest descriptive rates of residual disease or upstaging at restaging TURBT, but multivariable analysis did not demonstrate statistically significant independent associations. These findings may warrent closer surveillance or earlier intervention in select cases.

Buccal mucosal graft urethroplasty as a treatment for anterior urethral stricture is a method of choice nowadays in many cases. The Purpose of this study is to evaluate the complications of this technique. The study was initiated on July 2021 to July 2024, as a retrospective recording of the data of 120 patients underwent buccal mucosal graft substitution urethroplasty for anterior urethral stricture ⩾ 8 cm, age range 18-80 years. The mean duration of follow-up was 12 months for all patients. Postoperative complications were recorded. Data was analyzed by the use of SPSS version 26 program for data entry and analysis. The mean age was 45.5 ± 15.7 years old. Body mass index 28.3 ± 4.2 kg/m2. Six cases were diabetic, 15 cases were hypertensive. Etiology of stricture was 55% iatrogenic trauma, 17.5% inflammatory, 17.5% lichen sclerosus and 4% idiopathic stricture. Operative time was 210 ± 25.6 min. Early complications were noticed in 15% of cases, Late complications-after removal of the catheter- in 25% of cases, the rest of cases passes with good voiding and sexual functions. Buccal mucosal graft substitution urethroplasty as a treatment for long anterior urethral stricture is a good option, but as any other surgery it has its special complications.

Compared to other overactive bladder (OAB) symptoms, incontinence has a more negative impact on quality of life and is frequently challenging to treat with antimuscarinic monotherapy. This study's goal was to compare the safety, tolerability, and effectiveness of a combination of solifenacin 5 mg and mirabegron 25 mg or 50 mg versus solifenacin 5 mg in patients with OAB. In a tertiary care hospital, 258 individuals with overactive bladders participated in a randomised controlled open-label research to examine the safety and efficacy of mirabegron as a supplement to solifenacin. Randomisation was used to assign patients to one of three groups: those receiving solifenacin (5 mg) with mirabegron (25 mg), solifenacin (5 mg) plus mirabegron (50 mg) or solifenacin (5 mg) monotherapy. OABSS was used to examine the patients. A change in the OABSS from baseline to end of treatment (EOT) was the main outcome measure. This research also examined the safety and tolerability of combination treatment in comparison to solifenacin monotherapy. All combinations with solifenacin five substantially improved the OAB symptoms score as compared to solifenacin 5 mg monotherapy. When compared to solifenacin 5 mg, both combination groups significantly decreased the frequency of micturition. Although there were no dose-related differences between the combination and monotherapy groups in terms of TEAEs, blood pressure, pulse rate, PVR volume, or laboratory or ECG parameters, combination medication did result in a slightly higher frequency of constipation. When compared to solifenacin 5 mg monotherapy, combination therapy with solifenacin/mirabegron markedly improved OABSS, micturition frequency, and urgency. When compared to monotherapy, all combinations were well tolerated and showed no significant extra safety concerns.

Prostate cancer is the most common solid neoplasm in men, with an increasing incidence. This study describes clinical and sociodemographic features and PSA levels, and evaluate their associations with stage, risk categories, metastasis, and mortality in a public tertiary hospital in southern Colombia. The present retrospective cohort study included 590 patients diagnosed with prostate cancer between 2020 and 2023. Sociodemographic and clinical variables, PSA levels, pathological characteristics and risk scales were analyzed. Patients were categorized into two groups: living (n = 429) and deceased by prostate cancer (n = 109), and other causes (n = 44). Statistical analyses were performed to determine associations with mortality and presence of metastasis. PSA screening was more frequent among survivors (66.9%, n = 287) than among deceased (22.0%, n = 24; p < 0.001). Median PSA at diagnosis was higher in those who died (123 vs 16 ng/mL; p < 0.001). PSA > 100 ng/mL was associated with ~50% probability of metastatic disease, rising to >95% for PSA > 323 ng/mL. High-risk D'Amico classification was strongly associated with metastasis (RR 6.67) and mortality (OR 14.24, p < 0.001). Bone pain was the predominant presenting symptom in the deceased group (76.1%, n = 83) and showed a strong association with metastasis (RR 8.146). PSA screening was strongly associated with improved survival outcomes. Elevated PSA levels, high risk D'Amico classification and the presence of bone pain were important predictors of metastasis and mortality. The need to strengthen early detection in our population is evident, given the high percentage of patients presenting at advanced stages.

To evaluate the efficacy, safety, and patient-reported outcomes, including satisfaction and pain level, of electroconductive (EC) and electrohydraulic (EH) extracorporeal shock wave lithotripsy (ESWL) for the treatment of ureter and kidney stones in a randomized controlled trial. A total of 56 patients were randomly allocated to the EC or EH groups. Patient and stone characteristics and treatment outcomes were compared. The stone-free rates were not different between the groups. The EH group achieved the same stone-free rates as the EC group with less energy use. Pain scores were higher in the EH group (mean 4.76 ± 3.53) than in the EC group (mean 3.04 ± 2.84), with borderline significance (p = 0.063). Satisfaction scores and radiation exposure were significantly lower in the EH group than in the EC group, regardless of the stone location. Univariate and multivariate analyses identified the total number of shocks and stone location as significant predictors of stone-free status. EC and EH lithotripters demonstrated comparable efficacy and complication rates across different stone locations. While the EC group showed lower pain scores and higher satisfaction, these outcomes required greater energy use and resulted in higher radiation exposure. Patient satisfaction and pain level, as patient-reported outcomes, may be considered as additional measures alongside safety and efficacy in the evaluation of ESWL modalities.