Case report noting a rare differential diagnosis of ectopic decidual reaction in pregnancy in pregnant patients presenting with bladder lesions.
病例报告注意到一个罕见的鉴别诊断异位蜕膜反应在怀孕的怀孕患者表现为膀胱病变。
{"title":"Ectopic Decidual Reaction in Bladder","authors":"Blessing Dhliwayo, A. Dhanasekaran","doi":"10.22374/JELEU.V2I1.23","DOIUrl":"https://doi.org/10.22374/JELEU.V2I1.23","url":null,"abstract":"Case report noting a rare differential diagnosis of ectopic decidual reaction in pregnancy in pregnant patients presenting with bladder lesions.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121820127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The UroLift system (Teleflex Inc.) is a minimally-invasive and non-ablative technique used for the treatment of male lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia. It has been introduced as an alternative to transurethral resection of the prostate (TURP) to avoid any unwanted side affects such as erectile dysfunction, hospital stay and catheterisation. A 68-year old patient with bothersome LUTS and significant co-morbidities presented for consideration of UroLift to avoid the risks associated with more invasive TURP surgery. The patient had previously had an AMS 700 MS implanted penile prosthesis (IPP) inserted for erectile dysfunction refractory to medical therapy. To the authors best knowledge, there have been no reports or published literature on the use of the UroLift device to treat male LUTS in the presence of an IPP. This case report aims to present this unique case and discuss operative technique for use of the UroLift device in the presence of an IPP.
{"title":"UroLift for the Treatment of Lower Urinary Tract Symptoms in a Patient with AMS 700 MS Implanted Penile Prosthesis. The First Reported Case in the Literature","authors":"Adam V. Jones, Y. C. Phan, W. Mahmalji","doi":"10.22374/JELEU.V2I1.31","DOIUrl":"https://doi.org/10.22374/JELEU.V2I1.31","url":null,"abstract":"The UroLift system (Teleflex Inc.) is a minimally-invasive and non-ablative technique used for the treatment of male lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia. It has been introduced as an alternative to transurethral resection of the prostate (TURP) to avoid any unwanted side affects such as erectile dysfunction, hospital stay and catheterisation. A 68-year old patient with bothersome LUTS and significant co-morbidities presented for consideration of UroLift to avoid the risks associated with more invasive TURP surgery. The patient had previously had an AMS 700 MS implanted penile prosthesis (IPP) inserted for erectile dysfunction refractory to medical therapy. To the authors best knowledge, there have been no reports or published literature on the use of the UroLift device to treat male LUTS in the presence of an IPP. This case report aims to present this unique case and discuss operative technique for use of the UroLift device in the presence of an IPP.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128182005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PurposeRetrograde intrarenal surgery (RIRS) is an effective and safe therapeutic option in the treatment of renal stones&upper tract urothelial carcinoma. High frequency jet ventilation (HFJV) is a lung ventilation mode offering a substantial reduction of renal movement. In our pilot study, we evaluated a HFJV ventilatory protocol in endoscopic treatment of renal stones.Materials and methods15 consecutive cases of the treatment of renal stones larger than 7mm have been included in our study, with exclusion of patients suffering from severe pulmonary disease. Total intravenous anesthesia has been chosen with intraprocedural HFJV. The intraoperative gas exchange parameters, as well as eventual postoperative respiratory adverse events were taken note of. A laser stone disintegration has been performed in all procedures, including a three-month postoperative follow-up.ResultsMean duration of HFJV procedure was 56,3 min (35-110), Et CO2(end tidal ; carbon dioxide concentration measured at the end of expiration,the normal values of which are 4-6%) before HFJV - 4,81 % (4,1-5,8) and after HFJV 5,22 % (3,9-7,2) respectively. No signs of respiratory impairment were detected. The operative time ranged between 20- 102 min. The renal movement reduction with HFJV was of significantly noticeable by the surgeon. Three patients were readmitted to the hospital; one of them due to a urinary tract infection. No perioperative pulmonary complications were reported. ConclusionHFJV is a safe, feasible method that can be used in RIRS and can significantly enhance the efficacy of the procedure. However, further evaluation of the method is needed.
目的肾内行逆行手术是治疗肾结石和上尿路上皮癌的一种安全有效的治疗方法。高频喷射通气(HFJV)是一种肺通气模式，可大幅减少肾脏运动。在我们的初步研究中，我们评估了HFJV通气方案在内窥镜治疗肾结石中的应用。材料与方法我们的研究纳入了15例连续治疗大于7mm肾结石的病例，排除了患有严重肺部疾病的患者。术中HFJV手术选择全静脉麻醉。记录术中气体交换参数以及最终的术后呼吸不良事件。所有手术均采用激光结石崩解术，包括术后三个月的随访。结果HFJV手术平均持续时间为56.3 min (35 ~ 110)， Et CO2(end tidal;期满后测定二氧化碳浓度，正常值为4-6%，HFJV前为4.81 % (4,1-5,8)，HFJV后为5.22 %(3,9-7,2)。没有发现呼吸障碍的迹象。手术时间在20- 102分钟之间。外科医生明显注意到HFJV患者肾脏运动减少。3名患者再次入院;其中一个是因为尿路感染。无围手术期肺部并发症报道。结论hfjv是一种安全可行的治疗RIRS的方法，可显著提高手术疗效。然而，需要对该方法进行进一步的评价。
{"title":"Preliminary Evaluation of High Frequency Jet Ventilation in RIRS from a Tertiary Center","authors":"M. Hasan, M. Brehmer, P. Harbut","doi":"10.22374/JELEU.V2I1.25","DOIUrl":"https://doi.org/10.22374/JELEU.V2I1.25","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000PurposeRetrograde intrarenal surgery (RIRS) is an effective and safe therapeutic option in the treatment of renal stones&upper tract urothelial carcinoma. High frequency jet ventilation (HFJV) is a lung ventilation mode offering a substantial reduction of renal movement. In our pilot study, we evaluated a HFJV ventilatory protocol in endoscopic treatment of renal stones.Materials and methods15 consecutive cases of the treatment of renal stones larger than 7mm have been included in our study, with exclusion of patients suffering from severe pulmonary disease. Total intravenous anesthesia has been chosen with intraprocedural HFJV. The intraoperative gas exchange parameters, as well as eventual postoperative respiratory adverse events were taken note of. A laser stone disintegration has been performed in all procedures, including a three-month postoperative follow-up.ResultsMean duration of HFJV procedure was 56,3 min (35-110), Et CO2(end tidal ; carbon dioxide concentration measured at the end of expiration,the normal values of which are 4-6%) before HFJV - 4,81 % (4,1-5,8) and after HFJV 5,22 % (3,9-7,2) respectively. No signs of respiratory impairment were detected. The operative time ranged between 20- 102 min. The renal movement reduction with HFJV was of significantly noticeable by the surgeon. Three patients were readmitted to the hospital; one of them due to a urinary tract infection. No perioperative pulmonary complications were reported. ConclusionHFJV is a safe, feasible method that can be used in RIRS and can significantly enhance the efficacy of the procedure. However, further evaluation of the method is needed. \u0000 \u0000 \u0000 \u0000","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134175105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exertional haematuria is a relatively common reported symptom. We present a case of exercise induced haematuria in a long distance runner with proven hypercalciuria. Our case report highlights that urothelial calcifications in patients with hypercalciuria have the potential to cause traumatic haematuria during high intensity exercise. Whilst diagnostic work up of haematuria still applies, careful attention to the history in this specific group of patents has the potential to avoid further invasive investigations, such as renal biopsies.
{"title":"Hypercalciuria: A Rare Contributing Cause of Exercise-Induced Visible Haematuria","authors":"W. Barlow, M. Darrad, S. Fletcher, R. Devarajan","doi":"10.22374/JELEU.V1I2.16","DOIUrl":"https://doi.org/10.22374/JELEU.V1I2.16","url":null,"abstract":"Exertional haematuria is a relatively common reported symptom. We present a case of exercise induced haematuria in a long distance runner with proven hypercalciuria. Our case report highlights that urothelial calcifications in patients with hypercalciuria have the potential to cause traumatic haematuria during high intensity exercise. Whilst diagnostic work up of haematuria still applies, careful attention to the history in this specific group of patents has the potential to avoid further invasive investigations, such as renal biopsies.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122858321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Antegrade stents are commonly used to relieve malignant and benign ureteric obstruction. However, follow up of these patients often involves several specialties and the potential for delayed management and forgotten stents. This observational study reviews indications and outcomes of antegrade stent procedures at one university hospital to provide prognostic and quality improvement data. Patients and Methods A retrospective analysis of 152 antegrade stent procedures in 142 patients over a 27-month period was performed. Cohorts were studied according to underlying pathology, referring specialty and intended duration of stent placement. Measured outcomes were time to stent removal or stent exchange, death, forgotten stents and complications. Results The overall technical success rate of antegrade stent insertion was 98%. Follow-up data was available for 145 successful procedures in 138 patients. Malignancy (47%) and stone disease (35%) were the commonest indications. Overall, 43 patients (31%) died over a median follow up period of 2.2 years. 29 of 64 patients (45%) with malignancy died with stents in situ after a median interval of 3.5 months. Malignancy and unclear intended duration of stent placement were predictors of death with a stent in situ. Twelve patients (9%) had forgotten stents and a strong association with gynaecological malignancy was noted, which is felt to represent inadequate follow up of patients with non-urological pathology. Complications were reported in thirteen patients (9%), including ten cases of heavy stent encrustation and one malpositioned stent. Conclusions Prognostic factors should be considered in the management of patients stented for malignant obstruction, which is usually a marker of advanced disease. The hazards of inadequate follow up are highlighted, causing delays in stent removal and exchange, or the forgotten stent. Interventions are described to minimize these risks.
{"title":"Fate of the Antegrade Ureteric Stent","authors":"J. Raju, C. George, P. Patel, Samson Liu","doi":"10.22374/JELEU.V1I2.15","DOIUrl":"https://doi.org/10.22374/JELEU.V1I2.15","url":null,"abstract":"Introduction \u0000 Antegrade stents are commonly used to relieve malignant and benign ureteric obstruction. However, follow up of these patients often involves several specialties and the potential for delayed management and forgotten stents. This observational study reviews indications and outcomes of antegrade stent procedures at one university hospital to provide prognostic and quality improvement data. \u0000 \u0000Patients and Methods \u0000 A retrospective analysis of 152 antegrade stent procedures in 142 patients over a 27-month period was performed. Cohorts were studied according to underlying pathology, referring specialty and intended duration of stent placement. Measured outcomes were time to stent removal or stent exchange, death, forgotten stents and complications. \u0000 \u0000Results \u0000 The overall technical success rate of antegrade stent insertion was 98%. Follow-up data was available for 145 successful procedures in 138 patients. Malignancy (47%) and stone disease (35%) were the commonest indications. Overall, 43 patients (31%) died over a median follow up period of 2.2 years. 29 of 64 patients (45%) with malignancy died with stents in situ after a median interval of 3.5 months. Malignancy and unclear intended duration of stent placement were predictors of death with a stent in situ. Twelve patients (9%) had forgotten stents and a strong association with gynaecological malignancy was noted, which is felt to represent inadequate follow up of patients with non-urological pathology. Complications were reported in thirteen patients (9%), including ten cases of heavy stent encrustation and one malpositioned stent. \u0000 \u0000Conclusions \u0000 Prognostic factors should be considered in the management of patients stented for malignant obstruction, which is usually a marker of advanced disease. The hazards of inadequate follow up are highlighted, causing delays in stent removal and exchange, or the forgotten stent. Interventions are described to minimize these risks.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123054528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present the details of 3 patients who were referred to our endometriosis centre for multidisciplinary care with deep infiltrating endometriosis. The pre-operative assessments, intra-operative gynaecological findings and treatment and post-operative urological follow up are discussed to illustrate the specific considerations required to optimise their urological management.
{"title":"Endometriosis and the Ureter","authors":"Richard D Smith, A. Cutner","doi":"10.22374/JELEU.V1I2.18","DOIUrl":"https://doi.org/10.22374/JELEU.V1I2.18","url":null,"abstract":"We present the details of 3 patients who were referred to our endometriosis centre for multidisciplinary care with deep infiltrating endometriosis. The pre-operative assessments, intra-operative gynaecological findings and treatment and post-operative urological follow up are discussed to illustrate the specific considerations required to optimise their urological management.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121824222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Vazirian-Zadeh, Jane Anderson, R. Gill, I. Noaman, Katie Lee, Henryk Krasnowski, Ho Kj
Background and objective Transurethral resection of the prostate (TURP) has been the undisputed reference standard for elderly men with lower urinary tract symptoms (LUTS) caused by benign prostatic enlargement (BPE). However, morbidity after TURP remains significant, with increased risks of bleeding and TUR syndrome. In recent years, there has been a gradual increase in the role of laser technology for the treatment of symptomatic BPE. The aim of our study was to evaluate the efficacy and safety of the novel technique Thulim laser enucleation of prostate (ThuLEP) developed for the first time in 2009 by Imkamp et al. in treating symptomatic BPE. Materials and methods Analysis of the data from electronic records, case notes, clinic letters all the patients who had undergone ThuLEP using a 70 W thulium laser (Revolix) for symptomatic outflow obstruction over a 6-year period was done. We looked at the pre-procedure PSA, maximum urinary flow rate (Qmax), Post void residual (PVR) and haemoglobin, comparing it with the postoperative haemoglobin. Results 222 patients underwent ThuLEP procedure performed by 2 surgeons. We found a 159 % improvement in Q max, a 61 % improvement in PVR. No mortalities occurred and only 1 patient required post operative blood transfusion. ThuLEP represents a safe, effective surgical option in patients with symptomatic BPH with relatively little complications, producing significant improvements in both Qmax and PVR. Key words LUTS, BPE, Enucleation, TUR Syndrome, Qmax
{"title":"Thulium Laser Enucleation of the Prostate (ThuLEP) as a Technique for Treatment of BPH: Evaluation of a Six-Year Experience at a Single Institution","authors":"M. Vazirian-Zadeh, Jane Anderson, R. Gill, I. Noaman, Katie Lee, Henryk Krasnowski, Ho Kj","doi":"10.22374/JELEU.V1I2.21","DOIUrl":"https://doi.org/10.22374/JELEU.V1I2.21","url":null,"abstract":"Background and objective Transurethral resection of the prostate (TURP) has been the undisputed reference standard for elderly men with lower urinary tract symptoms (LUTS) caused by benign prostatic enlargement (BPE). However, morbidity after TURP remains significant, with increased risks of bleeding and TUR syndrome. In recent years, there has been a gradual increase in the role of laser technology for the treatment of symptomatic BPE. \u0000The aim of our study was to evaluate the efficacy and safety of the novel technique Thulim laser enucleation of prostate (ThuLEP) developed for the first time in 2009 by Imkamp et al. in treating symptomatic BPE. \u0000Materials and methods Analysis of the data from electronic records, case notes, clinic letters all the patients who had undergone ThuLEP using a 70 W thulium laser (Revolix) for symptomatic outflow obstruction over a 6-year period was done. We looked at the pre-procedure PSA, maximum urinary flow rate (Qmax), Post void residual (PVR) and haemoglobin, comparing it with the postoperative haemoglobin. \u0000Results 222 patients underwent ThuLEP procedure performed by 2 surgeons. We found a 159 % improvement in Q max, a 61 % improvement in PVR. No mortalities occurred and only 1 patient required post operative blood transfusion. \u0000ThuLEP represents a safe, effective surgical option in patients with symptomatic BPH with relatively little complications, producing significant improvements in both Qmax and PVR. \u0000Key words \u0000LUTS, BPE, Enucleation, TUR Syndrome, Qmax","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121414987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam V. Jones, S. Ehsanullah, A. Birring, Connor Gascoigne, Sid Singh, A. Ginepri, I. Apakama
Transurethral resection of the prostate (TURP) continues to be an effective intervention for certain indications; and this procedure is still one of the most commonly performed in urology. The use of a 3-way catheter with continuous bladder irrigation (CBI) post-TURP is widely practiced in a bid to prevent clot retention. We report our unique experience with the use of 2-way urethral catheters post-TURP surgery. Methodology Data was prospectively collected for 143 consecutive patients who underwent a bipolar TURP between July 2015 and October 2017. The following outcomes where measured and compared against the literature: resection time, resected weight, haemoglobin level, hospital stay, catheterization days, transfusion rate and complications. Results Two-way 18-French catheters were used in 132/143 (91.7%) patients. The remaining 11/143 (8.3%) patients had a 3-way 22-French catheter and CBI immediately post-TURP. There were no incidences of clot retention requiring a return to theatre. There were 2/132 (1.5%) patients requiring transfusion who received 2-way catheterization. The average resection time was 44.8 (10-100) minutes, with a mean resected weight of 22.8 (2.0-70.0) grams. Post-operatively, we found minimal drop in haemoglobin levels, with a fall of 0.7 g/dL on average, with a range of 0.1-3.4 g/dL. Mean length of stay following TURP was 1.45 days (1-18), and 101/132 (76.5%) of patients had a successful trial without catheter on the first post-operative day. Conclusion Our outcomes compare favorably with the published data. This study suggests it may be possible to reduce the cost and resources associated with the use of 3-way catheters and CBI post-TURP surgery by using a 2-way catheter instead. Despite this, appropriate patient selection for this novel technique needs to be adopted. Our results would suggest that patients with smaller prostates or limited resections might be suitable for a 2-way urethral catheter post-TURP.
{"title":"Transurethral Resection of Prostate (TURP): Surgery without Using a 3-Way Catheter","authors":"Adam V. Jones, S. Ehsanullah, A. Birring, Connor Gascoigne, Sid Singh, A. Ginepri, I. Apakama","doi":"10.22374/JELEU.V1I2.7","DOIUrl":"https://doi.org/10.22374/JELEU.V1I2.7","url":null,"abstract":" \u0000Transurethral resection of the prostate (TURP) continues to be an effective intervention for certain indications; and this procedure is still one of the most commonly performed in urology. The use of a 3-way catheter with continuous bladder irrigation (CBI) post-TURP is widely practiced in a bid to prevent clot retention. We report our unique experience with the use of 2-way urethral catheters post-TURP surgery. \u0000 \u0000Methodology \u0000Data was prospectively collected for 143 consecutive patients who underwent a bipolar TURP between July 2015 and October 2017. The following outcomes where measured and compared against the literature: resection time, resected weight, haemoglobin level, hospital stay, catheterization days, transfusion rate and complications. \u0000Results \u0000Two-way 18-French catheters were used in 132/143 (91.7%) patients. The remaining 11/143 (8.3%) patients had a 3-way 22-French catheter and CBI immediately post-TURP. There were no incidences of clot retention requiring a return to theatre. There were 2/132 (1.5%) patients requiring transfusion who received 2-way catheterization. The average resection time was 44.8 (10-100) minutes, with a mean resected weight of 22.8 (2.0-70.0) grams. Post-operatively, we found minimal drop in haemoglobin levels, with a fall of 0.7 g/dL on average, with a range of 0.1-3.4 g/dL. Mean length of stay following TURP was 1.45 days (1-18), and 101/132 (76.5%) of patients had a successful trial without catheter on the first post-operative day. \u0000Conclusion \u0000Our outcomes compare favorably with the published data. This study suggests it may be possible to reduce the cost and resources associated with the use of 3-way catheters and CBI post-TURP surgery by using a 2-way catheter instead. Despite this, appropriate patient selection for this novel technique needs to be adopted. Our results would suggest that patients with smaller prostates or limited resections might be suitable for a 2-way urethral catheter post-TURP.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127829228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 40-year-old female with an allergy to medium contrast, presented with bilateral loin pain and renal colic type radiation. Image study with non-contrast computerized tomography and magnetic resonance imaging revealed multiple nephrolithiasis and a complex cyst at lower pole of the right kidney and no findings in the left one. The patient was treated with laser lithotripsy by flexible ureterorenoscopy revealing multiple lithiasis within cystic dilatations of the urothelium. The complex cyst was submitted to partial nephrectomy. Finally, biopsy demonstrated that it was renal parenchyma with polycystic changes in the external corticomedullary area. All findings were compatible with unilateral medullary sponge kidney diagnosis.
{"title":"Unilateral Medullary Sponge Kidney","authors":"R. Neira, D. Barrera, G. Astroza","doi":"10.22374/JELEU.V1I1.12","DOIUrl":"https://doi.org/10.22374/JELEU.V1I1.12","url":null,"abstract":"A 40-year-old female with an allergy to medium contrast, presented with bilateral loin pain and renal colic type radiation. Image study with non-contrast computerized tomography and magnetic resonance imaging revealed multiple nephrolithiasis and a complex cyst at lower pole of the right kidney and no findings in the left one. The patient was treated with laser lithotripsy by flexible ureterorenoscopy revealing multiple lithiasis within cystic dilatations of the urothelium. The complex cyst was submitted to partial nephrectomy. Finally, biopsy demonstrated that it was renal parenchyma with polycystic changes in the external corticomedullary area. All findings were compatible with unilateral medullary sponge kidney diagnosis.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123553273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Balakrishnan, Y. C. Phan, J. Cobley, W. Mahmalji
Chemolysis of kidney stone is not unheard of. However, to our knowledge, there is no previous report of chemolysis of a kidney stone in a horseshoe kidney. We report the first ever case of chemolysis of a stone in a horseshoe kidney. As part of his visible haematuria workup 4 years ago, a 66-year-old gentleman with a history of gout was found to have a horseshoe kidney. In early 2017, he was seen in the urology clinic with some non-specific abdominal pain without a recent history of visible haematuria, lower urinary tract symptoms, and urinary tract infections. His CT KUB (computed tomography of kidneys, ureters and bladder), revealed a 1.3cm stone in his horseshoe kidney [Figure 1 and 2]. At the same time, his CT KUB has also picked up some retroperitoneal lymphadenopathy in the abdomen and pelvis which were suspicious of lymphoma. His serum uric acid level was noted to be normal. Subsequently, he underwent a laparoscopic right iliac lymph node biopsy which confirmed nodal marginal zone non‑Hodgkin's B-cell lymphoma. He was reviewed by the haematology team and they decided to adopt a watch and wait approach to his disease with quarterly CT CAP (computed tomography of chest, abdomen and pelvis) scans. During this period of time, he had several gout attacks and he was started on allopurinol i.e. 100mg once a day. He also considerably increased his daily fluid intake. 6 months after his initial CT KUB, he was found to be completely stone free on his CT scan [Figure 3 and 4].
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