A Case of Retrograde Treatment of a Ureteral Stone in a Retrocaval Ureter.

Background: Retrocaval ureter is a rare entity with a reported incidence of ∼1 in 1100 and a 2.8-fold male predominance. The course of the ureter could be classified, using an intravenous urography, as type 1 having S-shaped, fish-hook, or J-shaped retrocaval course or type 2 having sickle-shaped course. No case report describing retrograde endoscopic management of ureteral calculi in the presence of retrocaval ureter could be found in existing literature. We are presenting a case of type I retrocaval ureter with ureteral calculi and nonobstructive drainage, which was effectively managed by flexible ureteroscopy. Case Presentation: A 62-year-old Caucasian man presented with complaints of a renal colic. The patient was positive for a history of noninsulin-dependent diabetes and hypertension. A direct abdomen CT scan showed an 8 mm ureteral stone with suspected retrocaval course of right proximal ureter with no hydronephrosis. After informed consent, ureteroscopy was performed on the patient's right proximal ureter. No complications occurred intraoperatively and postoperatively. On follow-up of up to 3 months, patient was asymptomatic and direct abdomen CT scan showed normal kidney without hydronephrosis. Conclusion: In the presence of retrocaval ureter and associated ureteral calculi with a condition of nonobstructive drainage, retrograde ureteroscopy is a safe and optimal procedure.

Complications of the first 500 extra-peritoneal robot-assisted radical prostatectomy (EP-RARP) cases in an Italian medium volume centre.

OBJECTIVE: The aim of this study was to evaluate the prevalence and the predictors of postoperative complications in Extra-Peritoneal Robot Assisted Radical Prostatectomy (EP-RARP), and also to test the influence of the surgeons skills on perioperative variables and complications. MATERIALS AND METHODS: Data from the first consecutive 500 patients who underwent EP-RARP were prospectively collected from December 2004 and June 2014. Mean follow-up was 55.7 months. Standardized criteria were used to report the procedural complications. Independent predictors of complications were examined through multivariate analysis using logistic regression models. The influence of the surgeons learning curves on perioperative variables was tested. RESULTS: One hundred fifty (30%) patients experienced complications, with 104 medical complications in 95 (19%) patients and 89 surgical complications in 72 (14.4%) patients. There were 17 major (Clavien IIIa-b) surgical complications in 15 (3%) patients, with no mortality. Multivariate analysis showed that Charlson score [odds ratio: 1.514; 95% confidence interval (95% CI): 1.145-2.002; p = 0.0003] and gastroenteric diseases (odds ratio 1.108; 95% CI: 1.108-4.560; p = 0.003) were the best predictors of medical complications and cT1c/T2a stages (odds ratio: 2.697; 95% CI: 1.319-5.514; p<0.0001) and blood transfusions (odds ratio: 3.328; 95% CI: 1.471-7.530; p<0.0001) were strongly related to surgical complications. Finally, the statistical evaluation showed that all considered perioperative variables, except the complication rates, improved during the study period. CONCLUSIONS: With a precise report of the morbidity related to EP-RARP, this study showed that complications were relatively frequent, but their severity was generally low.

Solitary fibrous tumor/hemangiopericytoma of the penis: Report of the first case.

Hemangiopericytoma (HPC) is an uncommon perivascular tumor, first described in 1942, occurring most frequently in the extremities (pelvis, meninges, head and neck), and rarely affecting the urogenital system. In 1870, Wagner published the first histological description of a Solitary Fibrous Tumor (SFT) of the pleura. It is now thought that the majority of lesions previously called hemangiopericytomas (HPCs) are essentially indistinguishable from solitary fibrous tumors (SFTs). Nowadays, the new WHO classification of soft tissue tumors categorizes most HPCs as SFTs. We report the first case of penile SFT-HPC in a 44-year-old man, presenting with a 3-year history of slow-growing penile mass. The patient underwent a tumor excision. Six months after surgery he is free of local recurrence and distant metastasis.