A Modified Left Ileal Conduit in the Presence of a Left Short Ureter Following an Urgent Radical Cystectomy: A Case Report.

The ileal conduit is the most common method performed for urinary diversion following radical cystectomy. The prepared conduit is usually placed on the right abdominal wall. There is not enough experience and literature on left-sided ileal conduits. Here, we report a case of a left-sided ileal conduit with a modified method and describe the surgical technique. A 68-year-old male patient had undergone an urgent radical cystectomy operation one year ago due to bladder cancer and gross hematuria. However, urinary diversion was not performed, and a bilateral nephrostomy was inserted. An ileal conduit was planned for the patient after oncological stabilization. On preoperative evaluations, bilateral ureters were observed to be short, with the left being prominent. The prepared ileal conduit was passed under the sigmoid mesentery due to the short ureters and placed on the left abdominal wall. There were no major complications during follow-ups. We emphasize that the method we performed is a safe option in mandatory situations.

Asymptomatic Giant Right Renal Oncocytoma: A Case Report.

Renal oncocytoma is usually detected incidentally. It can be considered as a renal cell carcinoma (RCC) on preoperative imaging. They usually present as small masses and usually look like benign tumors. Giant oncocytomas are rare. A 72-year-old male patient was seen in the outpatient department for left scrotal swelling. Ultrasound (US) showed a giant mass compatible with RCC in the right kidney which was incidentally detected. Abdominal computed tomography (CT) revealed a mass with an axial diameter of 167×146 mm, compatible with RCC, a heterogeneous mass of soft tissue density with central necrosis. There was no evidence of tumor thrombus in the right renal vein or inferior vena cava. Open radical nephrectomy was performed through an anterior subcostal incision. Pathological examination revealed a 17×15 cm renal oncocytoma. The patient was discharged on the sixth day postoperatively. Clinically or radiologically, renal oncocytoma and renal cell carcinoma usually cannot be distinguished, although oncocytoma may be suspected if a central scar with fibrous extensions is seen, the so-called "spoke-wheel appearance". The treatment decision should be made according to the clinical aspects. Radical/partial nephrectomy or thermal ablation can be considered as treatment options. In this article, we review the literature on the radiological and pathological features of renal oncocytoma.

Uroflow findings in older boys with tubularized incised-plate urethroplasty.

AIM: To analyze uroflow findings in older boys with tubularized incised-plate urethroplasty (TIPU). MATERIALS AND METHODS: 79 toilet-trained patients who had TIPU were evaluated by studying their voiding history, a physical examination, suprapubic ultrasound and uroflowmetry, both pre- and postoperatively. The obstructive urinary flow pattern (OUFP) was accepted as low maximum urinary flow rate with plateau, staccato or intermittent shape. RESULTS: The mean age was 7 years (range 5-11). The mean follow-up was 30 months (range 6-36). Of the 79 patients, 70 recovered. A permanent OUFP was found in 10 of 63 patients, as follows: 7 were detected in the 6th month after operation, and 1 each in the 9th, 18th and 36th months.Ten patients had no voiding abnormality and significant residual urine. The mean interval from initial surgery to presentation with an OUFP was 10.5 months. CONCLUSIONS: An occult urethral obstruction develops in some asymptomatic children with TIPU and commonly occurres in the first year after operation.

Usefulness of a new dysfunctional voiding and incontinence scoring system in predicting treatment effect in children with voiding dysfunction.

AIM: To assess the role of the dysfunctional voiding and incontinence scoring system (DVAISS) in children with voiding dysfunction. METHODS: Ninety-three children were divided into three groups: those who had wetting only (group 1), recurrent urinary tract infections (UTIs) and wetting (group 2) and vesicoureteral reflux together with wetting and UTIs (group 3). Individualized multiple treatments modalities were applied. The success criteria defined by the reduction in the rate of wetting described as complete response (more than 90%), partial response (50-90%), no response (less than 50%).Also, in group 3, improvement was determined as a decrease of at least two grades in reflux. Scores of patients were determined before and after treatment. RESULTS: Complete response rates for groups 1, 2 and 3 were 67.5, 88.8 and 85.71%, respectively. The specificity of the DVAISS in predicting the complete response was 79, 88 and 100%, respectively, and its sensitivity was 100% in all groups. In group 3, improvement rate was 71.4%. The specificity and sensitivity of the DVAISS in predicting the improvement were 83 and 100%, respectively. CONCLUSION: The sensitivity of the DVAISS is higher in predicting the treatment effect; however, its specificity is decreased. The DVAISS may be an auxiliary diagnostic tool in voiding dysfunction patients.