Urology News Feeds

Two applications for laparoscopic combined ventral and dorsal side approach in the lateral decubitus position: 1) right-modified retroperitoneal lymph node dissection, 2) nephrectomy for horseshoe kidney

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
Laparoscopic retroperitoneal lymph node dissection (RPLND) in metastatic testicular cancer is a technically challenging procedure.1 In right-modified RPLND, retrocaval lymph nodes are often not visible and cannot be adequately dissected using only the transperitoneal approach. In laparoscopic nephrectomy (LN) for horseshoe kidney, the kidney cannot be sufficiently moved due to its connection to the contralateral kidney, and the isthmus and lower poles have separate blood supplies arising from the aorta or iliac artery.
Categories: Urology News Feeds

A Rare Case of Signet Ring Cell Carcinoma of the Colon with Selective Metastasis to the Prostate

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
A 50-year-old Italian-American male with a past medical history of colon cancer presented to our urology clinic in Fall 2018 with an acute elevation in serum prostate specific antigen (PSA). In 2015, he had been diagnosed with stage III (T4a, pN1, cM0) cancer of the ascending colon and treated with right hemicolectomy followed by seven cycles of adjuvant combination of folinic acid, 5-fluorouracil, and oxaliplatin (FOLFox) therapy. Final pathology was consistent with signet ring cell carcinoma (SRCC) of the ascending colon with regional nodal metastasis.
Categories: Urology News Feeds

Surgical precautions for Urologists in the era of COVID-19

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
Since our article detailing Urologists’ efforts in Singapore during its initial outbreak,1 COVID-19 has become a global pandemic. As incidence and mortality rises worldwide, countries have instituted crippling lockdowns. Singapore has not been immune, resulting in nation-wide restrictions and “circuit breaker” measures.2 It is evident that the medical community must prepare for a prolonged effort to not only contain COVID-19, but continue care for non-COVID-19 patients.
Categories: Urology News Feeds

“Myoepithelial carcinoma of urinary bladder in a pediatric patient. A case report”.

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
Myoepithelial carcinoma is a rare pathological variant, usually expressed in salivary gland. This case report describes a case of pediatric myoepithelial carcinoma in the urinary bladder. A 4-year-old male patient was admitted to a specialized hospital in Lima, Peru for hematuria. A CT scan showed a tumor lesion in the bladder wall, and biopsy revealed myoepithelial carcinoma of urinary bladder. 6 courses of chemotherapy + partial cystectomy + radiotherapy was completed. The treatment was defined based on the pathological variant and the tumor location.
Categories: Urology News Feeds

Optimal Cystectomy Outcome: A Composite Measurement Evaluating Quality of Care and Mortality Benefit

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
To evaluate the incidence and impact of an “optimal cystectomy outcome” (OCO), a simplified performance metric that encompasses multiple patient-centered outcomes.
Categories: Urology News Feeds

Abdominal aortic aneurysm complicated with aorto-left retroaortic renal vein fistula.

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
We present the case of a male with a fistula from an infrarenal aortic aneurysm to the left renal vein resolved with an endovascular prosthesis. Few cases have been reported in the literature.
Categories: Urology News Feeds

Impact of the COVID-19 Pandemic on the Urology Residency Match in Singapore

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
To the Editor: The COVID-19 pandemic has led to significant disruptions in undergraduate and postgraduate Urology education and training. In this letter, we examine the wide-ranging impact of the COVID-19 pandemic on the Urology Residency Match in Singapore, and share strategies to proactively mitigate these consequences.
Categories: Urology News Feeds

Nondilated Obstructive Uropathy – Still Underappreciated

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
In a recent review of the differential diagnosis of declining renal function, the discussant states: “absence of hydronephrosis on renal ultrasonography rules out [urinary tract] obstruction.”1 Many urologists and nephrologists believe this. But it is not true. I learned this the hard way 35 years ago when I evaluated an elderly man with three days of anuric renal failure. Renal ultrasonography showed no hydronephrosis, so I inferred parenchymal disease. To my surprise, a renal biopsy showed only interstitial edema and normal glomeruli.
Categories: Urology News Feeds

Concerns in redirecting uro-oncologic patients during COVID-19 pandemic

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
COVID-19 pandemic dramatically struck northern Italy during the last few weeks, causing a multi-regional health system crisis for the overwhelming number of patients who required hospital admission, particularly, with regards to the occupation of intensive care units (ICU) in case of acute respiratory syndrome. A survey among leading European urological centers showed a reduction in oncologic surgery of at least 40% to 50% in March.1 The following weeks of April saw a drastic reduction of the remaining elective surgery.
Categories: Urology News Feeds

Post-Operative Management of Ectopic Ureter Injury after Robotic Assisted Radical Prostatectomy: A Case Report

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
When operating in the robotic assisted radical prostatectomy (RARP) era, it is estimated that ureteric injuries happen in less than 0.05% of cases.1 Ureteral duplication is a risk factor for injury along with: previous pelvic surgeries, renal transplant, need for extensive adhesiolysis, previous pelvic irradiation, difficult posterior dissection, enlarged prostate glands and the presence of a median lobe. Given the incidence of less than 0.001%, management of ectopic ureters for patients undergoing a RARP is foreign to most urologists.
Categories: Urology News Feeds

Vaginal Estrogen–What a Urologist Should Know

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
The implications of estrogen depletion on the lower urinary tract and vagina are relevant to the urologist treating women with genitourinary symptoms. The main symptoms of vaginal estrogen depletion that affect women are dyspareunia and vaginal dryness, recurrent UTIs and lower urinary tract symptoms. Vaginal estrogen can be used to effectively treat these conditions. Vaginal estrogen is available in a variety of formulations. Each formulation has different considerations regarding its use and patients should be actively involved in choosing the right product for them.
Categories: Urology News Feeds

Skene's Gland Adenocarcinoma: Borrowing from Prostate Cancer Experience for the Evaluation and Management of a Rare Malignancy

Urology (Gold Journal) In Press - Wed, 06/03/2020 - 00:00
To determine if adenocarcinoma of the Skene's glands in women, which has a histological and immunohistochemical appearance similar to prostate cancer, can be evaluated and managed with the same tools we use for prostate cancer.
Categories: Urology News Feeds

Controlled Intramural Ureterotomy & Cystoscopic assistance during transvaginal repair of complex Vesicovaginal fistula

Urology (Gold Journal) In Press - Tue, 06/02/2020 - 00:00
Transvaginal approach has long been described as a gold standard for Vesicovaginal fistula (VVF) repair . But, presence of ureteral orifice at or near the fistulous margin presents unique challenges during VVF repair irrespective of the approach. We present a video on our novel techniques in these difficult VVF repair to aid in avoidance of ureteric orifice entrapment during VVF repair.
Categories: Urology News Feeds

Autologous Pubovaginal Sling For The Treatment Of Stress Urinary Incontinence In A Patient With High Risk Of Mesh Erosion

Urology (Gold Journal) In Press - Tue, 06/02/2020 - 00:00
Autologous pubovaginal sling is a surgical option for patients with stress urinary incontinence (SUI), either as primary treatment, or in those who have failed synthetic sling placement. It is also favourable for patients at high risk of mesh erosion, for example in those who are immunocompromised or post-radiation. This video reviews the technical considerations in performing an autologous pubovaginal sling fashioned from rectus fascia in an immunocompromised patient with multiple previous abdominal surgeries.
Categories: Urology News Feeds

Transvaginal Repair of a Peritoneal-Vaginal Fistula

Urology (Gold Journal) In Press - Tue, 06/02/2020 - 00:00
Pelvic organ prolapse is an increasingly reported complication following anterior pelvic exenteration and usually consists of an anterior enterocele [1-4]. We present the surgical management of a peritoneal-vaginal fistula in a woman who presented with an acute enterocele 16 months following vaginal sparing, robot-assisted laparoscopic (RAL) anterior pelvic exenteration.
Categories: Urology News Feeds

Aggressive angiomyxoma in an 11-year-old boy - diagnostic and therapeutic dilemmas: an unusual case report and review of the literature.

Urology (Gold Journal) In Press - Thu, 05/28/2020 - 00:00
Aggressive angiomyxoma (AAM) is a rare tumor with a high risk of local recurrence. Scrotal AAM mimics common pediatric pathologies including hernia or hydrocele. We present 11-year-old boy who underwent macroscopically radical excision of right scrotal AAM. The patient has been already followed up for 29 months utilizing US every 6 months and MRI every 2 years. Residual scrotal mass has been visualized in MRI 3 month after surgery however no further growth was reported. Long term follow up with reliable local imaging is mandatory.
Categories: Urology News Feeds

The Good, the Bad, and the Ugly of the COVID-19 Pandemic in a Urology Residency Program in Singapore

Urology (Gold Journal) In Press - Thu, 05/28/2020 - 00:00
To the Editor: The COVID-19 pandemic has affected Residency training worldwide in an unprecedented fashion.1-3 Residency Programs have been abruptly asked to respond in innovative and dynamic ways in the face of the pandemic.4 We share important lessons and insights about the impact on a Urology Residency Program in an Academic Medical Center in Singapore. We focus our discussion around the Academic, Administrative, Professional, and Personal Developmental aspects of Residency training.
Categories: Urology News Feeds

Obstructive sleep apnea syndrome as a potential cause of nocturia in younger adults

Urology (Gold Journal) In Press - Thu, 05/28/2020 - 00:00
To investigate the impact of age on the relationship between obstructive sleep apnea syndrome (OSAS), nocturia, and other lower urinary tract symptoms (LUTSs).
Categories: Urology News Feeds

Patient counseling through the pelvicalyceal-shaped labyrinth: in search of an easy understanding of the upcoming stone removal: a pilot study

Urology (Gold Journal) In Press - Thu, 05/28/2020 - 00:00
To investigate the impact of a mobile application (app) displaying a visualization of the internal anatomy of the pelvicalyceal system (PCS) and of kidney stones on patient understanding of their affected kidney anatomy and their upcoming percutaneous nephrolithotripsy (PCNL).
Categories: Urology News Feeds

Ureteral Extension of Cystic Childhood Renal Tumors: A Case Series and Review of Literature

Urology (Gold Journal) In Press - Thu, 05/28/2020 - 00:00
Ureteral extension of childhood renal tumors is exceedingly rare. Hematuria, hydronephrosis, poorly or non-functioning kidney should raise suspicion for ureteral tumor extension. Identifying ureteral extension on preoperative imaging or intraoperatively before ureteral transection is crucial to obtain good oncological outcome without unnecessary exposure to radiation therapy or more intensive chemotherapy. In this report, we present three children with cystic renal tumors extending into the ureter and review the relevant literature.
Categories: Urology News Feeds