Urology, Nephrology and Andrology International

The plants and its products are extensively used as source of medicines in Ayurveda, Siddha and traditional Chinese medicine. Even though rarely reported, adverse effects do occur with these types of medications. We report here an interesting case of AKI and hypokalaemia due to Kooshmandaswarasa ghrutham containing Benincasa Cerifera, Glycyrrhiza glabera and cow’s ghee which was used for epilepsy. The Glycyrrhiza glabera, containing glycyrrhizin is the most likely culprit for causing AKI. Keywords: Glycyrrhiza glabra; Licorice; Glycyrrhizin; AKI; Hypokalaemia

Introduction: Desmoid tumor also known as aggressive fibromatosis, is a rare, locally invasive, non-metastasizing soft tissue tumor. They arise from any part of the body in different types of connective tissues. Infiltration of the bladder is usually rare and very few cases have been reported till date. Case report : 35/F presented with mass in the suprapubic region and lower abdominal pain since 1 month. Total abdominal hysterectomy + 8 years with pfananstiel incision. Per abdomen- soft, mass about 5 × 6 cm was palpable over the lower abdomen in the suprapubic region with tenderness. Fnac showed features suggestive endometriosis of bladder wall. Cect revealed? Ca bladder/ endometriosis of bladder. In view of high clinical suspicion (no h/o cyclical bleeding and cyclical pain). Cystoscopy was done which showed mucosal edema in right lateral wall with no mass in bladder with normal cystoscopy findings. Diagnostic laparoscopy and biopsy from the mass and right lateral bladder wall was performed. Histopathological diagnosis was features are those of collagen forming fibrous lesion suggestive of fibromatosis. Hence surgical excision was planned. Complete excision of the mass was done. Final histopathology report was features suggestive of fibromatosis with no evidence of endometriosis/epithelial malignancy. Following surgery patient improved and was asymptomatic. Discussion: Desmoid is a rare tumor, with reported incidence of 2–4 per million population and accounts for 0.03% Of all neoplasms. Desmoid tumor arises from myofibroblast, lacks a true capsule, usually infiltrates into adjacent muscle bundles. But the infiltration of the bladder is rare. The etiopathogenesis is multifocal. Mutation in apc or beta catenin genes is seen. Complete excision of the mass with sufficient margins of anterior rectus sheath with deroofing of the tumor with bladder wall was done. Final histopathology report was features suggestive of fibromatosis with no evidence of endometriosis/epithelial malignancy. Conclusion: The course of desmoid tumor is unpredictable, there can be spontaneous regression, long-lasting mass and/or progression of disease can occur.5 Currently preferred management for asymptomatic cases may be “wait and see” approach. Tumors showing increase in size and/ or causing symptoms require active management. Keywords: Desmoid; Bladder; Excision.

Background: Since the starting of the pandemic caused by the COVID-19 virus, it has caused may health problems, apart from so many deaths. Because of its high morbidity and mortality, there has been an aura of fear among the people and the countries. Among the various health issues, sexual and reproductive health is one that needs attention. The virus affects the genitourinary system as well apart from the respiratory and the gastrointestinal systems. It attaches to the angiotensin-converting enzyme 2 and causes secondary changes. The effects on semen, vaginal secretions, vertical transmission, sexual and reproductive health and the psychology of the individual person will be discussed here. Methods: A literature review was performed to identify papers and analyses that discussed the outcomes of SARS-CoV-2 on the sexual and reproductive health, semen quality, modes of transmission, impact on the methods of sex, psychological aspects, etc. All the work related to COVID-19, sex and the sexual health were included in this review. Results: Various effects of SARS-Cov-2 on sexual and reproductive health include: The virus is found in semen, but no case of transmission has been recorded. It causes mild scrotal discomfort. No cases of transmission through vaginal secretions are noted. Only one case of vertical transmission noted in an infant in India. Take all standard precautions needed to protect the infant from the virus during breast feeding. Standard precautions should be taken to prevent spread during sexual intercourse, keeping in mind the need of physical distancing as advised by the WHO and ICMR. There are chances of increase in the gender-based violence and domestic abuse. Conclusion: The pandemic of COVID-19 has led to more and more medical and health related issues. Once it is over or the lockdown is released completely, we need to address the issue of post-traumatic stress disorders, depression, sexual health related issue, etc. Keywords: Sex and COVID-19; Sexual and Reproductive Health in Covid-19 era; Sexual problems in COVID-19; Role of Urologist in COVID-19; Role of Gynaecologist in COVID-19.

Background: Chronic inguinal neuralgia and post-operative sexual dysfunction are some of the significant complication following inguinal hernia repair. Routine ilioinguinal neurectomy has been proposed to avoid this complication.The aim of this study was to prospectively compare post-operative sexual function and pain in patients undergoing inguinal hernia surgical repair with or without excision of the ilio-inguinal nerve. Routine ilioinguinal neurectomy has been proposed as a means to avoid this complication. Materials and Methods: About 56 patients with a unilateral inguinal hernia underwent an open tension free repair with mesh implantation (“Lichenstein” technique). The ilio-inguinal nerve was identified and was either preserved or divided. Patients were asked to answer a pretested standardized questionnaire about their sexual function preoperatively, 3 months postoperatively and every 6 months afterwards during the follow up and postoperative pain was assessed by visual analogue scale. Results: About 20% of the patients in both groups reported an improvement of their pre-operative sexual disorders. New sexual functional symptoms were reported significantly more in the preservation group compared to the excision group. Six months after surgery the number of patients with functional sexual symptoms was lower in both groups but significantly higher in the preservation group. Groin Pain score was comparatively less during 1 month, when nerve is excised where as there was no statistically significant decrease was seen in groin pain at 6 month between the groups. Conclusion: Although results are nearly similar in both groups, routine ilio inguinal neurectomy has no major complications and reduces the intensity of groin pain and early recovery of sexual functions in the early postoperative periods and reduces the risk of ilio inguinal nerve entrapment under the mesh, sutures, staples and reduces the incidence of chronic inguinodynia.

Keywords: Hernia; Hernia; Ilio inguinal Nerve; Neuralgia; Neurectomy; Sexual functions.