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Adenocarcinomas represent 2% of bladder cancers and originate from the bladder urothelium or the urachus.1 Urachal adenocarcinoma constitutes less than 0.5% of all bladder cancers.2 We report a urachal adenocarcinoma case managed surgically with two incisions and an emphasis on cosmesis while maintaining oncologic principles.
Ureteral Triplication- Laparoscopic Partial Nephrectomy with Highly Selective Arterial Dissection: Description of Surgical Technique
Ureteral triplication is a rare congenital malformation with a wide spectrum of presentation that requires a high index of suspicion in order to diagnose. To date, only about 100 cases have been published in medical literature. Smith et al.1 proposed a classification for ureteral triplication that describes it as three separate ureters and three separate ureteral orifices with no interconnection between ureters. In this video, we present a surgical approach for laparoscopic partial nephrectomy of both upper moieties in the context of ureteral triplication.
Intrauterine devices(IUD) are used by women worldwide as the most conventional method of reversible contraception.Migration of an IUD to pelvic or abdominal organs is considered rare.We report a case of a 67 year old female who had neglected to remove her IUD for 20 years. She visited our clinic because of recurrent UTI's the previous year. After assessment and clinical investigation it was found that the coil had a late onset migration to the urinary bladder, with calculus formation, causing the patients’ symptoms.
The patient is a 42-year-old male referred for the evaluation of worsening lower urinary tract symptoms. His complaints include worsening urgency, frequency, dysuria, decreased urinary flow, and spraying of the urine stream over the past several years. He also complains of chafing, cracking and bleeding of the skin about the tip of the penis with erections and intercourse. He previously underwent an attempt at cystoscopy which confirmed the presence of a distal penile urethral stricture, for which he was instructed to treat with topical and intraurethral application of 0.025% triamcinolone acetonide cream.
A 90-year old man with no significant past medical history presented to urology clinic complaining of gross hematuria, urinary frequency, and dysuria. Previous urine cytology was atypical but two white-light cystoscopies failed to show any lesions. The patient was taken for intraoperative blue light cystoscopy, which revealed multiple lesions that were then resected. Pathology revealed high grade urothelial carcinoma with lamina propria invasion and the patient was managed successfully with Bacille Calmette Guerin therapy.
Anterior urethral valves are a rare cause of obstructed voiding in adolescent children and are often unheard by adult urologists. In this case report, we discuss the management of two adolescent patients who were referred to us with obstructive voiding symptoms with a diagnosis of neurogenic bladder and posterior urethral valves respectively but on evaluation were found to have anterior urethral valves. This article highlights the need for considering anterior urethral valve as an important differential diagnosis in children and adolescents presenting with obstructive voiding symptoms so as to avoid delay in diagnosis and management in young boys.
Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study
To assess the effects of robot-assisted radical prostatectomy in the Trendelenburg position on postoperative neurocognitive outcomes this study compared cognitive function between patients who underwent robot-assisted radical prostatectomy and those who underwent open retropubic radical prostatectomy.
To define the relationship between urology RVUs and measures of surgical complexity and physician workload. Secondary objectives include: 1) identifying procedures with outlying RVU values for their measures of surgical complexity and workload; and 2) calculating projected RVU values for these procedures.
Voiding Cystourethrogram in Children with Unilateral Multicystic Dysplastic Kidney: Is it still necessary?
To evaluate the value of the voiding cystourethrogram (VCUG) in children with multicystic dysplastic kidney (MCDK) who have a normal versus abnormal contralateral kidney and bladder ultrasound (US), and assess the risk of having vesicoureteral reflux (VUR) or urinary tract infection (UTI) based on the US results.
Fate of Pediatric Renal Angiomyolipoma During mTOR Inhibitor Treatment in Tuberous Sclerosis Complex
To evaluate the clinical and radiographic follow up of renal angiomyolipoma (AML) in pediatric patients with tuberous sclerosis (TSC) on mTOR inhibitors.
To compare the PERC-tic technique, described as placement of dual wires under fluoroscopic guidance adjacent to the stone within the obstructed calyx, to standard percutaneous nephrolithotomy (PCNL) with working wires secured down the ureter.
To improve our understanding of timely access to urologic care, we leveraged driving time combined with a measure of urologist density.
Ectopic intravesical ejaculatory ducts: case report of bulking agent injection for treatment of recurrent epididymitis in a patient with anorectal malformation
As far as we know this is the first report on bulking agent injection into intravesical ectopic ejaculatory orifices reported in the English literature. During a follow-up period of 16 months, the child was free of episodes of EO. Deflux injection in this rare anomaly of intravesical refluxing ducts had prevented irreversible damage to the testes from recurrent EO. Thus, it may be a better option than vasectomy when antibiotic treatment fails.
Female Authorship Publishing Trends and Forecasting in Pediatric Urology: Are we Closer to Gender Equality?
To review the literature of 5 pediatric urology topics and conduct gender based and forecasting analyses of first and corresponding authors.
Decrease in Urologic Discharge Opioid Prescribing after Mandatory Query of Statewide Prescription Drug Monitoring Program
To examine the effectiveness of the introduction of the Pennsylvania Prescription Drug Monitoring Program (PDMP) on discharge postoperative opioid prescriptions in patients undergoing major urologic procedures within a large single tertiary care hospital. Opioids have historically been prescribed to control postoperative pain, but with growing concern regarding opioid overdose, misuse, and diversion, measures have been introduced to curb opioid prescribing. Numerous states have introduced PDMP programs as a method to search patients’ prior opioid prescriptions.
The pathophysiology and therapy of erectile dysfunction in a newly discovered treatise by Wolfgang Reichart (1486–circa 1547)
The pathophysiology of erectile dysfunction was highly contested in Renaissance medicine due to the believe in witches and incantations.1,2 A newly-found treatise by the physician Wolfgang Reichart (1486–circa 1547) challenges the contemporary view that bewitchment as a cause of impotence defies any natural explanation. Reichart studied in Tübingen and worked as a town physician of Ulm since 1512. Nearly 600 letters of his letters are preserved, but only half of them are edited. The letters are not primarily medical in nature except one casuistry on melancholy and circa 60 letters which can be considered epistolary medicine.
Transperineal free-hand mpMRI fusion-targeted biopsies under local anesthesia: technique and feasibility from a single-centre prospective study
To evaluate the feasibility of ‘’in-office’’ TPFBx under LA.
To describe a novel tabularized bladder flap technique for repair of post-traumatic obliterate bladder neck and urethral stricture in women. Traumatic genitourinary injury in females is rare, and generally associated with pelvic fracture. Obliterate bladder neck is frequent in such cases. The options for obliterate strictures are limited with Tanagho‘s repair as one option. Limitations of Tanagho's repair include bladder neck being shifted antero-superiorly posing voiding issues, posteriorly directed suture-line risking fistula formation with vagina and rotational tug of bladder putting tension at suture line.
Evaluation, treatment, and insurance coverage for couples with male factor infertility in the US: A cross-sectional analysis of survey data
To characterize the evaluation, treatment, and insurance coverage among couples with male factor infertility in the US.
Pressure Regulating Balloon Herniation: A Correctable Cause of Artificial Urinary Sphincter Malfunction
To report our experience with isolated PRB replacement for AUS malfunction in the setting of PRB herniation.