Case Reports in Urology最新文献

{"title":"New Methods of Reconstruction for Old Challenges: The Use of the Integra Graft in Necrotizing Soft Tissue Infections of the Male Genitalia.","authors":"Katharina Mitchell,&nbsp;Chad Crigger,&nbsp;Chad Morley,&nbsp;John Barnard,&nbsp;Vidas Dumasius","doi":"10.1155/2021/5777235","DOIUrl":"https://doi.org/10.1155/2021/5777235","url":null,"abstract":"<p><p>In this paper, we describe two cases of Fournier's gangrene (FG) in which Integra grafting was used for reconstruction. FG is a progressive necrotizing infection occurring in the perineal region and on the external genitalia. Reconstructive options using local tissue are limited due to the destruction this infection imposes on the soft tissue. Integra graft is a bilaminate artificial dermis made of shark chondroitin 6-sulfate and bovine collagen. It is applied to the wound bed after debridement and establishment of a healthy, well-vascularized wound base. The patients in this case series had large defects which could not be closed primarily with tissue beds and would not have been appropriate for skin grafting. Therefore, an Integra graft was placed. In both patients, the wound beds were appropriate for skin grafting after three weeks. Without the Integra graft, both of our patients would have needed to wait a considerable amount of time prior to reconstruction. Our case series further illustrates and supports the use of Integra grafts in such a scenario following Fournier's gangrene which has only previously been published on three occasions, all of which demonstrated successful outcomes.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39529131","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":"The Intraoperative Use of a Portable Cone-Beam Computed Tomography System for the Diagnosis of Intraperitoneal Bladder Perforation.","authors":"Ankur Choksi,&nbsp;Benjamin Press,&nbsp;Cayce Nawaf,&nbsp;Shannon Longyear,&nbsp;Marc Ferrante,&nbsp;Thomas V Martin","doi":"10.1155/2021/2060572","DOIUrl":"https://doi.org/10.1155/2021/2060572","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative imaging for endourologic procedures is generally limited to single-plane fluoroscopic X-ray. The O-arm™ is a mobile cone-bean CT scanner that may have applications in urologic surgeries. <i>Case Presentation</i>. We present a case of an 85-year-old male with radiation cystitis and recurrent gross hematuria who was identified to have a bladder perforation on cystoscopy during emergent clot evacuation. Single-view fluoroscopic evaluation was inconclusive as to whether an intraperitoneal bladder perforation occurred. A portable cone-beam CT scan was used to acquire a 3-D CT cystogram, which demonstrated intraperitoneal contrast extravasation, confirming the diagnosis of an intraperitoneal bladder perforation.</p><p><strong>Conclusion: </strong>We report the first use of a portable cone-beam CT scanner to perform an intraoperative CT cystogram to diagnose an intraperitoneal bladder perforation and guide surgical management.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39481626","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":"An Unusual Location for a Nonurachal Bladder Adenocarcinoma.","authors":"George Khludenev,&nbsp;Akshay Reddy,&nbsp;Sinan Akosman,&nbsp;Michael J Whalen","doi":"10.1155/2021/5827120","DOIUrl":"https://doi.org/10.1155/2021/5827120","url":null,"abstract":"<p><p>Malignant bladder neoplasms represent a significant disease burden not only for urologists but also the broader medical community. While the majority of bladder tumors are urothelial in origin, up to two percent are found to be adenocarcinomas. Among bladder adenocarcinomas, roughly one-tenth are urachal and are frequently located at the dome of the bladder where urachal remnants can often be found. We describe a case of bladder adenocarcinoma that presented at the dome of the bladder but ultimately exhibited a nonurachal histology. A 65-year-old male with a history of myocardial infarction and cerebrovascular accident with residual right-sided hemiparesis and aphasia was referred to our clinic for evaluation of a bladder mass discovered in the setting of painless gross hematuria. Diagnostic cystoscopy demonstrated a large mass at the dome of the bladder, and subsequent transurethral resection revealed stage T1 mucinous adenocarcinoma arising in a villous adenomatous lesion without the presence of muscle in the specimen. The patient underwent a robotic-assisted laparoscopic partial cystectomy with extended bilateral pelvic lymph node dissection. Postoperatively, the patient experienced short-lived paralytic ileus and was discharged on postoperative day 5. Follow-up surveillance imaging at 6 months with CT chest, abdomen, and pelvis, repeat office cystoscopy, and negative tumor markers postoperatively indicated no evidence of disease recurrence. Characterization of bladder adenocarcinomas into urachal and nonurachal subtypes is critical in differentiating the operative management and oncologic outcomes of the respective neoplasms. However, given the paucity of literature describing treatment approaches to bladder adenocarcinoma in general, existing methods have largely mirrored genetically similar neoplasms, including ovarian and colon adenocarcinomas. Although there is still much to be understood regarding the potential mechanisms of carcinogenesis of nonurachal adenocarcinomas, further investigation may pave the way for a more standardized treatment paradigm and provide insight into the potential utility of modern immunotherapies.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39481627","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":"Two Different Upper Tract Urological Malignancies on Either Side.","authors":"W S L De Silva,&nbsp;S R De Almeida,&nbsp;G D B J Karunarathne,&nbsp;A A S Samarathunga,&nbsp;K M C S Gannoruwa,&nbsp;J A S B Jayasundara","doi":"10.1155/2021/9981381","DOIUrl":"https://doi.org/10.1155/2021/9981381","url":null,"abstract":"<p><strong>Introduction: </strong>The genitourinary system is a recognized site for multiple primary malignant neoplasms even without syndromic anomalies. However, to the best of our knowledge, a case of upper tract urothelial carcinoma (UTUC) with contralateral renal cell carcinoma (RCC) is not reported in surgical literature so far. <i>Case Presentation</i>. A 52-year-old Sri Lankan male patient was found to have a right lower ureteric tumour and a left renal mass together upon investigating for painless visible hematuria. The right ureteric tumour measured 32 × 22 mm resulting in moderate hydronephrosis and cortical thinning of the right kidney, and the left renal mass measured 43 × 38 mm involving the lower pole. The biopsy of the right ureteric lesion revealed a high-grade transitional cell carcinoma with focal nested pattern and that of the left renal mass revealed a clear cell carcinoma. Right nephroureterectomy followed by a left partial nephrectomy was performed in six weeks' interval. The histology of both the resected specimens confirmed the biopsy findings. <i>Discussion</i>. A high-risk upper tract urothelial carcinoma such as the right ureteric tumour of this patient required a nephroureterectomy which makes the management of the contralateral renal cell carcinoma more complex. An adequate functional renal remnant was ensured after offering oncologically sound surgical treatment for both the malignancies of this patient.</p><p><strong>Conclusion: </strong>A UTUC when associated with a contralateral RCC poses challenges in patient management. The preservation of renal excretory function has to be considered as an important determinant in addition to oncologically sound surgical resection when managing complex cases of genitourinary malignancies involving both sides of the upper urinary tract.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39481629","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":"Undiagnosed Behçet's Disease Presenting as Fournier's Gangrene in a Young Male.","authors":"Jasmine C Winyard,&nbsp;Anton Wong,&nbsp;Hala Rashed,&nbsp;John K Mellon","doi":"10.1155/2021/6626909","DOIUrl":"https://doi.org/10.1155/2021/6626909","url":null,"abstract":"<p><p>Behçet's disease is rare, especially in the paediatric population. In this case, a healthy 16-year-old made presented with discrete scrotal ulcers and systemic illness. He was found to have Fournier's gangrene and with subsequent investigation was diagnosed with Behçet's disease as an underlying cause. A PubMed search reveals no similar case reports. His only risk factors for Fournier's gangrene was his raised body mass index. His only risk factor for Behçet's disease was his ethnic origin. An understanding of risk factors and epidemiology can raise suspicion of these rare pathologies.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39481628","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":"Unilateral Giant Hydronephrosis Secondary to Ureteropelvic Junction Obstruction in a Middle-Aged Woman.","authors":"Masresha S Dino,&nbsp;Seid M Hassen,&nbsp;Tesfaye H Tufa","doi":"10.1155/2021/9900560","DOIUrl":"https://doi.org/10.1155/2021/9900560","url":null,"abstract":"<p><strong>Background: </strong>Giant hydronephrosis is a rare urologic problem defined as a collection of more than one liter of urine in the collecting system. The radiologic appearance may mimic benign cystic disease of the kidney. We report a case of giant hydronephrosis in a 32-year-old female who presented with progressive abdominal swelling of two-year duration, caused by ureteropelvic junction obstruction with more than nine liters of urine in the collecting system.</p><p><strong>Conclusion: </strong>Giant hydronephrosis is a rare differential diagnosis for cystic intra-abdominal mass in adults with progressively increasing abdominal swelling. CT and MRI are important in confirming the diagnosis by localizing the origin of the swelling. Management depends on the underlying cause and appearance of the diseased kidney.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39891192","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":"Concurrent Angiomyolipoma and Clear Cell Renal Cell Carcinoma in the Same Kidney: A Rare Finding in a Patient without Tuberous Sclerosis.","authors":"Amal Fekkar,&nbsp;Kaoutar Znati,&nbsp;Fouad Zouaidia,&nbsp;Hafsa Elouazzani,&nbsp;Zakia Bernoussi,&nbsp;Ahmed Jahid","doi":"10.1155/2021/6663369","DOIUrl":"https://doi.org/10.1155/2021/6663369","url":null,"abstract":"<p><p>Synchronous renal cell carcinomas (RCC) and angiomyolipomas (AML) occurring in the same kidney are rare. Cases in the setting of tuberous sclerosis (TS) have been reported in the literature. However, the association of these tumors in the same kidney without TS is even more rare. We report here a case of a clear cell renal cell carcinoma (CCRCC) associated with an AML in the same kidney in a 42 years old female lacking the TS diagnostic criteria. The patient underwent a radical nephrectomy. Six months after surgery, the patient is healthy without signs of tumor recurrence or distant metastasis.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39411604","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":"Septic Shock Immediately following Percutaneous Suprapubic Catheterization.","authors":"Cale E Leeson,&nbsp;Brianna-Lee Beaudry,&nbsp;Geoffrey R Wignall","doi":"10.1155/2021/2184866","DOIUrl":"https://doi.org/10.1155/2021/2184866","url":null,"abstract":"<p><p>Suprapubic catheterization (SPC) is considered a safe and effective procedure for long-term bladder decompression. With proper technique and appropriate patient selection, significant complications of SPC are rare. Immediate postoperative septic shock (i.e., within the first 24 hours of surgery) is rarely reported. We report a case of an 83-year-old patient who developed septic shock within one hour of suprapubic catheterization for a chronic hypotonic bladder, highlighting the importance of early recognition of complications from SPC and prompt management to ensure positive outcomes.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39411603","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 Groin Pain Using an Iliohypogastric Nerve Block in a Patient with Inguinal Hernia due to Persistent Müllerian Duct Syndrome.","authors":"Takanori Sekito,&nbsp;Takuya Sadahira,&nbsp;Masahiro Sugihara,&nbsp;Kohei Edamura,&nbsp;Motoo Araki,&nbsp;Yasutomo Nasu","doi":"10.1155/2021/7577632","DOIUrl":"https://doi.org/10.1155/2021/7577632","url":null,"abstract":"<p><p>Persistent Müllerian duct syndrome can cause an inguinal hernia, although this is a rare occurrence; recurrent inguinal hernias can, in turn, cause ongoing groin pain. Management of groin pain plays an important role in patients' quality of life. We present our experience with a 43-year-old man who had a 2-week history of left-sided groin pain. The patient underwent laparoscopic surgery for a left inguinal hernia via the transabdominal preperitoneal approach. Right-sided cryptorchidism was noted during surgery, with a solid structure-thought to be a uterus-extending into the left inguinal canal. The diagnosis was persistent Müllerian duct syndrome, and the groin pain was relieved after a laparoscopic right orchiectomy with a bilateral preperitoneal hernia repair using a mesh. Four years later, magnetic resonance imaging performed for new-onset left groin pain showed a left inguinal hernia caused by the uterine structure. We diagnosed the recurrent hernia as the cause of his pain. Prior to performing any invasive surgical procedures, an iliohypogastric nerve block was performed using 1% lidocaine. Short-term analgesia was provided by the block, improving his quality of life. He has been followed since then and has declined surgical neurectomy. An iliohypogastric nerve block can be an effective method of controlling groin pain caused by an inguinal hernia resulting from persistent Müllerian duct syndrome; the effectiveness of the nerve block will help determine whether surgical neurectomy is indicated for permanent pain control.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8376460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39337182","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":"Ureteroarterial Fistula: A Diagnosis Which Is Not Always Black and White.","authors":"A Haffar,&nbsp;T Trump,&nbsp;A A Elbakry,&nbsp;K McCluskey,&nbsp;M W Salkini,&nbsp;A Luchey","doi":"10.1155/2021/8165991","DOIUrl":"https://doi.org/10.1155/2021/8165991","url":null,"abstract":"<p><p>Ureteroiliac artery fistulas are a rare, life-threatening condition that requires a high index of suspicion for prompt diagnosis. Presurgical diagnosis is challenging as this condition can lie hidden despite advanced imaging modalities. We present two cases of patients presenting with gross hematuria and exsanguination in the setting of a ureteroiliac artery fistula. These cases highlight the difficulties in timely diagnosis and treatment in a multidisciplinary team.</p>","PeriodicalId":30323,"journal":{"name":"Case Reports in Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39335145","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}