Late chronic inflammatory reaction post-silastic sling insertion masquerading as an invasive bladder tumour.

There are various surgical techniques to treat female stress urinary incontinence. We present the case of a long-term complication in a lady, where a silastic sling caused a massive retropubic fibrous reaction, masquerading, clinically and radiologically, as a muscle invasive bladder cancer.

Epididymal germinoma: Reality or myth?

Epididymal tumours are rare, but definite pathological entity. Most tumours are benign, however, malignant lesions have also been reported. The common benign tumours are either leiomyomas or adenomatoid tumours. Malignant pathologies include primary epididymal adenocarcinoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, mesothelioma and lymphoma. We present a case of a 45-year-old male referred urgently for suspected scrotal mass which on ultrasonography showed a lesion in the left epididymal head (possible granuloma).

Polyarteritis nodosa presenting with frank hematuria.

Polyarteritis nodosa (PAN) is an uncommon systemic vasculitis characterized by necrotizing inflammation of small- or medium-sized arteries. The disease normally presents with non-specific symptoms. Urological symptoms at presentation are extremely rare. We report a 65-year-old man who was diagnosed with a polyarteritis nodosa having presented atypically with left testicular pain and swelling, and an intratesticular lesion. He developed painless visible hematuria while under investigation. No gross arterio-venous fistula was seen to suggest a false aneurysm. Subsequently, laboratory studies showed positive anti-neutrophil cytoplasmic antibody levels and a raised erythrocyte sedimentation rate. This was an unusual presentation of PAN diagnosed with multidisciplinary input from the urology, radiology and nephrology teams.