ABSTRACT
Horseshoe kidneys are one of the most common congenital genitourinary malformations and can increase the complexity of common urologic procedures, especially nephrolithiasis. We present a patient who underwent robotic-assisted laparoscopic pyelolithotomy with intracorporeal pyeloscopy and stone basketing to treat a left lower pole stone burden located in a horseshoe kidney. This procedure provided benefits of expanded maneuverability, dexterity, and stability, which resulted in successful elimination of stone burden on post-operative imaging. We believe that robotic-assisted laparoscopic pyelolithotomy with intracorporeal pyeloscopy should be considered as a treatment option in similar cases of complicated nephrolithiasis due to complex renal anatomy.
ABSTRACT
Necrotizing urethritis is a rare malady with only one other case reported in the literature found to be due to an infectious cause. We report a case of necrotizing urethritis caused by Candida glabrata and review all relevant literature to date. The patient is a 56-year-old man with a past medical history significant for poorly controlled insulin-dependent type 2 diabetes mellitus and incomplete bladder emptying who presented to the University Medical Center with perineal pain, fever, and urinary retention. Cross-sectional imaging showed emphysematous changes in the bulb of the corpus spongiosum. After admission, his fever and leukocytosis persisted, and his physical exam worsened with intravenous antibiotics alone. Subsequently, the patient underwent cystourethroscopy with incision and debridement of the corpus spongiosum. Postoperatively, he improved clinically and his spongiosum wound and urine grew Candida glabrata. To our knowledge, we report the first case of necrotizing urethritis caused by Candida glabrata.
