Objective: To study whether a particular type of diet predisposes to Urinary Tract Infections (UTI). Patients and Method: The questionnaire method was used to retrospectively evaluate 61 'Uncomplicated UTI' patients with 'Isolated Infections'. Twenty-six of them volunteered to give the details about their diet. Result: Of the 26 patients, UTI was significantly more common among the people consuming meat more frequently than once a week but not daily (among men P less than 0.02 and women P less than 0.005, by Binomial test). Conclusion: A specific predisposing factor was present in almost half the number of patients who had UTI. Frequent meat consumption appears to be one of them. More research is needed.

To study circadian rhythm pattern of biochemical parameters important in etiology of urolithiasis viz. serum calcium, urinary calcium and urinary oxalate in healthy controls in order to set time-quantified norms of their levels in tropical conditions; and to compare with them the rhythm patterns of these parameters in patients of urolithiasis. North and northwestern India being in the stone belt, urolithiasis is a very common problem on our OPD rolls, its etiology being more confusing than conclusive, exploration of an alterative etiological approach to urolithiasis and its recurrence is being sought keeping in mind the time structure of human being.

Up to 10 percent of Renal Cell carcinoma (RCC) involve the inferior vena cava (IVC). Surgical treatment involves radical nephrectomy with thrombectomy which is a challenging and demanding task. 12 out of our 107 patients of RCC had IVC thrombus; 7 infrahepatic and 5 retrohepatic. CT-scan and Doppler were the most useful tools to detect and define the extent of thrombus and nodal disease preoperatively. Seven underwent radical surgery of which cardiopulmonary bypass was used in only 2 cases. Three had nodal metastases and one a synchronus solitary distant metastasis. Only one patient died of disease within a year of operation and 4 patients are alive after more than 2 years of operation. We emphasize that all well-equipped departments of Urology in our country should undertake the programme of IVC thrombectomy.

We report five cases of vesical and paravesical granulomas of varied aetiology and discuss their diagnosis and management. Granulomas may occur a few months to several years after surgery. One of our patients had a neglected laminaria tent kept for abortion four years ago that migrated up anterior to the bladder. She had conceived and delivered a full-term normal baby uneventfully one and a half years after the abortion, and eventually presented with haematuria and right groin swelling. An-other patient who presented with a midline supravesical mass gave a histoer of two diagnostic laparoscopies done over a span of two years for infertility, and endometrial curettage for incomplete spontaneous abortion. The third patient had sustained a gunshot injury in the lower abdomen more than a year prior to the development of haematuria. The bullet deep in the left side of pelvis was left unretrieved at the time of initial laparotomy and there was an inflammatory band of encapsulated tissue from the bullet to the bladder wall. The fourth patient presented with a painful lower abdominal mass one year after herniorrhaphy. The fifth patient started having dysuria, abdominal pain and irregular fever two months after a laparoscopic cholecystectomy. Another five months later, she was found having a large paravesical inflammatory mass with intravesical bullous lesions. All these patients were managed surgically. The improtance lies in including granulomas as a differential diagnosis of paravesical mass lesions and thus avoiding judiciously a radical surgery.

Paragangliomas are rare tumours in childhood. They have a wide spectrum of presentation depending on the functional status and a significant characteristic is he lack of correlation between biological behaviour and gross morphological and routine histological features. Early diagnosis and adequate surgical excision usually result in a good prognosis. 4 children with extra-adrenal paragangliomas are being reported. These cases represent the two ends of the spectrum pf presentation-3 cases had small but secrtory tumours associated with severe hypertension and its sequelae and 1 case had a huge palpable tumour without hypertension. A preoperative diagnosis was possible in the 3 tumours associated with hypertension. All cases had highly vascular tumours and were treated by complete surgical excision. The need for a high index of suspicion in order to establish the diagnosis preoperatively, especially in "the clinically silent" or "the non-secretory" tumours has been emphasised because this would enable the surgeons and the anaesthetist to manage the intraoperative course better.

The importance of prostatic intraepithelial neoplasia (PIN) lies in its potential relationship with early prostatic cancer particularly high grade PIN. We reviewed our experience and recent data from the literature on ths topic. Total number of BPH patients undergoing TURP in our centre between july '94-july '98, was 450, out of which 90 patients had BPH with PIN in their histopathology report with serum PSA between 4-10 ng/ml. These patients were meticulously followed up by periodic serum PSA, needle biopsy, TRUS & DRE. On follow-up 27 patients (30 percent) out of the 90 patients progressed subsequently to carcinoma prostate and were treated accordingly. DRE. On follow-up 27 patients (30 percent) out of the 90 patients progressed subsequently to carcinoma prostate and were treated accordingly. DRE & TRUS were not much help in detection of subsequent malignancy. WE conclude that all bph with PIn particularly high grade should be followed up every six months by PSA and needle biopsy for two years and then annually, for detecting early malignancy as they are vulnerable to develop invasive cancer subsequently.

Twenty-six men (19 to 55 years of age, mean 36 years) presenting persistent symptoms of prostatitis of more than one year duration were studied. Localization of bacteria was done accoeding to the method described by Meares and Stamey. The patients were stratified into 3 groups: 1. Chronic Bacterial Prostatistis; 2. Nonbacterial Prostatitis; 3. Prostatodynia depending upon the findings. Patients with Chronic Bacterial Prostatitis were treated with antibiotics. Patients with the diagnosis of Chronic Nonbacterial Prostatitis and Prostatodynia underwent detailed urodynamic evaluation including pressure flow / EMG studies and managed accordingly. We hereby conclude that all patients with persistent prostaritis should be studied in detail by sophisticated microbiological techniques. Patients with Nonbacterial Prostatitis (NBP) and prostatodynia should undergo detailed urodynamic studies as a routine and than treated acccordingly.

Localisation and treatment of impalpable `undescended testes is diffcult by conventional methods. 41 consecutive patients with 50 impalpable testes were treated by laparoscopic surgery over last 6 years. We have successfully performed single-stage laparoscopic orchiopexy in 31 cases and two-stage Fowler Stephens orchiopexy in 3 cases. Detailed technique is described. The technique definitely diagnoses the location of undescended impalpable testes and is a superior method of orchiopexy for impalpable testes. There were no complications. None of the testes atrophied after orchiopexy over the follow-up period of 3 months to 6 years.

The technique and treatment results in 30 patients who had undergone Antigrade Scrotal Sclerotherapy (ASS) for symptomatic varicoceles are presented and discussed. The mean duration of surgery was 30 (plus 10) minutes. There were no perioperative complications, and one patient developed wound infection. During 4 to 24 months of follow-up, 23 patients reorted relieffrom pain, and 7 patients showed improvement in semen quality. Since our experience with ASS is limited, no definitive conclusions can be drawn, but we propose ASS as a safe and effective alternative treatment of idiopathic varicocele. The method has proved to be less invasive, and is quite economical. It requires no particular exertise, and the procedure can be repeated if necessary.

Conventional urethrography although the most commonly used technique for diagnosis and characterization of anterior urethral stricture has limitations in accurate characterization with associated complications. We compared retrograde urethrogram and/or micturating cystourethrogram (RGU and/or MCU) and sonourethrography in evaluation of anterior urethral stricture. Diagnostic accuracy of RGU was 85.71 percent compared to 96.44 percent of sonourethrography. This difference between RGU and sonourethrography was mainly in penobulbar (70 percent and 90 percent respectively) and bulbar region (93.75 percent and 100 percent respectively). RGU/MCU underestimated the length by 37 percent, which was statistically significant. Sonourethrography detected periurethral spongiofibrosis. All these characteristics are important for proper selection of treatment modalities. Sonourethrography was used for follow-up in 19 patients and correctly diagnosed the recurrence in short follow-up to 6 months (mean follow-up=4.6 months).

The occurrence of renal cell carcinoma in adult-dominant polycystickidney disease (AD-PKD) is rare. We report a case of papillary carcinoma associated with AD-PKD presenting with loin mass, pain, fever and persistent haematuria. CT-scan of the abdomen and CT-guided Fine Needle Aspiration Biopsy (FNAB) of the mass enabled us to diagnose the condition preoperatively and institute proper treatmen. The diagnosis of this rare and difficult condition is reviewed and discussed.

The Division of Human Genetics is a referral centre to patients with hypogonadism and infertility for karyotyping and genetic counselling. In this artical is reported the presence of the translocation between chromosomes 1 and 3 and Y;Y. A twenty-four-year-old male with hypogonadism had translocation (3;12) and, a thirty-year-old male with azoospermia and infertility had translocation (Y;Y). Counsellings offered are the prognosis and management with regular follow-up.

Urethral

For the purpose of treating individuals patients and also for ascertaining their prognosis mere disease identification is not enough and the details of anatomical extent of the disease, pathological severity of the disease, associated complications and accompanying problems are necessary. These details are communicated by ESCO System (Extent-Severity-Complications-Other Problems System) presented here for describing complete diagnosis and assessing prognosis in individual patients. The elements of the system are defined and examples of its application are described.