Urology Case Reports最新文献

The optimal treatment of adult-onset Wilms tumors (WTs) in elderly patients is a debated area, as pediatric protocols are thought to carry unacceptable toxicity. We treated a 62-year-old female with good performance status and Stage IV (T1b N1 M1) favorable histology WT using pediatric adjuvant and salvage chemoradiation protocols. Though she experienced nodal relapse and both adjuvant and salvage treatment were discontinued early due to toxicity, she obtained excellent oncologic outcomes, having remained disease-free for 32 months. We recommend considering pediatric protocols for elderly WT patients with good performance status, anticipating dose reductions and possible early chemotherapy termination.

Adenocarcinoma of the prostate affects up to 70 % of men over 80 and is the second leading cause of cancer related death in men. We reported an unusual case of a giant prostatic adenocarcinoma compressing bilaterally the 2 external and internal iliac veins that was revealed by a bilateral edema of the lower limbs after histological confirmation the patient was treated by radiotherapy and hormone therapy with a clinical amelioration.

Renal Artery Embolization (RAE) is a first-line treatment for arteriovenous fistula complications, which may occur following percutaneous nephrolithotomy (PCNL). A rare complication of RAE is metal coil migration, which may present with nephrolithiasis symptoms, including hematuria and flank pain. Imaging like Computed Tomography (CT) Angiography can help assess the risk of hemorrhage due to coil location relative to vasculature. Subsequently, ureteroscopy can be done with thulium laser excision of the coils and lithotripsy of adherent stone. This case is one of the first to demonstrate that endourological thulium laser excision is a safe and effective management for migrated angioembolization coils.

We present a case of acute urinary retention (AUR) with hyper-angulation of the urinary bladder neck secondary to uterine leiomyoma. Our patient is a 45-year-old female who presented with AUR and suprapubic pain requiring catheterization. CT images highlight the level of obstruction secondary to suspension of the urinary bladder rather than direct urethral compression. This case highlights this unique manifestation of AUR demonstrating the necessity for understanding its different mechanisms. Clinicians should maintain a high index of suspicion for AUR in patients with leiomyoma and lower urinary tract symptoms. Heightened awareness and timely intervention are crucial in preventing potential complications.

Obstructive lower urinary tract symptoms in young men can occasionally be attributed to rare intra-prostatic cystic lesions. This case reports a 27-year-old man presenting with sudden onset voiding difficulty, diagnosed with a midline prostatic cyst at the anterior bladder neck, a rare location. The cyst was successfully treated with bipolar transurethral endoscopic resection, resulting in the resolution of urinary symptoms without retrograde ejaculation which is a common complication that is a central concern in the literature regarding the choice of surgical modality.

Vesicostomy is a temporary solution for patients with bladder outlet challenger who are not eligible for catheterization.

A 73 year-old man who has successfully managed his bladder using a vesicostomy for 59 years. Complications of prolapse and dermatitis led to vesicostomy closure and cystostomy placement at age 73.

Vesicostomy can be safely used to preserve bladder and upper urinary tract health for a lifetime.

This case report describes the surgical management of a giant left adrenal mass (27 x 26 × 27 cm, 9.370 kg) in a 69-year-old female. We review the multidisciplinary decision-making process for pre-operative preparation, embolization, resection feasibility, and strategies to mitigate intra-operative complications. This is the largest adrenal adenoma removal reported to date. The case highlights the importance of meticulous surgical planning and execution in managing rare and challenging cases, with significant implications for patient outcomes.

The authors report the case of tuberculous spondylodiscitis with unusual clinical and paraclinical features, in a healthy young boy of 16 year old with persistent and complicated left orchiepididymitis despite a well-conducted treatment. The diagnosis was delayed for several months and the evolution was favorable after etiological treatment.

Massive localized lymphoedema (MLL) is a rare complication of morbid obesity and has been scarcely reported in the literature, especially in the pubic area and genitalia. It is associated to BMI more than 40 kg/m². We report the case of a 37-year-old patient known for morbid obesity with 68.8 kg/m² BMI and hypogonadism-obesity syndrome presenting an unusually voluminous scrotal MLL mass. Malignancy was ruled out before surgery. In total a 7.5 kg scrotal mass was resected. Surgery was performed with minor complications without requiring additional surgery.

Drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS) is a life-threatening, multi-organ adverse drug reaction with a mortality rate of approximately 10 %–20 %. The most common culprit drugs are anticonvulsants, some antibiotics such as dapsone and minocycline, salazosulfapyridine, allopurinol and some antiretroviral molecules such as abacavir and nevirapine. Only one case of DRESS induced by sildenafil has been reported in the literature. Here we report a new case.