Volume 5

UIJ Volume 5 2012

Ectopic Kidney


This rare case is an unusual form of ectopic kidney in an unusual site in a 4-year-old male child presenting with a history of a lump on the dorsal shaft of the penis since birth. He had a history of repeated UTI and failure of growth. Lump size was small at birth, as mentioned by his parents, and increased in size gradually until the last days when there was a noticable increase in size, with redness of the overlying skin and urine retention after complete investigations and full imaging studies. After a cystoscopy and surgical excision, the diagnosis of ectopic kidney on the penile shaft became clear.

Muhammad Abdullah Rahman Alshwani

Submitted December 7, 2011 - Accepted for Publication January 12, 2012

KEYWORDS: Ectopic kidney, congenital anomalies

CORRESPONDENCE: Muhammad Abdullah Rahman Alshwani, Department of Surgery, Medical College, Kirkuk University, Azadi Teaching Hospital, Kirkuk, Iraq ().

CITATION: UroToday Int J. 2012 June;5(3):art 22. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.09


Hydatid Cyst of a Kidney in a Child: A Case Report


Hydatid disease of the kidney is rare and constitutes only 2 to 4% of all cases of hydatid. Its occurrence in children is even more rare. It ranks third after liver and lung. In the urinary tract, kidneys are generally affected, usually together with multiple organ involvement. An isolated renal hydatid cyst of the kidney without other organ involvement is very rare. We hereby present a case of pure hydatid cyst of the left kidney in a child presenting with left flank swelling and renal colic. She also had episodes of fever on and off for 2 months. On the basis of imaging studies, a diagnosis of hydatid cyst of the left kidney was established. The patient was successfully managed by simple nephrectomy. The patient is doing well at an 8-month follow-up.

Sanjay Kumar Gupta, Ranjit Kumar, Mahendra Singh, Vijoy Kumar, Rajesh K Tiwary, Atul Khandelwal, Vinod Priyadarshi

Submitted December 5, 2011 - Accepted for Publication January 9, 2012

KEYWORDS: Renal, hydatid cyst, simple nephrectomy, floating membrane

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

CITATION: UroToday Int J. 2012 June;5(3):art 20. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.07


A Survey on the Effect of Anticholinergic Therapy on Post-Void Dribbling


Purpose: Post-void dribbling (PVD) is a type of incontinence defined as the involuntary loss of urine immediately after passing urine and rising from the toilet. The purpose of this study was to evaluate whether anticholinergic therapy reduces symptoms of PVD in women placed on therapy for overactive bladder (OAB).

Methods: A survey was administered via telephone to patients being treated for OAB with anticholinergic medications who also carried a diagnosis of PVD. Patients were asked whether PVD symptoms had worsened, were unchanged, or had improved on anticholinergic therapy. Variables such as drug response to OAB symptoms, non-drug treatments for incontinence, and compensatory behaviors to avoid PVD symptoms were included. Other symptoms and variables of voiding dysfunction and medical comorbidities were collected from the medical record. Standard descriptive statistics, Wilcoxon rank sum, and Fisher’s exact tests were used to describe the data.

Results: Sixty participants completed the survey. Of the eligible patients, 82% consented to participate in the survey. Of those, 72% (95% CI: 59%-83%, p < 0.01) improved PVD symptoms on anticholinergic therapy. The response rate for OAB was also 72%. No difference was found between the response to PVD and OAB (p = 1). No other variable measured affected improvement in PVD symptoms on anticholinergic therapy.

Conclusions: In our survey, anticholinergic medications appeared to be effective in treating PVD with an efficacy similar to that of OAB. Additional studies are needed to confirm these findings.

Jessica Rasmussen, Songwon Seo, Tova Ablove

Submitted February 10, 2012 - Accepted for Publication April 17, 2012

KEYWORDS: Incontinence, overactive bladder, post-micturition dribble, survey, urge incontinence, women

CORRESPONDENCE: Tova Ablove, MD, MSc, Assistant Professor, Department of Obstetrics and Gynecology, University of Wisconsin at Madison, Wisconsin, United States ().

CITATION: UroToday Int J. 2012 June;5(3):art 14. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.01


Robotic Partial Nephrectomy in a Morbidly Obese Patient: A Case Report


Laparoscopic surgical management of obese patients can be challenging. Data is limited on the use of robotic-assisted laparoscopic nephrectomy and partial nephrectomy in the management of renal masses in the obese population. We report a case of a morbidly obese white male with a BMI of 56.6 kg/m2 who underwent an uncomplicated robotic partial nephrectomy for 2 right-sided renal masses. We conclude that robotic partial nephrectomy is feasible for the management of renal masses in morbidly obese patients.

Adam B Althaus, Brad M Lake, Sam B Bhayani, R Sherburne Figenshau

Washington University School of Medicine, Department of Surgery, Division of Urologic Surgery, Missouri, United States

Submitted: January 24, 2012 - Accepted for Publication: April 12, 2012

KEYWORDS: Robotic partial nephrectomy, obese

CORRESPONDENCE: Adam Althaus, Washington University School of Medicine, Department of Surgery, Division of Urologic Surgery, 4960 Children’s Place, Campus Box 8242, St. Louis, MO 63110, United States ().

CITATION: UroToday Int J. 2012 June;5(3):art 15. http://dx.doi.org/10.3834/uij.1944-5784.2012.06.02


Transrectal Sectional Sonography (TRSS) in the Diagnosis and Treatment of Prostatic Abscesses


Aim: The aim of this study was to assess the effectiveness of transrectal sectional sonography (TRSS) in the diagnosis and treatment of prostatic abscess.

Materials and Methods: Eighteen patients with prostatic abscess were the material of the present study. The criteria of abscess collection within the prostate gland and the periprostatic tissues were confirmed by TRSS, which guided the aspiration in all patients.

Results: Diagnosis and transperineal needle aspiration of prostatic abscesses were successful in all cases. After the second puncture procedure, recurrence was noted in 2 (11.1%) out of 18 patients, who were further subjected to transurethral unroofing under TRSS vision. The amount of pus drained ranged between 3.6 to 29.3 mL (mean 15.1 mL), compatible with the estimated volume by virtual organ computer-aided analysis (VOCAL) 3D measurements. The organism most frequently involved is escherichia coli. All patients received intravenous antibiotics (third generation cephalosporin) after the midstream urine analysis and further proper antibiotics, according to the aspirated pus culture and sensitivity.

Conclusions: Transrectal sectional sonography could be a more reliable method in the diagnosis of prostatic abscesses. It can provide precise needle guides into the best drainage location of the abscess cavity and justify transurethral unroofing if persistent recurrence is there.

Salah Elwagdy, Mohamed A-Khalek, Abdalla El-Kheshen, Abdel Aziz Aun, Ahmed Eldaly, Amr Mostafa, Ehab Adel, Ashraf Enite

Date Received: January 04, 2012 Accepted on: February 10, 2012

KEYWORDS: Transrectal sectional sonography, prostatic abscess, diagnosis and treatment

CORRESPONDENCE: Salah Elwagdy, Azhar University, Cairo, Egypt ().

UroToday Int J. 2012 Apr;5(2):art 01. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.09


A Case-Matched Comparative Analysis of a Laparoscopic Donor Nephrectomy in Single and Multiple Renal Arteries


Introduction: Laparoscopic live donor nephrectomy (LLDN), in cases with multiple renal arteries, has not been universally practiced worldwide. This paper demonstrates LLDN experience in donors with multiple arteries and compares the results with single artery donors on a case-matched basis.

Methods: Of 553 LLDN surgeries performed between December 1999 and November 2009, 132 cases were performed for multiple renal arteries. One hundred cases were selected. Detailed demographic profiles, operative profiles, and renal function tests in the immediate postoperative period and up to 1 year post transplantation were recorded. A matched comparison was made with 100 cases of LLDN in single arteries.

Results: Ninety-two cases had double arteries, 7 had triple arteries, and 1 revealed quadruple arteries prior to vascular disconnection. One accidental creation of 5 arterial branches was encountered. Warm ischemia time (WIT), total ischemia time (TIT), operative duration, blood loss, analgesic need, and hospital stay were significantly different between 2 groups (p < 0.05). No significant difference was observed in operative complications, renal function at 5 days, time to normalization of creatinine, or creatinine at 1 month, 3 months, and 1 year. Two patients in multiple artery groups required dialysis in the first postoperative week.

Conclusions: LLDN is equally feasible in the scenario of multiple renal arteries.

George P Abraham, Krishanu Das, Krishnamohan Ramaswami, Datson P George, Jisha J Abraham, Thomas J Tachil, Oppukeril S Thampan

Date Received: September 11, 2011 Accepted on: October 14, 2011

KEYWORDS: Laparoscopy, donor nephrectomy

CORRESPONDENCE: Krishanu Das, MS, MRCS, MCh, FCPS, DNB, Senior Specialist in Urology, Lakeshore Hospital, Kochi, 682030, Kerala, India ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 11. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.11


ESRD: end stage renal disease

LLDN: laparoscopic live donor nephrectomy

USG: ultrasound

VCUG: voiding cystourethrogram 3D

CTA: three-dimensional spiral computed tomography angiogram

CTU: computed tomography urogram

MM: millimeter

GRT: Graft retrieval time (minutes)

WIT: Warm ischemia time (minutes)

GRT25, WIT25: GRT, WIT 25 cases, terminal and assisted approach

GRT75, WIT75: GRT, WIT 75 cases, total laparoscopic approach CIT: cold ischemia time (minutes)

TIT: total ischemia time (minutes) RI= resistive index

AT: acceleration time

BMI: body mass index (kg/m2)

BL: blood loss (milliliters)

HS: hospital stay (days)

OD: operation duration (minutes)

OT: time to tolerance of orals (hours)

A: analgesic need (grams of paracetamol)

CNT: serum creatinine normalisation time (days)

Cr5d, Cr1m, Cr3m, Cr6m, Cr1y: serum creatinine at fifth postoperative day, 1 month, 3 months, 6 months, and 1 year post-transplantation (mg/dl)


Laparoscopic or Robotic Sacrocolpopexy with Tension-Free Sling to Prevent and Treat Symptomatic or Occult Stress Urinary Incontinence


Objective: This retrospective review was conducted to assess whether the concomitant use of a tension-free sling (TVT) with minimally invasive sacrocolpopexy for the treatment of pelvic organ prolapse decreases postoperative stress urinary incontinence (SUI) in women with and without preoperative symptoms of stress incontinence.

Design: Women who reported symptoms of SUI and chose to undergo minimally invasive sacrocolpopexy received a concomitant retropubic tension-free sling, and women who did not report symptoms of SUI and who chose to undergo sacrocolpopexy to treat prolapse received a prophylactic concomitant mini-sling. These patients were compared with those that did not have a sling procedure and chose to proceed with a step approach. They were evaluated 3 months and 1 year after surgery. The primary outcomes included measures of stress incontinence (symptoms, stress testing, or treatment) and urge symptoms. Complications with the additional procedures were also tabulated.

Setting: University hospital, single-surgeon cases

Patients: Of 236 women who underwent minimally invasive sacrocolpopexy, 157 were symptomatic with SUI and 75 were not symptomatic with SUI. They are compared with 100 patients who underwent a prolapse repair without incontinence repair in the 2 years prior to this study.

Interventions: One hundred and fifty-seven symptomatic patients underwent a concomitant retropubic sling and 75 asymptomatic patients received a mini-sling.

Measurements and Main Results: One year after surgery, 6.4% of the women in the TVT group and 7.2% of the mini-sling group met 1 or more of the criteria for stress incontinence (p = 0.38). There was no significant difference between the TVT and the mini-sling group in the frequency of urge incontinence (12.7% versus 13.4%, p = 0.44). After surgery, women in both groups were less likely to report bothersome symptoms of stress incontinence compared to those reported previously in the literature (24.5% versus 6.7%, p < 0.001). Major sling complications included cystotomy (8.1%), infection (UTI) (15%), and catheter use for 2 days (12.6%).

Conclusions: In women with or without stress incontinence who were undergoing minimally invasive sacrocolpopexy for prolapse, a full or mini-sling significantly reduced postoperative symptoms of SUI without increasing complications or other lower urinary tract symptoms.

Lauren B Westermann, Jessika Kissling, Neena Agarwala

Date Received: January 26, 2012 Accepted on: March 20, 2012

KEYWORDS: sacracolpopexy, prolapse, SUI, sling, prophylaxis

CORRESPONDENCE: Neena Agarwala, MD, MSc, The Reading Hospital and Medical Center, Reading, Pennsylvania, United States ().

CITATION: UroToday Int J. 2012 April;5(2):art 07. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.13


Outcomes of Prone and Complete Supine Percutaneous Nephrolithotripsy According to Body Mass Index


Introduction: To determine whether body mass index (BMI) can influence the outcomes of percutaneous nephrolithotripsy (PCNL) in the prone and the supine position or cannot.

Materials and Methods: We have reviewed the files of 110 patients who underwent the prone and the complete supine PCNL (csPCNL) between September 2007 and December 2008 in the 3 categories: BMI < 25, 25 > BMI < 30, and BMI > 30.

Results: The demographic data and surgical outcomes of the patients were evaluated. There was no statistically significant difference between groups, except the stone-free rate in the BMI < 25 group, which was higher in the prone position. Moreover, in groups with higher BMIs, the anesthesia time was increased. The overall stone-free rate was 78 and 73.3% in the prone and supine positions, respectively (p = 0.57). No statistically significant differences were found, except a higher incidence of fever in the prone approach and a significantly shorter anesthesia time in the complete supine position.

Conclusion: The outcomes of PCNL in both positions were not dependent on the patient‘s BMI. Also, the anesthesia time was prolonged in patients with a higher BMI. This study showed that the prone and the supine PCNL in obese and morbidly obese patients were safe and effective.

Siavash Falahatkar, Marzieh Akbarpour, Ahmad Enshaei, Samaneh Esmaeili, Amin Afsharimoghaddam

Date Received: January 10, 2012 Accepted on: February 14, 2012

KEYWORDS: Complete supine PCNL, prone PCNL, BMI, stone-free rate, fever, total ultrasonic guidance

CORRESPONDENCE:Siavash Falahatkar, Professor of Urology, Urology Research Center, Razi Hospital, Sardare Jangal Street, Rasht, Gilan Province, Iran ()

CITATION: UroToday Int J. 2012 Apr;5(2):art 12. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.12


Urological Cancer Metastasis to the Brain: When Should We Resect?


Introduction: Although metastasis from urological malignancies to the brain occur late in the disease process and are typically associated with a poor prognosis, prolonged survival and excellent quality of life is achievable in a small, select population of patients. Surgical management has historically been utilized with large brain metastases, resulting in rapid increases in intracranial pressure and/or severe neurological deficits; however, the indications for surgical resection in the nonemergent setting are less clear.

Methods: The National Library of Medicine search engine PubMed was used to search for terms, including “brain metastasis, renal cell carcinoma,” “brain metastasis, bladder cancer,” “brain metastasis, prostate cancer,” and “brain metastasis, nonseminomatous testicular germ cell tumors.”

Results: Patients with renal cell carcinoma who typically have well circumscribed, firm radio and chemoresistant brain metastasis and patients with nonseminomatous testicular germ cell tumors who are generally younger with synchronous brain metastasis should be considered for aggressive surgical resection. Patients with brain metastasis from bladder or prostate cancer have a poor overall prognosis, and surgical resection is typically used only to improve quality of life, if not marginally extend survival.

Conclusion: Brain metastasis from urologic cancers are a late disease manifestation and surgical therapy is reserved for patients with a good Karnofsky Performance Status (> 70), minimal-to-no systemic disease, solitary large lesions (preferably > 3 cm), and those with a life expectancy of more than 3 months.

Zachary Klaassen, Faris Shweikeh, Ronald S Chamberlain

Date Received: January 26, 2012 Accepted on: February 22, 2012

KEYWORDS: brain metastasis, renal cell carcinoma, bladder cancer, prostate cancer, nonseminomatous testicular germ cell tumors

CORRESPONDENCE: Ronald S. Chamberlain, Chairman and Surgeon-in-Chief, MD, MPA, FACS, Saint Barnabas Medical Center, Livingston, New Jersey, 07039 United States ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 10. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.10


Transitional Cell Carcinoma of the Bladder in Young Adults: Presentation, Natural History, and Outcome of 158 Cases


Background: The natural history of bladder transitional cell carcinoma (TCC) in young patients remains a matter of debate.

Purpose: To compare the clinicopathological characteristics and the prognosis of bladder TCC according to age in young adults.

Materials and Methods: From 1993 to 2006, 158 patients < 50 years with newly diagnosed bladder TCC were enrolled in this study. Patients were subdivided into 3 age groups: < 30 years (group I, n = 10), < 40 but > 30 years (group II, n = 37), and > 40 years (group III, n = 111). Data were analyzed with the Kaplan-Meier method to assess disease recurrence, progression, and survival.

Results: The study consisted of 140 males and 18 females. Eighty (50.6%) patients presented with pTa, 55 (34.8%) with pT1, and 23 (14.5%) with pT2-T3. The follow-up duration ranged from 36 to 158 months. The recurring tumors were stage Ta in 13 patients and stage T1 in 15. Five patients progressed to invasive cancer. The overall cancer-specific survival rate was 93%. The tumor size (p = 0.10), multiplicity (p = 0.71), tumor location (p = 0.60), T stage (p = 0.34), and tumor grade (p = 0.21) were similar in the 3 groups. The 5-year recurrence-free rates were 66.7, 77.4, and 81% (p = 0.76), respectively. The 5-year progression-free rates were 100, 96.8, and 95.8% (p = 0.74), respectively. The 5-year cancer-specific survival rates were similar in the 3 groups (p = 0.56).

Conclusion: Initial bladder TCC stage and natural history in young adults under 40 years old are similar to that in older patients.

Sallami Satâa, Adel Dahmani, Karim Cherif, Ines Chelly, Nidhameddine Kchir, Ali Horchani

Date Received: September 16, 2011 Accepted on: October 21, 2011

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

Citation: UroToday Int J. 2012 April;5(2):art 07. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.07


Spontaneous Ureteric Rupture: An Uncommon Emergency


Spontaneous ureteric rupture is an uncommon urologic emergency. Its presentation can vary, leading to clinical diagnostic challenges. We describe such a case, and its presentation is discussed briefly.

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

Date Received: September 11, 2011 Accepted on: November 07, 2011

KEYWORDS: Spontaneous, ureter, rupture, perforation

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 Apr;5(2):art 3. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.03


Isolated Renal Hydatid Cyst: A Report of 2 Cases


Human echinococcosis remains a complex problem that affects several organs. Primary involvement of the kidney without the involvement of the liver and lungs is very rare. The treatment of a renal hydatid cyst usually requires intervention ranging from minimally invasive percutaneous aspiration techniques to laparoscopic and open techniques. Herein, we describe 2 cases of isolated renal hydatid cysts treated successfully by cyst excision, with open techniques without content spillage. They were treated with 400 mg of albendazole for 2 months. The patients showed no evidence of recurrence within their 2-year follow-up.

Vijayabhaskar Reddy Gouru, Surya Prakash Vaddi, Vedamurthy Pogula Reddy, Chandra Mohan Godala, Ajit Vikram, Sreedhar D, Punit M, Venkata Krishna

Date Received: July 27, 2011 Accepted on: November 13, 2012

KEYWORDS: Hydatid disease, kidney, isolated renal hydatid

CORRESPONDENCE: Vedamurthy Pogula Reddy, Narayana Medical College, Nellore, Andhra Pradesh, India ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 06. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.06


Pelvic Lipomatosis: A Rare Case with a Good Surgical Outcome


Pelvic lipomatosis is defined as a condition characterized by the diffuse proliferation of normal mature fatty tissue in the perirectal and perivesical region. We report a case of a 40-year-old, obese male who presented with marked lower urinary tract symptoms. Imaging studies and blood tests revealed bilateral hydroureteronephrosis and right non-excretory kidney with deranged renal function. Diagnosis of the pelvic lipomatosis was established on the basis of clinical and radiological findings. The patient was successfully managed by simple cystectomy and ileal conduit. After 6 years of follow-up, the patient is doing well with normal renal parameters.

Sanjay Kumar Gupta, Mahendra Singh, Vijoy Kumar, Rajesh Tiwari, Sanjay K Suman, Atul Khandelwal, Vinod Priyadarshi

Date Received: December 03, 2011 Accepted on: January 04, 2012

KEYWORDS: Pelvic lipomatosis, pear shaped bladder, simple cystectomy, cystitis glandularis

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

CITATION: UroToday Int J. 2012 Apr;5(2):art 4. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.04


High-Grade Pleomorphic Sarcoma of the Scrotum: A Rare Clinical Entity


A majority of the malignant extratesticular tumors arise from the spermatic cord. Sarcomas are the most common malignant tumor, with rhabdomyosarcoma being common in children while liposarcoma is common in adults. However, pleomorphic sarcoma, leiomyosarcoma, mesothelioma, and lymphoma also occur in the scrotum. High-grade pleomorphic sarcoma is a rarely reported tumor of the scrotum.

Atul Khandelwal, Sanjay Kumar Gupta, Mahendra Singh, Vijoy Kumar, Rajesh Tiwari, Anju Singh

Date Received: October 21, 2011 Accepted on: January 04, 2012

KEYWORDS: Paratesticular, sarcoma, scrotal, malignant

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

CITATION: UroToday Int J. 2012 Apr;5(2):art 5. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.05


A Rare Presentation of Penopubic Testis in an Infant


An ectopic testis is defined as one that has emerged from the external ring but fails to reach the scrotum. There are, in general, 5 sites of ectopic testis. A rare case of penopubic ectopic testis is reported here. A 6-month-old infant presented with penopubic ectopic testis. An orchidopexy was performed. During the operation, a gubernacular attachment was not found on the testis. Although Lockwood’s 5 tails of gubernaculum form a commonly quoted mechanism of ectopic testis, our case could not fit in this mechanism since the gubernaculum was absent. A break in the gubernaculum during testicular descent, as suggested by Sonneland, leaving the testis radar-less after its exit from the superficial ring, may be an explanation for ectopic location in our case.

Nitinkumar Bhajandas Borkar, Nitin Pant, Satish Kumar Aggarwal

Date Received: November 26, 2011 Accepted on: January 06, 2012

KEYWORDS: Ectopic, penopubic, testis

CORRESPONDENCE: Nitinkumar Bhajandas Borkar, MCh, Department of Pediatric Surgery, Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra, India ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 92. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.02


Megacalycosis or Puigvert Disease, a Rare Congenital Calyceal Anomaly: A Report of 3 Cases


Megacalycosis is most likely congenital. It is primarily a disease of the renal calyces, which is usually diagnosed because of its complications, such as calculi or infections in the urinary tract. It has also been diagnosed prenatally. In the absence of complications, the disease is discovered accidentally in the course of urologic examination undertaken for a different reason. This article reports 3 cases of megacalycosis presenting to us with varying symptoms. Awareness of the possible existence of megacalycosis in patients suffering from infections and calculi in the urinary tract contributes to and facilitates the choice of appropriate treatment.

Bikash Bawri, Rajeev T Puthenveetil, Saumar J Baruah, Sassanka K Barua, Puskal K Bagchi

Date Received: November 23, 2011 Accepted on: December 22, 2011

KEYWORDS: Megacalycosis, hydronephrosis, nonobstructive

CORRESPONDENCE: Bikash Bawri, RK Singh Apartment, House No 54, Ashram Road, Kasturba Nagar, Ulubari, Guwahati-781007, Assam, India ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 01. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.01


Decellularized Porcine-Derived Blood Vessel Matrix Graft for Urethral Replacement in a Rabbit Model


Objective: To evaluate a xenographic urethral replacement model utilizing porcine-derived, decellularized blood vessel matrices in rabbits.

Materials and Methods: In 17 male rabbits, a 1 cm tubular segment of porcine, acellular blood vessel matrix replaced a 1 cm urethral defect without a postoperative catheter. The animals were sacrificed at varying intervals (1, 3, and 6 months) and assessed for graft patency and integration properties.

Results: All but 1 animal survived. One animal died of unknown etiology 1 month after surgery. In all 17 rabbits, the urethra was patent, without evidence of stricture formation as confirmed by gross inspection and passage of a 10 Fr catheter at the time of euthanasia/tissue harvest. At 1 month, histological examination revealed epithelialization, host-cell infiltration, angiogenesis, and migration of the smooth muscle. The smooth muscle bundles were more organized by 6 months. No significant fibrosis or stricture was observed in the anastomotic area.

Conclusion: This successful experiment would support efforts for further investigation of a potentially off-the-shelf product using acellular blood vessel matrices for single-stage urethral reconstruction without requiring stem cell technology. To our knowledge, this is the first report of a xenograft blood vessel matrix for urethral substitution.

Sam Kuykendall, Gilad A Amiel, Erin T Bird

Date Received: November 22, 2011 Accepted on: February 02, 2012

KEYWORDS: Urethra, graft, repair, urethroplasty, biomaterial

CORRESPONDENCE: Sam Kuykendall, MD, Scott and White, Texas A&M Health Science Center, Temple, Texas, United States ().

CITATION: UroToday Int J. 2012 Apr;5(2):art 8. http://dx.doi.org/10.3834/uij.1944-5784.2012.04.08


Letter from the Editor - February 2012

Dear Colleagues,

Welcome to our first issue of 2012. UroToday International Journal has come a long way, and though there have been various changes, we remain a truly unique publication with a global reach. It’s a new year, but our formula is still the same—provide informative articles written by a broad spectrum of investigators from all over the globe. Thanks to our free manuscript submission and peer review, there is more to come, and we look forward to sharing all of the new and exciting content 2012 will offer to our worldwide readership.

Drake et al. present a thorough review of lower urinary tract dysfunction and its management in patients with neurological disease. They suggest a multidisciplinary approach, through various assessments and treatments, to achieve full rehabilitation and support.

Sherif et al. evaluate the technical aspects, success rates, and the complications of percutaneous nephrolithotomy in the supine position. Using ultrasound-guided renal puncture, they demonstrate a feasible, safe, and successful operation technique, with minimal complications

There is continued intensive research involving overactive bladder; however, Ho et al. argue that documentation of OAB in the Malaysian community has been neglected. Their study sheds light on the high prevalence of OAB, warranting close attention to the issue and an outline of preemptive measures.

Although epidemiological studies of penile cancer in Brazil are rare, de Andrade et al. discuss the highly affected male population, assessing various risk factors, such as socioeconomic status, access to medical care, and hygiene.

Siami et al. investigate dutasteride therapy with as-needed tamsulosin in the prevention of further lower urinary tract symptoms in patients with benign prostatic hyperplasia. Their research demonstrates little or no deterioration in the final 12 months of study.

We also present a series of case studies that include various topics, including psuedotumor of the urachus, Mondor’s disease of the penis, and Wilms tumor.

I offer my sincere thanks to our dedicated authors and readers, and to all of the reviewers who share their expertise and assist us in publishing this journal. We look forward to another successful and productive year.

Kind regards,

Karl-Erik Andersson

Lymphoepithelioma-like Carcinoma of the Bladder: Is the Prognosis Different from Conventional Bladder Carcinoma?


Recognition of other histological variants of urothelial carcinoma of the bladder is important because they may mimic benign lesions or have different clinical implications and associated prognoses, as well as treatment protocols. We report a case of lymphoepithelioma-like carcinoma (LELCA) in the bladder and discuss this rare entity with a review of other articles. Although we could not draw a conclusion on this particular disease, it is hoped that by adding cases with sufficient detail into literature, we will enable a more thorough and meaningful study where characteristics of the disease and the appropriate treatment regime could be facilitated.

KEYWORDS: Bladder; Lymphoepithelioma-like carcinoma; Cancer

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 Feb;5(1):art 84. http://dx.doi.org/10.3834/uij.1944-5784.2012.02.02


Mondor’s Disease of the Penis: A Forgotten Entity


Introduction: Thrombophlebitis of the superficial dorsal vein of the penis, known as Mondor’s disease of the penis, was first described by Braun-Falco in 1955.

Case Presentation: An apparently healthy 37-year-old man presented with painful swelling of the dorsal aspect of his penis. Doppler ultrasonography revealed a noncompressible portion of superficial dorsal vein of the penis, as well as the lack of venous flow signals. The patient was treated conservatively.

Conclusion: Mondor’s disease of the penis is a rare clinical entity and a urologist should be aware of this condition.

Kapil Singla, Ashish Kumar Sharma, Sistla Bobby Viswaroop, Ganesh Gopalakrishnan, Sangam Vedanayagam Kandasami

Department of Urology, Vedanayagam Hospital, Coimbatore, Tamil Nadu, India

Submitted: October 19, 2011

Accepted for Publication: November 23, 2011

KEYWORDS: Mondor’s disease; Superficial thrombophlebitis; Conservative management

CORRESPONDENCE: Kapil Singla, Department of Urology, Vedanayagam Hospital, Coimbatore, Tamil Nadu, India 641 002 ().

CITATION: UroToday Int J. 2012 Feb;5(1):art 87. http://dx.doi.org/10.3834/uij.1944-5784.2012.02.05





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