ABSTRACT
Key Clinical Message: Although anatomical and vascular abnormalities of the horseshoe kidney might be challenging, complete preoperative imaging evaluations and accurate organ-sparing surgical planning can lead to much lower complications. Abstract: Horseshoe kidney (HK) is one of the most common renal fusion anomalies. Renal carcinoids are rarely reported in HK patients. Here, we described a rare case of advanced right renal cell carcinoma (RCC) along with proximal left ureter stone in a 41-year-old man who presented with a complaint of turbid urine. Early blood tests revealed a blood urea nitrogen of 44 mg/dL and serum creatinine of 1.35 mg/dL. The urine analysis showed microscopic hematuria (6-8 RBCs) and few calcium oxalate crystals. The imaging evaluations revealed an HK anomaly with a solid mass on the right side and a 4 mm stone in the proximal left ureter. The findings suggested RCC which was confirmed by histopathology examination. Consequently, the patient was scheduled for an organ-preserving open surgery of a right kidney tumor with concomitant left ureterolithotomy. The 16-month follow-up showed no urological complications, metastasis, or tumor proliferation. Although the anatomical and vascular abnormalities of HK might be challenging, organ-sparing surgical treatment should be considered in feasibly resectable tumors. Complete preoperative imaging evaluations to identify the characteristics of HK, as well as accurate surgical planning, can lead to much lower complications.
ABSTRACT
Renal cell carcinoma includes about 2% of global cancer and mostly diagnosed in early stages due to wide usage of imaging studies, in this article we report a huge 9 kg renal mass. A 54 years old woman consulted for her stomach ache, in the CT scan study, it revealed a huge abdominal mass occupying most of the abdomen and pelvic area. Innovative surgical resection was performed. Our 9kg renal mass was the first and largest fully solid spindle cell renal tumor, with the longest survival ever reported.
ABSTRACT
PURPOSE: This study evaluates the efficacy of Vacuum constrictive device (VCD) and the reasons for its failure. MATERIALS AND METHODS: In this cross-sectional study, 1500 men with organic erectile dysfunction(ED) were enrolled from July 2003 to July 2010. The treatment efficacy was analyzed using International Index of Erectile Function (IIEF) and questioning patient's partner regarding the man's ability to perform vaginal penetration (APVP). The patient's spouses, who responded negatively to APVP, were evaluated by a midwife for virginity, vaginal atrophy and abstained sex. RESULTS: Totally 1310 (87.4%) patients attained full erection at first training session, remaining 188 (12.6%) were able to have full erection one week after practicing with VCD, 1419 (94.6%)were able to have successful intercourse and responded positively to APVP, 81 (5.4%) were unable to have intercourse as stated by their wife's (negative response to APVP) that in 43 (53%),30 (37%), and 8 (9.8%) cases the causes of failures were their wife's virginity, sex abstinence, and senile vaginal atrophy, respectively. Regarding erectile issue of IIEF scores in patients responded positive to APVP there were significant improvement from the scores of 9.3 ± 3.0 to 27.5 ± 5.0 after treatment (P < .05). CONCLUSION: With proper training and appropriate devices, VCD could induce sufficient erection in all patients. VCD in patients with virgin wife is ineffective, and female factors affect on success rate in VCD therapy.
