Zinner syndrome is a rare congenital anomaly characterized by a triad of renal dysgenesis/agenesis, cysts in the ipsilateral seminal vesicle, and ejaculatory duct obstruction. Though often diagnosed in infancy, the diagnoses can be incidentally found in adults who present with nonspecific genitourinary symptoms including dysuria, ejaculatory dysfunction, or genital pain. We present an unusual case of a 29-year-old male patient who presented to the emergency department with recurrent testicular pain and hematospermia and was found to have an atrophic right kidney with an ectopic ureter implanting into a cystic seminal vesicle. These findings were consistent with a rare subvariant of Zinner syndrome only previously described four times in the literature. We performed a robotic-assisted laparoscopic ectopic nephroureterectomy with sparing of his seminal vesicle. To our knowledge, this is the first report to describe the safe and effective use of robotic surgery in this setting to remove affected anatomy while preserving the patient's seminal vesicle.
A 64-year-old man was diagnosed with invasive bladder and right lower ureteral urothelial cancer with right pelvic lymph node and lung metastases. He received four courses of gemcitabine and cisplatin therapy. He underwent lung metastasectomy and radical cystoprostatectomy, with not only primary lesions but also metastatic lesions showing a complete response. New multiple lung metastases were revealed five months after adjuvant chemotherapy. On starting pembrolizumab therapy, the metastatic lesions are notably reduced in size. He is currently receiving pembrolizumab therapy, and no recurrence has been observed for over one year.
Prune belly syndrome (PBS) is a rare congenital anomaly characterized by a triad of abdominal flaccidity, varying degrees of urinary system involvement, and cryptorchidism. The exact cause of PBS is unknown. Clinical symptoms can range from stillbirth to significant renal and respiratory abnormalities to almost normal children. Treatment typically involves surgical repair of the abdominal wall defect and urinary tract abnormalities, early orchiopexy, and supportive management of related problems. We report the first case of a female newborn with PBS following in vitro fertilization-induced pregnancy with a comprehensive systematic review of all relevant cases.
Unlike female genital mutilation, the alteration of male genitals has not received much attention. Circumcision is the most common and oldest surgical procedure being performed. When performed by surgeons or well-trained personal the procedure is safe, but most of the times it is being performed by untrained people with no or little medical background. This has led to many complications. Total skin loss is an uncommon but serious complication. There is an ongoing debate regarding the management of this complication. Here, we present a case of total penile skin loss which had resulted from penile mutilation in the name of ritual circumcision.
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