The Hypospadias represents a common urogenital anomaly amenable to surgical correction. Vesicoureteral reflux (VUR) are though may be found associated with hypospadias but it is unusual to have a severe VUR along with several episodes of high grade fever and culture positive urinary tract infections. We are presenting a rare association of high grade vesicoureteral reflux with febrile urinary tract infections (UTI’s) with subcoronal hypospadias. We also reviewed the available literature on this rare association and present its work-up and management.

The case in this study was presented, the features in the diagnosis and treatment of rare complications such as bladder stone and vesicorectal fistula caused by the injection needle, which is a foreign body in the bladder. A 1-year-old male child came to our outpatient department with chief complaints of straining during micturition, dribbling of urine and history of high-grade fever, chills & rigor. A kidney, ureter, and bladder (KUB) X-ray revealed an approximately 1.5 cm bladder stone with radiopaque linear foreign body. On diagnostic cystoscopy anterior, posterior urethra was normal, fecal debris, stone and a needle was seen coming out through posterior wall of bladder. Open anterior cystolithotomy was done to remove 1.5-cm stone and a foreign body described as injection needle 24 gauge surrounded with fecal debris coming out through posterior wall was also removed. Fistulous tract was present and probed with 5 Fr feeding tube. A diversion colostomy was done. Patient discharged with colostomy and in follow up after 1 month micturating cystourethrogram (MCU) and distal loopogram of colon were normal; no fistulous communication present. Colostomy was closed after 3 months. There has been many cases reported in literature about insertion of different foreign bodies in bladder but foreign body ( injection needle) leading to bladder stone and vesicorectal fistula is first of its kind as far as our knowledge is concerned.

During circumcision, glans amputation is a rare but potentially devastating complication. Causative factors are varied. External genital injury can be categorized as accidental in origin including during circumcision and as other traumatic origins including animal bite, gunshots, or self-mutilation. We report a case of a 4 year child undergoing circumcision with glans injury. He presented to us with bleeding from glans and the partially amputated glans brought together in normal saline. Child underwent immediate glans reimplantation. On one month follow up there was complete glans uptake.

A case of posterior urethral valve is described with multiple urethroperineal fistulas. This association is extremely rare. The crucial point in the diagnosis is to distinguish these fistulas from the urethral duplications that actually guide the treatment. The presence of these fistulas in patients with posterior urethral valve may have a beneficial effect on renal function as it reduces the pressure on the bladder. On the other hand, incomplete valve ablation may contribute to the recurrence of the fistula.

The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions – be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for noncommunicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.