Case Reports in Urology http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Hormonal Treatment for Severe Hydronephrosis Caused by Bladder Endometriosis Tue, 18 Nov 2014 10:53:29 +0000 http://www.hindawi.com/journals/criu/2014/891295/ The incidence of endometriosis cases involving the urinary system has recently increased, and the bladder is a specific zone where endometriosis is most commonly seen in the urinary system. In the case presented here, a patient presented to the emergency department with the complaint of side pain and was examined and diagnosed with severe hydronephrosis and bladder endometriosis was determined in the etiology. After the patient was pathologically diagnosed, Levonorgestrel-Releasing Intrauterine System (LNG-IUS) was administered to the uterine cavity. At the 12-month follow-up, endometriosis was not observed in the cystoscopy and symptoms had completely regressed. Hydronephrosis may be observed after exposure of the ureter, and silent renal function loss may develop in patients suffering from endometriosis with bladder involvement. For patients with moderate or severe hydronephrosis associated with bladder endometriosis, LNG-IUS application may be separately and successfully used after conservative surgery. Erkan Efe, Murat Bakacak, Salih Serin, Eyüp Kolus, Önder Ercan, and Sefa Resim Copyright © 2014 Erkan Efe et al. All rights reserved. Transitional Cell Carcinoma in Orthotopic Ileal Neobladder Tue, 18 Nov 2014 06:31:16 +0000 http://www.hindawi.com/journals/criu/2014/218615/ Urothelial carcinoma developing in orthotopic ileal neobladder is an extremely rare entity. Fewer than 10 cases have been reported in the literature describing urothelial carcinoma recurrence in orthotopic ileal neobladder. We report a case of transitional cell carcinoma recurrence in orthotopic ileal neobladder after 11 years of surgery. Ozgur Cakmak, Huseyin Tarhan, Orcun Celik, Ulku Kucuk, and Yusuf Ozlem Ilbey Copyright © 2014 Ozgur Cakmak et al. All rights reserved. Ureteroarterial Fistula from Ureteral Stump: A Challenging Case Thu, 13 Nov 2014 09:13:05 +0000 http://www.hindawi.com/journals/criu/2014/514625/ Ureteroarterial fistula (UAF) is a relatively rare condition with about 150 cases reported in the literature. Since it is a potentially life-threatening condition, a prompt diagnosis and treatment are crucial. We present here a rare, challenging case of UAF diagnosed after left nephrectomy, thus involving the ureteral stump. The difficult diagnosis and treatment by contemporary use of endovascular stent placement and ureteral occlusion by mean of metallic coils and Onyx injection are discussed. Pietro Pozzilli, Massimo Lenti, Stefano Mosca, Elisabetta Nunzi, and Luigi Mearini Copyright © 2014 Pietro Pozzilli et al. All rights reserved. Intraneobladder Hem-o-Lok Migration with Stone Formation after Orthotopic Neobladder Cystectomy Mon, 10 Nov 2014 12:49:22 +0000 http://www.hindawi.com/journals/criu/2014/872989/ Introduction. Laparoscopic and robot-assisted laparoscopic surgery are widely performed in urology field, so Hem-o-Lok clips are thus extensively used in the laparoscopic procedures. We describe the first case of Hem-o-Lok clip which migrated into the neobladder with calculus formation 26 months after laparoscopic orthotopic neobladder cystectomy, which causes symptoms of gross hematuria and frequent urination. Case Presentation. A 57-year-old man with T2a muscle invasive bladder cancer underwent laparoscopic orthotopic sigmoid neobladder reconstruction after cystectomy which was complicated by intestinal anastomosis leak and peritoneal abscess requiring transverse colostomy and drainage 15 days postoperatively. Twenty-six months after cystectomy, he complained of gross hematuria and frequent urination. Computerized tomography and plain pelvic X-ray revealed a stone measuring approximately 2.8 cm in diameter in the neobladder. During cystoscopy, a closed whitish Hem-o-Lok clip was seen in the center of the calculi. No anastomotic leak or neoplasm was found during cystoscopy. Conclusion. Hem-o-Lok clip migration into the bladder after laparoscopic orthotopic neobladder cystectomy is a rare complication; the first reported case in the literature. To prevent Hem-o-Lok clip migration, it is recommended to avoid extensive use of Hem-o-Lok clip close to anastomosis site, and any loose Hem-o-Lok clip should be retrieved before closure. Zeng Shu-xiong, Zhang Zhen-sheng, Yu Xiao-wen, Li Hui-zhen, Lu Xin, Sun Ying-hao, and Xu Chuan-liang Copyright © 2014 Zeng Shu-xiong et al. All rights reserved. A Case of Prostatic Abscess with Malignant Lymphoma Involving the Prostate Thu, 06 Nov 2014 11:53:25 +0000 http://www.hindawi.com/journals/criu/2014/965823/ Here, we report a case of prostatic abscess probably due to malignant lymphoma of the prostate. An 82-year-old man was referred to our hospital with chief complaints of urinary frequency and discomfort on urination. Antibiotics were prescribed, but the symptoms remained and intermittent fever appeared. The patient was diagnosed with prostatic abscess by computed tomography (CT). Digital rectal examination (DRE) revealed soft prostate, and thick pus was milked out from the extrameatus by prostatic massage. For drainage, we performed transurethral resection of the prostate (TURP). Drainage by TURP was successful as CT clearly showed reduction of prostatic abscess after the operation. Nevertheless, intermittent fever did not improve and the patient’s general condition deteriorated. The day before the patient died, histopathological analysis showed prostatic abscess probably due to malignant lymphoma of the prostate and incidental adenocarcinoma. This is the first report of prostatic abscess with malignant lymphoma involving the prostate. Wataru Noguchi, Yoshihiro Inoue, and Mana Fukushima Copyright © 2014 Wataru Noguchi et al. All rights reserved. Choroidal and Cutaneous Metastasis from Urothelial Carcinoma of the Bladder after Radical Cystectomy: A Case Report and Literature Review Thu, 06 Nov 2014 10:04:01 +0000 http://www.hindawi.com/journals/criu/2014/491541/ Bladder cancer is the second most common genitourinary malignancy and has variable metastatic potential; however, choroidal and cutaneous metastases are extremely rare. Generally, a patient with these uncommon metastases has a very poor prognosis. We present a bladder cancer patient with a visual disorder in the right eye and multiple nodules on head and lower abdomen that developed 17 months after a radical cystectomy. These symptoms were determined to be caused by choroidal and cutaneous metastasis of bladder cancer. Although two cycles of combination chemotherapy were performed, the patient died 5 months after diagnosis of multiple metastases. Yozo Mitsui, Naoko Arichi, Keita Inoue, Miho Hiraki, Shigenobu Nakamura, Takeo Hiraoka, Noriyoshi Ishikawa, Riruke Maruyama, Hiroaki Yasumoto, and Hiroaki Shiina Copyright © 2014 Yozo Mitsui et al. All rights reserved. A Unique Presentation of an Undiagnosed Renal Cell Carcinoma Thu, 06 Nov 2014 07:17:10 +0000 http://www.hindawi.com/journals/criu/2014/840163/ We describe a 58-year-old lady who presented initially to her general practitioner with a palpable warty urethral nodule. She was subsequently referred to the urology department for further investigations. She underwent flexible cystoscopy and imaging, followed by rigid cystoscopy and excision of the nodule. Histological analysis was consistent with renal cell carcinoma (RCC). CT imaging confirmed the presence of an invading metastatic left renal cell carcinoma with bilateral metastatic deposits to the lungs and adrenal glands. The patient was enlisted on the Panther Trial and received a course of Pazopanib before undergoing radical nephrectomy. Two years later she is still alive with metastases remaining reduced in size and numbers. During this study we have performed a literature review of similar cases with this unusual presentation of RCC. Georgios Kravvas, Michalis Varnavas, and Saad Aldujaily Copyright © 2014 Georgios Kravvas et al. All rights reserved. A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy Thu, 23 Oct 2014 00:00:00 +0000 http://www.hindawi.com/journals/criu/2014/137605/ Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy. Konstantinos Stamatiou, Aggeliki Papadatou, Hippocrates Moschouris, Ioannis Kornezos, Anargiros Pavlis, and Georgios Christopoulos Copyright © 2014 Konstantinos Stamatiou et al. All rights reserved. First Report of the Stapled Mesh Stoma Reinforcement Technique in a Urologic Context Wed, 22 Oct 2014 11:27:27 +0000 http://www.hindawi.com/journals/criu/2014/294304/ Parastomal hernia is a common complication of ileal conduit formation. Mesh repair of parastomal hernia has lower rate of recurrence than nonmesh techniques but can be time-consuming to perform. The stapled mesh stoma reinforcement technique (SMART) is a novel method of rapidly constructing a reinforced stapled stoma. We report the first case utilising this technique in a urologic context. The procedure was performed on a middle-aged female with recurrent parastomal hernia of her ileal conduit. There were no perioperative complications. The resited stoma remained healthy and functioned normally. Longer term data is clearly desirable though this technique deserves consideration in the treatment of urologic parastomal hernias. This case demonstrates that SMART is an easy and convenient procedure for parastomal hernia repair. Dwayne Tun Soong Chang, Isaac Andrew Thyer, John Oliver Larkin, Marina Helen Wallace, and Dickon Hayne Copyright © 2014 Dwayne Tun Soong Chang et al. All rights reserved. Inflammatory Pseudotumor Containing Necrotizing Granulomatous Lesions of Kidney: A Hitherto Undescribed Entity Tue, 14 Oct 2014 07:48:51 +0000 http://www.hindawi.com/journals/criu/2014/263859/ Herein reported is a case of inflammatory pseudotumor (IPT) of kidney. It is not described in WHO, AFIP, and other books. A review of the literature revealed about 35 cases. A 76-year-old man underwent nephrectomy under clinical diagnosis of renal pelvic carcinoma. Grossly, a solid tumor was seen in renal parenchyma. Microscopically, it was composed of spindle cell tissue with inflammation and many necrotizing granulomas. Epithelioid histiocytes were abundant but giant cells were few. Lymphocytes and plasma cells were also seen. The features suggested tuberculosis (TB), but Ziehl-Neelsen stains and PCR revealed no TB bacillus. Immunohistochemistry showed that the tumor spindle cells were positive for vimentin, CD68, CD45, and Ki-67 (labeling = 18%), α-smooth muscle antigen, and NSE. Focal staining of KIT (mast cells), S100 protein (Langerhans cells), and CD10 (spindle cells) was present. IgG4 was negative. The tumor spindle cells were negative for other antigens examined. Tadashi Terada Copyright © 2014 Tadashi Terada. All rights reserved. Urethrogluteal Fistula Developing Secondary to the Use of Clean Intermittent Self-Catheterization: First Case Report in the Literature Thu, 02 Oct 2014 09:29:03 +0000 http://www.hindawi.com/journals/criu/2014/218037/ Clean intermittent self-catheterization is the standard method for bladder evacuation in these patients today. The patient was diagnosed with urethrogluteal fistula and gluteal-perineal abscess by radiological evaluation. Gluteal drainage decreased after cystostomy. In our paper, a case of urethrogluteal fistula and pelvic urinoma that developed as a result of the use of clean intermittent self-catheterization (CISC), which is rarely found in the literature, is presented. Aliseydi Bozkurt, Mehmet Karabakan, Mehmet Soyturk, Erkan Hirik, and Barış Nuhoglu Copyright © 2014 Aliseydi Bozkurt et al. All rights reserved. Autopsy Report with Clinical and Pathophysiologic Discussion of Autosomal Dominant Adult Polycystic Kidney Disease Wed, 17 Sep 2014 07:35:00 +0000 http://www.hindawi.com/journals/criu/2014/727580/ The average weight of a kidney is approximately 135 gm, measuring on average 10 × 6 × 4 cm. In hereditary conditions, autosomal dominant and autosomal recessive polycystic kidney disease, the shape, size, and the weight can be significantly abnormal, causing progressive renal failure, often necessitating dialysis or renal transplant for survival. We report a case of adult polycystic kidney disease in a 50-year-old female without a family history, who died of complications of the disease which included accelerated hypertension, and renal and cardiac failure. Anup Hazra, Richard Siderits, Cheryl Rimmer, and Noah Rolleri Copyright © 2014 Anup Hazra et al. All rights reserved. Basal Cell Carcinoma of the Penis: A Case Report and Review of the Literature Sun, 14 Sep 2014 08:46:41 +0000 http://www.hindawi.com/journals/criu/2014/173076/ Basal cell carcinoma of the penis is an extremely rare entity, accounting for less than 0.03% of all basal cell carcinomas. Fortunately, wide local excision of such lesions is generally curative. Fewer than 25 cases have been reported in the literature describing penile basal cell carcinoma. Here we report a case of penile basal cell carcinoma cured with wide local excision. R. J. Roewe, Matthew A. Uhlman, Nathan A. Bockholt, and Amit Gupta Copyright © 2014 R. J. Roewe et al. All rights reserved. Penile Gangrene with Abscess Formation after Modified Al-Ghorab Shunt for Idiopathic Ischemic Priapism Mon, 08 Sep 2014 09:15:08 +0000 http://www.hindawi.com/journals/criu/2014/705417/ Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora cavernosa. Beneranda S. Ford-Glanton, Parth Patel, and Sameer Siddiqui Copyright © 2014 Beneranda S. Ford-Glanton et al. All rights reserved. Surgical Reconstruction of the Urinary Sphincter after Traumatic Longitudinal Disruption Tue, 02 Sep 2014 12:17:03 +0000 http://www.hindawi.com/journals/criu/2014/176073/ The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe three cases of urethral sphincter injury of different aetiologies. All resulted in a total longitudinal disruption of the muscular components of the urethral sphincter complex. After making the diagnosis of urethral sphincter injury, a primary approximation repair was done. Follow-up of at least two and up to three years is promising with one male patient being completely continent and the two female patients needing one safety pad per day. Longitudinal disruption of the muscular elements of the sphincteric urethra may be primarily reconstructed with good success using an approximation technique with simple interrupted sutures. Peter Rehder, Florian Schillfahrt, and Viktor Skradski Copyright © 2014 Peter Rehder et al. All rights reserved. Robot-Assisted Excision of a Pararectal Gastrointestinal Stromal Tumor in a Patient with Previous Ileal Neobladder Mon, 01 Sep 2014 05:36:59 +0000 http://www.hindawi.com/journals/criu/2014/632852/ Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal tumors of the gastrointestinal tract with surgical resection remaining the cornerstone of therapy. Pararectal lesions are considered to be technically difficult and pose in some cases a challenge. We report, to the best of our knowledge, the first robotic-assisted pararectal GIST excision. A 43-year-old man was referred to our center with pararectal GIST recurrence, despite treatment with targeted therapy. Eleven years ago, he underwent extensive abdominal surgery including cystoprostatectomy with ileal neobladder diversion due to GIST resection in the rectoprostatic space. Robot-assisted surgical resection was successfully performed without the need for temporary colostomy. The postoperative course of the patient was uneventful, and the pathology report confirmed a GIST recurrence with negative surgical margins and pelvic lymph nodes free of any tumor. Robotic-assisted pelvic surgery can be extended to incorporate excision of pararectal GISTs, as a safe, less invasive surgical alternative with promising oncological results and minimal injury to adjacent structures. A. Ploumidis, A. Mottrie, A. F. Spinoit, M. Gan, V. Ficarra, and R. Andrianne Copyright © 2014 A. Ploumidis et al. All rights reserved. IgG4-Related Disease in a Urachal Tumor Mon, 18 Aug 2014 07:48:33 +0000 http://www.hindawi.com/journals/criu/2014/275850/ IgG4-related disease is a newly recognized fibroinflammatory disorder that has the ability to affect nearly every organ system. It is characterized by tumefactive lesions and fibrosis and closely mimics neoplasms. Only one case of IgG4-related bladder mass has been reported in the literature, but there are no reports of IgG4-related disease in a urachal mass. Herein, we report a 26-year-old male who initially presented with symptoms of recurrent UTI. Work-up revealed a 6 cm urachal tumor, a 1.4 cm pulmonary lesion, and mediastinal lymphadenopathy; all metabolically active on PET scan and suspicious for urachal adenocarcinoma. Lung lesion fine needle aspiration and TURBT pathology revealed inflammation but no evidence of malignancy. The patient underwent a partial cystectomy and umbilectomy with pathology demonstrating dense plasmacytic cells, a high rate of immunohistochemistry staining positive for IgG4 plasma cells, a storiform pattern of fibrosis, and an obliterative phlebitis. Furthermore, the patient had an elevated serum IgG4 level of 227 mg/dL (range 2.4–121 mg/dL). IgG4-related disease is a newly recognized fibroinflammatory disorder that can mimic neoplastic processes and a high index of suspicion and accurate tissue pathology is necessary for an accurate diagnosis. Travis W. Dum, Da Zhang, and Eugene K. Lee Copyright © 2014 Travis W. Dum et al. All rights reserved. Forgotten DJ Stent with a Large Calculus at Its Distal End in an Ileal Conduit Diversion Mon, 18 Aug 2014 07:41:30 +0000 http://www.hindawi.com/journals/criu/2014/684651/ Calculus formation in an ileal conduit following cystectomy is a known complication. Encrustation and formation of calculus may also occur over a DJ stent retained for a long period; but this is never reported in patients with conduit diversion because of close surveillance of these patients. Here we report first case of a large calculus encrusted over a forgotten DJ stent within an ileal conduit in a man who had undergone urinary diversion following radical cystectomy for carcinoma urinary bladder 8 years earlier. Anurag Puri, Vinod Priyadarshi, Nivedita Raizada, and Dilip Kumar Pal Copyright © 2014 Anurag Puri et al. All rights reserved. Nanoparticle Albumin-Bound-Paclitaxel in the Treatment of Metastatic Urethral Adenocarcinoma: The Significance of Molecular Profiling and Targeted Therapy Mon, 18 Aug 2014 06:59:14 +0000 http://www.hindawi.com/journals/criu/2014/489686/ Primary urethral cancer is rare and accounts for only 0.003% of all malignancies arising from the female genitourinary tract. Due to the rarity of this disease, no consensus exists regarding the optimal therapeutic approach. Nanoparticle albumin-bound-paclitaxel has been shown to be effective in the treatment of a number of malignancies including metastatic breast, pancreatic, and bladder cancer. We present a 67-year-old woman with advanced metastatic urethral adenocarcinoma resistant to two lines of chemotherapy (ifosfamide/paclitaxel/cisplatin and irinotecan/5-fluorouracil/leucovorin) that showed a dramatic response to nanoparticle albumin-bound-paclitaxel. This is the first case report to document the use and efficacy of nanoparticle albumin-bound-paclitaxel in the treatment of unresectable metastatic urethral cancer. Yasmin M. Abaza and Carlos Alemany Copyright © 2014 Yasmin M. Abaza and Carlos Alemany. All rights reserved. Growing Teratoma Syndrome Sun, 17 Aug 2014 11:03:03 +0000 http://www.hindawi.com/journals/criu/2014/139425/ Growing teratoma syndrome (GTS) is a rare clinical entity, which presents with enlarging teratomas masses of the retroperitoneum or other locations, occurring during or after systemic chemotherapy for the treatment of nonseminomatous germ cell of the testis (NSGCT), with normalised tumour markers. Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management. Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible. Surgical resection of bulky GTS lesions is technically challenging; intraoperative complications may occur; that is, why the treatment must not be delayed. Our experience in the surgical management of these lesions is reviewed in the following work. Anna Scavuzzo, Zael Arturo Santana Ríos, Nancy Reynoso Noverón, and Miguel Angel Jimenez Ríos Copyright © 2014 Anna Scavuzzo et al. All rights reserved. Metastatic Prostate Adenocarcinoma Posing as Urothelial Carcinoma of the Right Ureter: A Case Report and Literature Review Wed, 13 Aug 2014 12:58:07 +0000 http://www.hindawi.com/journals/criu/2014/230852/ This is a case report of a 67-year-old patient with distant metastasis of prostate cancer to the right ureter which caused hydronephrosis. At the beginning, both of the cytology of the morning urine and imaging findings were consistent with urothelial carcinoma. Nephroureterectomy was subsequently performed. Interestingly, the pathological examination of the excised ureter revealed that the malignancy was derived from the prostate. No skeletal metastasis was detected. However, after four months of follow-up, several abnormal signal shadows were reported in skeletal scintigraphy and the prostate specific antigen (PSA) was gradually increasing. We present such a case for its unique presentation. A review of the literature is also provided. Tian-bao Huang, Yang Yan, Huan Liu, Jian-ping Che, Guang-chun Wang, Min Liu, Jun-hua Zheng, and Xu-dong Yao Copyright © 2014 Tian-bao Huang et al. All rights reserved. Bladder Endometriosis and Endocervicosis: Presentation of 2 Cases with Endoscopic Management and Review of Literature Tue, 12 Aug 2014 13:07:59 +0000 http://www.hindawi.com/journals/criu/2014/296908/ Urinary tract endometriosis and endocervicosis are an uncommon pathologic finding, with a common embryological origin. We present 2 cases of female patients with bladder mass. The first one was a finding of a nodular formation in the bladder during study of a nonviable foetus and the second was an incidental finding of a neoformation in the fundus of the bladder during the realization of an ultrasound. In both cases, we performed a surgical management with transurethral resection. Histopathological examination revealed a bladder endometrioma in the first case and endocervicosis with associated endometriosis in the second. Javier Fuentes Pastor, Roberto Ballestero Diego, Miguel Ángel Correas Gómez, Eduardo Torres Díez, Alejandro Fernández Flórez, Gerardo Ballesteros Olmos, and Jose Luis Gutierrez Baños Copyright © 2014 Javier Fuentes Pastor et al. All rights reserved. Glanuloplasty with Oral Mucosa Graft following Total Glans Penis Amputation Tue, 12 Aug 2014 00:00:00 +0000 http://www.hindawi.com/journals/criu/2014/671303/ This is a report on the technique of neoglans reconstruction in a patient with amputated glans penis following guillotine neonatal circumcision. A 4 cm long and 2 cm wide lower lip oral mucosa graft was harvested and used to graft the distal 2 cm of the corporal bodies after 2 cm of the distal penile skin had been excised. One edge of the lower lip oral mucosa graft was anastomosed to the urethral margins distally and proximally to the skin. At six months of followup, patient had both satisfactory cosmetic and functional outcomes. Kwaku Appiah, George Amoah, Roland Azorliade, Kofi Gyasi-Sarpong, Ken Aboah, Douglas Arthur, Baah Nyamekye, Kwaku Otu-Boateng, Patrick Maison, Benjamin Twumasi-Frimpong, Issac Opoku Antwi, and Edwin Yenli Copyright © 2014 Kwaku Appiah et al. All rights reserved. Coexisting Papillary and Clear Renal Cell Carcinoma in the Same Kidney Sun, 10 Aug 2014 09:05:55 +0000 http://www.hindawi.com/journals/criu/2014/575181/ Renal cell carcinoma (RCC) is the most common solid lesion of the kidney. Bilateral synchronous benign and malignant renal tumors have been defined in some reports. However, unilateral concordance of malignant renal tumors is very rare and there are only a few cases that had synchronous different subtypes of malignant renal tumors arising within the same kidney. Herein, we describe a 67-year-old male patient who had clear cell RCC and papillary RCC in his right kidney that were successfully treated with radical nephrectomy. We also reviewed the pertinent literature. Murat Ustuner, Busra Yaprak, Kerem Teke, Seyfettin Ciftci, Mucahit Kart, Kursat Yildiz, and Melih Culha Copyright © 2014 Murat Ustuner et al. All rights reserved. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer Tue, 05 Aug 2014 07:20:19 +0000 http://www.hindawi.com/journals/criu/2014/584957/ Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature. Enrique Gómez Gómez, Jose Carlos Carrasco Aznar, Maria del Mar Moreno Rodríguez, José Valero Rosa, and Maria José Requena Tapia Copyright © 2014 Enrique Gómez Gómez et al. All rights reserved. Giant Malignant Pheochromocytoma with Palpable Rib Metastases Sun, 03 Aug 2014 12:52:48 +0000 http://www.hindawi.com/journals/criu/2014/354687/ Pheochromocytoma is a rare and usually benign neuroendocrine neoplasm. Only 10% of all these tumors are malignant and there are no definitive histological or cytological criteria of malignancy. Single malignancy criteria are the presence of advanced locoregional disease or metastases. We report a case, with a giant retroperitoneal tumor having multiple metastases including palpable rib metastases, who was diagnosed as a malignant pheochromocytoma. The patient was treated with surgery. The literature was reviewed to evaluate tumor features and current diagnostic and therapeutic approaches for patients with metastatic or potentially malignant pheochromocytoma. Esat Korgali, Gokce Dundar, Gokhan Gokce, Fatih Kilicli, Sahande Elagoz, Semih Ayan, and Emin Yener Gultekin Copyright © 2014 Esat Korgali et al. All rights reserved. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic Tue, 22 Jul 2014 07:26:20 +0000 http://www.hindawi.com/journals/criu/2014/351270/ A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup. Sakir Ongun, Sermin Coban, Abdullah Katgi, Funda Obuz, and Aykut Kefi Copyright © 2014 Sakir Ongun et al. All rights reserved. A Case of the Nutcracker Syndrome Developed after Delivery Tue, 22 Jul 2014 06:38:47 +0000 http://www.hindawi.com/journals/criu/2014/503017/ We report a case of nutcracker syndrome that developed after delivery. A 32-year-old woman visited our clinic complaining of gross hematuria 4 months after delivery. Urethrocystoscopic examination failed to show hematuria coming from the ureteral orifice; however, enhanced computed tomography revealed the compression of the left renal vein between the aorta and superior mesenteric artery. Therefore, we diagnosed her with nutcracker syndrome and conservatively observed her. The macrohematuria disappeared by itself after 1 month. This is the first report to describe a case of nutcracker syndrome that developed after delivery. Koji Tsumura, Kanae Yoshida, Sachi Yamamoto, Sayuri Takahashi, Katsuyuki Iida, and Yutaka Enomoto Copyright © 2014 Koji Tsumura et al. All rights reserved. SIMPLE Technique of Laparoscopic Nephrectomy for Ectopic Nonfunctioning Pelvic Kidney Secondary to Pelviureteric Junction Obstruction: A Feasible and Safe Technique Mon, 21 Jul 2014 09:10:47 +0000 http://www.hindawi.com/journals/criu/2014/367246/ Ectopic kidneys are rare developmental anomalies. Anomalous blood supply of the pelvic ectopic kidneys poses a problem for a minimally invasive surgery. Although laparoscopic nephrectomies have been described for symptomatic nonfunctioning pelvic ectopic kidney, this is the first case report that highlights the safety and feasibility of SIMPLE technique of laparoscopic nephrectomy in a pelvic kidney. Santosh Kumar, Kalpesh Mahesh Parmar, Sriharsha Shankaregowda Ajjoor, Nitin Garg, Kumar Jayant, and Shrawan Kumar Singh Copyright © 2014 Santosh Kumar et al. All rights reserved. Spontaneous Postmenopausal Urethral Prolapse Treated Surgically and Successfully Mon, 21 Jul 2014 07:51:17 +0000 http://www.hindawi.com/journals/criu/2014/695471/ Urethral prolapse (UP) is a circular complete eversion of the distal urethral mucosa through the external meatus. It is a rare condition seen mostly in African-American premenarcheal girls. Both a medical and a surgical approach to this condition have been described. We present a case of a spontaneous urethral prolapse in a 60-year-old postmenopausal Caucasian woman, who failed medical management and underwent successful surgical management. The patient is asymptomatic 18 months following the procedure. I. Klein, Y. Dekel, and A. Stein Copyright © 2014 I. Klein et al. All rights reserved.