Case Reports in Urology最新文献

{"title":"Recurrent Urethral Phyllodes Tumour Presenting With Urinary Retention: A Case Report and Literature Review.","authors":"M Sharif, B Lamb, N Etessami, L Lazzereschi, A Freeman, G Ellis","doi":"10.1155/criu/2134277","DOIUrl":"10.1155/criu/2134277","url":null,"abstract":"<p><p>We report a rare case of a urethral phyllodes tumour. A 58-year-old male presented with urinary retention requiring catheterisation, preceded by a gradual onset of poor urinary flow. He had a prior history of poor urinary flow in 2022, when a urethral fibroepithelial polyp was identified and excised. Histopathology at the time confirmed a fibroepithelial polyp. On recurrence, flexible cystoscopy showed a polyp arising from the prostatic urethra and extending into the bladder neck, while MRI prostate revealed a 63 cc gland with a small median lobe and a PI-RADS 1, Likert 1 lesion. The patient underwent redo transurethral resection of the lesion, and histology revealed a low-grade phyllodes tumour. This case underscores the importance of recognising rare urological tumours in order to guide appropriate management.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"2134277"},"PeriodicalIF":0.0,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary Testicular Metastasis From Ductal Prostate Cancer 5 Years After Radical Prostatectomy: A Case Report.","authors":"Martina Romani, Tonino Morena, Denise Bianchi, Chiara Ogliosi, Alberto Pettenò, Alberto Zaniboni, Angelo Peroni","doi":"10.1155/criu/2532587","DOIUrl":"10.1155/criu/2532587","url":null,"abstract":"<p><p>Testicular metastases from prostate carcinoma are exceedingly uncommon, particularly from the ductal histological subtype, which is associated with aggressive clinical behavior and a propensity for atypical metastatic dissemination. We report the case of a 73-year-old male with a history of prostate ductal adenocarcinoma (PDA) treated in 2018 with robot-assisted radical prostatectomy (RARP) and extended pelvic lymphadenectomy. Pathological staging was pT2c R0 N0 (0/53 nodes), and postoperative PSA was undetectable. The patient remained free of recurrence for 5 years. In March 2023, a biochemical recurrence prompted repeated thoracoabdominal computed tomography (CT) and pelvic magnetic resonance imaging (MRI) scans; neither study included dedicated scrotal imaging, and both were negative for recurrence. By March 2024, serum PSA had increased to 5.6 ng/mL, coinciding with the onset of progressive, painless enlargement of the left testicle. Scrotal ultrasonography revealed a solid mass replacing the left testicular parenchyma. 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and choline PET/CT showed a hypermetabolic lesion confined to the left testis, with no evidence of extratesticular disease. The patient underwent left inguinal orchiectomy. Histopathological examination revealed metastatic adenocarcinoma with papillary architecture, morphologically consistent with ductal prostate origin. PSA levels declined rapidly postoperatively, reaching 0.07 ng/mL within 40 days. At 13-month follow-up, the patient remained clinically and biochemically free of disease without further treatment. This case represents one of the few documented instances of solitary testicular metastasis from PDA. It underscores the importance of continued PSA monitoring and highlights that isolated testicular involvement, whereas rare, may confer a more favorable prognosis than typically expected in metastatic PDA. In selected cases, orchiectomy may serve both diagnostic and therapeutic roles, supporting a conservative postoperative approach.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"2532587"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Grade Papillary Urothelial Carcinoma of the Bladder Presenting as Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia: A Case Report.","authors":"Sarah Ponce, Eliza Burr, Melissa Davide, Évéline Poirier, Marta Kolbuszewska, Shari McKinny, Rachel S Rubin, Barry R Komisaruk, Irwin Goldstein","doi":"10.1155/criu/3816720","DOIUrl":"10.1155/criu/3816720","url":null,"abstract":"<p><p>Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a rare and distressing condition characterized by unwanted genital arousal without associated sexual desire. While cases of PGAD/GPD in association with interstitial cystitis, urethritis, urinary tract infection, and urethral diverticulum have been described, bladder cancer has not yet been reported. To our knowledge, the present report describes the first known case of PGAD/GPD as the initial presentation of low-grade papillary urothelial carcinoma of the bladder in a young female.</p><p><strong>Case presentation: </strong>A 26 year-old healthy female presented with a 3-month history of constant, distressing clitoral engorgement, throbbing, and pain in her vulvar vestibule that began during masturbation. She also noted dysuria, urinary frequency, urgency, intermittent hematuria, and nocturia two to three times per night, pelvic floor hypertonicity, and restless legs. She denied any smoking history but did report a history of occasional resin exposure while making jewelry as a hobby. She underwent a bladder ultrasound that revealed a 7 × 5 × 6-mm nonmobile lesion in the left posterior bladder wall, lateral to the ureteral orifice. Cystoscopy and pathology revealed low-grade papillary (Ta) urothelial carcinoma of the bladder, and transurethral resection of bladder tumor was performed. Symptoms had completely resolved 3 months after the procedure, with continued use of topical lidocaine gel applied to the clitoris and pelvic floor physical therapy.</p><p><strong>Discussion: </strong>Our postulate to account for the constellation of symptoms tumor-induced chronic irritation of the pelvic nerve resulting in reflexive bladder hypermotility, clitoral engorgement, and bowel dysfunction. In addition, central cross-sensitization at the level of the sacral spinal cord could activate the postsynaptic neurons that normally respond to pudendal nerve afferent activity, resulting in clitoral and vestibular dysesthesia, reflexive pelvic floor hypertonicity via postsynaptic pudendal nerve efferents, and reflexive restless legs via postsynaptic sciatic nerve efferents. Further investigation is warranted to better understand the relationship between bladder tumors, PGAD/GPD, and related viscero-visceral and viscero-somatic reflex activity.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"3816720"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescent Ureteral Catheter-Assisted Laparoscopic Nephrectomy for a Pediatric Patient With Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome.","authors":"Masaki Shinohara, Kenichiro Konishi, Shigemitsu Kojima, Hisashi Kanda, Takeshi Yamaguchi, Akira Nishi","doi":"10.1155/criu/9979542","DOIUrl":"10.1155/criu/9979542","url":null,"abstract":"<p><p>Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare congenital disorder characterized by Müllerian duct malformation and ipsilateral renal abnormalities. Variant forms associated with hypoplastic kidneys and ectopic ureteral insertion in the vagina may require nephrectomy because of persistent urinary incontinence. In such cases, urinary drainage through a vaginal opening permits direct ureteral access via vaginoscopy without the size limitations associated with transurethral cystoscopy. Therefore, retrograde catheter placement is technically feasible in patients with OHVIRA syndrome. Consequently, OHVIRA is a particularly suitable indication for ureteral catheterization. Fluorescent ureteral catheters, which were recently introduced in surgery for adults, enable real-time intraoperative visualization of the ureter and may further enhance surgical safety. We report a case involving laparoscopic nephrectomy for OHVIRA syndrome with an ectopic ureter and severely hypoplastic kidney in a pediatric patient. The ectopic ureteral orifice was successfully identified during vaginoscopy when the patient was 5 years of age; therefore, retrograde placement of a fluorescent ureteral catheter was feasible. Intraoperative fluorescence enabled the reliable identification of both the ureter and small renal remnant, thus facilitating safe dissection and resection. This case demonstrates that retrograde placement of a fluorescent ureteral catheter via vaginoscopy is feasible and useful for pediatric patients with OHVIRA syndrome who require nephrectomy. This technique may improve intraoperative ureteral visualization and surgical safety; therefore, it should be considered for selected patients with ectopic ureteral drainage.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"9979542"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyelo-Hepatic Fistula Resulting From a Perinephric Abscess: A Case Report and Literature Review.","authors":"Jonathan Alcantar, Emily Hahn, Anthony Castelvecchi, Mark Wille","doi":"10.1155/criu/2556392","DOIUrl":"10.1155/criu/2556392","url":null,"abstract":"<p><p>The extension of a renal infection to the liver is extremely rare. We present the case of a 70-year-old woman with right hip pain and delayed detection of a perinephric abscess involving her liver. Tomographic and endoscopic contrast studies revealed the presence of a fistulous tract between her liver and right kidney. With minimally invasive intervention, including placement of a ureteral stent, two hepatic drains, a nephrostomy tube, and culture-directed antimicrobial therapy, her infection resolved. Closure of the fistula was subsequently confirmed radiographically. This is the first reported incidence of a pyelo-hepatic fistula resulting from a perinephric abscess.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"2556392"},"PeriodicalIF":0.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyorchidism: A Case Report on Diagnostic Approach and Surgical Considerations.","authors":"Ali Alyami, Ebtesam Almajed, Ahmed AlShammari, Tariq Burki","doi":"10.1155/criu/5686215","DOIUrl":"10.1155/criu/5686215","url":null,"abstract":"<p><p>Polyorchidism is a rare developmental anomaly in which more than two testes are present, usually diagnosed incidentally through imaging. The most frequent presentation is triorchidism, with the supernumerary testis typically located within the scrotum or inguinal canal. Embryologically, the condition is attributed to abnormal partitioning of the genital ridge during early development, specifically before the eighth week of gestation. Ultrasonography remains the initial imaging modality of choice, with MRI providing further diagnostic clarity if needed. We report the case of a 4-year-old male with a history of right cryptorchidism and prior orchidopexy, in whom left-sided polyorchidism was incidentally detected during ultrasound assessment of an atrophic right testis. Management is determined by associated anomalies and the risk of malignancy; conservative surveillance is generally recommended for morphologically normal, scrotal testes, whereas surgical intervention, including orchiectomy, is reserved for extrascrotal locations, atrophic gonads, or when malignancy is suspected.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"5686215"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pinch-and-Punch Excision: A Minimally Invasive Technique for Idiopathic Scrotal Calcinosis-A Case Report.","authors":"Krittin Naravejsakul","doi":"10.1155/criu/6621943","DOIUrl":"10.1155/criu/6621943","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic scrotal calcinosis (ISC) is a rare, benign condition characterized by painless, calcified nodules within the scrotal dermis. Although typically asymptomatic, progressive growth and cosmetic concerns often lead patients to seek surgical intervention.</p><p><strong>Case presentation: </strong>We report a 35-year-old male with multiple asymptomatic scrotal nodules progressively enlarging over 3 years. Physical examination revealed firm, subcutaneous nodules ranging from 2 to 20 mm. Laboratory investigations, including serum calcium, phosphate, and parathyroid hormone, were unremarkable. Histopathological examination confirmed the diagnosis of ISC, revealing basophilic calcified deposits within a fibrous stroma without cystic epithelial lining, consistent with dystrophic calcification.</p><p><strong>Intervention: </strong>A \"pinch-and-punch\" excision technique was performed under regional anesthesia supplemented by tumescent local infiltration. Individual nodules were elevated by pinching the overlying scrotal skin, followed by targeted removal using 2-4 mm disposable biopsy punches. No sutures were required.</p><p><strong>Outcome: </strong>The procedure was completed with minimal bleeding and no intraoperative or postoperative complications. Complete epithelialization occurred within 1 week via secondary intention. At 3-month follow-up, no recurrence was observed and the patient reported high satisfaction with the aesthetic outcome.</p><p><strong>Conclusion: </strong>The pinch-and-punch excision technique-distinguished by its combination of the tissue-elevation pinching maneuver, tumescent infiltration for hydrodissection, and sutureless wound management-is a safe and cosmetically favorable approach to ISC, particularly for patients with multiple nodules. Histopathological confirmation remains essential. Further prospective studies with longer follow-up are warranted.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"6621943"},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculous/BCG-Related Chronic Orchiepididymitis With Fistulization: Expanded Case Report and Literature Review.","authors":"Guilherme Bernardo, João A Carvalho, Maria Alzamora, João Lobo, António Morais","doi":"10.1155/criu/2998895","DOIUrl":"10.1155/criu/2998895","url":null,"abstract":"<p><p>Intravesical Bacillus Calmette-Guérin (BCG) therapy is a well-established treatment for high-grade nonmuscle invasive bladder cancer. However, infectious complications such as granulomatous orchiepididymitis may rarely occur. We report a case of chronic necrotizing granulomatous orchiepididymitis with fistulization following intravesical BCG instillations. The patient presented with persistent epididymal swelling, caseous discharge, and inadequate response to conventional antibiotic therapy. Polymerase chain reaction (PCR) testing identified <i>Mycobacterium tuberculosis</i> complex. Despite clinical improvement under antituberculous therapy, surgical orchiectomy was required due to persistent anatomical destruction. Histopathological examination confirmed necrotizing granulomas with Langhans-type giant cells, consistent with bacillary orchiepididymitis.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"2998895"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Arterial Hemorrhage From Ureteral-Arterial Fistula After Long-Term Ureteral Stenting.","authors":"Kentaro Yoshihara, Kojiro Tashiro, Maria Okamoto, Keiichiro Miyajima, Ryoko Sakakibara, Kensuke Fujiwara, Yusuke Takahashi, Masaki Hashimoto, Akira Hisakane, Fumihiko Urabe, Hiroki Yamada, Takahiro Kimura","doi":"10.1155/criu/1581782","DOIUrl":"10.1155/criu/1581782","url":null,"abstract":"<p><p>Ureteroarterial fistula (UAF) is a rare but potentially life-threatening condition that can cause massive hematuria. We report a case of UAF in a 74-year-old woman with a history of pelvic surgery, radiotherapy, and long-term ureteral stenting who presented with severe intermittent hematuria. The diagnosis was challenging because initial contrast-enhanced computed tomography showed no findings suggestive of UAF, and the bleeding pattern led to an initial suspicion of radiation cystitis. As hemorrhage recurred and anemia progressed, angiography was eventually performed and revealed a pseudoaneurysm of the left external iliac artery, leading to the diagnosis of UAF. Endovascular stent-graft placement achieved successful hemostasis. This case highlights that UAF should be suspected early in high-risk patients with intermittent hematuria, even when initial imaging findings are negative.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"1581782"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male Parameatal Urethral Cyst: A Report of Two Cases and Literature Review.","authors":"Loukas Charalambous, Joshua Luzuriaga, Michael Ernst","doi":"10.1155/criu/5555012","DOIUrl":"10.1155/criu/5555012","url":null,"abstract":"<p><strong>Background: </strong>Parameatal urethral cysts are rare, benign cystic lesions at the urethral meatus, most often occurring in females during childhood. Fewer than 100 cases have been documented, and their pathogenesis remains unclear. This case series describes the symptoms, histological characteristics, and postoperative outcomes of two adolescent males with parameatal urethral cysts and provides an updated review of the literature.</p><p><strong>Case presentation: </strong>Two male adolescents (Ages 16 and 17) without prior medical history presented with cystic lesions at the ventral urethral meatus. One reported mild voiding discomfort and altered urinary stream, while the other experienced discomfort and intermittent pain. Both described gradual cyst enlargement over several years. Examination revealed clear, fluid-filled cysts measuring 1-2 cm. Each underwent complete cyst excision. Pathology demonstrated a urothelial-type cyst in one case and a mixed-type cyst in the other.</p><p><strong>Results: </strong>Both patients demonstrated excellent postoperative cosmesis and complete symptom resolution at 1-month follow-up.</p><p><strong>Conclusion: </strong>Parameatal urethral cysts are rare benign lesions of uncertain origin. Patients typically present due to discomfort or cosmetic concerns. Complete surgical excision remains the gold standard, offering excellent cosmetic and functional outcomes with minimal recurrence risk. These cases contribute to the limited literature and reinforce excision as the preferred treatment.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2026 ","pages":"5555012"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}