A comparative account of phototoxicity of anthracene and pyrene in the tadpoles of the anuran amphibian Fejervarya limnocharis using multiple toxicological end points.

Anthracene (Anth) and pyrene (Pyr), two of the priority polycyclic aromatic hydrocarbons (PAHs), being lipophilic in nature, not only accumulate in animals, but also settle in the sediment of water bodies leading to continuous exposure for animals. Anth and Pyr when exposed to sunlight can be photoactivated and have harmful effects on aquatic organisms. A comparative analysis was carried out to assess the acute, sub-chronic, genetic and biochemical toxicity of Anth and Pyr in F. limnocharis tadpoles following short exposures to sunlight on a daily basis. In the bioaccumulation studies, it was found that both Anth and Pyr accumulated in the tadpole tissues in a concentration and time dependent manner. The LC50 values for Anth (under 15 min of daily sunlight exposure) were found to be 2.87, 2.59, 2.28, 1.80 mg/L at 24, 48, 72 and 96 h of the exposures. The corresponding LC50 values for Pyr were 1.03, 0.80, 0.62, 0.42 mg/L. Sublethal exposure of Anth and Pyr affected the survivality, time to metamorphosis as well as morphometric parameters under sunlight exposure. In the genotoxicity assessment studies, particularly the micronucleus test and comet assay, it was found that Pyr led to a higher incidence of micronucleus formation and DNA damage in comparison to Anth. The exposure to PAHs resulted in significant changes in the activity of antioxidant-mediated protective response, specifically the SOD activity, which varied between the groups treated with Anth and Pyr. On the other hand, Pyr treated group showed a higher level of GSH as compared to Anth treated groups. Moreover, the elevation in MDA level in the Anth and Pyr treated groups suggests an increase in lipid peroxidation. Future research should focus on understanding the ecotoxicological risk faced by anuran amphibia due to PAHs that frequently occur in aquatic environments and developing strategies to mitigate these risks.

Effect of intravesical immunotherapy on sperm parameters in young patients with non--muscle-invasive bladder carcinoma: prospective analysis.

INTRODUCTION: To investigate the effects of intravesical immunotherapy on semen parameters in young patients with non-muscle invasive bladder tumour. METHODS: A total of 17 sexually active male patients < 45 years of age underwent transurethral resection of bladder tumour (TURBT) from Jan 2010 to Dec 2012. On HPE analysis, T1 high grade was found in 16 patients and Ta grade high grade in 1 patient. Associated CIS was found in 4 patients. Induction course of 6 weeks of adjuvant BCG therapy was given. Semen analysis was done 1 week prior to BCG therapy and 3 months after BCG therapy. Serum levels of hormones like total testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were also measured. RESULTS: Mean age of patients at diagnosis was 34.6 (29-43) years. Total semen volume was found to be decreased in 2 patients. Main parameter which was deteriorated was total sperm concentration which was significantly decreased in 12 patients and 5 patients even had their counts below oligospermia levels. Seven patients had associated decrease in sperm motility. However, no patient showed significant difference in other semen parameters. Also no patient had any change in androgen hormonal status except 2 patients in which serum testosterone was found to be non-significantly decreased. CONCLUSION: Intravesical therapy with BCG was found to adversely affect spermatogenesis and cause oligospermia. It is important that relatively young patients must be informed of these effects and advised to have sperm preservation before instillation of BCG therapy to avoid fertility issues in future.

Coexistence of inflammatory pseudotumour and pseudomembranous cystitis: a histopathological surprise.

We report a case of inflammatory pseudotumour (IP) and pseudomembranous cystitis (PC) in a young female patient who presented with gross haematuria and clot retention. Cystoscopy revealed a single glistening, polypoid growth of approximately 3 cm × 2.5 cm at the left lateral wall and the trigone of the urinary bladder. She was treated by transurethral resection of bladder mass. The patient's symptoms significantly improved after surgery. Histopathology report revealed haphazardly arranged myofibroblasts, fibroblasts and histiocytes and discrete areas of non-keratinising squamous metaplasia that was suggestive of IP coexistence with PC. She was doing well during the follow-up period of 12 months. Cystoscopy taken at 3 monthly intervals did not show any evidence of tumour recurrence.

Chyluria: is retrograde pyelogram mandatory prior to endoscopic sclerotherapy?

Chyluria is the passage of milky urine due to a lymphourinary fistula secondary to lymphatic stasis caused by obstruction of the lymphatic flow. This can be caused by parasitic or non-parasitic infections. Though chyluria is a commonly encountered entity in clinical practice particularly in developing countries like India, it is rarely discussed in English literature. We report a case of chyluria with right bifid ureter in a 50-year-old male patient who was treated with intrarenal pelvic instillation of 1% silver nitrate (AgNO3) and emphasis on the diagnostic implication of retrograde pyelography prior to endoscopic sclerotherapy in managing chyluria particularly in renal anomalies.

Intravesical knotting of guide wire during insertion of Foley catheter.

Guide wires are frequently used in urology for upper and lower urinary tract procedures. Spontaneous knotting of guide wire is a rare complication and only a few cases have been reported in the literature until now. We report a case of spontaneous intravesical knotting of guide wire during per urethral catheterisation that led to retained Foley catheter. The balloon was punctured percutaneously under ultrasound guidance and the whole assembly was removed. Guide wire knot was found near the balloon. The cystoscopy showed normal urethra and bladder. The patient was recatheterised and is doing well.

Dorsal onlay buccal mucosal graft urethroplasty in female urethral stricture disease: a single-center experience.

INTRODUCTION AND HYPOTHESIS: The aim of this report is to present our initial, short-term experience with dorsal onlay buccal mucosal graft urethroplasty (DBMGU) in women with urethral stricture. METHODS: Between May 2011 and April 2013, eight women with moderate to severe bothersome lower urinary tract symptoms due to mid- or distal urethral stricture underwent DBMGU. All women were evaluated preoperatively with the American Urological Association (AUA) symptom score, uroflowmetry with post-void residual volume (PVR) estimation, urodynamic study, calibration with 14 F catheter, and voiding cystourethrography. Postoperatively, the women were followed at regular intervals with AUA symptom score, uroflowmetry, and PVR estimation. Increase in AUA symptom score, maximum flow rate (Q(max)) < 12 ml/s, and failure to calibrate with 18 F catheter were considered as recurrence of the disease. RESULTS: The mean age of the patients was 40.6 years. The mean follow-up period was 14.8 months. All women voided successfully after catheter removal. One patient was lost to follow-up after 3 months. There was significant improvement in AUA symptom score and Q(max) and reduction in PVR (p < 0.0001) at 3, 6, and 9 months. Two women had recurrence of stricture at 12 months, while another had recurrence at 18 months which was treated by urethral dilatation followed by a self-dilatation protocol. The limitations of the study include the small number of cases with short follow-up. CONCLUSIONS: DBMGU is a simple and safe method of urethroplasty in women with unsatisfactory results. Large size studies with long-term follow-up are desirable to document the success rates.

Vesicovaginal fistula due to vaginal herb for primary infertility: could it be devastating?

Vesicovaginal fistula (VVF) is a very commonly encountered urogynaecological entity in developing countries such as India. The most common cause of VVF in developing counties is secondary to obstructive labour. We report a very unusual case of VVF in a young woman that developed due to insertion of an unknown vaginal herb for treatment of primary infertility. Cystoscopy showed a single trigonal fistula measuring 3×2 cm just near the bladder neck. Vaginoscopy revealed cicatrised less capacious vagina and unhealthy vaginal mucosa. She was treated with transvaginal VVF repair using Martius flap interposition which leaked on 10th postoperative day. She underwent re-evaluation and another transvaginal fistula repair for small trigonal residual fistula after 3 months. She is doing well during the follow-up of 2 years. She attained sexual activity after 3 months of surgical repair but could not conceive.

Renal aspergillosis secondary to renal intrumentation in immunocompetent patient.

Primary renal aspergillosis is a rare urological entity and immune-compromised persons are commonly prone to it. The clinical presentation resembles that of usual bacterial pyelonephritis. We report a case of localised unilateral renal aspergillosis with obstructive uropathy (hypoplastic contralateral kidney) in a young man, occurring after the endoscopic removal of impacted right upper ureteric calculus in a non-immunocompromised patient. In view of deranged renal function, he was initially managed by percutaneous nephrostomy and DJ stent removal followed by oral voriconazole therapy for 3 weeks. He responded well to the treatment. Subsequently, the patient was free of renal colic, fever and urine culture negative for Aspergillus.

Congenital anterior urethral valve with or without diverticulum: a single-centre experience.

INTRODUCTION: Congenital anterior urethral valves (AUV) are rare and can occur as an isolated entity or in association with proximal diverticula. Diagnosis may be overlooked and ideal treatment is not standardized when both the valve and diverticulum are simultaneously present. We present our experience of congenital AUV. MATERIAL & METHODS: From January 2007 to June 2012 a retrospective review of the medical records of 7 cases of AUV was performed. RESULTS: Three patients were diagnosed as isolated AUV while four presented with associated diverticula. The age of presentation ranged from 10 months to 6 years. Weak voiding stream and dribbling were the most common symptoms. Renal function was found to be deranged in two patients (28%). Hydro-ureteronephrosis was present in three boys (42%) and reflux was present in one patient. Post-void residual volume was >20 ml (mean 55 ml) in all children. Transurethral holmium laser fulguration was carried out on isolated AUV or AUV with small diverticula. Open resection and reconstruction or plication was performed in patients with AUV and proximal large (>3 cm) diverticula. Surgical outcome was successful in all patients except for occurrence of urethrocutaneous fistula in one patient. CONCLUSIONS: In isolated AUV or valve with associated small diverticulum, transurethral holmium:YAG laser ablation is the treatment of choice. Primary excision and repair or plication are preferred if a large diverticula has formed. Eventual outcomes of AUV are good if irreversible changes have not been established.