Case Reports in Urology

Prune belly syndrome (PBS) is a rare congenital anomaly characterized by a triad of abdominal flaccidity, varying degrees of urinary system involvement, and cryptorchidism. The exact cause of PBS is unknown. Clinical symptoms can range from stillbirth to significant renal and respiratory abnormalities to almost normal children. Treatment typically involves surgical repair of the abdominal wall defect and urinary tract abnormalities, early orchiopexy, and supportive management of related problems. We report the first case of a female newborn with PBS following in vitro fertilization-induced pregnancy with a comprehensive systematic review of all relevant cases.

Unlike female genital mutilation, the alteration of male genitals has not received much attention. Circumcision is the most common and oldest surgical procedure being performed. When performed by surgeons or well-trained personal the procedure is safe, but most of the times it is being performed by untrained people with no or little medical background. This has led to many complications. Total skin loss is an uncommon but serious complication. There is an ongoing debate regarding the management of this complication. Here, we present a case of total penile skin loss which had resulted from penile mutilation in the name of ritual circumcision.

Intra-abdominal cancer in an adult with undescended testis (UDT) is rare owing to widespread screening and management during childhood. Here, we present a 33-year-old gentleman with a complaint of abdominal pain and pelvic mass which appeared to be an uncorrected UDT with cancerous degeneration. Additional evaluation revealed a suspicious mass in the retrovesical space which remained after chemotherapy. Histologic evaluation after resection of this mass indicated cancer spread of testicular origin behind the bladder.

Penile rings have been used to help sustain erection and enhance sexual pleasure for centuries. Constriction of the penis reduces the outflow of blood from the cavernosal tissue. However, if left for an extended time period, a condition called penile ring entrapment can occur. This may result in severe edema, gangrene, necrosis, and even penile amputation. Penile ring entrapment is a very rare condition; complete urinary obstruction with concomitant bladder rupture as a result renders this case even more extraordinary. We discuss our experience in the management of a 64-year-old man, who presented with altered mental status and inability to urinate, found to have penile ring entrapment and intraperitoneal bladder rupture. Removal of the constricting ring was performed in the ED, and bladder injury and penile necrosis were subsequently repaired with robot-assisted laparoscopic cystorrhaphy, penectomy, and perineal urethrostomy.

Introduction. The ureteropelvic junction obstruction is more common in children; however, it can also affect adults. The management of this condition has shifted toward a nonoperative approach with serial ultrasonography and renography. Case Presentation. The ureteropelvic junction obstruction imaging with significant renal function deterioration in an adult patient is described in this report. Laparoscopic exploration revealed aberrant vessels that compress the ureteropelvic junction against the lower pole of the kidney. Conclusion. It is important to consider that some of the ureteropelvic junction obstruction cases can get worse even in a short period of time.

Background. Pseudoaneurysm (PA) with associated arteriovenous fistula (AVF) is a rare delayed bleeding complication, occurring in less than 1% of patients after percutaneous nephrolithotomy (PNL). Case presentation. A 54-year-old man underwent PNL on February 28, 2023, for a large renal calculus in the right kidney lower pole, with postoperative delayed bleeding: macroscopic hematuria and bladder clot retention after 3 weeks. An iatrogenic PA and AVF were diagnosed after the failure of conservative measures. The patient was successfully treated with superselective angioembolization (SAE) under local anesthesia. Conclusion. Late hemorrhagic complications after PNL can be severe. Rapid identification of a renal PA and AVF with SAE has a high success rate and low complication rate, avoiding prolonged hospitalization time and major renal surgery for this patient.