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Case Reports in Urology

Edward Assaf, Rawad Abou Zahr, Elie Ghabi, Imad Ghantous
Subcapsular hematoma is an exceedingly rare complication of extracorporeal shockwave lithotripsy (ESWL) for renal stones with cases demonstrating evidence of active arterial bleeding even more so. A 49-year-old male presented with acute onset right flank pain two hours following ESWL. CT scan with contrast revealed active contrast extravasation consistent with arterial bleeding. The patient was managed with arterial embolization and recovered uneventfully following a 4-day hospitalization.
2019: Case Reports in Urology
Kazuya Tanabe, Shigeru Nakamura, Taiju Hyuga, Shina Kawai, Masahiro Yamazaki, Yohei Kawashima, Rieko Furukawa, Toshiro Niki, Shigeru Ono, Hideo Nakai
A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis...
2018: Case Reports in Urology
Antonios Katsimantas, Spyridon Paparidis, Konstantinos Bouropoulos, Nikolaos Ferakis
Sporadic, synchronous, bilateral, or unilateral Renal Cell Carcinomas constitute a rare clinical entity. We report the case of a 68-year-old male patient who presented in our department due to incidentally discovered multiple, bilateral renal tumors. Magnetic Resonance Imaging demonstrated cT1b renal tumors at the lower pole of each kidney and a cT1a renal tumor at the upper pole of the right kidney. The patient underwent transperitoneal, laparoscopic left partial nephrectomy with renal artery occlusion, histology revealed high-grade, pT1b, clear-cell renal cell carcinoma; however we observed decline of patient's estimated glomerular filtration rate postoperatively...
2018: Case Reports in Urology
N Lumen, D Sharma, Y Abu-Ghanem, N Djakovic, F Kuehhas, E Serafetinidis, A Sujenthiran, M Waterloos, P Hallscheidt, N D Kitrey
Blunt trauma to the lower urinary tract is usually associated with pelvic fractures. The European Association of Urology (EAU) provides guidelines to diagnose and treat these injuries. The guidelines summarise the available evidence and provide recommendations on diagnosis and treatment of these patients. Therefore, these guidelines are important adjuncts to the urologist and emergency physician in the clinical decision-making. However, strict adherence to the guidelines is not always easy or possible because of concomitant injuries obscuring the clinical picture...
2018: Case Reports in Urology
Shiva Poola, Arjun Mohan
Bladder injury is a rare condition mostly due to high-energy trauma. Bladder injury tends to be suspected during traumatic events in the setting of hematuria, pain, and voiding difficulty. Unfortunately, in end-stage renal disease patients who are oliguric or anuric these classic clinical findings would not be seen. We report a case of bladder rupture without a history of trauma or without a history of hematuria or voiding difficulties. To our knowledge this is the first case to describe such an injury with a lack of trauma history...
2018: Case Reports in Urology
Chrysovalantis Gkekas, Evangelos N Symeonidis, Ioannis Tsifountoudis, Christos Georgiadis, Vasileios Kalyvas, Apostolos Malioris, Michail Papathanasiou
Transverse testicular ectopia (TTE) with fused vas deferens is an extremely rare clinical entity. Herein, we present a case of a 19-year-old patient with persistent left testicular pain lasting for a week. Clinical examination revealed an empty right hemiscrotum, a normal left-sided descended testis, and in close proximity a mass-like structure resembling testicular parenchyma. Laboratory tests were significant for elevated follicle-stimulating hormone (FSH), while sperm count revealed azoospermia. Ultrasound imaging (US) of the scrotum demonstrated the presence of both testes in the same left hemiscrotum with varicocele and no signs of inguinal hernia...
2018: Case Reports in Urology
Chalil Arif, Konstantinos Kotoulas, Chrysostomos Georgellis, Konstantinos Frigkas, Athanasios Bantis, Emmanouil Patris
Varicocele is characterized by the dilatation of the veins of the spermatic cord. Its prevalence in general male population is 15% while in the infertile population the prevalence rises up to 25%. The varicocele is considered an etiological factor for male infertility. Although different pathophysiological patterns have been proposed, there is no consensus in the urological society to date. In most of the cases varicocele is asymptomatic but sometimes gives mild symptoms as dull pain at the scrotal region. A rare complication of this condition is the spontaneous or traumatic rupture and hematoma formation, either as spermatic cord hematoma or as scrotal hematoma...
2018: Case Reports in Urology
Rawad Abou Zahr, Khalil Chalhoub, Elias Mansour, Camil Chouairy, Georges Ghazal, Joe Nohra
Carcinoid tumors usually arise in the gastrointestinal tract. Immunocytohistochemical and radiologic studies are important in detecting the primary tumor site. Primary carcinoid tumors of the testis are particularly rare with a high malignant potential warranting long-term follow-up. We present the case of a primary carcinoid tumor of the testis with long-term surveillance.
2018: Case Reports in Urology
Robert H Moore, Uzoma A Anele, Sarah C Krzastek, Adam P Klausner, J Tyler Roseman
Despite the known nephrotoxicity of gentamicin, in 2008 the American Urological Association published guidelines recommending single high-dose weight-based gentamicin prophylaxis of 5 mg/kg for procedures involving urologic prostheses. These guidelines are based on the theoretical renal safety and improved antimicrobial activity of a single large dose of gentamicin. However, the risk of nephrotoxicity after weight-based gentamicin prophylaxis specifically in penile prosthetic surgery has never been established with evidence-based studies...
2018: Case Reports in Urology
Megan L Swonke, Ali M Mahmoud, Elias J Farran, Tamer J Dafashy, Preston S Kerr, Christopher D Kosarek, Joseph Sonstein
A urinary tract infection (UTI) and sepsis secondary to an obstructing stone are one of the few true urological emergencies. The accepted management of infected ureteral stones includes emergent decompression of the collecting system as well as antibiotic therapy. Despite this, no consensus guidelines clarify the optimal time to undergo definitive stone management following decompression. Historically, our institution has performed ureteroscopy with laser lithotripsy (URS-LL) treatment at least 1 to 2 weeks after decompression to allow for clinical improvement and completion of an antibiotic course...
2018: Case Reports in Urology
Firas Addas, Sylvia Yan, Marios Hadjipavlou, Michael Gonsalves, Samer Sabbagh
Testicular trauma is relatively uncommon. However, severe injuries can result in many complications and should be carefully diagnosed and managed. We present a case of testicular fracture diagnosis made by ultrasonography. The surgical exploration revealed the fracture as well as complete rupture of the tunica albuginea. Testicular rupture is the disruption of the tunica albuginea, while testicular fracture is a "break" in the testicular parenchyma. Management could be conservative in mild fracture cases without rupture while suspected or confirmed fracture should be treated by surgical exploration...
2018: Case Reports in Urology
Omar Karray, Mohamed Ali Ben Chehida, Ahmed Sellami, Kheireddine Mrad Daly, Zied Mahjoubi, Alia Zehani, Sami Ben Rhouma, Yassine Nouira
Introduction: Paratesticular tumors are rarely observed among scrotal neoplasm. Various types of benign lesions are described. Cavernous hemangioma belongs to uncommon epididymal benign tumors. Clinical and sonographic features are not conclusive and diagnosis requires histological confirmation. Case Presentation: Authors report a case of an epididymal hemangioma in a 56-year-old patient, consulting for a painful scrotal swelling. As malignancy was suspected, he underwent inguinal orchiectomy...
2018: Case Reports in Urology
Loren Custer, Morris Jessop, Stanley Zaslau, Robert Shapiro
A urethral diverticulum is a relatively uncommon finding. The estimated prevalence is approximately 1-5% in the general population. While the definitive treatment is surgical correction, there are limited studies guiding the best approach to repair. This is the case of a 48-year-old female who initially presented with vaginal discharge, dysuria, and dyspareunia. MRI revealed the diagnosis of suspected urethral diverticulum. The patient was treated with surgical correction with the aid of needle localization prior to the procedure...
2018: Case Reports in Urology
F Löcherbach, P Grimsehl, A Sauer, S Wyler, M Kwiatkowski
We would like to present the case of a 64-year-old woman who underwent ureterorenoscopy and suffered an iatrogenic ureteral lesion due to an accidental intubation of the left ureter with a Foley-Catheter during the procedure. A Double-J-Stent was implanted into the damaged ureter, and 6 weeks later it fully recovered. To our knowledge there are few similar cases described in the literature with none of those having happened during ureterorenoscopy so far.
2018: Case Reports in Urology
Tyler Overholt, Ali Hajiran, Cristiane Ueno, Stanley Zaslau
Fournier's gangrene isolated to the penis is exceedingly rare. It is an urologic emergency that requires emergent parenteral antibiotics as well as aggressive irrigation and debridement. While human bite wounds can be overlooked as a serious cause of injury and infection, they can result in highly dangerous, polymicrobial infections in affected patients. Here, we report a case of penile Fournier's gangrene caused by a human bite wound managed with broad spectrum antibiotics, irrigation and debridement, penile reconstruction, and skin grafting with successful preservation of a normal penile structure and function...
2018: Case Reports in Urology
Makoto Isono, Keiichi Ito, Shinsuke Hamada, Masahiro Takahashi, Hidenori Sasa, Hideyuki Shimazaki, Tomohiko Asano
Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin...
2018: Case Reports in Urology
Ali Hajiran, Morris Jessop, Zachary Werner, Chad Crigger, John Barnard, Jeffrey Vos, Michael Ost
We present an unusual case of a rare ossifying renal tumor of infancy. A 6-month-old male initially presented with gross hematuria and without any palpable abdominal mass. Renal ultrasound and MRI showed a right lower pole, calcified, endophytic renal mass. Laparoscopic radical nephrectomy was performed without complications. Pathology demonstrated an ossifying renal tumor of infancy. We report this case, in addition to a review of the literature for similar cases, to highlight a rare renal tumor in infancy that can be managed laparoscopically...
2018: Case Reports in Urology
Abdulrahman Ahmad, Ali Albaghli, Adel Michael, Khaled Refaat, Mohammad Omar, Ahmad Ibrahim, Bahaa Elmenshawy, Ashraf Maher, Rasha Alramah, Sami Mikhail, Mustafa Almahmid, Husain Alenezi, Yahya Elshebiney
Calciphylaxis or calcific uremic arteriolopathy (CUA) is a potentially life-threatening vasculopathy involving the skin and subcutaneous tissues. It is usually associated with chronic kidney disease (CKD) and rarely with acute renal failure or predialysis patients. The clinical diagnosis of calcific uremic arteriolopathy relies on high index of suspicion. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. Moreover, using biopsy as a diagnostic tool is controversial, due to the high risk of poor wound healing and sepsis...
2018: Case Reports in Urology
Pinaki Dutta, Girish Parthan, Anuradha Aggarwal, Santosh Kumar, Nandita Kakkar, Anil Bhansali, Fabio Rotondo, Kalman Kovacs
[This corrects the article DOI: 10.1155/2014/136984.].
2018: Case Reports in Urology
Andrea Tubaro, John Heesakkers, Jean Nicolas Cornu, Dudley Robinson
Urgency is the cornerstone symptom of overactive bladder (OAB) syndrome, which is associated with reduced health-related quality of life (HRQoL) and affects patients with different profiles. We report here three clinical pictures of OAB: a male patient with mixed lower urinary tract symptoms (LUTS), a young woman with comorbidities, and an elderly woman with mixed urinary incontinence. The aim is to analyze the specificities of these real cases, to discuss what would be the most appropriate management, and how treatment with fesoterodine, an antimuscarinic agent with key pharmacological properties, might meet the patients' expectations...
2018: Case Reports in Urology
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