ABSTRACT

Megalourethra is a non-obstructive dilatation of the penile urethra. It is a rare congenital anomaly characterized by the congenital absence of the corpus spongiosum and/or corpus cavernosum, leading to dilatation of the urethra. Only 80 cases have been reported so far in English literature. Incidence is sporadic with no hereditary or racial predisposition. We report a case of six-year-old child who presented with ballooning of the phallus on micturition and post-void dribbling. The diagnosis of megalourethra was established on the basis of clinical and radiological findings. The patient was successfully managed by reduction urethroplasty. The patient is doing well after 4 years of follow-up.

Sanjay Kumar Gupta, Shashidharan, Khalid Mahmood, Ahsan Ahmed, Atul Khandelwal, Vijoy Kumar, Mahendra Singh

Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

Submitted November 20, 2013 - Accepted for Publication November 28, 2013

KEYWORDS: Megalourethra, scaphoid, reduction urethroplasty

CORRESPONDENCE: Sanjay Kumar Gupta, Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India ()

CITATION: UroToday Int J. 2013 December;6(6):art 74. http://dx.doi.org/10.3834/uij.1944-5784.2013.12.09

ABSTRACT

Recent reports of magnetic beads inserted into the urethra have identified challenges for urologists during removal. Even moderate numbers of these beads in the bladder necessitate open removal due to their tendency to cluster tightly in a spherical formation. This case report describes a novel approach to using the magnetic property of the beads to aid in removal.

Ryan C. Hedgepeth

Center for Urologic Oncology, Gayle and Tom Benson Cancer Center, Ochsner Clinic, New Orleans, Louisiana, United States 70121

Submitted November 15, 2013 - Accepted for Publication December 1, 2013

KEYWORDS: Urethra, bladder, magnetic beads, surgical management, foreign body

CORRESPONDENCE: Ryan C. Hedgepeth, MD, MS, 1514 Jefferson Highway, Center for Urologic Oncology, Gayle and Tom Benson Cancer Center, Ochsner Clinic, New Orleans, Louisiana, United States 70121 ()

CITATION: UroToday Int J. 2013 December;6(6):art 70. http://dx.doi.org/10.3834/uij.1944-5784.2013.12.05

ABSTRACT

Objective: We report the case of the management of neobladder vaginal fistulae and stress incontinence following radical cystectomy with Martius flap interposition and a transobturator sling. We review the literature on the evaluation and treatment of these patients.

Methods: A 62-year-old patient required cystectomy and a Studer’s neobladder, which presents a neobladder vaginal fistula and stress incontinence

Results: Those complications were successfully treated using a vaginal approach with the interposition of a Martius flap and a sling placed after the fistula was repaired.

Conclusions: A neobladder vaginal fistula is a devastating complication. In our experience, we believe that closure in 2 planes by a transvaginal approach with Martius flap interposition plays a crucial role in avoiding a therapeutic abdominal approach. The surgical treatment of stress incontinence in the neobladder has serious potential complications and requires the judicious use of slings, with obturator tape being important in this context.

Francisco-Xavier Elizalde-Benito, Angel-Gabriel Elizalde-Benito, Maria Urra-Palos

Clinica del Pilar de Zaragoza, Zaragoza, Spain

Submitted October 27, 2013 - Accepted for Publication December 1, 2013

KEYWORDS: Fistula, neobladder, incontinence, sling, Martius flap

CORRESPONDENCE: Francisco-Xavier Elizalde-Benito, MD, Clinica del Pilar de Zaragoza, Paseo Ruiseñores 22-24 pta. 12 50006, Zaragoza, Spain ()

CITATION: UroToday Int J. 2013 December;6(6):art 69. http://dx.doi.org/10.3834/uij.1944-5784.2013.12.04

ABSTRACT

A colovesical fistula is the most common type of fistula associated with diverticular disease of the colon. Diverticular disease accounts for 65-75% of vesicoenteric fistulae. We present a case of a 56-year-old male who presented with pneumaturia and fecaluria, and was found to have colovesical fistulae. A micturating cytourethrogram and CECT scan of the abdomen confirmed the diagnosis. Primary repair of the bladder with excision of fistulae and resection anastomosis of the colon was done in a single stage. At the 6-month follow-up, the patient was doing well and was symptom free.

Nikhil Ranjan, Ahsan Ahmed, Kumar Rohit, Mahendra Singh, Rajesh Tiwary, Vijoy Kumar

Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna Bihar, India 800014

Submitted May 4, 2013 - Accepted for Publication September 27, 2013

KEYWORDS: Colovesical fistula, diverticulitis, sigmoid colon

CORRESPONDENCE: Dr. Nikhil Ranjan, Quarter 3/5, Old MDH, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna Bihar, India 800014 ()

CITATION: UroToday Int J. 2013 October;6(5):art 61. http://dx.doi.org/10.3834/uij.1944-5784.2013.10.08