ABSTRACT
Purpose. Port-site metastasis has been a concern with the common use of laparoscopy in urologic oncology. We conducted this study to provide a review of port-site metastases reported after the laparoscopy in managing urologic malignancies, possible contributing factors and preventative measures. Materials and Methods. An electronic search of MEDLINE using the combined MESH key words "port-site metastasis" and "Urology". Results. 51 articles addressing port-site metastasis after laparoscopic surgery for urolo¬gical malignancy were identified. Conclusion. Port-site metastasis after laparoscopic surgery for urolo¬gical malignancy is rare. The incidence is comparable to the rate for surgical wound metastases.
ABSTRACT
We present a case of human herpes virus 8 (HHV8)-associated Kaposi sarcoma (KS) occurring in a renal allograft ureter from a male donor. The female patient presented with a rising creatinine due to ureteric obstruction, and subsequent histological examination of the excised tumor revealed a KS. The tumor tested positive for HHV8 antigen and, using in situ hybridization to identify X and Y chromosomes, we were able to demonstrate that the tumor was of male origin. In the absence of any other KS lesions, this suggested that the tumor arose due to reactivation of latent HHV8 in the donor tissue, permitted by the recipient's immunosuppression. The patient was managed by a gradual reduction in immunosuppression and there has been no subsequent recurrence of the tumor. KS in renal transplantation is discussed in detail including the possible utility of pre-transplant HHV8 screening.
Subject(s)
Herpesvirus 8, Human/isolation & purification , Kidney Transplantation/adverse effects , Sarcoma, Kaposi/etiology , Tissue Donors , Female , Humans , Male , Middle Aged , Transplantation, HomologousABSTRACT
We present the rare case of a ureteric hernia into the sciatic foramen. The presentation was that of a 59-year-old woman with urinary tract sepsis associated with an acute deterioration of renal function. The hernia was successfully repaired laparoscopically.
Subject(s)
Herniorrhaphy , Laparoscopy/methods , Proteus Infections/drug therapy , Sepsis/etiology , Ureteral Diseases/surgery , Abdominal Pain/etiology , Acute Kidney Injury/etiology , Acute Kidney Injury/surgery , Female , Hernia/complications , Humans , Middle Aged , Sepsis/drug therapy , Ureteral Diseases/complicationsABSTRACT
Renal insufficiency because of obstruction may not always be represented by dilated pelvicalyceal system. This may make diagnosis and thence the management very difficult with the present available investigative armamentarium. Experience and clinical acumen may help with a decision of empirical treatment in the form of stenting or nephrostomy in these cases. This may be diagnostic as well as curative of the renal failure. We present herewith three such challenging cases managed by us. We also have reviewed the literature as to the diagnosis and management of such cases.
Subject(s)
Kidney Pelvis/diagnostic imaging , Tomography, X-Ray Computed , Ureteral Obstruction/diagnostic imaging , Aged, 80 and over , Diagnosis, Differential , Female , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/surgery , Male , Middle Aged , Nephrostomy, Percutaneous , Ureteral Obstruction/surgeryABSTRACT
We describe a very unusual presentation of misplaced Macroplastique injection. This incidentally showed up as bladder lesion and vaginal nodule during a tension-free vaginal tape surgery.
Subject(s)
Dimethylpolysiloxanes/adverse effects , Foreign Bodies/etiology , Medical Errors , Silicones/adverse effects , Urinary Bladder Diseases/etiology , Urinary Incontinence, Stress/therapy , Dimethylpolysiloxanes/therapeutic use , Female , Foreign Bodies/pathology , Humans , Incidental Findings , Middle Aged , Silicones/therapeutic use , Urinary Bladder Diseases/pathology , Vaginal Diseases/etiologyABSTRACT
Stenosis and necrosis of the ureter are amongst the severe complications after renal transplantation. Several surgical techniques like simple nephrostomy or native pyeloureterostomy using the native ureter have been applied for repair. We report a case of modification to the conventional pyeloureterostomy where the native ureter was anastomosed to the transplant calyx to restore continuity of the urine collecting system. This technique is recommended as a feasible alternative when secondary reconstruction by native pyeloureterostomy is not possible.
Subject(s)
Kidney Calices/surgery , Kidney Transplantation/adverse effects , Ureteral Obstruction/surgery , Ureterostomy/methods , Anastomosis, Surgical , Female , Follow-Up Studies , Humans , Kidney Transplantation/methods , Middle Aged , Radiography , Risk Assessment , Treatment Outcome , Ureteral Obstruction/diagnostic imaging , Ureteral Obstruction/etiology , UrodynamicsABSTRACT
OBJECTIVE: To analyse critically the reasons for a poor outcome of the Nesbit operation for Peyronie's disease in 51 patients over a 20-year period. PATIENTS AND METHODS: Fifty-one patients who were classified as having a poor result from the Nesbit operation were reviewed (mean age 53 years, mean follow-up 21 months). The factors responsible for a poor result were analysed and classified into three groups: (i) deformity > 30 degrees; (ii) penile shortening > 2 cm; and (iii) impaired erection. Patients with a recurrent deformity were further classified according to the interval from surgery to the presentation of the recurrence. RESULTS: Thirty-one patients had a deformity of > 30 degrees; this occurred immediately in three patients through surgical error, soon after surgery in eight patients because of suture failure and after 11 months in the remaining 20 patients because their Peyronie's disease progressed. Penile shortening of > 2 cm was present in 19 patients but this only affected coital function in four. Erection was impaired in 10 patients but this was present before surgery in most. CONCLUSION The results of the Nesbit operation for Peyronie's disease can be improved by a preoperative assessment of erectile function and the use of sutures of high tensile strength. Patients should be warned that the disease may progress and that some penile shortening should be expected, although this does not affect coital function.
Subject(s)
Penile Induration/surgery , Adult , Aged , Disease Progression , Erectile Dysfunction/etiology , Follow-Up Studies , Humans , Male , Middle Aged , Penile Erection/physiology , Penile Induration/pathology , Penile Induration/physiopathology , Postoperative Complications/etiology , Recurrence , Sutures/adverse effects , Treatment FailureABSTRACT
OBJECTIVE: To assess the results of the correction of congenital penile curvature using the Nesbit operation. PATIENTS AND METHODS: The records of 106 patients who had a Nesbit operation to correct a congenital penile curvature between 1977 and 1992 were reviewed. RESULTS: An excellent (78.3%) or satisfactory (17.9%) result was achieved representing an overall success rate of 96.2%. The reasons for a poor or satisfactory result were either an impaired erection--7 (6.6%) [all psychogenic] or a residual deformity of 10 degrees--16 (15.1%). There were no major complications although five patients (5.3%) needed a further Nesbit operation. CONCLUSION: The Nesbit operation is a simple and effective technique for the correction of a congenital penile curvature.
Subject(s)
Penis/abnormalities , Penis/surgery , Surgical Procedures, Operative , Adolescent , Adult , Humans , Male , Postoperative Complications , Treatment OutcomeABSTRACT
PURPOSE: We analyze the long-term outcome of the Nesbit operation for the correction of the penile deformity due to Peyronie's disease. MATERIALS AND METHODS: Between 1977 and 1992, the penile deformity due to Peyronie's disease was corrected in 359 patients using the Nesbit operation. RESULTS: The overall success rate was 82%, which increased to 90% during the last 8 years with better patient selection due to improved preoperative investigation. Complications were minimal and only 6 patients had significant penile shortening that precluded sexual intercourse. CONCLUSIONS: The Nesbit operation remains the procedure of choice to correct the penile curvature of Peyronie's disease.
