ABSTRACT
The ureteral avulsion during ureterolithotripsy (URS) occurs due to the sudden movement of the optical device or endoscopic extractor either in its removal or insertion, associated with a probable previous lesion in the ureter wall, causing a vital fragility area. A 52-year-old male patient with, an obstructive calculus of 9 mm was found in the left middle ureter, and a heterogeneous hypervascular nodule located in the right kidney, suggesting neoplasia. During procedure with rigid ureteroscopy with ureteroscope removal, due to the pressure of the device and tissue fragility, there was total ureter avulsion.
ABSTRACT
Staghorn, struvite or coral calculus are the ones that completely or partially occupies the renal pelvis and branches to the renal calices. The presence of renal calculi of any kind in the urinary tracts is related to the appearing of malign tumor in the kidneys, especially in the absence or failed treatment. A male patient, 51 years old, native of Manaus, reports about dysuria and polyuria associated with constant fever episodes and urinary tract infections with improvement by using several antibiotics but returning the symptoms after suspending it. The patient return was in a month and no improvement of the pain in the patient's feeling, with the tomography image tests result showing atrophy in the right kidney, which presents dilatation of the collector system, that it's filled with material with density varying between thick liquid and soft parts (average of 45 UH), in addition to calculus in the pelvis and ureteropelvic junction, suggesting a pattern for xanthogranulomatous pyelonephritis and matching previous history of right staghorn calculus. The association between kidney cancer and staghorn calculus should be consider through the treatment. Patients with renal diseases of severe prognosis in both kidneys must be kept under constant surveillance by the urology and nephrology team, the association of both clinics is essential to a fortunate ending like the case reported.
ABSTRACT
INTRODUCTION: Penile cancer is a rare malignant tumour top in urology, especially in developed countries or in a favourable cultural habit. However, in developing countries or with a low socio-economic population, the incidence increases considerably, as does the stage at which the patient arrives for the first care. CASE PRESENTATION: Male patient, 20 years old, from the interior of Amazonas - Brazil, has been referred to a Urological Service in the Emergency Room due to a vegetative lesion of approximately 10 centimetres, with an ulcerated centre and irregular borders in penile glans. An incisional biopsy was performed, which revealed invasive squamous cell carcinoma and was referred to the elective surgery service. CONCLUSIONS: The socioeconomic condition of the population influences in a relevant way in cases in the Amazon region, with little and difficult access to preventive information and to the public health system, mainly in the interior of the state. Young patients tend to maintain the confidentiality of the picture that leads to the progression of the disease, with negative outcomes, requiring intense psychological monitoring.
ABSTRACT
The insertion of a double-j catheter in patients with urinary lithiasis is currently important because it reduces the chances of obstructive complications such as hydronephrosis and renal functional loss. The following case aims to show the patient evolution which presented the complete migration of the catheter to the renal pelvis and how it could complicate its prognosis. Placing a dual-catheter for treatment of lithiasis is a routine procedure in urology services but is not beyond complications during the process. Even with exhaustive complementary imaging exams, we must maintain a constant evaluation of the patient.
