Case Reports in Urology最新文献

{"title":"Renal Autotransplantation After Yang-Monti Neoureter Procedure: Surgical Case Report and Brief Literature Review.","authors":"Reece M Anderson, Alex Chang, Wesley Baas","doi":"10.1155/criu/1351432","DOIUrl":"10.1155/criu/1351432","url":null,"abstract":"<p><strong>Purpose: </strong>Ureteral strictures are a well-documented pathology in urology, commonly resulting from congenital anomalies, iatrogenic injury, or other acquired conditions such as infection, trauma, or radiation. While ischemic and nonischemic strictures are recognized, bilateral idiopathic ureteral strictures remain rare, particularly when associated with systemic thrombotic microangiopathy. This case report describes a 25-year-old female with a history of IgA deficiency and atypical hemolytic uremic syndrome (aHUS), who developed bilateral ureteral strictures following envenomation by a brown recluse spider. The purpose of this report is to highlight an unusual cause of ureteral stricture formation, discuss its underlying pathophysiology, and evaluate long-term surgical outcomes, including the failure of a Yang-Monti neoureter and the subsequent necessity for left renal autotransplantation.</p><p><strong>Results: </strong>The patient initially developed bilateral ureteral ischemia and subsequent stricture formation, requiring percutaneous nephrostomy tubes for urinary drainage. The left ureter exhibited an 8-9 cm occlusion, leading to the decision to perform a Yang-Monti neoureter using a jejunal interposition graft. Despite initial surgical success, the patient later presented with left-sided hydronephrosis and recurrent urinary tract infections, revealing complete stricture of the neoureter. After thorough evaluation, she underwent left renal autotransplantation with ureteral reimplantation. Postoperative outcomes were favorable, with stable renal function, although complicated by transient ileus. This case underscores the challenges of managing extensive ureteral stricture disease, particularly when secondary to systemic microangiopathic processes triggered by envenomation.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first documented case of long-segment ureteral stricture as a sequela of brown recluse spider envenomation. The venom's prothrombotic and endothelial-damaging effects likely contributed to progressive ischemic injury and fibrosis, leading to bilateral stricture formation. While the Yang-Monti technique provided temporary urinary diversion, its long-term viability was limited, necessitating a definitive solution via renal autotransplantation. This case highlights the need for increased awareness of envenomation-related ischemic complications, particularly in patients presenting with delayed-onset ureteral obstruction. Future research should further explore envenomation-induced microangiopathy and optimal surgical management strategies for complex ureteral stricture disease.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"1351432"},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865960","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":"Wunderlich Syndrome Triggered by Deadlifting: A Rare Case Report of Spontaneous Renal Haemorrhage.","authors":"Katie McComb, Samuel Bishara, Abhisekh Chatterjee, Konstantinos Charitopoulos, Ivo Donkov, Norma Gibbons, Nisha Pindoria, Panagiotis Nikolinakos","doi":"10.1155/criu/3951765","DOIUrl":"10.1155/criu/3951765","url":null,"abstract":"<p><strong>Background: </strong>Wunderlich syndrome (WS) is a rare phenomenon. It was first described by Carl Wunderlich in 1857 as a clinical picture of spontaneous renal bleeding with dissection of blood into either or both the subcapsular and perinephric spaces. Tumours, vascular malformations, coagulopathy and inflammatory states have been shown to be aetiological factors, yet up to 10% of cases remain idiopathic. WS is usually diagnosed on CT imaging due to the variable history and signs on examination which can mimic many other abdominal conditions. Management strategies include conservative treatment, embolisation and surgical nephrectomy.</p><p><strong>Case presentation: </strong>A 37-year-old female presented to the emergency department with acute onset severe right flank pain after performing deadlift exercises in the gym. She collapsed on arrival. Clinical observations and blood results were indicative of haemorrhagic shock. Computed tomography (CT) with angiography demonstrated an acute right renal haemorrhage with active extravasation and the formation of a large perirenal haematoma. Blood products and vasopressors were administered to resuscitate the patient. Definitive management with embolisation was undertaken by the interventional radiology team.</p><p><strong>Conclusion: </strong>WS is a rare diagnosis that should be considered in patients presenting with flank pain and evidence of haemorrhagic shock. Weightlifting can act as a trigger for this condition. Early recognition and intervention can enable successful resuscitation and definitive treatment with minimally invasive embolisation.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"3951765"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865943","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":"Management of Acute Urinary Retention due to Bladder Outlet Obstruction in the Setting of Incarcerated Gravid Uterus.","authors":"Carolyn M Nguyen, Corrie DeGraffenreid, Gabriela E Halder","doi":"10.1155/criu/1691627","DOIUrl":"10.1155/criu/1691627","url":null,"abstract":"<p><strong>Objective: </strong>An incarcerated gravid uterus (IGU) is a rare condition that occurs when a retroverted gravid uterus becomes trapped between the sacral promontory and pubic symphysis. If untreated, IGU could have devastating consequences including uremia, renal failure, sepsis, peritonitis, uterine wall necrosis/rupture, and ultimately maternal and/or fetal death. Our objective is to provide education on the presentation, diagnosis, and management of a rare diagnosis to assist clinicians in better recognizing and treating IGU.</p><p><strong>Methods: </strong>We present two cases of gravid females with acute urinary retention (AUR) in the setting of IGU. In this case series, we will discuss patient presentation, workup, and management of both IGU and AUR secondary to IGU.</p><p><strong>Results: </strong>The first patient represents delayed recognition of IGU and a protracted clinical course resulting in increased morbidity. The second case represents heightened recognition of IGU and appropriate, timely management.</p><p><strong>Conclusion: </strong>Prompt bladder decompression by urethral or suprapubic catheterization is the mainstay treatment for nearly all etiologies of AUR. In the case of AUR due to IGU, it is imperative to address bladder decompression prior to the reduction of IGU.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"1691627"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12662680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649514","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":"Incidental Renal Langerhans Cell Histiocytosis Within Clear Cell Renal Carcinoma: A Case Report and Literature Review.","authors":"Charles-Antoine Garneau, Cathie Ouellet, Sophie Morin, Isabelle Harvey, Bruno Turcotte","doi":"10.1155/criu/4441127","DOIUrl":"10.1155/criu/4441127","url":null,"abstract":"<p><p>Langerhans cell histiocytosis (LCH) is a disease characterized by the excessive proliferation and abnormal differentiation of immune cells, including monocytes, T cells, and dendritic cells. The most affected organs are the bones, skin, lungs, liver, and spleen, while renal involvement is rare. LCH primarily affects children and is seldom diagnosed in adults. In this case report, we describe a 64-year-old man patient with no prior urological history nor history of LCH and presenting with both localized renal LCH and clear cell renal carcinoma (ccRCC). Renal cancer was first discovered fortuitously on an abdominal computed tomography (CT) scan while the patient presented symptoms of a complicated urinary tract infection. Following radical nephrectomy, LCH foci was detected as incidental histological finding within the ccRCC pathological analysis. Immunohistochemical staining confirmed the positivity of S-100 and CD1a markers and PCR analysis identified the BRAF^V600E mutation. Based on these findings, a diagnosis of ccRCC associated with LCH was established.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"4441127"},"PeriodicalIF":0.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12623108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551253","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":"Epididymal Dissociation to Facilitate Vasectomy Reversal in a Patient With Sizeable Vasal Defect: A Case Report.","authors":"Jack C Millot, Aaron J Smith, Scott D Lundy","doi":"10.1155/criu/7984429","DOIUrl":"10.1155/criu/7984429","url":null,"abstract":"<p><strong>Background: </strong>Close to a quarter of men seek paternity after vasectomy. Microsurgical vasectomy reversal is a common choice for men seeking children after vasectomy, with outcomes dependent on surgical expertise and intraoperative decision-making. Here, we describe the case of a patient with an unexpectedly long vasal gap that necessitated the dissection of the tail and midbody of the epididymis from the testis during a vasoepididymostomy.</p><p><strong>Case discussion: </strong>We report a case of a 31-year-old male who underwent vasectomy reversal that required a rare surgical approach. During the operation, we discovered a secondary distal obstruction and an additional proximal obstruction on the patient's left side, which resulted in a long vasal gap that did not permit a tension-free vasoepididymostomy. To bridge the long gap, the tail and midbody of the epididymis were carefully dissected and mobilized from the testis. Dissociation of the epididymis from the testis allowed a tension-free vasoepididymostomy. Postoperative semen analysis confirmed patency, and the patient had no concerns.</p><p><strong>Conclusion: </strong>Dissection of the tail and midbody of the epididymis is discussed in textbooks, but is not readily documented in real-world patients. Here, we provide a case discussion where the dissection of the epididymis from the testis was successfully performed to gain additional length to bridge a long vasal gap.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"7984429"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459643","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":"Perforated IUD as Atypical Cause of Recurrent Urinary Tract Infection: A Case Report.","authors":"Sophia Ford, Samantha Levine, Aaron Baer, Kristie Lou, Eric Ballon-Landa","doi":"10.1155/criu/8941217","DOIUrl":"10.1155/criu/8941217","url":null,"abstract":"<p><p>Clinicians faced with common diagnoses such as pelvic pain or recurrent urinary tract infection (rUTI) may not consider less frequent etiologies, such as a delayed erosion of an intrauterine device (IUD). Given that modern IUDs are not approved for more than 10 years, early or midcareer clinicians unfamiliar with the earlier versions of these devices may not consider that a long-retained foreign object may be the source of symptoms in an older woman. We report a case of an IUD placed 50 years ago that eroded into the bladder, causing recurrent UTI and pelvic pain. Thankfully, minimally invasive laparoscopic techniques available now-to date unreported-enable surgical management while limiting morbidity, which is especially important in an elderly population.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"8941217"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410130","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 Prostate Cancer Treated With Orchiectomy: A Rare Case of Isolated Recurrence After Salvage Radiotherapy.","authors":"Moritz Gutjahr-Holland, Shreya Armstrong","doi":"10.1155/criu/7042029","DOIUrl":"10.1155/criu/7042029","url":null,"abstract":"<p><p>Prostate cancer (PCa) is the most commonly diagnosed cancer in Australia with almost 25,000 cases being diagnosed each year. Treatment for PCa varies depending on stage, patient preferences and the general health of the patient. PCa most commonly spreads to lymph nodes and bones. We present a case of a 66-year-old male who presented with PSA elevation post salvage radiation and was diagnosed with oligometastatic PCa to the right testis. This patient subsequently underwent a right orchidectomy resulting in a rapid fall in PSA.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"7042029"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356185","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":"Giant Atonic Bladder (4000 mL) in the Postpartum Period: A Case Report.","authors":"Nona Sabeti, Leila Pourali, Mahdieh Mottaghi, Atiyeh Vatanchi","doi":"10.1155/criu/1448191","DOIUrl":"10.1155/criu/1448191","url":null,"abstract":"<p><strong>Background and aim: </strong>Postpartum urinary retention (PUR) is a well-recognized complication of childbirth. The prolonged duration and exceptionally large residual bladder volume of 4000 mL observed in this case, despite the patient's report of spontaneous voiding on the first postpartum day, is rare.</p><p><strong>Case report: </strong>A 21-year-old primiparous woman presented on Postpartum Day 16 with abdominal distension. She reported no urinary symptoms. Her condition had previously been misattributed to postpartum infection during an earlier admission. She was diagnosed with covert PUR, and catheterization drained 4000 mL of urine. However, after 4 days of catheterization, the patient remained unable to void spontaneously. She was then managed with clean intermittent catheterization (CIC) for 2 weeks, and urinary tract function gradually recovered.</p><p><strong>Conclusion: </strong>This case report stands out due to the extraordinary bladder volume and protracted course, providing a unique perspective on the spectrum of PUR severity. While routine postpartum discharge protocols rely on spontaneous voiding, this case emphasizes the importance of thorough subjective assessment of lower urinary tract symptoms (LUTSs) for early recognition of PUR to prevent such extreme presentations.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"1448191"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309350","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":"Systemic Sporotrichosis With Testicular Involvement: Literature Review and Case Report.","authors":"Juan Eduardo Rios Rodriguez, Andreia Naiuf Lima Tuma, Aiko Iwamoto, Déborah Cristina Andrade Neves, Alexandre Kapteinat Lima, Felipe Nogueira Clementoni, Paula Heroso Moreira, Juan Felipe Martins Filgueiras, Luiz Sergio Santos, Osny de Barros Junior","doi":"10.1155/criu/4235866","DOIUrl":"10.1155/criu/4235866","url":null,"abstract":"<p><strong>Introduction: </strong>Sporotrichosis is an endemic fungal infection in Brazil, caused by a dimorphic fungus of the genus <i>Sporothrix</i>. Transmission occurs through traumatic inoculation from soil, contaminated plants, and zoonotic sources, mainly from cats, as well as through inhalation of conidia. It commonly presents as localized, lymphocutaneous, disseminated, or systemic forms. The testicles are among the organs that can be affected, often manifesting as a testicular mass. This work is aimed at analyzing a clinical case along with a bibliographic review on the testicular involvement of sporotrichosis.</p><p><strong>Case report: </strong>A 35-year-old male with positive HIV serology and a history of psychoactive substance use presented with disseminated ulcerated lesions that progressed over 1 month, with a positive blood culture for sporotrichosis. Upon hospitalization, a painless lump in the right testicle was diagnosed upon palpation and peripheral vascularization. An orchiectomy was performed, and anatomopathological analysis revealed the presence of <i>Sporothrix</i>.</p><p><strong>Discussion: </strong>Few reports on testicular sporotrichosis were found in the literature. Systemic forms are rare and are often associated with immunosuppression, particularly in cases of HIV and chronic alcoholism. This immunosuppression can favor the prevalence and dissemination of the fungus. The fungus also produces melanin, which aids in evading the immune system. The gold standard for diagnosis is culture. Furthermore, the treatment of choice is prolonged therapy with Amphotericin B, followed by itraconazole.</p><p><strong>Conclusion: </strong>Given the suspicion of disseminated sporotrichosis and the presence of a testicular nodule, the possibility of testicular sporotrichosis should be evaluated while maintaining attention to the differential diagnosis for neoplasia.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"4235866"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281301","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":"Navigating Penile Metastases: Personalized Management in a Rare Oncologic Challenge.","authors":"R Hamal, A Feyaerts, S Thiry, H Dano, J Van Damme","doi":"10.1155/criu/7231390","DOIUrl":"10.1155/criu/7231390","url":null,"abstract":"<p><p>Secondary malignancy of the penis is a rare clinical entity. Nearly three-quarters of metastatic lesions in the penis originate from genitourinary and pelvic organs (such as the bladder, prostate, and colon). Less than 25% of penile metastases arise from extrapelvic primary sites and are usually associated with disseminated disease. Fewer than 50 cases of renal cancer metastasis to the penis have been described in the literature to date. We present the case of a 47-year-old male patient with a single metastasis of papillary renal cell carcinoma (pRCC) in the left corpus cavernosum. The patient had a history of left radical nephrectomy in 2004 and two lung wedge resections for unique metastases in 2007 and 2009. The patient complained of a growing, painless mass at the base of his penis. No other sites of metastasis were identified at staging. We performed a complete excision of the mass, and the final histopathological report confirmed the metastasis of pRCC with negative surgical margins. The patient remains treatment-free 8 years later.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":"2025 ","pages":"7231390"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281261","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}