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Year : 2014  |  Volume : 30  |  Issue : 4  |  Page : 459

Challenging and rare cases in urology

Prof. of Urology, Consultant Urologist, Vedanayagam Hospital, 52, East Bashyakarulu Road, R.S. Puram, Coimbatore - 641 002, Tamil Nadu, India

Date of Web Publication1-Oct-2014

Correspondence Address:
Dr Ganesh Gopalakrishnan
Prof. of Urology, Consultant Urologist, Vedanayagam Hospital, 52, East Bashyakarulu Road, R.S. Puram, Coimbatore - 641 002, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Gopalakrishnan G. Challenging and rare cases in urology . Indian J Urol 2014;30:459

How to cite this URL:
Gopalakrishnan G. Challenging and rare cases in urology . Indian J Urol [serial online] 2014 [cited 2022 Aug 17];30:459. Available from:

Edited by Narmada P Gupta

Jaypee Publishers, 2014

It is the dream of every teacher to write a book. This applies more to medical teachers. Being in a large teaching institution provides, additionally, a world of experience that needs to be shared. The types of cases seen, their rarity and the challenges they pose to management need to be put in print. Unfortunately, many of these experiences are not on a large scale of numbers and therefore do not fulfill the scrutiny of a meta-analysis or a randomized controlled trial and hence will not find space in the current medical journals. Most of us fail to document our experiences accurately, record every detail and categorize our material. We are thus left to dream and recall, needless to say, with a degree bias and error on our own material.

Procrastination they say is the thief of time. Dr. Narmada Gupta has not let this happen. He needs to be congratulated on producing the book, "Challenging and Rare Cases in Urology," published by Jaypee Publishers. It is clear that he had started out on this journey probably at the start of his career in the All India Institute of Medical Sciences, New Delhi. I can imagine that he must have had his camera ready and loaded all the time. There might not have been a laptop when he started and he must have used the conventional register to log his cases. What he has produced is nothing short of a textbook of urology, appropriately referenced. This book will certainly be a quick ready reckoner for residents in urology as they prepare for their exit examinations.

The color pictures and radiographs are of high quality. Every case is well illustrated with a brief clinical presentation, relevant investigations and, in some, intraoperative photographs. He has also mentioned the treatment carried out and, in some, the long-term follow-up.

Nevertheless, as I read the book my mind kept going back to the title. To the best of my understanding, a rare case, by virtue of its rarity, is challenging because the global experience in managing the same is limited and we have no reference to fall back on. On the other hand, a challenging case could be common but its presentation makes it a challenge to treat. I therefore did ask myself if in fact some of the cases illustrated in the book would actually qualify as being rare and challenging. I am afraid not. Some of them are straightforward.

One of the other facets of surgical treatment is that what we envisage or plan before putting the knife to skin might not be present intraoperatively. This could force us to use an alternate treatment strategy or sometimes think out of the box to salvage a difficult problem. I would have liked Dr. Gupta to have actually shared these thoughts with his readers on both the pre-operative and intraoperative situations as they unfolded. Information about the long-term outcome in such situations would have been of vital information to our readers, lest they encounter a similar situation in their own practice. A one line comment on the follow-up might not reveal the magnitude of the case.

To fall back on the experience of someone more learned would be invaluable. Sometimes, constraints of time and space prevent us from expanding our thoughts.

I started out by saying that it is a dream of every teacher to write a book. For many, it remains a dream. I would therefore recommend that this book be made available in all teaching departments of urology and be a constant reminder to us to do what Dr. N.P. Gupta has achieved.


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