[Influence of ureter stenting before ureterorenoscopic treatment of ureteral calculi]. / Einfluss der Ureterschienung vor ureterorenoskopischer Behandlung von Harnleitersteinen.

BACKGROUND: Due to a worldwide rise of incidence, urolithiasis presents an increasing strain on the health system. Ureterorenoscopy (URS) is a standard treatment to extract stones in case of ureteral calculi. To increase the success rate of URS and to minimize complications, preoperative ureteral stenting (prestenting) has previously been described as suitable. However, published data are still conflicting. This article describes our single-center experience on the influence of prestenting on the outcome of ureterorenoscopic stone therapy. METHODS: A total of 442 patients who had undergone ureterorenoscopic stone extraction at the Wolfsburg Clinic between 2010 and 2011 were retrospectively evaluated regarding peri- and postoperative results. The Fisher's exact, the χ(2), and the Mann-Whitney U test were used to compare the group of patients with and without prestenting. RESULTS: Even though patients with prestenting suffered from stones with larger diameter that were more frequently located in the proximal ureter, the rates for postoperative stenting, perioperative complications, and retreatment were much lower then in the group of patients without prestenting (p<0.001). Furthermore, patients who had received prestenting had a significantly shorter hospital stay (median, 3 vs. 2 days, p<0.001) and higher rates of stone clearance (83.0 vs. 69.7%, p=0.001). CONCLUSION: According to our retrospective monocentric analysis, prestenting may significantly reduce the risk of complications as well as intra-/post-URS restenting and can increase the rate of complete stone clearance.

[Mesonephroid carcinoma of the urinary bladder (clear cell carcinoma). Two case reports and review of the literature in a rare variation of the primary adenocarcinoma]. / Das mesonephroide Karzinom der Harnblase (Klarzellkarzinom). Zwei Kasuistiken und Literaturübersicht über eine seltene Variante des primären Adenokarzinoms.

Mesonephroid adenocarcinoma of the bladder may be a malignant form of nephrogenic adenoma or nephroid metaplasia. The lesion is extremely rare in the urinary bladder, and to our knowledge 19 cases have been reported in the literature. We report two cases of mesonephroid adenocarcinoma of the bladder which were treated by radical cystectomy.

[Recurrent testicular torsion: is retorsion of a fixed testis possible? A case report and literature review]. / Wiederauftretende Hodentorsionen: Kann ein pexierter Hoden torquieren? Fallbericht und Literaturübersicht.

Painful testicular torsion is an emergency which can occur at any age, even after previous fixation of the testis. In the described cases, it was not expected and a misdiagnosis led to loss of the testis. For a patient who has already lost one testicle, this is a catastrophe. A literature search was performed. Previous fixation of the testis does not always prevent torsion. The diagnostic work-up and management of acute testicular pain should not be different after previous fixation of the testis, regardless of age.

El linfangioma cavernoso de los genitales externos / The cavernous lymphangioma of the external genitalia

INTRODUCCIÓN: Tumores fluctuantes en la base escrotal y penil pueden ser causados por linfangiomas benignos genitourinarios. Estas malformaciones son muy poco frecuentes y son observadas preferentemente en niños. MÉTODO Y RESULTADOS: Presentamos un paciente de 10 años de edad que acude a nuestro centro con un tumor azulado, indoloro y fluctuante, con un tamaño de 4 x 2 cm en el escroto y la base penil. Por resonancia magnética nuclear fue posible realizar una reconstrucción exacta de la extensión anatómica de esta lesión de imagen hipoecogénica. La extirpación quirúrgica fue realizada sin complicaciones demostrándose en el estudio histológico un linfangioma cavernoso. En la actualidad no se observa recurrencia local (follow up: 6 meses). CONCLUSIÓN: Un linfangioma cavernoso del escroto o pene es muy poco común. Éste es el segundo caso descrito en la literatura. Incluso linfangiomas de otras características histológicas raramente afectan esta región. Los linfangiomas son tumores benignos de vasos linfáticos. El tejido circundante muestra una reacción inflamatoria con escarificación. En el 50 % de los casos se considera una lesión congénita. 9/10 linfangiomas se manifiestan antes de los dos años de edad. La terapia es la excisión completa

PURPOSE: Fluctuating tumours of the scrotal and penile basis can be caused by benign lymphangiomas. These rare malformations can preferently be seen in children. CASE REPORT: We report about a 10 year old boy, who was presented in our department with a bluish, indolent, 4x2 cm sized, fluctuating tumor of the scrotum and penile basis. Magnetic resonance imaging could demonstrate the whole anatomic extension of the sonographically hypoechoic lesion. Operative removal of the tumour was performed without complication. Histologically, the specimen was diagnosed as cavernous lymphangioma. To date, there is no sign of recurrence (follow-up period: 6 months). CONCLUSION: A cavernous lymphangioma of the scrotum or penis is very uncommon. We report, to the best of our knowledge, the 2nd case reported in literature. Even lymphangiomas with other histological features rarely affect this region. Lymphangiomas are benign tumours of lymphatic vessels. The surrounding tissue sometimes shows a perifocal inflammation and scarification. About 50% of the cases are considered congenital. 9/10 lymphangiomas become obvious during the first 2 postnatal years. Therapy of choice is the complete excision

[The cavernous lymphangioma of the external genitalia]. / El linfangioma cavernoso de los genitales externos.

PURPOSE: Fluctuating tumours of the scrotal and penile basis can be caused by benign lymphangiomas. These rare malformations can preferently be seen in children. CASE REPORT: We report about a 10 year old boy, who was presented in our department with a bluish, indolent, 4x2 cm sized, fluctuating tumor of the scrotum and penile basis. Magnetic resonance imaging could demonstrate the whole anatomic extension of the sonographically hypoechoic lesion. Operative removal of the tumour was performed without complication. Histologically, the specimen was diagnosed as cavernous lymphangioma. To date, there is no sign of recurrence (follow-up period: 6 months). CONCLUSION: A cavernous lymphangioma of the scrotum or penis is very uncommon. We report, to the best of our knowledge, the 2nd case reported in literature. Even lymphangiomas with other histological features rarely affect this region. Lymphangiomas are benign tumours of lymphatic vessels. The surrounding tissue sometimes shows a perifocal inflammation and scarification. About 50% of the cases are considered congenital. 9/10 lymphangiomas become obvious during the first 2 postnatal years. Therapy of choice is the complete excision.