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DNA methylation profiles in urothelial bladder cancer tissues and children with schistosomiasis from Eggua, Ogun State, Nigeria 尼日利亚奥贡州埃瓜市尿路上皮膀胱癌组织和血吸虫病儿童的DNA甲基化谱
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-25 DOI: 10.1186/s12301-023-00392-0
Cephas A. Akpabio, Rachael P. Ebuh, Oluwaseun E. Fatunla, Henrietta O. Awobode, Chiaka I. Anumudu
Squamous cell carcinoma has been attributed to chronic schistosomiasis and is the predominant type of bladder cancer in schistosomiasis endemic areas. The aim of this study was to assess early promoter DNA methylation in selected genes implicated in schistosomiasis-associated bladder cancer (SABC). A total of 159 urine samples were collected from school-aged children in Eggua Community of Ogun State and examined by microscopy for Schistosoma haematobium eggs. From this sample, a subset of 34 (21.1%) urine samples positive for S. haematobium, age and sex-matched with negative urine control samples, and 16 formalin-fixed paraffin-embedded bladder cancer tissues obtained from the University College Hospital were subjected to DNA isolation and bisulphite DNA conversion. Quantitative methylation-specific PCR was used to determine the methylation status of APC, RARβ2, RASSF1A, and TIMP3 in the samples. High degrees of methylation of RARβ2(67.7%), RASSF1A (38.2%), and TIMP3(52.9%) was more common in urogenital schistosomiasis (UGS)-positive urine samples than negative urine (control) samples and in bladder cancer tissues. Promoter DNA methylation in the positive urine samples was 1.4-fold, 13.3-fold, 3.4-fold, and 3.8-fold higher in APC, RARβ2, RASSF1A, and TIMP3, respectively, than in the matched controls. The odds of promoter methylation were likely to increase with age group for APC (OR: 1.615) and TIMP3(OR: 2.000); sex for TIMP3(OR: 2.644); and haematuria for RARβ2(OR: 1.094), RASSF1A (OR: 1.143), and TIMP3(OR: 1.842), although there were no significant associations. Conclusions: Gene promoter DNA methylation in tumour suppressor genes was observed in schistosomiasis cases. Hence, promoter DNA methylation may occur during active schistosomiasis in children. This result may serve as an early non-invasive biomarker to detect and hint at the risk of developing SABC later in life.
鳞状细胞癌被认为是由慢性血吸虫病引起的,是血吸虫病流行地区膀胱癌的主要类型。本研究的目的是评估与血吸虫病相关膀胱癌(SABC)有关的选定基因的早期启动子DNA甲基化。从奥贡州Eggua社区的学龄儿童共收集了159份尿液样本,并用显微镜检查了血血吸虫卵。从该样本中,34份(21.1%)血氧梭菌阳性尿液样本,年龄和性别与阴性尿液对照样本相匹配,以及从大学学院医院获得的16份福尔马林固定石蜡包埋的膀胱癌组织进行DNA分离和亚硫酸盐DNA转化。采用定量甲基化特异性PCR检测样品中APC、RARβ2、RASSF1A和TIMP3的甲基化状态。RARβ2(67.7%)、RASSF1A(38.2%)和TIMP3(52.9%)的高度甲基化在泌尿生殖血吸虫病(UGS)阳性尿液样本中比阴性尿液(对照)样本和膀胱癌组织中更为常见。与对照组相比,阳性尿样中APC、RARβ2、RASSF1A和TIMP3的启动子DNA甲基化分别高出1.4倍、13.3倍、3.4倍和3.8倍。APC (OR: 1.615)和TIMP3(OR: 2.000)的启动子甲基化几率可能随着年龄组的增加而增加;TIMP3的性别(OR: 2.644);和血尿中RARβ2(OR: 1.094)、RASSF1A (OR: 1.143)和TIMP3(OR: 1.842)的相关性,尽管没有显著相关性。结论:血吸虫病患者肿瘤抑制基因启动子DNA甲基化。因此,启动子DNA甲基化可能发生在儿童活动性血吸虫病期间。该结果可作为早期非侵入性生物标志物,用于检测和提示生命后期发生SABC的风险。
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引用次数: 0
Comparison of responses to neoadjuvant and adjuvant chemotherapies in muscle-invasive bladder cancer 肌肉浸润性膀胱癌新辅助与辅助化疗疗效比较
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-25 DOI: 10.1186/s12301-023-00398-8
Serhat Sekmek, Gökhan Ucar, Irfan Karahan, Dogan Bayram, Selin Aktürk Esen, Ismet Seven, Mehmet Ali Nahit Sendur, Dogan Uncu
Bladder cancer surgery is critical for treatment, and systemic treatment before or after cystectomy may be necessary. We aimed to investigate the efficacy and response to neoadjuvant and adjuvant treatments. Data on 93 patients with resectable muscle-invasive bladder cancer were analyzed retrospectively. Patients who received neoadjuvant and adjuvant chemotherapies were included. The neoadjuvant treatment group was divided into pathological responders and non-responders. Overall survival and disease-free survival were calculated. The median age was 61.5 years; there were 6 female and 87 male patients. Baseline characteristics were similar between the groups. While there was no difference in OS between the neoadjuvant and adjuvant treatment groups (20 months vs. not reached), DFS was significantly higher in the adjuvant group (20.6 vs. 25.3 months). While there was no significant difference in DFS between the responders and non-responders to neoadjuvant treatment (20.6 vs. 19.1 months), OS was significantly longer in the responders (Not reached vs. 12.3 months). Our results concluded that neoadjuvant and adjuvant chemotherapies have similar survival rates, but no response was associated with poor outcomes. Determining the group for patient selection may be helpful for optimal management.
膀胱癌手术是治疗的关键,膀胱切除术前后的全身治疗可能是必要的。我们的目的是探讨新辅助治疗和辅助治疗的疗效和反应。回顾性分析93例可切除的肌肉浸润性膀胱癌患者的资料。包括接受新辅助和辅助化疗的患者。新辅助治疗组分为病理应答组和无应答组。计算总生存期和无病生存期。中位年龄为61.5岁;女性6例,男性87例。两组的基线特征相似。虽然新辅助治疗组和辅助治疗组之间的OS没有差异(20个月vs.未达到),但辅助治疗组的DFS明显更高(20.6 vs. 25.3个月)。虽然对新辅助治疗有反应者和无反应者的DFS没有显著差异(20.6个月对19.1个月),但有反应者的OS明显更长(未达到vs. 12.3个月)。我们的研究结果表明,新辅助化疗和辅助化疗具有相似的生存率,但没有反应与不良预后相关。确定患者选择组可能有助于最佳管理。
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引用次数: 0
Laparoscopic versus open partial nephrectomy: prospective randomized study for assessment of surgical, functional, and oncological outcomes 腹腔镜与开放式部分肾切除术:评估手术、功能和肿瘤预后的前瞻性随机研究
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-22 DOI: 10.1186/s12301-023-00397-9
Basheer N. Elmohamady, Rabea Goma, Tarek Gharib, Mohamed K. Mostafa, Islam Nouh
The purpose of this study was to compare the surgical, functional, and oncological outcomes between open partial nephrectomy (OPN) and laparoscopic partial nephrectomy (LPN). This prospective, randomized study was performed on patients who underwent partial nephrectomy under general anesthesia. Patients were randomized using the closed envelope method to either LPN or OPN. Baseline demographics and surgical, functional, and oncological outcomes were compared. A per-protocol analysis was used. Randomized study was conducted on 166 patients. The LPN, in comparison to the OPN group, was associated with significantly shorter hospital stay (3 vs. 4 days), less blood transfusion (10% vs. 12%), longer operative time (134 min vs. 124 min), lower visual analog pain score (7 vs. 8), and lower estimated GFR (70.7 ± 17.5 vs. 72.3 ± 14.7). Oncological and functional results were comparable between LPN and OPN. However, LPN was superior to open surgery because of less hospital stay, visual analog pain score, and blood loss.
本研究的目的是比较开放式部分肾切除术(OPN)和腹腔镜部分肾切除术(LPN)的手术、功能和肿瘤学结果。这项前瞻性、随机研究是在全身麻醉下进行部分肾切除术的患者。患者采用封闭包络法随机分为LPN和OPN两组。比较基线人口统计学、手术、功能和肿瘤结果。采用了按协议分析。随机选取166例患者进行研究。与OPN组相比,LPN组显著缩短住院时间(3天对4天),减少输血(10%对12%),延长手术时间(134分钟对124分钟),降低视觉模拟疼痛评分(7对8),降低GFR(70.7±17.5对72.3±14.7)。LPN和OPN的肿瘤和功能结果具有可比性。然而,LPN优于开放手术,因为住院时间短,视觉模拟疼痛评分低,出血量少。
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引用次数: 0
Huge Renal Leiomyoma Masqurading as Cystic Renal Cell Carcinoma: a case report 伪装成囊性肾细胞癌的巨大肾平滑肌瘤1例
IF 0.5 Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-17 DOI: 10.1186/s12301-023-00395-x
Najeem Adedamola Idowu, Ayoade Adebayo Adekunle, Mumini Wemimo Rasheed, Peter Olalekan Odeyemi
Renal leiomyoma is an extremely rare benign tumour of the kidney. It is mostly asymptomatic. Our aim was to report the first case of symptomatic renal leiomyoma in Nigeria which was suspected to be renal cell carcinoma and our objective was to document the clinical, radiological, histological and treatment of this rare lesion. We describe a 46-year-old woman with a two-week history of right flank pain and intermittent haematuria. The examination was remarkable for the ballotable right kidney. Abdominopelvic sonogram and computed tomography were suggestive of cystic right renal mass with suspicion of right renal cell carcinoma. She had surgical resection of the mass and histopathological analysis showed renal leiomyoma. We have illustrated our experience on the first case of symptomatic renal leiomyoma masquerading as cystic renal cell carcinoma in Nigeria. A high index of suspicion is required for accurate diagnosis. This may go a long way in considering kidney-sparing surgery rather than radical nephrectomy.
肾平滑肌瘤是一种极为罕见的肾脏良性肿瘤。它大多是无症状的。我们的目的是报告尼日利亚第一例疑似肾细胞癌的症状性肾平滑肌瘤,我们的目的是记录这种罕见病变的临床、放射学、组织学和治疗方法。我们描述了一位46岁的女性,有两周的右侧疼痛和间歇性血尿史。右肾球囊检查结果显著。腹部盆腔超音波及电脑断层显示右肾囊性肿块,怀疑为右肾细胞癌。手术切除肿块,病理分析显示为肾平滑肌瘤。我们已经说明了我们的经验,第一例症状性肾平滑肌瘤伪装成囊性肾细胞癌在尼日利亚。准确诊断需要高度的怀疑指数。这可能对考虑保留肾脏手术而不是根治性肾切除术有很大帮助。
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引用次数: 0
Primary scrotal lipoma in a pediatric patient: a case report with current literature review 小儿原发性阴囊脂肪瘤1例,并附文献复习
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-11 DOI: 10.1186/s12301-023-00391-1
Zhino Noori Hussein, Rawa Bapir, Rawa M. Ali, Esmaeel Aghaways, Nali H. Hama, Rezheen J. Rashid, Wirya N. Sabr, Ari M. Abdullah, Zana Baqi Najmadden, Berun A. Abdalla, Fahmi Hussein Kakamad, Dashty Anwar Abdulkareem
Abstract Backgrounds Primary scrotal lipomas are benign fatty tumors that develop from adipocytes of the scrotum. The exact cause of their development is unknown. They are typically painless and may exhibit symptoms of heaviness and discomfort. Case presentation A 9-year-old boy presented with a painless scrotal mass that had been present since birth. The mass was located in the left hemiscrotum. Ultrasound showed an enlarged left testicle with an abnormal outline and heterogeneous texture. Magnetic resonance imaging demonstrated a mass arising from the left hemiscrotum with no invasion of the testis. Under general anesthesia and through a scrotal incision, the mass was excised. Histopathological examination revealed a lipoma. Conclusion Primary scrotal lipomas are benign lesions with an unclear pathogenesis. They are very uncommon in the pediatric age group. Ultrasound is the first-line modality for diagnosing lipomas; however, it may provide ambiguity. MRI provides a more accurate assessment of the mass. Surgical excision of the mass is the standard treatment for primary scrotal lipomas.
摘要背景原发性阴囊脂肪瘤是由阴囊脂肪细胞发展而来的良性脂肪肿瘤。他们发展的确切原因尚不清楚。它们通常是无痛的,可能表现出沉重和不适的症状。病例介绍一名9岁男孩,自出生以来一直存在无痛性阴囊肿块。肿块位于左半球。超声示左侧睾丸肿大,轮廓异常,质地不均一。磁共振成像显示肿块起源于左半阴部,未侵犯睾丸。在全身麻醉下,通过阴囊切口切除肿块。组织病理学检查显示脂肪瘤。结论原发性阴囊脂肪瘤为良性病变,发病机制不明确。它们在儿科年龄组中很少见。超声是诊断脂肪瘤的一线手段;然而,它可能会产生歧义。MRI能更准确地评估肿块。手术切除肿块是原发性阴囊脂肪瘤的标准治疗方法。
{"title":"Primary scrotal lipoma in a pediatric patient: a case report with current literature review","authors":"Zhino Noori Hussein, Rawa Bapir, Rawa M. Ali, Esmaeel Aghaways, Nali H. Hama, Rezheen J. Rashid, Wirya N. Sabr, Ari M. Abdullah, Zana Baqi Najmadden, Berun A. Abdalla, Fahmi Hussein Kakamad, Dashty Anwar Abdulkareem","doi":"10.1186/s12301-023-00391-1","DOIUrl":"https://doi.org/10.1186/s12301-023-00391-1","url":null,"abstract":"Abstract Backgrounds Primary scrotal lipomas are benign fatty tumors that develop from adipocytes of the scrotum. The exact cause of their development is unknown. They are typically painless and may exhibit symptoms of heaviness and discomfort. Case presentation A 9-year-old boy presented with a painless scrotal mass that had been present since birth. The mass was located in the left hemiscrotum. Ultrasound showed an enlarged left testicle with an abnormal outline and heterogeneous texture. Magnetic resonance imaging demonstrated a mass arising from the left hemiscrotum with no invasion of the testis. Under general anesthesia and through a scrotal incision, the mass was excised. Histopathological examination revealed a lipoma. Conclusion Primary scrotal lipomas are benign lesions with an unclear pathogenesis. They are very uncommon in the pediatric age group. Ultrasound is the first-line modality for diagnosing lipomas; however, it may provide ambiguity. MRI provides a more accurate assessment of the mass. Surgical excision of the mass is the standard treatment for primary scrotal lipomas.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"53 22","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041598","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}
引用次数: 0
Investigating bothersome lower urinary tract symptoms among people living with HIV on antiretroviral therapy: prevalence, influencing factors, and quality-of-life implications 在接受抗逆转录病毒治疗的艾滋病毒感染者中调查恼人的下尿路症状:患病率、影响因素和生活质量影响
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-11 DOI: 10.1186/s12301-023-00394-y
Imane H. S. Benyamina, Obadia V. Nyongole, Fransia A. Mushi, Daniel W. Kitua, Aubrey Otieno, Ally H. Mwanga
Abstract Background Urological complications are not uncommon among people living with HIV and are often the initial clinical manifestation of HIV and AIDS. These complications, when presenting with bothersome lower urinary tract symptoms (LUTS), can significantly impact the Quality of life (QoL) of affected individuals. We, therefore, conducted a study aiming at determining the prevalence of bothersome LUTS, identifying factors influencing the severity of these symptoms, and examining their influence on the QoL among people living with HIV on antiretroviral treatment (ART). Methods A cross-sectional study was conducted among randomly selected adult HIV-positive patients who attended the Care and Treatment Center at Muhimbili National Hospital, located in Dar es Salaam, Tanzania, from September 2021 to February 2022. Data was collected using a questionnaire that incorporated the American version of the International Prostate Symptom Score (IPSS). The IPSS was utilized to assess the severity of LUTS and their influence on the QoL. Descriptive statistics were used to summarize the results, and ordinal regression analysis was employed to assess the factors influencing the severity of LUTS. Results The prevalence of LUTS in the study population was 57.8%, with mild symptoms (mean IPSS 3.92 ± 1.92) being the most common manifestation. The mean age of the study participants who presented with LUTS was 47.89 ± 12.05 years, and the majority were females (55.6%). Factors that were significantly associated with increased severity of LUTS included male sex (OR 2.75; 95% CI 1.59–4.75; p < 0.001), age above 49 years (OR 3.02; 95% CI 1.49–6.16; p = 0.002), ART use for over 10 years (OR 3.03; 95% CI 0.9–6.10; p = 0.021), and HIV stage IV (OR 2.42; 95% CI 0.9–3.4; p = 0.047). The majority of the study participants reported an above-average QoL, with only 9.7% of them reporting unhappy-terrible experiences with urinary symptoms. However, a statistically significant (p < 0.001) inverse correlation between QoL and the severity of LUTS was observed. Conclusions In light of these findings, policymakers and healthcare providers should integrate routine assessment and management of LUTS into the care protocols tailored for these high-risk groups. This proactive approach holds the potential to enhance the QoL and overall welfare of people living with HIV.
背景泌尿系统并发症在HIV感染者中并不少见,往往是HIV和AIDS的初始临床表现。这些并发症,当出现麻烦的下尿路症状(LUTS)时,可以显著影响患者的生活质量(QoL)。因此,我们进行了一项研究,旨在确定令人烦恼的LUTS的患病率,确定影响这些症状严重程度的因素,并检查它们对接受抗逆转录病毒治疗(ART)的艾滋病毒感染者生活质量的影响。方法在2021年9月至2022年2月期间,随机选择在坦桑尼亚达累斯萨拉姆Muhimbili国立医院护理和治疗中心就诊的成年艾滋病毒阳性患者进行横断面研究。数据的收集采用了美国版的国际前列腺症状评分(IPSS)问卷。IPSS用于评估LUTS的严重程度及其对生活质量的影响。采用描述性统计对结果进行总结,并采用有序回归分析评估影响LUTS严重程度的因素。结果研究人群中LUTS患病率为57.8%,以轻度症状(平均IPSS 3.92±1.92)为最常见的表现。出现LUTS的研究参与者的平均年龄为47.89±12.05岁,大多数为女性(55.6%)。与LUTS严重程度增加显著相关的因素包括男性(OR 2.75;95% ci 1.59-4.75;p & lt;0.001),年龄大于49岁(OR 3.02;95% ci 1.49-6.16;p = 0.002),使用抗逆转录病毒治疗超过10年(OR 3.03;95% ci 0.9-6.10;p = 0.021)和HIV IV期(OR 2.42;95% ci 0.9-3.4;P = 0.047)。大多数研究参与者报告了高于平均水平的生活质量,只有9.7%的人报告了泌尿系统症状的不愉快经历。然而,统计学上显著(p <0.001),生活质量与LUTS严重程度呈负相关。根据这些发现,决策者和卫生保健提供者应将LUTS的常规评估和管理纳入为这些高危人群量身定制的护理方案中。这种积极主动的方法有可能提高艾滋病毒感染者的生活质量和整体福利。
{"title":"Investigating bothersome lower urinary tract symptoms among people living with HIV on antiretroviral therapy: prevalence, influencing factors, and quality-of-life implications","authors":"Imane H. S. Benyamina, Obadia V. Nyongole, Fransia A. Mushi, Daniel W. Kitua, Aubrey Otieno, Ally H. Mwanga","doi":"10.1186/s12301-023-00394-y","DOIUrl":"https://doi.org/10.1186/s12301-023-00394-y","url":null,"abstract":"Abstract Background Urological complications are not uncommon among people living with HIV and are often the initial clinical manifestation of HIV and AIDS. These complications, when presenting with bothersome lower urinary tract symptoms (LUTS), can significantly impact the Quality of life (QoL) of affected individuals. We, therefore, conducted a study aiming at determining the prevalence of bothersome LUTS, identifying factors influencing the severity of these symptoms, and examining their influence on the QoL among people living with HIV on antiretroviral treatment (ART). Methods A cross-sectional study was conducted among randomly selected adult HIV-positive patients who attended the Care and Treatment Center at Muhimbili National Hospital, located in Dar es Salaam, Tanzania, from September 2021 to February 2022. Data was collected using a questionnaire that incorporated the American version of the International Prostate Symptom Score (IPSS). The IPSS was utilized to assess the severity of LUTS and their influence on the QoL. Descriptive statistics were used to summarize the results, and ordinal regression analysis was employed to assess the factors influencing the severity of LUTS. Results The prevalence of LUTS in the study population was 57.8%, with mild symptoms (mean IPSS 3.92 ± 1.92) being the most common manifestation. The mean age of the study participants who presented with LUTS was 47.89 ± 12.05 years, and the majority were females (55.6%). Factors that were significantly associated with increased severity of LUTS included male sex (OR 2.75; 95% CI 1.59–4.75; p < 0.001), age above 49 years (OR 3.02; 95% CI 1.49–6.16; p = 0.002), ART use for over 10 years (OR 3.03; 95% CI 0.9–6.10; p = 0.021), and HIV stage IV (OR 2.42; 95% CI 0.9–3.4; p = 0.047). The majority of the study participants reported an above-average QoL, with only 9.7% of them reporting unhappy-terrible experiences with urinary symptoms. However, a statistically significant (p < 0.001) inverse correlation between QoL and the severity of LUTS was observed. Conclusions In light of these findings, policymakers and healthcare providers should integrate routine assessment and management of LUTS into the care protocols tailored for these high-risk groups. This proactive approach holds the potential to enhance the QoL and overall welfare of people living with HIV.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"22 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135041686","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}
引用次数: 0
“Duplex sans duplex: a cryptic cause”: a case report “双工无双工:一个神秘的原因”:一个案例报告
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-08 DOI: 10.1186/s12301-023-00396-w
S. Rajkiran Raju, Jobin Pathrose, Dyan D’Souza, Attibele Mahadevaiah Shubha
Abstract Background Duplex kidneys represent an embryologic maldevelopment at time of renogenesis resulting in a spectrum of bifurcation anomalies of the reno-ureteric system. Though most are antenatally detected, recurrent urinary tract infections (UTIs), abdominal mass due to obstruction and incontinence are other common manifestations. Upper moiety ureter is usually obstructed and the lower moiety is refluxing. Management is guided by the percentage function of each of the moieties. A non-functioning system warrants a heminephrectomy. We report a toddler with right flank mass and a provisional diagnosis of right duplex system following investigations but met with a cryptic cause at surgery thereby altering the management. Case presentation A 2 ½ years girl with progressively increasing right abdominal mass for 6 weeks was found to have 12 × 10 cm right non-tender flank mass. Ultrasonography, contrast tomography and nuclear scans showed a right duplex system with obstructed, poorly functioning lower moiety. A lower moiety heminephrectomy was planned but at surgery, a densely adherent cystic structure displacing the right kidney superiorly was noted. On decompressing, the ureter was found to enter the cyst with discontinuation for a length of 6cms before being traced distally to its entry into the bladder. Retrograde pyelogram confirmed mid-ureteral transection and cystic urinoma. The cyst was excised and the ureter reconstructed with an appendicular interposition graft. Child recovered uneventfully and at 8 months follow up is well with good drainage across the conduit. Conclusion The case highlights a rare presentation of mid-ureteral transection with urinoma masquerading as a duplex system and its satisfactory management.
背景:双肾是肾发生时胚胎发育不良导致的肾输尿管系统分叉异常。虽然大多数是在产前检测到的,但复发性尿路感染(uti)、腹部肿块引起的梗阻和尿失禁是其他常见的表现。通常上段输尿管梗阻,下段输尿管返流。管理是由每个部分的百分比功能来指导的。如果系统不能正常工作,就需要切除半肾。我们报告了一名患有右侧肿块的幼儿,在检查后临时诊断为右侧双工系统,但在手术中遇到了一个神秘的原因,从而改变了治疗方法。一名2岁半女孩,右腹部肿块逐渐增大6周,发现右侧腹部肿块为12 × 10 cm,无压痛性肿块。超声,造影和核扫描显示右双工系统梗阻,功能低下。原计划行下半部分肾切除术,但手术时发现右肾上方有致密附着的囊性结构。在减压时,发现输尿管进入囊肿并中断了6cm的长度,然后在远端追踪其进入膀胱。逆行肾盂造影证实输尿管中段横断和囊性尿瘤。切除囊肿,用阑尾间置移植物重建输尿管。患儿恢复平稳,随访8个月,导管引流良好。结论本病例是一例罕见的输尿管中段横断合并泌尿道瘤伪装成双系统的病例,治疗效果良好。
{"title":"“Duplex sans duplex: a cryptic cause”: a case report","authors":"S. Rajkiran Raju, Jobin Pathrose, Dyan D’Souza, Attibele Mahadevaiah Shubha","doi":"10.1186/s12301-023-00396-w","DOIUrl":"https://doi.org/10.1186/s12301-023-00396-w","url":null,"abstract":"Abstract Background Duplex kidneys represent an embryologic maldevelopment at time of renogenesis resulting in a spectrum of bifurcation anomalies of the reno-ureteric system. Though most are antenatally detected, recurrent urinary tract infections (UTIs), abdominal mass due to obstruction and incontinence are other common manifestations. Upper moiety ureter is usually obstructed and the lower moiety is refluxing. Management is guided by the percentage function of each of the moieties. A non-functioning system warrants a heminephrectomy. We report a toddler with right flank mass and a provisional diagnosis of right duplex system following investigations but met with a cryptic cause at surgery thereby altering the management. Case presentation A 2 ½ years girl with progressively increasing right abdominal mass for 6 weeks was found to have 12 × 10 cm right non-tender flank mass. Ultrasonography, contrast tomography and nuclear scans showed a right duplex system with obstructed, poorly functioning lower moiety. A lower moiety heminephrectomy was planned but at surgery, a densely adherent cystic structure displacing the right kidney superiorly was noted. On decompressing, the ureter was found to enter the cyst with discontinuation for a length of 6cms before being traced distally to its entry into the bladder. Retrograde pyelogram confirmed mid-ureteral transection and cystic urinoma. The cyst was excised and the ureter reconstructed with an appendicular interposition graft. Child recovered uneventfully and at 8 months follow up is well with good drainage across the conduit. Conclusion The case highlights a rare presentation of mid-ureteral transection with urinoma masquerading as a duplex system and its satisfactory management.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"103 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135390044","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}
引用次数: 0
Atypical compound melanocytic naevus of the urethral meatus case report 尿道非典型复合黑素细胞痣1例报告
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-11-03 DOI: 10.1186/s12301-023-00388-w
Richard Menzies-Wilson, Sophie Bashall, Rowland Rees, Sally Deverill
Abstract Background Atypical melanocytic naevus (AMN) of the urethral meatus is very rare with only a handful of reported cases. It is important to note that the rarity of AMN in the penis may contribute to a delay in diagnosis and treatment, as well as a lack of awareness among healthcare providers. This is the first case report to describe workup and management of AMN of the urethral meatus of a male, making it a valuable contribution to the literature. Case presentation A Caucasian male patient in his fourth decade presented with a several month history of a pigmented lesion on his glans penis. The differential diagnosis was of malignant melanoma but after biopsy and specialist pathological review, atypical melanocytic naevus was diagnosed. A punch biopsy, followed by two wide local excisions, was undertaken for complete excision and evaluation of the lesion. Conclusion Since AMN cannot be clinically distinguished from malignant melanoma, timely histological evaluation of the lesion is essential for workup. In this case, site and visibility of the lesion, expedient biopsy, and tissue analysis resulted in identification and excision of the naevus early enough for penis preserving surgery to be performed.
摘要背景尿道非典型黑素细胞痣(AMN)非常罕见,仅有少数病例报道。值得注意的是,阴茎中AMN的罕见可能会导致诊断和治疗的延误,以及医疗保健提供者缺乏认识。这是第一个描述男性尿道道AMN的检查和处理的病例报告,使其成为文献的宝贵贡献。病例介绍:一位四十多岁的白人男性患者,在他的阴茎头有几个月的色素性病变史。鉴别诊断为恶性黑色素瘤,但经活检和专科病理检查,诊断为非典型黑素细胞痣。穿孔活检,随后进行两次广泛的局部切除,以完全切除和评估病变。结论由于AMN在临床上不能与恶性黑色素瘤区分,因此及时对病变进行组织学评估对临床检查至关重要。在本例中,病变的位置和可见性、适当的活检和组织分析导致及早发现并切除痣,以便进行阴茎保留手术。
{"title":"Atypical compound melanocytic naevus of the urethral meatus case report","authors":"Richard Menzies-Wilson, Sophie Bashall, Rowland Rees, Sally Deverill","doi":"10.1186/s12301-023-00388-w","DOIUrl":"https://doi.org/10.1186/s12301-023-00388-w","url":null,"abstract":"Abstract Background Atypical melanocytic naevus (AMN) of the urethral meatus is very rare with only a handful of reported cases. It is important to note that the rarity of AMN in the penis may contribute to a delay in diagnosis and treatment, as well as a lack of awareness among healthcare providers. This is the first case report to describe workup and management of AMN of the urethral meatus of a male, making it a valuable contribution to the literature. Case presentation A Caucasian male patient in his fourth decade presented with a several month history of a pigmented lesion on his glans penis. The differential diagnosis was of malignant melanoma but after biopsy and specialist pathological review, atypical melanocytic naevus was diagnosed. A punch biopsy, followed by two wide local excisions, was undertaken for complete excision and evaluation of the lesion. Conclusion Since AMN cannot be clinically distinguished from malignant melanoma, timely histological evaluation of the lesion is essential for workup. In this case, site and visibility of the lesion, expedient biopsy, and tissue analysis resulted in identification and excision of the naevus early enough for penis preserving surgery to be performed.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135868443","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}
引用次数: 0
A case report of Cobb’s collar with posterior urethral valves: a rare entity Cobb颈圈合并后尿道瓣膜1例:罕见病例
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-10-31 DOI: 10.1186/s12301-023-00389-9
Farooq Hameed, Adeel Anwaar
Abstract Background Posterior urethral valve (PUV) is a congenital disorder typically presenting in the neonatal period and is associated with the obstruction of the urinary tract. Cobb’s collar is congenital narrowing of bulbar urethra in infants. It can lead to significant morbidity, which may include irreversible renal failure if left untreated. Case presentation A 21-month-old child presented with acute retention of urine and distended lower abdomen. His baseline tests were normal. Ultrasound KUB showed grossly enlarged bladder with almost 1100-ml residual urine. Foley’s catheterization attempted but failed. Urgent cystoscopy was planned where congenital anterior urethral stricture with posterior urethral valves was seen. DVIU done for urethral stricture followed by fulguration of posterior urethral valves. The patient was discharged from hospital the next day. Conclusion A congenital narrowing of the bulbar urethra is uncommon. Though it is rare, it can occur concomitantly with PUV. If this double pathology is missed can result in serious consequences. Children with recurrent urinary tract infections should be ruled out for anterior urethral strictures.
后尿道瓣膜(PUV)是一种先天性疾病,通常出现在新生儿时期,并与尿路梗阻有关。柯布氏颈圈是婴儿先天性尿道球部狭窄。如果不及时治疗,它可能导致严重的发病率,包括不可逆的肾功能衰竭。一个21个月大的婴儿表现为急性尿潴留和下腹肿胀。他的基线测试正常。超声KUB显示膀胱肿大,残尿近1100毫升。Foley的导尿尝试了,但失败了。发现先天性前尿道狭窄伴后尿道瓣膜者行紧急膀胱镜检查。尿道狭窄伴后尿道瓣灼烧行DVIU治疗。病人第二天就出院了。结论先天性尿道球部狭窄不常见。虽然它很少见,但它可以伴随PUV发生。如果忽略了这双重病理,可能会导致严重的后果。复发性尿路感染患儿应排除前尿道狭窄。
{"title":"A case report of Cobb’s collar with posterior urethral valves: a rare entity","authors":"Farooq Hameed, Adeel Anwaar","doi":"10.1186/s12301-023-00389-9","DOIUrl":"https://doi.org/10.1186/s12301-023-00389-9","url":null,"abstract":"Abstract Background Posterior urethral valve (PUV) is a congenital disorder typically presenting in the neonatal period and is associated with the obstruction of the urinary tract. Cobb’s collar is congenital narrowing of bulbar urethra in infants. It can lead to significant morbidity, which may include irreversible renal failure if left untreated. Case presentation A 21-month-old child presented with acute retention of urine and distended lower abdomen. His baseline tests were normal. Ultrasound KUB showed grossly enlarged bladder with almost 1100-ml residual urine. Foley’s catheterization attempted but failed. Urgent cystoscopy was planned where congenital anterior urethral stricture with posterior urethral valves was seen. DVIU done for urethral stricture followed by fulguration of posterior urethral valves. The patient was discharged from hospital the next day. Conclusion A congenital narrowing of the bulbar urethra is uncommon. Though it is rare, it can occur concomitantly with PUV. If this double pathology is missed can result in serious consequences. Children with recurrent urinary tract infections should be ruled out for anterior urethral strictures.","PeriodicalId":7432,"journal":{"name":"African Journal of Urology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870382","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}
引用次数: 0
Massive pre-prostatic nodal metastasis from localized aggressive prostate cancer removed during robotic-assisted radical prostatectomy with extended pelvic lymph node dissection: a case report with brief literature review 机器人辅助根治性前列腺切除术合并盆腔淋巴结清扫术切除局部侵袭性前列腺癌的大量前列腺前淋巴结转移:1例报告并简要文献回顾
Q4 UROLOGY & NEPHROLOGY Pub Date : 2023-10-30 DOI: 10.1186/s12301-023-00390-2
Moncef Al Barajraji, Serge Holz, Ilan Moussa, Michel Naudin, Pamart Didier
Abstract Background During robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa), few attention is given to pre-prostatic fat tissue (PPT) even during pelvic lymph node dissection (PLND). However, the rare potential involvement of PPT lymph nodes (LN) by PCa metastasis has already been reported by several authors and may influence therapeutic strategy in intermediate and high-risk patients. We present the case of a 69-year-old man who underwent RARP with extended PLND (ePLND) for aggressive PCa with massive pre-prostatic nodal metastasis, sampled during prostate biopsies. We sought to report this case for the particular preoperative images and reinforce benefits of resecting PPT during PLND for PCa.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Moncef] Last name [Al Barajraji].Ok Case presentation A 69-year-old man consulted our department for high serum prostate specific antigen level (57 ng/mL). He had familial history of PCa only at first degree. On digital rectal evaluation, induration of left prostatic lobe was felt. Transrectal ultrasonography showed hypoechogenic lesion in left prostatic lobe with supra-centimetric nodule in PPT. Pelvic magnetic resonance revealed two lesions in the peripheral zone with a 19-mm nodule on right paramedian side of PPT (see Fig. 1). Transrectal ultrasound-guided prostate biopsies were performed, including the nodule. On left side, 2 biopsies out 6 showed Gleason 10 prostate cancer. On right side, all biopsies showed Gleason 9 prostate cancer. The PPT nodule showed Gleason 9 prostate cancer. Prostate specific membrane antigen (PSMA) positron emission tomography computed tomography scan showed hypermetabolic expression from left prostate lesions and PPT nodule. Transperitoneal RARP with ePLND was performed including PPT. Histopathological study revealed advanced prostate cancer with lymphovascular invasion and ECE (see Fig. 2). Evaluation of ePLND material showed metastasis in on pelvic LN and 23 mm nodal metastasis in PPT (see Fig. 2). Therefore, adjuvant therapy was initiated. Please check the edit made in the article title.OPk Conclusions PPT resection is not part of routine RARP with ePLND for PCa. However, this tissue might contain LN harbouring metastasis independently from pelvic LN, indicating adjuvant therapy in case of upstaging. Considering the low morbidity of resecting PPT and its facility, it should always been resected and sent for analysis in intermediate and high-risk PCa.
背景在机器人辅助根治性前列腺切除术(RARP)治疗前列腺癌(PCa)的过程中,即使在盆腔淋巴结清扫(PLND)过程中,也很少关注前列腺前脂肪组织(PPT)。然而,一些作者已经报道了前列腺癌转移对PPT淋巴结(LN)的罕见潜在侵犯,这可能会影响中高危患者的治疗策略。我们报告一名69岁的男性患者,在前列腺活检期间,因侵袭性前列腺癌伴有大量前列腺前淋巴结转移,接受了RARP和扩展PLND (ePLND)。我们试图报告这个病例的特殊术前图像,并强调在前列腺癌PLND期间切除PPT的好处。请确认作者姓名是否准确且顺序正确(名,中间名/首字母,姓)。作者1名:[Moncef]姓[Al Barajraji]。一名69岁男性因血清前列腺特异性抗原高(57 ng/mL)求诊。他有家族病史,仅在一级学位。直肠指诊显示左侧前列腺叶硬结。经直肠超声示左前列腺叶低回声病变伴超厘米结节。盆腔磁共振示外周区2个病变,PPT右侧右侧有一个19mm结节(见图1)。经直肠超声引导下行前列腺活检,包括结节。左侧6例活检中2例Gleason - 10前列腺癌。右侧活检显示Gleason 9型前列腺癌。PPT结节显示Gleason 9型前列腺癌。前列腺特异性膜抗原(PSMA)正电子发射断层扫描显示左侧前列腺病变和PPT结节高代谢表达。经腹腔RARP伴ePLND,包括PPT。组织病理学研究显示晚期前列腺癌伴淋巴血管浸润和ECE(见图2)。ePLND材料评估显示盆腔LN转移,PPT 23 mm淋巴结转移(见图2)。因此,开始辅助治疗。请检查文章标题中的编辑。结论:PPT切除不是前列腺癌ePLND常规RARP的一部分。然而,该组织可能包含独立于盆腔淋巴结转移的淋巴结转移,提示在病情加重的情况下需要辅助治疗。考虑到切除PPT的低发病率和它的便利,在中高风险性前列腺癌中,应该总是切除PPT并送去分析。
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African Journal of Urology
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