Primary adenocarcinoma of the renal pelvis in spina bifida patient with history of simple cystectomy.

Primary renal adenocarcinomas comprise of less than 1% of renal and ureteral epithelial tumors. We present a case of a 67-year-old male with a history of simple cystectomy who underwent left nephroureterectomy for primary enteric-type renal adenocarcinoma with cystitis glandularis features. Pathological examination confirmed grade 2 pT1N0MX primary enteric-type renal adenocarcinoma. The patient underwent left open radical nephroureterectomy, with an uneventful postoperative course. Surgical excision is the mainstay treatment, while chemotherapy and radiation are potential adjuncts. Prognosis remains poor, with a 50% overall survival rate within two years of surgery. Further research is needed to enhance treatment recommendations.

Retroperitoneal drop metastases following robotic partial nephrectomy for renal cell carcinoma.

Rare retroperitoneal recurrence of clear cell renal cell carcinoma highlights the risk of tumor violation during surgery. A 61-year-old female with recurrent RCC in the retroperitoneum is presented six years after partial nephrectomy. Initial surveillance CT revealed a renal cyst and subsequent imaging confirmed clear cell RCC. Multiple small lesions indicated retroperitoneal recurrence. Surgical excision confirmed metastatic clear cell RCC. The proximity of the recurrence to the lower pole of the primary tumor suggests tumor violation as the cause. Respecting tumor boundaries during surgery is crucial to prevent metastasis and improve patient survival.

Penile Implant Instrument Innovations.

PURPOSE OF REVIEW: Numerous innovations have been made since the first inflatable penile prosthesis was introduced in 1973-not just of the implant apparatus itself, but crucially also in the surgical instruments used for prosthetic surgery. Starting with Dr. Furlow's revolutionary inserter tool, advancements were quickly made in dilators, retractors, and cavernotomes. RECENT FINDINGS: More recent innovations have been made in inserter tools, forceps, needle holders, clamps, and disposable instruments. Leading companies Boston Scientific and Coloplast have contributed significantly to the evolution of IPP surgical placement, and companies such as Uramix and Rigicon are developing a wide array of new specialized tools. We aim to summarize the instruments needed for IPP placement, with a focus on describing the variety of instrument innovations since Dr. Brantley Scott designed and placed the first IPP.

Infant With Severe Penoscrotal Hypospadias: A Complex Case of Genital Ambiguity and Mistaken Identity.

Individuals with an incongruence of their chromosomal sex and genital appearance are classified as having a disorder of sexual development (DSD), and they often present with ambiguous genitalia. The diagnosis and management of DSD patients are usually challenging and require a multidisciplinary approach. Gender assignment should not be based solely on physical exam and imaging but also on the genotype and hormonal function of the gonads. We present an infant born with ambiguous genitalia; the parents were told they were having a male infant during the prenatal ultrasound but at birth, the infant was found to have female-appearing external genitalia with no palpable gonads. MRI of the abdomen was inconclusive, but further workup, including karyotype, hormonal function, and intraoperative evaluation, was consistent with a male infant. He was, therefore, subsequently assigned to the male sex.