The Da Vinci Single-Port (SP) Treatment of Nutcracker Syndrome: A Case Report of a Novel Approach.

Nutcracker syndrome (NCS) is a rare disease affecting the left kidney. Surgical management is the only choice of treatment. Minimal invasive surgeries can be effective and may prevent complications of the major surgery. We present the case of a 33-year-old woman suffering from chronic left flank pain, diagnosed with NCS and treated with extravascular stents. Robotic-assisted extravascular stent insertion was performed using the Da Vinci single-port (SP) (Intuitive Surgical, Inc., Sunnyvale, USA) system. This approach offers the advantages of minimal invasiveness, precise stent placement, and reduced operative time. To our knowledge, this is the first case of using Da Vinci SP for this indication. Further studies are needed to evaluate the long-term outcomes and safety.

An endourological management of 4-year-old bilateral neglected and encrusted ureteral stents.

Double-J (DJ) stents are integral tools in the hands of urologists. Nonetheless, it might be associated with significant complications. Forgotten DJ stent is a commonly encountered problem. Herein, we present a case of a 42-year-old female patient who presented with extensively encrusted bilateral DJ stents, with bulky stones and encrustations at the entire course of the DJ stents on both sides. They were inserted 4 years ago with no follow-up. Multimodal endourological techniques were tailored to manage this difficult case. Cystolithotripsy, endoscopic combined intrarenal surgeries, and spontaneous bilateral endoscopic surgery were required to render her stone free.

Comparison of Two Treatment Modalities in Overactive Bladder: A Rapid Overview.

Background: Overactive bladder is a syndrome of urgency with the absence of infection and is usually accompanied by frequency and nocturia. Both sacral neuromodulation (SNM) and intravesical botulinum toxin (BTX) injection are used contentiously in overactive bladder after failure of conservative management. Objective: We aimed to provide an updated comparative overview of BTX injection versus SNM in the treatment of overactive bladder. Methods: PubMed and Google scholar databases were explored starting from 2016 to 2022 to obtain relevant articles. English studies on adult population were included. Results: Six articles included 648 participants were included in the current overview. Both BTX and SNM are comparable for the treatment of overactive bladder, with no major complications were reported. However, the use of SNM for refractory overactive bladder after failure of BTX was more successful and effective and resulted in patient satisfaction compared to the use of BTX after failure of SNM. Conclusion: Our update provides the latest comparative overview of outcomes of BTX versus SNM in the treatment of overactive bladder.

Open Partial Cystectomy of Intramural Bladder Leiomyoma With Unfavorable Position: A Rare Case Report.

Benign tumor of the bladder (Leiomyoma) is a rare condition representing less than 0.5% of all bladder tumors. A 50-year-old female presented with asymptomatic hematuria for three months. Abdomen and pelvic magnetic resonance imaging (MRI) revealed a large intraluminal mass originating from the submucosal layer of the left anterolateral wall of the urinary bladder. An ultrasound-guided biopsy was performed, and a histopathological examination showed a spindle cell tumor. Cystoscopy revealed a massive indentation in the left posterolateral site of the urinary bladder extending to the bladder's dome. The patient underwent open partial cystectomy. At the follow-up, the patient was evaluated, and there was no hematuria or other complaints. Open partial cystectomy is the treatment of choice in an intramural tumor with an unfavorable position and difficulty in recognition.

Percutaneous Nephrolithotomy in a Patient with Cross-Fused Renal Ectopia.

Background: Cross-fused renal ectopia (CFRE) is a rare congenital anomaly in which an ectopic kidney crosses the midline and merges with the orthotopic kidney on the other side. Patients with CFRE could present with urolithiasis. The abnormal anatomy and the lack of consensus to treat urolithiasis in these cases present challenges to treatment. In this study, we present a case of renal stone in a CFRE managed through percutaneous nephrolithotomy (PCNL). Case Presentation: We present a case of a 59-year-old man with right flank pain. Radiologic studies showed a 2 cm renal pelvis stone in a CFRE. The patient was effectively managed with PCNL. Conclusion: With proper radiologic study and thorough understanding of the aberrant anatomy, PCNL represents a safe and effective treatment for patients with renal stones in CFRE with high stone-free rate and low mortality.