Volume 15, Number 3Case ReviewObstructed Bifid Uretereric System Causing Unilateral HydronephrosisAmyn BhamaniManoj SrivastavaBifid ureters are a common malformation of the urinary system. In clinical practice, hydronephrosis resulting from obstruction of such a system is rare. The authors present a case involving an 88-year-old man admitted to the hospital with symptoms of renal failure, where bifid ureters were found incidentally in a hydronephrotic kidney during an emergency nephrostomy. This had been missed on a previous CT scan, resulting in a unique therapeutic dilemma. [ Rev Urol. 2013;15(3):131-134 doi: 10.3909/riu0578] © 2013 MedReviews®, LLCBifid uretersHydronephrosisNephrostomy
Volume 15, Number 3Case ReviewUreteral Metastasis as the Presenting Manifestation of Pancreatic CarcinomaNand Kishore ArvindShilpi GuptaQutub AliOnkar SinghWe recently cared for a patient with adenocarcinoma of the pancreas who presented with ureteral metastasis followed by hydroureteronephrosis long before the appearance of any symptoms related to the primary lesion. The entity is extremely rare; only seven similar cases are on record in the scientific literature. No recent review exists on this topic. This encouraged us to present our case along with the previous cases of adenocarcinoma of the pancreas with ureteral metastasis that have been reported. [Rev Urol. 2013;15(3):124-130 doi: 10.3909/riu0575] © 2013 MedReviews®, LLCMetastasisHydronephrosisUreterUreteral metastasisPancreatic adenocarcinoma
Volume 15, Number 2Case ReviewEndoscopic Management of Genitourinary Foreign BodiesAlana C DesaiJoseph B SongYoussef S TanaghoMohammed HaseebuddinBrian M BenwaySam B BhayaniRobert S FigenshauRetrieval of foreign bodies from the genitourinary system, most commonly inserted for sexual satisfaction or as a result of a psychiatric illness, can pose a significant surgical challenge. Due to their breadth of size, shape, and location within the genitourinary system, endoscopic management can be difficult. Here, we review the management of four cases of foreign object insertion into the genitourinary system and their outcomes and management. [Rev Urol. 2013;15(2):84-91 doi: 10.3909/riu0571] © 2013 MedReviews®, LLCForeign body insertionSoundingGenitourinary foreign objectEndoscopic extraction
Volume 15, Number 1Case ReviewInguinal Bladder Hernia: Four Case AnalysesKamal MoufidDriss TouitiLezrek MohamedA study of four cases presenting as inguinal bladder hernia was performed based on a review of the clinical presentation, circumstances of diagnostics, and surgical management. The mean age of patients was 66.5 years. Presenting symptoms included lower urinary tract symptoms (LUTS; three cases) and decrease in scrotal size after voiding (one case). The diagnostic circumstances were incidental finding during investigation for urethral stricture (one case), preoperative discovery on the basis of decrease in scrotal size after voiding (one case), perioperative discovery during standard herniorrhaphy (one case), and peritoneal effusion secondary to bladder injury in the early postoperative period. All patients were managed successfully by replacement of the bladder in its original position and inguinal herniorrhaphy, the Lichtenstein technique (two cases), Shouldice repair (one case), or modified Bassini repair (one case) through the same inguinal incision. For one patient, bladder injury was diagnosed at the time of inguinal herniorrhaphy and repair was promptly made. For another, bladder injury was discovered only at surgical abdominal exploration. Surgical repair led to the resolution of signs and urologic symptoms in all but one patient who needed medical therapy for residual LUTS. An awareness of this possibility on the part of general surgeons should guide preoperative evaluation and therapy appropriately. Even if the preoperative diagnosis is missed, a perioperative diagnosis is crucial to avoid bladder injury during surgery. [Rev Urol. 2013;15(1):32-36 doi: 10.3909/riu0560] © 2013 MedReviews®, LLCComplicationsBladderInguinal herniaCystographyHerniorrhaphy
Volume 16, Number 4Case ReviewTesticular Sclerosing Sertoli Cell Tumor: A Case Report and Review of the LiteratureAndres A RomaSarah ColemanYagil BarazaniEdmund S SabaneghSertoli cell tumors are very rare testicular tumors, representing 0.4% to 1.5% of all testicular malignancies. They are subclassified as classic, large-cell calcifying, and sclerosing Sertoli cell tumors (SSCT) based on distinct clinical features. Only 42 cases of SSCTs have been reported in the literature. We present a case of a 23-year-old man diagnosed with SSCT. [Rev Urol. 2014;16(4):191-193 doi: 10.3909/riu0620] © 2014 MedReviews®, LLCTesticular neoplasmSertoli cell tumorSclerosing Sertoli cell tumor
Volume 16, Number 4Case ReviewIntratesticular Epidermoid Cyst Masquerading as Testicular TorsionJeremy SlawinKevin M SlawinEpidermoid cysts are benign tumors that comprise approximately 1% of all testicular masses. They usually present as painless masses that can be identified on scrotal ultrasound as well-demarcated intratesticular lesions with mixed echogenicity. This case report describes a rare presentation of an extremely large intratesticular epidermoid cyst with clinical and radiologic findings more consistent with testicular torsion. The sizeable cyst obliterated the surrounding testicular parenchyma, causing it to appear on scrotal Doppler ultrasound as a testicle devoid of blood flow. This obliteration also resulted in failure to identify a testicular mass on physical examination or imaging. The current literature contains previous reports of extratesticular epidermoid cysts presenting as torsion; however, this is the first report of an intratesticular epidermoid cyst presenting in this manner. Though smaller cysts may be managed effectively with testicular-sparing surgery, optimal management of a cyst this size requires orchiectomy. [Rev Urol. 2014;16(4):198-201 doi: 10.3909/riu0633] © 2014 MedReviews®, LLCEpidermoid cystTesticular torsionAcute testicular painIntratesticularDoppler
Volume 16, Number 4Case ReviewThe Use of Botulinum Neurotoxin Type A in a Patient With Refractory Urge Incontinence to Facilitate the Intravesical Treatment of Bladder CarcinomaPatricia GilhoolyMina FamIntravesical Bacillus Calmette-Guérin (BCG) has become the preferred initial treatment after resection of high-grade T1 urothelial carcinoma and carcinoma in situ (CIS). We report the case of a patient with high-grade T1 urothelial carcinoma and CIS who was treated with intravesical BCG. Due to the patient’s severe urge incontinence, however, the BCG solution leaked from the bladder immediately upon instillation. We describe our experience of using botulinum neurotoxin A intradetrusor injections to facilitate successful intravesical therapy by increasing bladder capacity to enable the BCG to remain in the patient’s bladder for the appropriate treatment duration. [Rev Urol. 2014;16(4):194-197 doi: 10.3909/riu0621] This article is a US Government work, and, as such, is in the public domain in the United States of America. Published by MedReviews®, LLC.Bacillus Calmette-GuérinBladder carcinomaBotulinum neurotoxinGemcitabine
Volume 16, Number 3Case ReviewOccult Renal Cell Carcinoma Manifesting as Nasal Mass and EpistaxisRajeev MathurVishwas BahetiJanak SinghSher Singh YadavMetastasis of renal cell carcinoma (RCC) to the nasal cavity and paranasal sinuses is rare, with fewer than 50 cases described in the literature. Nasal metastasis as the initial presentation of RCC is even rarer. Metastases to the nasal cavity usually represent advanced disease with poor outcome. The authors report a case of metastatic RCC presenting with right nasal cavity mass and epistaxis, followed by a brief review of the relevant literature. [Rev Urol. 2014;16(3):145-148 doi: 10.3909/riu0607] © 2014 MedReviews®, LLCRenal cell carcinomaNasal metastasisEpistaxis
Volume 16, Number 3Case ReviewUrethral Duplication in a 15-Year-Old: Case Report With Review of the LiteratureArindam DuttaMayank BaidUrethral duplication is a rare congenital malformation mainly affecting men and boys. Although a number of theories have been proposed to describe this condition, the actual mechanism of this disorder is still not clear. This article highlights a case of urethral duplication in a 15-year-old boy. The malformation was characterized by the presence of continent epispadic and normal apical urethra. Retrograde urethrogram through both urethral tracts simultaneously revealed the malformation as Effmann type IIA2. The patient was not offered surgical intervention as he was asymptomatic and had no problems except for a double stream of urine. [Rev Urol. 2014;16(3):149-151 doi: 10.3909/riu0618] © 2014 MedReviews®, LLCUrethraDuplicationMalformationAbnormality
Volume 16, Number 2Case ReviewSolitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal EtiologiesJoel M SumfestJared M BieniekTiffany A PerkinsPolymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLCFournier gangreneFournier’s Gangrene Severity IndexCandida albicans