Volume 5

UIJ Volume 5 2012

Letter from the Editor - December 2012

Dear Colleagues,

We at UroToday International Journal have seen the course of another year come and go, and with it, many changes have transpired. We have seen updates to our website that have increased your ability to view our articles, submit to our journal, and have an all-around joyful experience.

As always, with the New Year, we hope to increase our readership and global community so to better provide articles of importance, as well as interest. And, with our new archiving opportunities with Portico, we know the information offered through UIJ is here to stay.

In this issue, a review from Leao and team discusses the relationship between urinary tract symptoms and renal damage, bearing in mind the epidemiology and pathophysiology of benign prostatic hyperplasia (BPH) and potential associations. They emphasize that renal damage secondary to BPH is a preventable disease.

Three studies came to us from Satáa et al.: In one, they conducted a study to evaluate the correlation between Gleason scores obtained on prostate biopsies and radical prostatectomy. They determine that the accuracy of Gleason scores determined by transrectal needle biopsy in patients with prostate cancer seems unreliable.

In the second, they examined the various modalities employed in the diagnosis and treatment of patients with Crohn disease complicated by fistulae, and they discovered that treatment, based on resection of the diseased bowel and extirpation of the fistula, could be accomplished with minimal morbidity and mortality.

In the third, they report experiences and results of balloon antegrade dilatations for benign ureteroenteric anastomotic strictures after total cystectomy and urinary diversion by ileal conduit, concluding that it is a minimally invasive and effective treatment option.

Singh et al. present their experience performing percutaneous nephrolithotomy in solitary kidneys, and they assess the postoperative complications and importance of nadir serum creatinine as a marker of long-term renal function. They find that nadir serum creatinine remains the most important predictor of long-term renal function.

We also present a series of case studies on several topics, including migratory intrauterine contraceptive devices, the use of guide wires, and horseshoe kidney malignancies, among others.

We are always grateful to our loyal readership and our ever-increasing list of authors who have contributed to UIJ after all these years. Without your dedication, we would not be where we are today. Thank you for your support. 

Warm regards, 

Karl-Erik Andersson

Malignancy of a Horseshoe Kidney: A Case Series with a Rare Presentation


Horseshoe kidney is the most common fusion anomaly. Patients with horseshoe kidney typically present with symptoms related to infection, stone formation, and hydronephrosis. Rarely, patients may present with malignancy of horseshoe kidney, and most of them arise from isthmus. We are presenting a case series of 2 cases of renal cell carcinoma arising from horseshoe kidney.

Navin Ram, Bharat Behera, Sudheer Rathi, Sameer Trivedi, Uday Shankar Dwivedi

Submitted September 6, 2012 - Accepted for Publication November 8, 2012

KEYWORDS: Clear-cell carcinoma, fusion anomaly, horseshoe kidney, papillary-cell carcinoma, renal cell carcinoma

CORRESPONDENCE: Sameer Trivedi, Associate Professor Mch, DNB, Department of Urology, Institute of Medical Sciences, Banaras Hindu University,  Varanasi, Uttar Pradesh, India, 221005 ()

CITATION: UroToday Int J. 2012 December;5(6):art 70. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.15



Ectopic Scrotum: A Rare Clinical Entity


Congenital scrotal disorders, including penoscrotal transposition, bifid scrotum, ectopic scrotum, and accessory scrotum are unusual anomalies. We present a case of ectopic scrotum with renal agenesis.

Atul Khandelwal, Mahendra Singh, Rajesh Tiwari, Vijoy Kumar, Sanjay Kumar Gupta, Rohit Upadhyay

Submitted October 11, 2012 - Accepted for Publication November 8, 2012

KEYWORDS: Ectopic, scrotum, suprainguinal

CORRESPONDENCE: Atul Khandelwal, MBBS, MS, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India ()

CITATION: UroToday Int J. 2012 December;5(6):art 68. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.13



Retroperitoneal Ganglioneuroma: A Rare Case Presenting As Right Ureteric Colic


Background: Ganglioneuromas are rare benign tumors arising from the autonomic nervous system, and they are composed of well-differentiated Schwann and ganglion cells.

Case Report: An 11-year-old girl presented with colicky right loin pain that had occurred on and off for the past 1 year. On evaluation, she was found to have a retroperitoneal mass of 6 cm x 4 cm just below the right renal hilum. Her laboratory parameters were normal. The mass was hormonally silent. Surgery was performed and the mass was resected completely. The mass was closely opposed to the inferior vena cava with tributaries to it. Fibrous attachments were also noted on the spine, which were freed. Her histopathology and immunohistochemistry confirmed the mass to be a ganglioneuroma. Her neuron-specific enolase marker was positive. She was symptom free at 3 months post surgery, and her imaging was normal.

Conclusion: Ganglioneuromas have an excellent prognosis. This case is presented for its rarity and unique presentation as right colicky pain.

Paul Vincent, Udaya Kumar

Submitted October 2, 2012 - Accepted for Publication November 8, 2012

KEYWORDS: Ganglioneuroma, retroperitoneal mass, retroperitoneal ganglioneuroma, ureteric colic

CORRESPONDENCE: Paul Vincent, MBBS, DNB (General Surgery), DNB (Urology), MIMS Hospital, Kottakkal, Kottakkal, Kerala, India

CITATION: UroToday Int J. 2012 December;5(6):art 71. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.16


Metanephric Adenoma of the Kidney: Can We Take a Step Forward in a Presurgery Diagnosis?


The widespread use of imaging diagnostic tools has led to the detection of a greatly increased number of incidental renal tumors. Many of these tumors are benign and can be treated with nephron sparing surgery or radical nephrectomy. However, the clinical and even imagiological aspects of these histopathologically benign tumors are too scarce and nonpathognomonic, making their diagnosis rather difficult. Metanephric adenoma (MA) of the kidney, a rare and benign neoplasm, is an example of an entity usually difficult to distinguish from malignant neoplasms. We report one clinical case and review of this clinical entity emphasizing the need for better and more accurate diagnostic means for benign renal masses.

R. R. Leão, B. J. Pereira, R. Borges, V. Grenha, H. Coelho

Submitted August 13, 2012 - Accepted for Publication October 25, 2012

KEYWORDS: Echinococcus, cystic hydatid disease, retroperitoneum, secondary hypertension

CORRESPONDENCE: Ricardo Romão Nazário Leão, Department of Urology and Renal Transplantation, University Hospital Center EPE General Hospital, Quinta dos Vales, Sao Martinho do Bispo, 3041 Coimbra, Portugal ()

CITATION:UroToday Int J. 2012 December;5(6):art 67. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.12



Spontaneous Transvesical Migration of a Foreign Body


Spontaneous migration of foreign bodies into the bladder is rare. Patients present late with urinary symptoms. Here we report two such cases of delayed tranvesical migration: a large bullet and an intrauterine device (Copper-T), with their successful retrieval by endoscope and a minimally invasive procedure.

Tapas Kumar Majhi, Supriya Basu, Anowar Ali Mallick, Dilip Kumar Pal

Submitted October 11, 2012 - Accepted for Publication November 8, 2012

KEYWORDS: Foreign bodies, intravesical, migration, IUD

CORRESPONDENCE: Dilip Kumar Pal, Vinayak Garden, Flat No. A/3D 41B, Simla Road, Kolkata, 700006, India ()

CITATION: UroToday Int J. 2012 December;5(6):art 69. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.14


The Guide Wire: When Too Much of a Good Thing Is No Good at All


The guide wire is a very useful medical device that helps make the cannulation of blood vessels or hollow structures safer. However, guide wires themselves can be a source of complication, such as with perforation and bleeding. Kinking of the guide wire is another complication that is less described. We postulate the sequence of events that precede kinking and discuss the ways to avoid them.

 A 60-year-old man underwent optical urethrotomy for a bulbar urethral stricture. A guide wire was passed into an existing suprapubic catheter (SPC) track to facilitate the passage of a flexible cystoscope. This was performed to examine the proximal extent of the urethral stricture. At the end of the procedure, there was unexpected resistance when withdrawing the guide wire from the bladder. Cystoscopic examination via the SPC track eased the guide wire out eventually. It was found that a kink in the guide wire had prevented its smooth retrieval. The cause of this complication was likely due to looping of the guide wire within the bladder. The loop then resulted in the guide wire getting kinked. In order to prevent kinking, one must avoid looping. Looping occurs when an excessive length of guide wire is forced into a confined space. Therefore, it is important to stop advancing the guide wire when resistance is felt. Another method to avert this problem is to first estimate the length of guide wire that would pass into the space without it curling back. Then pass the guide wire only up to the point where it is deemed adequate. By practicing such precautions, the chances of running into a complication, such as guide wire kinking, can be reduced significantly.

Guan Hee Tan, Hemanth Kumar Ramasamy, Kah Ann Git

Submitted July 26, 2012 - Accepted for Publication August 10, 2012

KEYWORDS: guide wire, complications, endourology

CORRESPONDENCE: Guan Hee Tan, MBBS, MRCS, MS, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia ()

CITATION: UroToday Int J. 2012 December;5(6):art 65. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.10


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