A case report on buccal mucosa graft for upper ureteral stricture repair

Management of ureteric stricture especially long length upper one-third poses a challenging job for most urologists. With the successful use of buccal mucosa graft (BMG) for stricture urethra leads the foundation for its use in ureteric stricture also. A 35-year-old male diagnosedcase of left upper ureteric stricture, postureteroscopy with left percutaneous nephrostomy (PCN) in situ. Cysto-retrograde pyelography and nephrostogram done simultaneously suggestive of left upper ureteric stricture of 3 cm at L3 level. On exploration, diseased ureteral segment exposed, BMG harvested and sutured as onlay patch graft with supportive omental wrap. The treatment choice for upper ureteric long length stricture is inferior nephropexy, autotransplantation, or bowel interposition. With PCN in situ, inferior nephropexy becomes technically difficult, other two are morbid procedures. Use of BMG in this situation is technically better choice with all the advantages of buccal mucosa. Onlay BMG for ureteral stricture is technically easy, less morbid procedure and can be important choice in future

Uroflow nomogram for healthy, 15-40 year old Indian men

Introduction: Uroflowmetry is the objective method of measuring rate of urine flow. Nomograms are required to observe the change in flow rates at different voided volumes (VVs) and the use of which overcomes the limitation of referencing flow rates to any single VV. The purpose of the present study was to construct the Indian uroflow nomogram for adult healthy males between 15-40 years of age. Methods: A total of 1000 healthy males between 15 and 40 years of age were included in the study. Exclusion criteria were any urinary symptoms or urological intervention. Parameters analyzed statistically were age, peak flow rate (Q max ), average flow rate (Q avg ), and VV. A nomogram was drawn for the fitted regression model. Results: The mean age was 27.26 ΁ 6.71 years. The mean Q max , Q avg , and VV were 24.32 ΁ 3.50 ml/s, 9.45 ΁ 2.55 ml/s, and 420.93 ΁ 97.89 ml, respectively. The correlation between flow rates and VV was statistically significant, indicating that the higher the VV, the higher the flow rates. A negative significant correlation of Q max with age was seen in our study. We observed a decline of Q max by 1 ml/s/decade. The relationship of Q max with VV is in linear progression up to 600 ml, and then it becomes a plateau and with higher VV it declined. Conclusion: Q max exhibits significant correlation with VV and age. A nomogram was constructed to attain normal reference values of flow rate over different VVs