ABSTRACT

Renal cell carcinoma has myriad presentations. Inguinal metastasis at presentation is a rare finding in this tumor. Possible mechanisms of such metastasis may include retrograde lymphatic spread or spread via retrograde spermatic vein flow. Excision of the left inguinal nodal mass was done with a left radical nephrectomy. At a 1-year follow-up, there was no evidence of any locoregional or systemic recurrence, even in the absence of systemic adjuvant immunotherapy.

Amit Attam, Arun Kerketta, Sameer Trivedi, Udai Shankar Dwivedi

Submitted April 9, 2012 - Accepted for Publication May 17, 2012

 KEYWORDS: Renal cell carcinoma, inguinal metastasis, varicocele

CORRESPONDENCE: Sameer Trivedi, MCh, Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India ()

CITATION: UroToday Int J. 2012 August;5(4):art 41. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.14

ABSTRACT

Purpose: To present the results of a large multi-institutional series of patients treated with ureteroscopic holmium laser lithotripsy (UHLL) for ureteric stones; demonstrating its safety and efficacy in different age groups, stone locations, and other special situations.

Materials and Methods: The medical records of 239 patients with ureteral stones managed by UHLL were reviewed. Patients’ medical records were reviewed for age, sex, stone laterality, location, the number and size of stones, the need for ureteral dilation, stenting, and residual fragment extraction.

Results: The 239 patients included 199 males and 40 females. The mean age was 40.6 years (range: 5 to 93 years). Six patients had bilateral ureteric stones that were managed in 1 session. The average stone burden was 9.8 mm (range: 4 to 20 mm). The 239 patients harbored 272 ureteral stones and underwent 255 UHLL sessions. Acute ureteral dilation was performed just prior to ureteroscopy in 73 procedures (28.6%). Stone retrieval was done in 124 (48.6%) of the procedures. Twenty-six patients presented with renal insufficiency and were rendered stone-free with UHLL. Following ureteroscopy, minimal stone clearance was noted on the first postoperative day (20%) but improved to 96% after 3 months. The success rate after a single session was 96.3% and increased to 99% after 2 sessions.

Conclusion: This study demonstrates that the use of holmium laser lithotripsy is a safe and effective modality in the treatment of ureteral stones regardless of sex, age, stone location, or stone size. Good stone clearance was also obtained in patients with renal impairment.

 Ahmed S Safwat, Nabil K Bissada, Udaya Kumar, Mahmoud M Osman, Toulupe Bakare, Ehab Eltahawy, Samy Heshmat

Submitted April 17, 2012 - Accepted for Publication June 17, 2012

 KEYWORDS: Urinary stones, ureteral calculi, lithotripsy, laser, anuria

CORRESPONDENCE: Mahmoud M Osman, MD, Department of Urology, Assiut University Hospital, Assiut 71516, Egypt ()

CITATION: UroToday Int J. 2012 August;5(4):art 34. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.07

ABSTRACT

Primary adult soft tissue sarcomas represent 1% of all cancers and represent a treatment challenge for surgeons and oncologists. Of these sarcomas, 15% are located in the retroperitoneum. Randomized series that have examined both radiation therapy and chemotherapy have not shown a survival benefit. Conversely, radiotherapy may delay the time to local recurrence but not overall survival. Our review presents medical records of 5 consecutive patients undergoing retroperitoneal sarcoma excision from May 2004 through February 2006. Images were obtained from the patients’ exams and during their surgical procedures. Surgery is the only potential curative treatment as “retroperitoneal surgeons.” Urologists are completely able to approach these kinds of tumors.

BJ Pereira, R Borges, R Leão, V Grenha, H Coelho, A Brandão, P Temido

Submitted April 4, 2012 - Accepted for Publication April 23, 2012

KEYWORDS: Retroperitoneal sarcomas, liposarcoma, angiosarcoma, rhabdomyosarcoma, pararenal mass, retroperitoneal surgery

CORRESPONDENCE: Bruno Jorge Pereira, MD, Urology Department, Centro Hospitalar de Coimbra, Hospital dos Covões, Quinta dos Vales, São Martinho do Bispo, Coimbra, Protugal ()

CITATION: UroToday Int J. 2012 August;5(4):art 35. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.08

ABSTRACT

Objectives: To analyze the clinical presentation, investigations, and outcome of the surgical treatment of penile fractures.

Methods: We present a retrospective study of 18 consecutive cases of penile fracture presented to our institution from March 2008 to August 2011. All patients were completely evaluated and emergency surgical repair was carried out. The outcome of the surgical repair was analyzed.

Results: Trauma during sexual intercourse was the most common cause of penile fracture. Ultrasonography was accurate in localizing tunical defect in 16 cases. Six patients presented 24 hours after injury. Following surgical repair, 2 patients had painful erection and 1 patient had mild chordee. None of the patients had erectile dysfunction.

Conclusion: Ultrasonography is a good adjunct to clinical examination in diagnosing penile fracture. The long-term outcome of surgical repair is good in all groups, including delayed presentation.

Avinash T Siddaiah, Madhumohan R Prabhudessai, Prashant R Lawande, Nilesh B Talwadker, Rajeev N Palvia, Elphiston Fernandes, Pravin Govardhane, Pankaj D Chari, Prashant TN Mandrekar

Submitted March 14, 2012 - Accepted for Publication April 9, 2012

KEYWORDS: Erectile dysfunction, rupture, ultrasonography, penis, urethra

CORRESPONDENCE: Avinash T Siddaiah, Department of Urology, Goa Medical College, Bambolim, Goa, 403202, India ()

CITATION: UroToday Int J. 2012 August;5(4):art 36. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.09

ABSTRACT

Penile carcinoma with metastasis to umbilicus is a rare entity. We report a case of penile carcinoma with umbilical metastasis in a 46-year-old male. On initial presentation with penile growth over glans and shaft of the penis he was treated by total penectomy with perineal urethrostomy. Three months later, he developed a painful ulcerative mass over umbilicus. Biopsy from the ulcer confirmed metastasis from squamous cell carcinoma penis. Chemotherapy was given, but the patient succumbed to the disease after the first cycle. 

 Simanta Jyoti Nath, Rajeev T Puthenveetil, Saumar J Baruah, Sasanka K Barua, Puskal K Bagchi, Bikash Bawri

Submitted March 8, 2012 - Accepted for Publication April 9, 2012

 KEYWORDS: Carcinoma penis, penectomy, umbilical metastasis

CORRESPONDENCE: Simanta Jyoti Nath, MD, Department of Urology, Gauhati Medical College Hospital, Bhangagarh, Guwahati PIN-781032, Assam, India, ()

CITATION: UroToday Int J. 2012 August;5(4):art 37. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.10

ABSTRACT

Introduction: Ureteropelvic junction obstruction (UPJO) can lead to symptoms such as hydronephrosis and progressive renal damage. We explain our primary experiences about laparoscopic pyeloplasty (LP) as the new probable gold standard in the treatment of UPJO in comparison with open pyeloplasty (OP).

Methods: Between March 2008 and August 2009, after confirming the diagnosis of UPJO, 21 patients underwent transperitoneal dismembered LP and 25 patients underwent dismembered OP. This selection was not randomized and was related to the surgeon’s experience. Success was assessed by IVU and diuretic renograghy 3 months after surgery. Important parameters were compared between 2 groups. P < 0.05 was considered statistically significant.

Results: No significant differences were seen in the mean age and gender between the 2 groups. LP (280 ± 95 minutes) had a significantly (p = 0.003) higher mean operating room time than OP (204 ± 59 minutes). The mean indwelling duration of drainage (LP: 2.5 ± 1.56 days; OP: 2.1 ± 1.14 days; p = 0.31) and the mean postoperative hospital stay (LP: 4.6 ± 1.76 days; OP: 4.3 ± 1.55 days; p = 0.934) were similar between the 2 groups. The mean dosage of postoperative analgesics and complication rates in LP (26.25 mg; 23.8%) were lower than OP (38.33 mg; 36%). But these differences were not significant. The mean duration of return to normal activity after discharge in LP was significantly lower than OP (3.9 versus 5.2 days; p = 0.002).

Conclusion: Despite a shorter operating room time of OP, LP is a gold substitute for OP even in primary experiences due to cosmetic advantages, faster returns to normal activity, and comparable results. Laparoscopic pyeloplasty can be the gold standard treatment for UPJO if LP is performed by experienced and skillful surgeons.

Siavash Falahatkar, Ali Roushani, Hamidreza Nasseh, Ehsan Kazemnezhad, Keivan Gholamjani Moghaddam, Seyedeh Mahboobe Raoofi, Mani Mohiti Asl, Ahmad Enshaei, Alireza Farzan

Submitted April 19, 2012 - Accepted for Publication June 1, 2012

KEYWORDS: Laparoscopic pyeloplasty, open pyeloplasty, ureteropelvic junction obstruction

CORRESPONDENCE: Keivan Gholamjani Moghaddam, MD, Urology Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran ()

CITATION: UroToday Int J. 2012 August;5(4):art 33. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.06

ABSTRACT

A 16-year-old boy underwent visual internal uretherotomy in the lithotomy position for short urethral stricture. The next day, the patient developed right foot drop and sensory loss over the right foot. Published literature describes a long surgery duration in the lithotomy position as the most significant risk factor. In our case, foot drop developed despite short surgical duration in the lithotomy position, signifying the importance of other, less-discussed factors.

 NH Nagaraja, Satyam Sharma, GB Manjuprasad

Submitted January 13, 2012 - Accepted for Publication February 28, 2012 

 KEYWORDS: Foot drop, VIU (visual internal urethrotomy), lithotomy, compartment syndrome

CORRESPONDENCE: Satyam Sharma, Mch, Department of Urology, Institute of Nephrourology, Bangalore, Karnataka, India ()

CITATION: UroToday Int J. 2012 August;5(4):art 38. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.11

ABSTRACT

Introduction: Urethral strictures are first described as causing bladder outlet obstruction in ancient literature dating back to the Greek and Egyptian period. The management of urethral stricture remains a challenge to all urologists, especially for those failing to respond to repeated dilatation or optical urethrotomy, and for strictures recurring after urethroplasty. So the idea is to use stents for preventing stricture recurrence based on mechanical interference, and to prevent the scarring process that ends in contraction.

Objective: In this study, we tried to assess the efficacy and safety of the Memokath 044 temporary stent in the treatment of recurrent bulbar urethral strictures.

Patients and Methods: Between April 2010 and May 2011, 16 patients presented with bladder outlet obstruction (BOO) due to recurrent bulbar urethral strictures. All underwent Memokath 044 stenting. The stents were inserted endoscopically under local or saddle-block anesthesia. Patients were followed up with Qmax , post-void residual urine (PVR), sexual function, and quality of life (QoL) scores at 2 weeks, 1 month, 3 months, 6 months, and 12 months, post-insertion.

Results: All the stents were successfully inserted. The operative time ranged from 20 to 40 minutes (30 ± 6.45) with no intraoperative complications. All patients achieved spontaneous voiding after insertion. The mean Qmax, PVR, and QoL scores significantly improved after the procedure and continued to improve throughtout the follow-up period. There were minimal postoperative complications; transient and treated conservatively. Stent migration took place in 6.25% of cases with easy endoscopic repositioning. Obstruction of the stent lumen occurred in 6.25%, which mandated stent removal.

Conclusion: The Memokath 044 stent is straightforward to insert and to remove, it can relieve the symptoms of BOO due to recurrent bulbar urethral strictures in surgically risky patients, maintaining urethral patency without affecting sexual intimacy and thereby improving the quality of life.

Magdy Ahmad Alsayed El-Tabey

Submitted April 2, 2012 - Accepted for Publication May 3, 2012

KEYWORDS: Uerthral stricture, Memokath 044, stent, bladder outlet obstruction

CORRESPONDENCE: Magdy Ahmad Alsayed EL-Tabey, MD, Department of Urology, Benha University Hospital, Benha, Egypt ().

CITATION: UroToday Int J. 2012 August;5(4):art 29. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.02

Acronyms and Abbreviations

Qmax: Maximum flow rate UTI: Urinary tract infection

PVR: Post-void residual urine

QoL: Quality of life

BOO: Bladder outlet obstruction

VIU: Visual internal urethrotomy

AUR: Acute urinary retention

BPH: Benign prostatic hyperplasia

ABSTRACT

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females worldwide, accounting for 23% of total new cancer cases and 14% of total cancer deaths in 2008. Common metastatic sites include the lungs, bones, liver, lymph nodes, and skin. Less frequently it involves the brain, adrenal glands, ovaries, spleen, pancreas, kidney, thyroid, and heart. There are reports of unusual sites of breast cancer metastases; the urinary bladder and retroperitoneum are considered some of these unusual sites. Metastasis usually occurs many years after diagnosis, and the prognosis is poor. Breast carcinoma metastatic to the retroperitoneum has been reported only sporadically. We report a rare presentation of occult breast carcinoma with obstructive uropathy.

Waleed Mansour Shabana, Tariq Tassadaq, Hosam Al-Oudah, Syed Gillani, Hisham Abu-Taha, Sameh Barayan

Submitted February 13, 2012 - Accepted for Publication February 28, 2012

KEYWORDS: Breast carcinoma, obstructive uropathy

CORRESPONDENCE: Waleed Mansour Shabana, PhD, Zagazig University, Zagazig, Sharkia, Egypt ()

CITATION: UroToday Int J. 2012 August;5(4):art 32. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.05

ABSTRACT

Ovarian dermoid cysts are common lesions accounting for up to 40% of all ovarian neoplasms. Most of the cases are asymptomatic. Symptoms develop once complications set in. Invasion into adjacent viscera such as the rectum, the small bowel, the peritoneum, and the urinary bladder is extremely rare. We present a rare case of ovarian dermoid cyst perforating into the urinary bladder presenting with irritative lower urinary tract symptoms characterized by urgency, frequency, dysuria, poor urine stream, and the passage of hairs and seborrhoeic gravels through the urethra for last 7 years.

Sanjay Kumar Gupta, Manoj Kumar, Mahendra Singh, Vijoy Kumar, Rajesh Kumar Tiwari, Sanjay Kumar Suman, Vijayanand Choudhary

Submitted January 6, 2012 - Accepted for Publication January 26, 2012

KEYWORDS: Dermoid cyst, urinary bladder, ovary, perforation, teratoma

CORRESPONDENCE: Sanjay Kumar Gupta, MS, General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India ()

CITATION: UroToday Int J. 2012 August;5(4):art 31. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.04

ABSTRACT

A fungus ball of the urinary bladder is unusual and it is even more so in cases in which the causative agent is candida tropicalis. We present such a case and briefly discuss the management of a fungus ball of the urinary tract caused by candida tropicalis.

Sivaneswaran Lechmiannandan, Eng Hong Goh, Boon Wei Teoh, Kah Ann Git

Submitted March 5, 2012 - Accepted for Publication April 4, 2012

KEYWORDS: Fungus ball, bladder

CORRESPONDENCE: Eng Hong Goh, Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia ()

CITATION: UroToday Int J. 2012 August;5(4):art 30. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.03

ABSTRACT

Vesicouterine fistula (VUF) is an abnormal communication between the posterior wall of the bladder and the anterior wall of the uterus. Although it represents only 1 to 4% of all urogenital fistulae, its prevalence is increasing all over the world because of the large indications of cesarean section. VUF usually presents with urine leak, amenorrhoea, and cyclic hematuria. It has a considerable marital and social impact and may cause serious urogenital infections. Herein we report on one more case of VUF following cesarean section with review and update of the recent literature regarding the aetiological, diagnostic, and therapeutic aspects of this entity. Some suggestions are mentioned concerning surgical repair and how to minimize their occurrence.

Benatta Mahmoud, Sallami Satáa

Submitted October 24, 2011 - Accepted for Publication March 14, 2012

KEYWORDS: Vesicouterine fistula, cesarean section, surgery, prevention

CORRESPONDENCE: Benatta Mahmoud, MD, Department of Urology, Ehu Oran, Oran, Algeria ().

CITATION: UroToday Int J. 2012 August;5(4):art 28. http://dx.doi.org/10.3834/uij.1944-5784.2012.08.01

Dear Colleagues, 

UroToday International Journal has seen a lot of changes over the years, and as we have grown and evolved with the times, we have continued to focus on accessible, informative content catering to our extensive urology readership. That being said, we knew it was time for some enhancement.

We recently debuted the improved UIJ website, with superior search functionality, an easy-to-navigate archive, and a host of other enhanced options to make each visit to the journal not just productive but enjoyable. We hope that once you’ve browsed our most recent issue, you’ll take a tour of the site to see our fresh, new face. 

In this issue, Siami et al. discuss an effective and generally well-tolerated alternative administration method for intra-abdominal histrelin acetate implants in patients with advanced prostate cancer.

Rasmussen and team determine the results of a 60-person survey regarding the results of anticholinergic therapy on post-void dribbling. Their results suggest anticholinergic medications appear effective in treating PVD with efficacy similar to that of OAB.

Presented in their URO-RISK study, Mendive et al. investigate the epidemiological significance of urinary incontinence and overactive bladder in a primary care setting. They conclude that a higher level of health care be made available.

Elkoushy et al. compare and contrast three different lithotripters and their results during shock wave lithotripsy re-treatment. The big three—Storz, Siemens, and Philips—provide some interesting outcomes.

Al-Ba’adani and colleagues present their expertise in performing tubeless percutaneous nephrolithotomy as well as their diagnoses for indications, safety, and effectiveness.

We also present a variety of case reports, including acute penile prosthesis, ectopic kidney, and robotic partial nephrectomy.

With our new makeover comes a host of possibilities, and we hope that our dedicated readers, writers, and researchers get the most out of each and every article, CME, and case diagnosis available. 

Warm Regards, 

Karl-Erik Andersson

ABSTRACT

Introduction: Luteinizing hormone-releasing hormone (LHRH) agonists are an androgen deprivation therapy used in advanced prostate cancer. The LHRH agonist histrelin is available as an implant of histrelin acetate for once-yearly subcutaneous administration into the upper arm. A single-center, clinical retrospective chart review was performed to characterize the safety and efficacy of abdominal insertion of the histrelin acetate implant.

Methods: Data were collected retrospectively from the charts of 64 patients aged > 45 years with prostate cancer who received the histrelin acetate implant subcutaneously inserted into the abdomen at a single center. Of these, 37 patients received a second implant after 1 year.

Results: Following the first implant, mean serum testosterone levels were 0.38 nmol/L (10.89 ng/dL) at 6 months (n = 19) and 0.52 nmol/L (14.96 ng/dL) at 12 months (n = 33); serum testosterone level was < 1.04 nmol/L (< 30 ng/dL) in 94.7 and 90.9% of patients at 6 and 12 months, respectively. Mean serum prostate-specific antigen levels were 6.56 μg/L (6.56 ng/mL) at 6 months (n = 23) and 4.58 μg/L (4.58 ng/mL) at 12 months (n = 40). Efficacy was maintained in patients who received a second implant. Adverse events occurred in 3 patients. Eleven patients died during the chart review period; these deaths were deemed unrelated to histrelin acetate implant use.

Conclusion: Insertion of the histrelin acetate implant into the abdomen appears to be an effective and generally well-tolerated alternative administration method.

Paul F Siami, Knox Beasley, Sean Woolen, Joseph Zahn

Submitted December 9, 2011 - Accepted for Publication April 4, 2012

KEYWORDS: histrelin acetate, implant, prostate cancer, subcutaneous

CORRESPONDENCE: Paul F Siami, MD, Department of Urology, Deaconess Clinic, 421 Chestnut Street, Evansville, Indiana, 47713, United States ().

CITATION:UroToday Int J. 2012 June;5(3):art 26. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.13

ABSTRACT

Crohn’s disease often is detected in adolescents with nonspecific gastrointestinal complaints. Extraintestinal complications are common but usually follow the onset of the bowel complaints. We present an unusual case in which scrotal swelling was the first symptom in a patient discovered to have Crohn’s disease. This is particularly unusual in that the patient presented as a case of urethral fistula.

Houda Boussourra, Sallami Satáa, Yosra Said, Hatem Rajhi, Najla Menif

Submitted October 1, 2011 - Accepted for Publication October 24, 2011

KEYWORDS: Crohn’s disease, diagnostic, fistula, complication, penis, MRI, treatment

CORRESPONDENCE: Sallami Satáa, Department of Urology, La Rabta Hospital-University, Tunis, Tunisia ().

CITATION: UroToday Int J. 2012 June;5(3):art 25. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.12

ABSTRACT

Objective: To prescribe our experience in performing tubeless percutaneous nephrolithotomy and how we diagnose its indication, safety, and effectiveness.

Methods: Two hundred and fifty-three patients with renal stones were enrolled for a tubeless percutaneous nephrolithotomy with an externalized ureteric catheter. Their ages ranged between 4 to 80 years old, and of the sample, 168 were male and 85 were female. The stones ranged from 15 to 80 mm in size and were located in different areas of the pelvicalceal system. The majority of the procedures were conducted in the prone position while 24 cases were supine. The majority of the patients were treated with a single puncture, 20 patients were treated with double punctures, and 2 patients required 3 punctures. Haemostatic substances were used in only 50 of the patients, with no significant differences when compared to 50 who were treated without. In addition, 40 patients had a history of previous ipsilateral renal surgery, 20 had renal impairments, and 15 had a solitary kidney.

Results: The mean operative time was 44.34 minutes, the mean stent time was 1.1 days, and the mean hospital stay was 1.6 days. The mean drop in Hb levels was 1.67gm/dl, with 3.95% of the patients needing blood transfusions and 12.65% needing postoperative analgesia. The stone-free rate was 91.76% while the overall success rate was 97.25%. Complications were encountered in 7.9% of the patients, most of which were minor and were managed conservatively. One patient suffered from a colonic injury and 2 patients suffered from hydrothorax.

Conclusion: In the era of tubeless percutaneous nephrolithotomy, nephrostomy tube insertion should only be used for large residuals that need a second look. Tubeless percutaneous nephrolithotomy should be extended to include large stones, multiple numbers, multiple punctures, prone or supine positions, sub- or supracostal approaches, recurrent cases, solitary kidneys, renal impairment, extended time, and bilateral simultaneous cases. It’s safe and effective, and it decreases postoperative pain, discomfort, the need for analgesia, and the length of hospital stay.

Tawfik H Al-Ba’adani, Khaled Telha, Shihab Al-Gormozi, Khalid Al-Badwey, Gamil Al-Alimi, Mohammed Alwan, Nabil Al-Gonaid, Ibraheim H El-Nono

Submitted April 2, 2012 - Accepted for Publication May 1, 2012

KEYWORDS: Percutaneous, nephrolithotomy, tubeless, ureteric, catheter

CORRESPONDENCE: Tawfik H Al-Ba’adani, MD, Urology Department, Urology and Nephrology Center, Al-Thawra Modern General/Teaching Hospital, Medical College-Sana’a University, Sana’a, Yemen ().

CITATION: UroToday Int J. 2012 June;5(3):art 17. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.04

Nephrocutaneous fistula is a distressing clinical condition. The fistula can be very difficult to treat and has a high chance of recurrence. The standard treatment of a recurrent fistula is nephrectomy along with the excision of the fistula. We present a case with recurrent nephrocutaneous fistula along with a hypofunctional contralateral kidney. This was a difficult clinical scenario as any compromise of the affected kidney could have resulted in renal failure. The patient was treated with a left upper polar partial nephrectomy and excision of the fistulous tract.

Tarun Jindal, Satyadip Mukherjee, Soumendra Nath Mandal, Dilip Karmakar

Submitted January 17, 2011 - Accepted for Publication February 22, 2012

KEYWORDS: Fistula, kidney, cutaneous

CORRESPONDENCE: Tarun Jindal, MS, Calcutta National Medical College, Kolkata, West Bengal, India ().

CITATION: UroToday Int J. 2012 June;5(3):art 21. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.08

ABSTRACT

Adrenocortical carcinoma (ACC) is a rare tumor that accounts for only 0.02% of all cancers. About 60% of patients present with symptoms of excessive hormone production. However, ACC is usually nonfunctional when it occurs in adults. Its presentation with only virilizing symptoms is extremely rare. We report a case of a huge functional, virilizing ACC of the right adrenal gland that measured 14 cm by 9 cm by 6 cm and weighed 600 gm, which was successfully extirpated.

Bikash Bawri, Rajeev Thekumpadam Puthenveetil, Saumar Jyoti Baruah, Sasanka Kumar Barua, Puskal Kumar Bagchi

Submitted: November 23, 2011 - Accepted for Publication: January 31, 2012

KEYWORDS: Adrenocortical carcinoma, functional, virilizing

CORRESPONDENCE: Bikash Bawri, MD, Gauhati Medical College Hospital, Guwahati, Assam, India ().

CITATION: UroToday Int J. 2012 June;5(3):art 16. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.03

We present an uncommon case of an encrusted urethral hairball in an adult patient who had hypospadias repair during childhood. The management of such a case is discussed briefly and suggestions are made to overcome this issue.

Eng Hong Goh, Omar Syed, Boon Wei Teoh, Kah Ann Git

Submitted December 21, 2011 - Accepted for Publication January 23, 2012 

 KEYWORDS: Urethra, stone, hair

CORRESPONDENCE: Eng Hong Goh, Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia ().

CITATION: UroToday Int J. 2012 June;5(3):art 19. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.06

ABSTRACT

Wilms tumor is rare in adulthood. The prognosis is poor when compared with children. Adults more frequently present with advanced disease stages, and chemotherapy has a moderate effect. The various protocols of chemotherapy and indications for surgery and radiotherapy are not yet precisely defined, mainly due to the rarity of the disease. Here we report a case of adult Wilms tumor with spinal metastases who remains disease free for 3 years after undergoing multimodality treatment.

Vedamurthy Pogula Reddy, Madhurima Pothula, Ravi Shankar Ganji, Surya Prakash Vaddi

Submitted October 24, 2011 - Accepted for Publication November 7, 2011

KEYWORDS: Adult Wilms Tumor, spinal metastases

CORRESPONDENCE: Vedamurthy Pogula Reddy, MS, MCh, Department of Urology & Renal Transplantation, Narayana Medical College, Nellore, Andhra Pradesh, India ().

CITATION: UroToday Int J. 2012 June;5(3):art 24. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.11