Case Reports in Urology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Paraneoplastic Dermatomyositis Associated with Metastatic Seminoma Tue, 31 May 2016 13:05:49 +0000 We report the first case in Japan of paraneoplastic dermatomyositis with pure seminoma, a tumor that extremely rarely accompanies dermatomyositis. The patient presented to the hospital with muscle weakness and erythema and was diagnosed with dermatomyositis from skin biopsy. Routine radiological screening revealed testicular tumor and massive lymph node metastases. We initially performed orchiectomy along with conventional immunotherapy. However, muscle weakness gradually worsened, and he eventually showed dysphagia and forced respiration and became bedridden. Although he seemed close to being too unstable to tolerate further treatment, we started carefully adjusted chemotherapy comprising 4 courses of etoposide plus cisplatin, which proved highly successful. Lymph node metastases completely disappeared and swallowing and respiration fully normalized after completing chemotherapy. We believe that this clinical success was due to our decision to initiate chemotherapy even in such a weak patient. Hidekazu Yoshie, Ryuto Nakazawa, Wataru Usuba, Hiroya Kudo, Yuichi Sato, Hideo Sasaki, and Tatsuya Chikaraishi Copyright © 2016 Hidekazu Yoshie et al. All rights reserved. Diagnosing and Treating Inflammatory Myofibroblastic Tumor of the Bladder Wed, 18 May 2016 11:52:19 +0000 Inflammatory myofibroblastic tumor (IMT) is an uncommon condition that is rarely encountered in the urinary tract. In this report, we present a case of IMT of the bladder in a woman with multiple previous pelvic surgeries. We further review the relevant literature to highlight this rare but important clinical presentation. Ridwan Alam, Michael H. Johnson, Trevor Caldwell, Christian P. Pavlovich, Trinity J. Bivalacqua, and Jeffrey J. Tosoian Copyright © 2016 Ridwan Alam et al. All rights reserved. Metastatic Granulosa Cell Tumor of the Testis: Clinical Presentation and Management Sun, 15 May 2016 08:01:18 +0000 Granulosa cell tumors (GCTs) of the testis are rare sex cord-stromal tumors that are present in both juvenile and adult subtypes. While most adult GCTs are benign, those that present with distant metastases manifest a grave prognosis. Treatments for aggressive GCTs are not well established. Options that have been employed in previous cases include retroperitoneal lymph node dissection (RPLND), radiation, chemotherapy, or a combination thereof. We describe the case of a 57-year-old man who presented with a painless left testicular mass and painful gynecomastia. Serum tumor markers (alpha fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) and computed tomography of the chest and abdomen were negative. The patient underwent left radical orchiectomy. Immunohistochemical staining was consistent with a testicular GCT. He underwent a left-template laparoscopic RPLND which revealed 2/19 positive lymph nodes. Final pathological stage was IIA. He remains free of disease 32 months after surgery. Anand Mohapatra, Aaron M. Potretzke, Brent A. Knight, Min Han, and Robert S. Figenshau Copyright © 2016 Anand Mohapatra et al. All rights reserved. Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon Sat, 30 Apr 2016 13:35:19 +0000 Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon. Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy. Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (), urethral dilatation (), vesicostomy (), and urethral catheterization (). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free. Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered. F. F. Mouafo Tambo, G. Fossi kamga, C. Kamadjou, L. Mbouche, A. S. Nwaha Makon, J. Birraux, O. G. Andze, F. F. Angwafo, and P. Y. Mure Copyright © 2016 F. F. Mouafo Tambo et al. All rights reserved. A Very Rare Complication of Acute Appendicitis: Appendicovesical Fistula Thu, 28 Apr 2016 13:30:36 +0000 Appendicovesical fistula (AVF) is an uncommon type of enterovesical fistula and a very rare complication of acute appendicitis. Herein, we report a case of 39-year-old male patient who presented with persistent urinary tract infection, recurrent abdominal pain, and pneumaturia. Imaging techniques including ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) were performed to identify the abnormality. However, definitive diagnosis of AVF was made by cystoscopy. Deniz Alis, Cesur Samanci, Yesim Namdar, Fethi Emre Ustabasioglu, Elif Yamac, Onur Tutar, Burak Ucpinar, and Bulent Onal Copyright © 2016 Deniz Alis et al. All rights reserved. Solitary Fibrous Tumor of the Kidney Developing Local Recurrence Thu, 28 Apr 2016 11:37:46 +0000 Solitary fibrous tumor (SFT) of the kidney is a rare entity and usually displays a favorable prognosis. We herein report a second case of renal SFT developing local recurrence. A 50-year-old man was referred to our hospital because of a left renal mass. An abdominal CT detected a large renal tumor and radical nephrectomy was performed with a possible diagnosis of renal cell carcinoma. The resected tumor size was measured at 17 × 11 × 8 cm. Grossly, necrosis was observed in central lesion of the tumor but hemorrhage was not observed. Microscopically, the tumor consisted of spindle-shaped cells with scant cytoplasm accompanied by hyalinized collagenous tissue, which displayed hemangiopericytomatous patterns. The cellularity was normal and nuclear pleomorphism was not observed. Ki-67 labeling index was less than 3%. The pathological diagnosis of SFT was made without obvious malignant findings. Three years after the surgery, a follow-up CT scan detected a mass lesion in the tumor bed. Surgical resection was performed and the resected tumor was compatible with local recurrence of the SFT without obvious malignant findings. Renal SFT should be carefully monitored even in the absence of obvious malignant findings. Wataru Usuba, Hideo Sasaki, Hidekazu Yoshie, Kazuki Kitajima, Hiroya Kudo, Ryuto Nakazawa, Yuichi Sato, Masayuki Takagi, and Tatsuya Chikaraishi Copyright © 2016 Wataru Usuba et al. All rights reserved. Leiomyoma in a Renal Allograft Mon, 18 Apr 2016 09:54:23 +0000 Leiomyomas are smooth muscle tumours that are rarely found in the kidney. There is one report of a leiomyoma in a kidney transplant in a paediatric recipient. Here, we report an adult renal transplant recipient who developed an Epstein-Barr virus-positive leiomyoma in his allograft 15 years after transplantation. The patient was converted to everolimus for posttransplant immunosuppression management and there was no sign of progression over a year. Yan Jun Li, Amila Rohan Siriwardana, James Lawrence Penn Symons, Gordon Francis O’Neill, Min Ru Qiu, and Timothy John Furlong Copyright © 2016 Yan Jun Li et al. All rights reserved. Panniculectomy and Cystectomy: An Approach to the Morbidly Obese Patient Mon, 18 Apr 2016 09:53:35 +0000 The obese patient undergoing radical cystectomy faces a unique set of challenges. We present the case of a 68-year-old gentleman who presented to our institution with Bacillus Calmette-Guerin refractory disease, a body mass index of 38.5, and a large pannus. The present paper describes our technique for performing radical cystectomy with ileal conduit urinary diversion and concomitant panniculectomy. We discuss the impact of obesity on patients undergoing radical cystectomy and how this may be mitigated by panniculectomy. Lee A. Hugar, Robert M. Turner, Jeffrey A. Gusenoff, Andres F. Correa, Bruce L. Jacobs, and Benjamin J. Davies Copyright © 2016 Lee A. Hugar et al. All rights reserved. Posttransurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Rare Cause Tue, 12 Apr 2016 09:11:56 +0000 Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-year-old male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4 gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical aneurysm. CT angiography showed pseudoaneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities. MC Arya, Lalit Kumar, Ruchi Mittal, Rajeev Kumar, and Mayank Baid Copyright © 2016 MC Arya et al. All rights reserved. Retained Urethral Catheter Secondary to Placement in Proximal Ureter Sun, 10 Apr 2016 09:06:40 +0000 We present an unusual complication secondary to indwelling urethral catheter placement. Routine catheter placement by the obstetrics team in a postpartum female leads to retention of the catheter and inability of its removal by both the obstetrics and urology teams. Although a retained urinary catheter is relatively common, inability to remove a catheter secondary to placement inadvertently into a ureter is extremely rare. In this paper we will discuss the options in removing a retained catheter and present our case of a retained catheter secondary to placement within the right proximal ureter. Thomas B. McGregor and Rajan Sharda Copyright © 2016 Thomas B. McGregor and Rajan Sharda. All rights reserved. Management of Testicular Silicone Gel-Filled Prosthesis Rupture: Case Report of a Rare Event and a Review of the Literature Wed, 30 Mar 2016 16:15:54 +0000 Introduction. We report a case of spontaneous rupture of a single testicular prosthesis in a patient who had undergone bilateral orchiectomy and silicone gel-filled prosthesis insertion. The consequences of this rare event are discussed. There is no management algorithm. Case Presentation. A 55-year-old man presented to our outpatient department with altered consistency in his right testicular prosthesis and a painful right hemiscrotum with no systemic symptoms thirty-three years after the implantation of the prosthesis. We removed this implant without replacement, in accordance with the patient’s wishes. Conclusion. The long time between the implantation and the spontaneous rupture is remarkable and was never before described. The removal of the prosthesis was straightforward and it would have been possible to implant a new prosthesis after taking into account the condition of the skin. Quang-Bao Phan, Nicolas Koutlidis, Céline Duperron, Eric Mourey, Frédéric Michel, and Luc Cormier Copyright © 2016 Quang-Bao Phan et al. All rights reserved. Urothelial Carcinoma Recurrence in an Ileal Neobladder Nine Years after Primary Surgery with Muir-Torre Syndrome Wed, 30 Mar 2016 06:53:57 +0000 We report a patient who presented with a urothelial carcinoma recurrence developed nine years after radical cystoprostatectomy, related to Muir-Torre syndrome. Floryn Cherbanyk, Marc Prod’homme, Edgardo Pezzetta, Bernard Chevaux, Anass Anaye, and Jean-Joseph Boillat Copyright © 2016 Floryn Cherbanyk et al. All rights reserved. Transurethral Unroofing of a Symptomatic Imperforate Cowper’s Syringocele in an Adult Male Mon, 28 Mar 2016 14:12:35 +0000 Cystic dilatation of bulbourethral gland ducts (Cowper’s gland syringocele) is a rare abnormality. The condition has been described among pediatric populations, but it is uncommon in adults. It can be asymptomatic or present with obstructive and irritative urinary symptoms. We report a case of a symptomatic imperforate Cowper’s syringocele in a young patient that was successfully managed with transurethral unroofing of the cyst. Mohannad A. Awad, Amjad Alwaal, Catherine R. Harris, Uwais B. Zaid, Thomas W. Gaither, E. Charles Osterberg, and Benjamin N. Breyer Copyright © 2016 Mohannad A. Awad et al. All rights reserved. Prelamination of Neourethra with Uterine Mucosa in Radial Forearm Osteocutaneous Free Flap Phalloplasty in the Female-to-Male Transgender Patient Wed, 16 Mar 2016 12:03:47 +0000 Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM) transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts. We present the successful use of uterine mucosa for prelamination of the neourethra in an FtM patient who underwent hysterectomy and vaginectomy at the prelamination stage of a radial forearm phalloplasty. Three months postoperatively, the patient was able to void while standing and showed no evidence of stricture or fistula on retrograde cystogram. These results suggest that uterine mucosa may be used for prelamination of the penile neourethra in patients undergoing phalloplasty. Christopher J. Salgado, Lydia A. Fein, Jimmy Chim, Carlos A. Medina, Stephanie Demaso, and Christopher Gomez Copyright © 2016 Christopher J. Salgado et al. All rights reserved. Multiple Site Fracture of Both Rods in a Malleable Penile Implant Tue, 15 Mar 2016 12:43:59 +0000 Penile prosthesis implant is the definitive treatment for refractory erectile dysfunction. Fracture of malleable prosthesis is rarely described due to its low incidence. We describe a case of multiple, bilateral fracture of a malleable penile implant, ten years after implantation. After the diagnosis, a review surgery was performed and the implants were replaced. No corporal rupture or urethral lesion was observed. Review of the literature shows few articles reporting penile implant fractures, and to our knowledge no other article has described multiple, bilateral fractures of a penile prosthesis. Marcelo Almeida Pinheiro, Haroldo Brasil Barroso Filho, Francisco José Cabral Mesquita, Ivon Teixeira de Souza, Rafael Silva Guimarães, Everaldo Moura Santos, Rômulo Augusto da Silveira, Rommel Prata Regadas, and Geraldo Munguba Macedo Copyright © 2016 Marcelo Almeida Pinheiro et al. All rights reserved. Granulomatosis with Polyangiitis (Wegener’s Granulomatosis) Accompanied by Dysuria Sun, 13 Mar 2016 06:40:12 +0000 A 65-year-old male visited us with complaints of retarded urination, dysuria, gross hematuria, and fever. Urinalysis showed pyuria. Prostatic tumor with lung metastasis was suspected from computed tomography and magnetic resonance imaging. Transurethral prostatic biopsy and bronchoscopic biopsy only revealed fibrinoid necrosis and inflammatory infiltration. Right lateral maxillary sinusitis was also found by MRI. ANCA testing was positive with specificity for anti-PR3 (PR3-ANCA). On the basis of these results, Granulomatosis with polyangiitis (GPA) was diagnosed. GPA involving the prostate gland is unusual, and only a few cases have previously been reported. Hisashi Takeuchi, Isao Kuroda, Issei Takizawa, Teiichiro Aoyagi, and Masaaki Tachibana Copyright © 2016 Hisashi Takeuchi et al. All rights reserved. Botulinum Toxin A Injection in the Bladder Neck: A Promising Treatment for Urinary Retention Thu, 10 Mar 2016 14:33:23 +0000 Secondary to failure of optimal medical therapy and the high morbidity that accompanies surgical techniques in high risk patients, the use of de novo treatments including botulinum toxin A is emerging in the treatment of benign prostatic hyperplasia (BPH). However, the treatment of urinary retention secondary to BPH via injecting botulinum toxin into the bladder neck is not well established in the literature. This case report describes the case of a 75-year-old male patient with a chronic history of obstructive lower urinary tract symptoms (LUTS) and multiple comorbidities who was admitted to the hospital for management of recurrent urinary retention. The patient was not a surgical candidate for transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Botulinum toxin injection into the bladder neck was performed with very satisfying results. Botulinum toxin injection in the bladder neck presents a promising minimally invasive, tolerated, and cost-effective approach for the treatment of urinary retention in patients with benign prostatic obstruction who are not candidates for surgery or in whom medical treatment has failed. More research is needed to identify the efficacy of this novel approach. Marianne Alam, Joseph Zgheib, Mohamad-Fadi Dalati, and Fouad El Khoury Copyright © 2016 Marianne Alam et al. All rights reserved. Seminoma in a Man with Russell-Silver Syndrome Presenting with Testicular Torsion Mon, 29 Feb 2016 08:26:13 +0000 Russell-Silver syndrome (RSS) is a type of primordial dwarfism. Only one case of testicular cancer in RSS has been reported, the pathology of which was nonseminoma. Here, we report a case of seminoma in a 36-year-old man who was diagnosed with RSS at birth. The seminoma was diagnosed when the patient presented with testicular torsion. This is the first report of testicular seminoma in an RSS patient in the literature. We also discussed the correlation between seminoma and RSS. Satoshi Funada, Ryosuke Ikeuchi, Toru Yoshida, and Takehiko Segawa Copyright © 2016 Satoshi Funada et al. All rights reserved. Holmium Laser Enucleation of the Prostate and Iatrogenic Arteriovenous Fistula Treated by Superselective Arterial Embolization Sun, 28 Feb 2016 12:01:08 +0000 Iatrogenic pelvic pseudoaneurysm with concomitant arteriovenous fistula has been described as a rare and challenging complication, which may occur during transurethral resection of the prostate. We provide the first report of this complication after holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia. The attempt to control the bleeding by conversion to open surgery and placement of haemostatic stitches into the prostatic fossa failed. Angiography with superselective arterial embolization proved to be a modern, quick, safe, and efficient treatment of this uncommon complication. Anastasios D. Asimakopoulos, Lorenzo Dutto, Paolo Preziosi, Enrico Spera, Francesco Micali, Andrea De Carolis, and Beniamino Iorio Copyright © 2016 Anastasios D. Asimakopoulos et al. All rights reserved. Ureteral Embolization to Prevent Thrombotic Obstruction of Nephrostomy Catheters in the Context of Refractory Hemorrhagic Radiation Cystitis with Severe Vesicoureteral Reflux Thu, 25 Feb 2016 09:41:29 +0000 We present a case of refractory hemorrhagic radiation cystitis in a patient who failed conservative management and was unable to undergo operative urinary diversion secondary to multiple comorbidities. His management was complicated by recurrent obstruction of his nephrostomy catheters due to marked ureteral thrombus formation from blood refluxing into the ureters from the urinary bladder. We were successful in treating his condition by occluding his distal ureters with a combination of embolization coils and glue to prevent the reflux of blood in order to allow his nephrostomy catheters to function properly. Vidhush Yarlagadda, Keith Pettibon, Nathan Ertel, and Jeffrey Nix Copyright © 2016 Vidhush Yarlagadda et al. All rights reserved. Intravesical Botulinum Toxin for Persistent Autonomic Dysreflexia in a Pediatric Patient Tue, 23 Feb 2016 14:05:34 +0000 Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin. Study Design. A retrospective chart review of one patient seen at the Children’s Hospital of Wisconsin from 2006 to 2012 was performed. Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months. Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient. Gina Lockwood, Charles Durkee, and Travis Groth Copyright © 2016 Gina Lockwood et al. All rights reserved. Fornix Rupture in Duplex Kidney due to Internal Iliac Artery Aneurysm Tue, 16 Feb 2016 13:59:37 +0000 A 70-year-old man presented with severe pain on the right side of the abdomen for 7 days. An abdominal CT angiographic scan showed an impending rupture of a large right internal iliac artery aneurysm which compressed to a right ureter causing hydroureteronephrosis. Fornix rupture of a right duplex kidney was also detected. Selective embolization of right gluteal arteries and then ligation of the right internal iliac artery and right ureterotomy with double J stenting were performed. At the 4-month follow-up appointment, an abdominal ultrasound demonstrated a decrease in the size of the aneurysm and no hydroureteronephrosis after the removal of double J stent. Phitsanu Mahawong, Tanop Srisuwan, and Kittipan Rerkasem Copyright © 2016 Phitsanu Mahawong et al. All rights reserved. Hematospermia and Cloacogenic Transitional Cell Carcinoma: A Twist on Significance and Meaning Mon, 08 Feb 2016 08:05:37 +0000 A 52-year-old gentleman presented with recurrent hematospermia. Further history revealed recent onset of constipation and difficulty voiding. Rectal examination revealed a firm, polypoid mass and colonoscopy showed suspicious, ulcerated lesions of the rectal mucosa with narrowing of the rectal vault. Pathology demonstrated transitional cell carcinoma of the rectum. While transitional cell carcinoma is a common genitourinary cancer, its presence in the anus and rectum is exceedingly rare. Furthermore, hematospermia is generally not associated with malignancy. This case is a remarkable example of two pathologic processes presenting in rare form and underscores the value of a thorough investigation of hematospermia when associated with other clinical symptoms. Alex M. Hennessey, Jessica M. Clement, Faripour Forouhar, and John A. Taylor III Copyright © 2016 Alex M. Hennessey et al. All rights reserved. Scrotal Abscess Precipitating Late Infection of a Malleable Penile Prosthesis: The Risk Never Evanesces Thu, 04 Feb 2016 11:12:35 +0000 Although infrequent, infections represent the dreadful complication of penile prosthesis implantation. The incidence substantially decreases after a few infection-free postoperative months. We report herein a case of a very late penile prosthesis infection from a fistualizing scrotal abscess in a 67-year-old man. The patient presented with a one-month history of persistent penile-base discharge from a right hemiscrotal swelling. On examination, mild penile tenderness and a discharging penoscrotal-junction sinus were noted. Microbiological wound culture was positive for Staphylococcus epidermidis. Magnetic resonance imaging revealed this multiloculated fluid collection’s communication with the right corporal body. Removal of the prosthesis was performed. Pathological evaluation of the dissected fistula was suggestive of acute on top of chronic inflammatory reactions. To our knowledge, this is the first report of a scrotal abscess leading to penile prosthesis infection 15 years after an uneventful implantation. Osama Mustafa, Sultan Althakafi, Said Kattan, Mohamed Kattan, and Naif AlHathal Copyright © 2016 Osama Mustafa et al. All rights reserved. Duplicated Renal System with H Shaped Ureter: An Extraordinary Anomaly Thu, 28 Jan 2016 15:04:22 +0000 Duplex collecting systems are the most commonly encountered anomaly of the urinary system. Complete duplex system with an H shaped ureter is a very rare situation. There are only two reported H ureter cases in the literature. Herein, we aimed to present an H shaped ureter case, which was identified while performing ureterorenoscopy to a 48-year-old female patient due to a right distal ureteral stone. Fatih Akbulut, Metin Savun, Burak Ucpinar, Murat Sahan, Burak Arslan, Faruk Ozgor, Abdulmuttalip Simsek, Ahmet Yalcın Berberoglu, Murat Baykal, and Murat Binbay Copyright © 2016 Fatih Akbulut et al. All rights reserved. Salvage Procedure in Case of Urethrocavernous Fistula after Revision Surgery for Malfunctioning Three-Piece Penile Prosthesis Wed, 27 Jan 2016 06:11:23 +0000 Urethrocavernous fistula is a rare complication of penile prosthesis. Literature lacks any materials regarding this complication’s treatment. We report our experience with a 66-year-old man who developed urethrocavernous fistula after penile prosthesis implant. Our technique involves the careful closure of urethral and corpus cavernosum defects with application of TachoSil above the sutures. After the salvage procedure, no recurrence of fistula occurred and patient was able to have sexual intercourse. We believe that our technique may be successfully used in case of urethrocavernous fistula after penile prosthesis implant. Enrico Caraceni, Angelo Marronaro, and Luca Leone Copyright © 2016 Enrico Caraceni et al. All rights reserved. A Rare Case of the Simultaneous, Multifocal, Metastatic Renal Cell Carcinoma to the Ipsilateral Left Testes, Bladder, and Stomach Thu, 21 Jan 2016 12:08:42 +0000 We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC metastasis and simultaneous presentation is even rarer, further emphasizing the importance of continuous and careful follow-up in this patient population, despite what could appear as complete remission. Michael Kongnyuy, Samuel Lawindy, Daniel Martinez, Justin Parker, and Mary Hall Copyright © 2016 Michael Kongnyuy et al. All rights reserved. Synchronous Renal Cell Carcinoma and Gastrointestinal Malignancies Tue, 19 Jan 2016 18:26:17 +0000 While renal cell carcinoma is the most commonly diagnosed neoplasm of the kidney, its simultaneous diagnosis with a gastrointestinal malignancy is a rare, but well reported phenomenon. This discussion focuses on three independent cases in which each patient was diagnosed with renal cell carcinoma and a unique synchronous gastrointestinal malignancy. Case explores the diagnosis and surgical intervention of a 66-year-old male patient synchronously diagnosed with clear cell renal cell carcinoma and a carcinoid tumor of the small bowel. Case describes the diagnosis and surgical intervention of a 61-year-old male found to have clear cell renal cell carcinoma and a mucinous appendiceal neoplasm. Lastly, Case focuses on the interventions and management of a 36-year-old female diagnosed with synchronous clear cell renal carcinoma and hereditary nonpolyposis colorectal cancer. This case series examines each distinct patient’s presentation, discusses the diagnosis, and compares and contrasts the findings while discussing the literature on this topic. Tamer J. Dafashy, Cameron K. Ghaffary, Kyle T. Keyes, and Joseph Sonstein Copyright © 2016 Tamer J. Dafashy et al. All rights reserved. Spontaneous Retroperitoneal Haematoma due to Polyarteritis Nodosa: Report of a Case and Literature Review Mon, 18 Jan 2016 16:27:01 +0000 Retroperitoneal haematoma is a rare clinical entity with variable etiology. It can happen spontaneously, without any obvious precipitating factors, the so-called spontaneous retroperitoneal haematoma. There is no general consensus as to the best management plan for patients with retroperitoneal haematoma. Polyarteritis nodosa (PAN) is a rare cause of retroperitoneal haematoma. Here we report relationship between PAN and retroperitoneal haematoma and treatment approaches. However, an accepted and clearly defined treatment has not been established due to its rarity. Emrah Simsek, Hasan Yilmaz, Kerem Teke, Ali Kemal Uslubas, and Mustafa Yuksekkaya Copyright © 2016 Emrah Simsek et al. All rights reserved. Incidental Finding of a Rare Urachal Pathology: Urachal Mucinous Cystic Tumour of Low Malignant Potential Sun, 03 Jan 2016 11:17:38 +0000 Urachal mucinous cystic tumours are rare pathological findings with only 23 previously reported cases in the literature. We present the case of a 54-year-old man with an incidentally found urachal mucinous cystic tumour laparoscopically excised. With its known potential to cause pseudomyxoma peritonei, complete surgical excision is important. Long-term cystoscopic and radiological surveillance is also required. Luke L. Wang, Heath Liddell, Sharman Tan Tanny, Briony Norris, Sree Appu, and David Pan Copyright © 2016 Luke L. Wang et al. All rights reserved.