Prolonged impaction and large bulk continue to pose challenges in ureteroscopic retrieval of lower ureteral calculi. The salvage options of adjunct ESWL or immediate ureterolithotomy have been unsatisfactory in our experience. We have, instead, treated 13 such cases with staged ureteroscopy. In the first stage, a splint (DJ stent/ureteric catheter/guide wire) was left in the ureter, in 7 cases bypassing the calculus, and in 6 left just below the calculus. After an intervening period of 3 days to 3weeks repeat ureteroscopy was successful in clearing the calculi in all the cases, the average post procedure hospital stay for the staged ureteroscopy has been lesser than that for ureterolithotomy and there is no added morbidity. Following the intervening period of ureteric intubation, the ureter below the calculus becomes straight and dilated facilitating the approach to the calculus. Dilatation of the ureteric meatus with resolution of the edema close to the impacted calculus also make the second procedure easy to perform. This approach is especially suitable for the developing countries where calculi are usually bigger and impacted due to neglected disease, and economic constraints preclude the use of ESWL and flexible ureteroscopy in such cases.

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Primary amyloidosis of urinary bladder is a rare condition. In a recent review, less than 100 cases have been reported.' We report two new cases of primary amyloidosis localized to urinary bladder. In one case, there was involvement of lower ureter. They were treated by repeated Trans-Urethral Resections (TUR). In one intravesical Dimethyl Sulphoxide (DMSO) instillation was used.

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A study of 15 cases, of histologically proved patients of carcinoma prostate is presented with a view to evaluate the relative roles of transrectal ultrasound (TRUS), magnetic resonance imaging (MRI) and computerized tomography (CT) in staging the disease. Using capsular breach, bladder base infiltration and seminal vesicle involvement as parameters, for comparison, MRI was found to be superior to TRUS and CT in detecting periprostatic disease. In context of evaluation of gross lymph node enlargement both MRI and CT were comparable. Of the 15 patients, 3 underwent radical prostatectomy and the histopathological findings correlated with the preoperative staging

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In past 11 years (1982-1992), we have come across 3 patients of leiomyoma of urinary bladder between 28 to 38 years of age. All had haematuria and dysuria while one had bladder outflow obstruction. All were managed by transurethral resection of thetumor after appropriate preoperative evaluation by various imaging techniques of the urinary tract. Follow up of these patients till date has not shown any evidence of recurrence. Benign mesothelial tumors of the urinary bladder are rare. Of this group, leiomyomas are the most common and constitute 35 percent. Approximately 163 cases have been described in the literature. We report our experience of 3 such cases.

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