RESUMO
A 70-year-old male presented with refractory urinary retention 3 years back. He had undergone a prior trans urethral resection of prostate (TURP) 5 months back elsewhere. A revision TURP was done and the histopathology showed differentiated adenocarcinoma with cartilaginous and osseous metaplasia. Bone scan showed no evidence of metastasis. He underwent bilateral orchidectomy soon after. He presented with urinary retention 14 months later and underwent TURP. Hard prostatic tissue was resected and histopathology reports were same as previous report. Bone scan showed evidence of solitary metastasis in the second rib. MRI and CT scan showed re-growth. He had persisting lower urinary tract symptoms with hematuria. A palliative radiation was given which alleviated the urinary symptoms; patient refused radical cystoprostatectomy and currently is on conservative management.
RESUMO
A 55-year-old man presented with intermittent episodes of urinary leak through the left groin following an abscess drainage at that site at the age of 5 years. Since then he had been suffering from recurrent urinary tract infections and urinary leak, which used to be treated symptomatically. Intravenous urogram (IVU), voiding cystourethrogram (VCU), and cystoscopy done in our institution revealed a bladder diverticulum with a stone in situ, which was communicating with the fistulous opening located in the left groin. Diverticulectomy and excision of the fistulous tract cured the patient. A long-standing fistula arising from a bladder diverticulum at relatively distant site is of extreme rarity. Vesicocutaneous fistula from an iatrogenic injury to vesical diverticulum resulting from a groin surgery has not been reported so far.