Issue 4: August 2012

Letter from the Editor - August 2012

Dear Colleagues,

With new changes come new challenges and we at UroToday International Journal have seen our share. I want to thank our devoted readers and dedicated authors who continue to count on us for our broad content and urologic focus—the basis of which could not be possible without our many reviewers striving to make sure you get the information you need and the articles that matter most in the field. The future of UIJ is bright and we look forward to expanding our readership as the year progresses.

We would also like to encourage everyone to view the new social media outlets promoting the UIJ on both Facebook and Twitter. We hope you’ll take the time to visit our pages, like us, and follow our breaking news.

In this issue, Pereira et al. review medical records of five consecutive patients undergoing retroperitoneal sarcoma excision. Demonstrating that surgery is the only potential curative treatment, urologists can successfully approach these kinds of tumors.

By presenting the results of a large multi-institutional series of patients treated with ureteroscopic holmium laser lithotripsy (UHLL) for ureteric stones, Safwat et al. demonstrate 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.

Siddaiah et al. analyze the clinical presentation, investigations, and outcome of the surgical treatment of penile fractures. Ultrasonography poses a positive adjunct to clinical examination, and the long-term outcome of surgical repair is good for all groups.

El-Tabey examines the management of urethral strictures utilizing the Memokath 044 stent, proving it is straightforward to insert and to remove, it can relieve the symptoms of bladder outlet obstruction due to recurrent bulbar urethral strictures in surgically risky patients. It maintains urethral patency without affecting sexual intimacy and improves quality of life.

Falahatkar et al. explain their primary experiences with laparoscopic pyeloplasty as the new probable gold standard in the treatment of ureteropelvic junction obstruction in comparison to open pyeloplasty. Through their research, they show that laparoscopic pyeloplasty is an excellent substitute due to its cosmetic advantages, faster returns to normal activity, and comparable results.

We also present a series of case studies that include various topics, including foot drop, ovarian dermoid cysts, and ureteric endometriosis with adenomyosis.

It is our primary goal to publish original studies, and we encourage you to submit the results of clinical or basic science research in all areas of urology. I personally thank the authors and reviewers for their valuable contributions to this issue.

Warm Regards, 

Karl-Erik Andersson

Primary Myeloid Sarcoma of the Urinary Bladder


Leukemia is a systemic disease affecting both the hematological system and the extramedullary sites alike. Myeloid sarcoma has been defined as a localized tumor mass of immature cells of granulocytic lineage in extramedullary sites. Myeloid sarcoma usually occurs with or after the onset of systemic leukemia but rarely before it. Localized myeloid sarcoma presenting before the onset of systemic leukemic disease has been termed primary myeloid sarcoma. The most common extramedullary sites affected by myeloid sarcoma are the central neurological system and the testes. The kidneys are the most common genitourinary organ affected by myeloid sarcoma; however, the urinary bladder can be involved. Here we report a rare case of primary myeloid sarcoma of the urinary bladder.

Yeng Kwang Tay, David Pan, Sree Appu, Mark Frydenberg

Submitted March 12, 2012 - Accepted for Publication April 4, 2012

KEYWORDS: Primary myeloid sarcoma, bladder, granulomatous sarcoma

CORRESPONDENCE: Yeng Kwang Tay, MBBS, Monash Medical Centre, Melbourne, Victoria, Australia ()

CITATION: UroToday Int J. 2012 August;5(4):art 40.


Ureteric Endometriosis with Adenomyosis: A Rare Association Leading to the Death of a Kidney


A 34-year-old female presented with recurrent right flank pain with severe dysmenorrhoea. She was diagnosed with a right parametrial mass encasing the right ureter, leading to severe hydroureteronephrosis and non-functioning kidney. Initially she was managed with danazol and showed a positive response but there was a relapse following cessation of danazol. Finally, we performed a right nephroureterectomy with total abdominal hysterectomy and a bilateral salpingo-oophorectomy. The histopathological examination showed right ureteric wall involvement of endometrial tissue, adenomyosis, and chocolate ovarian cysts. The patient is doing well in the last 12 months of follow-up.

Dheeraj Kumar Gupta, Vishwajeet Singh, Rahul Janak Sinha, Pushp Lata Sankhwar

Submitted January 18, 2012 - Accepted for Publication February 17, 2012

KEYWORDS: Ureteric endometriosis, renal loss, chronic pelvic pain

CORRESPONDENCE: Vishwajeet Singh, MS, MCh, Department of Urology, Chhatrapati Shahuji Maharaj Medical University (Formerly KGMC), Lucknow, Uttar Pradesh, India ()

CITATION: UroToday Int J. 2012 August;5(4):art 39.


Renal Cell Carcinoma Presenting with Inguinal Metastasis: A Rare Presentation


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.


A Multi-institutional Study Demonstrating the Safety and Efficacy of Holmium Laser Ureterolithotripsy


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.


Retroperitoneum Beyond the Kidney: Retroperitoneal Sarcomas in a Urology Department


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.


Penile Fractures: Tertiary Center Experience and a Review of the Literature


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.


Page 1 of 3

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.