Primary localized amyloidosis of bladder is rare. We report a case of recurrence of multifocal primary amyloidosis of urinary bladder. Cystoscopy revealed a diffuse left lateral wall lesion with normal surrounding mucosa. Histopathological examination of the specimen revealed urinary bladder amyloidosis with negative surgical margins. Recurrent urinary bladder amyloidosis was confirmed 3 months after the first resection. Close follow-up is recommended.

INTRODUCTION:We evaluated the safety and efficacy of ex vivo ureteroscopy (ExURS) and extracorporeal shock wave lithotripsy (ESWL) as means of rendering a donated kidney stone-free in living related and deceased donor renal transplantation.MATERIAL AND METHODS:Three cases with calculi in donor kidneys were managed; 1 was from a living related donor and 2 were from deceased donors. Immediately after cold perfusion, ExURS was performed with iced saline solution in 2 cases. Access to the collecting system was via the ureteral stump. Calculi were fragmented with pneumatic intracorporeal lithotripsy and fragments were removed with forceps. Posttransplantation ESWL was given to 1 patient for migration of a small lower caliceal calculus in the upper ureter in 1 allograft of a dual-kidney transplantation.RESULTS:Access to the renal collecting system and stone fragmentation was technically successful in both cases. Indwelling ureteral stents were kept during transplantation in all cases. There were no intraoperative or postoperative ureteral complications. Following ESWL, stone was fragmented and cleared on its own within a week. At mean follow up of 2.2 years no new stone formed in any recipient or donor.CONCLUSIONS:ExURS was technically feasible to render a stone-bearing kidney stone- free without compromising ureteral integrity or renal allograft function. ESWL could be performed at a later date.

Objective: To assess the results of retroperitoneal laparoscopic nephrectomy at a single centre. Materials and methods: A retrospective study of 40 patients (group A: initial 20, group B: late 20 cases) who underwent retroperitoneal laparoscopic nephrectomy was done. Analysis of the complication rate, conversion rate to open surgery, operative time and the blood loss and analgesia requirement were studied. Results: Laparoscopic retroperitoneal nephrectomy was carried out successfully in 60% cases of group A and in 95% cases of group B cases. There was a statistically significant reduction in the blood loss and duration of surgery in group B. Analgesia requirement was not different in either group. Conclusions: Retroperitoneal laparoscopic nephrectomy has a steep learning curve. Results of the procedure improved and complications reduced significantly after the initial 20 cases.