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   2014| July-September  | Volume 6 | Issue 3  
    Online since June 12, 2014

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Simple cyst of urinary bladder
Yang Bo
July-September 2014, 6(3):244-246
DOI:10.4103/0974-7796.134288  PMID:25125900
Simple cysts are rare in the urinary bladder and can pose a diagnostic dilemma to both the urologist and the histopathologist. No case study was found in the database of Elsevier Science Direct, Spring-Link, or PubMed. We present two cases of subserous cyst in the bladder and discuss the diagnosis and treatment of the condition. The cystic lesion at bladder dome was detected by radiologic examination and confirmed by cystoscopy. In case 1, transurethral resection was first performed which was followed by partial cystectomy; In case 2, the cyst was removed with the urachus using laparoscopic surgery. The patients recovered uneventfully and the histopathology showed cysts in subserous layer of urinary bladder. The bladder cyst should be distinguished from urachal tumor, and laparoscopic partial cystectomy is the preferred operative procedure.
  16,407 468 -
Comparative evaluation of naftopidil and tamsulosin in the treatment of patients with lower urinary tract symptoms with benign prostatic hyperplasia
Mahavir Singh Griwan, Y. R. Karthikeyan, Mandeep Kumar, Bikram Jit Singh, Santosh Kumar Singh
July-September 2014, 6(3):181-186
DOI:10.4103/0974-7796.134254  PMID:25125888
Introduction: Naftopidil, approved initially in Japan, is an α1d-adrenergic receptor antagonist (α1-blocker) used to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). It is different from tamsulosin hydrochloride and silodosin, in that it has a higher affinity for the α1D-adrenergic receptor subtype than for the α1A subtype and has a superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin. The incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may also be lower than that for tamsulosin and silodosin, which have a high affinity for the α1A-adrenergic receptor subtype. However, it remains unknown if the efficacy and safety of naftopidil in Japanese men is applicable to Indian men having LUTS/BPH. Material and Methods: Two groups of 60 patients each, having LUTS due to BPH, were treated with tamsulosin 0.4 mg and Naftopidil 75 mg for three months. Ultrasonography (for prostate size, post-void residual volume), uroflowmetry, and the International Prostate Symptom Score (IPSS) and Quality of Life (QOL) score were recorded at the beginning of the study, and then at one and three months. Results: The prostate size, post-void residual volume, all the uroflowmetry variables, and the IPSS QOL scores showed a statistically significant improvement (P < 0.001) in both the groups. The improvement in the average flow rate and the QOL index was better in the naftopidil group on the intergroup comparison and was statistically significant (P < 0.001). C onclusion: Although the QOL life index was significantly better in the naftopidil group, overall both naftopidil and tamsulosin were found to be equally effective in the treatment of LUTS due to BPH.
  3,244 602 -
Use of computed tomography scout film and Hounsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter and bladder radiographs
Michael E. Chua, Odina R. Gomez, Lorelei D. Sapno, Steve L. Lim, Marcelino L. Morales
July-September 2014, 6(3):218-223
DOI:10.4103/0974-7796.134270  PMID:25125894
Objective: The objective of this study is to determine the diagnostic utility of computed tomography (CT)- scout film with an optimal non-contrast helical CT scan Hounsfield unit (HU) in predicting the appearance of urinary calculus in the plain kidneys, ureter, urinary bladder (KUB)-radiograph. Methods: A prospective cross-sectional study was executed and data were collected from June 2007 to June 2012 at a tertiary hospital. The included subjects were diagnosed to have <10mm urolithiasis with non-contrast helical CT scan and KUB X-ray, which were carried out on the same day. Both KUB radiographs and CT-scout film were read by two qualified radiologists with inter-observer standardization prior to the study. Urolithiasis characteristics such as stone location, CT attenuation value, CT-scout film and KUB radiograph appearance were recorded independently by two observers. Univariate logistic analysis with receiver operating characteristic curve was generated to determine the best cut-off HU value of urolithiases not identified in CT-scout film, but determined radio-opaque in KUB X-ray. Subsequently, its sensitivity, specificity, predictive values and likelihood ratios were calculated. Statistical significance was set at P value of 0.05 or less. Results: Two hundred and three valid cases were included. 73 out of 75 CT-scout film detected urolithiasis were identified on plain radiograph and determined as radio-opaque. The determined best cut off value of HU utilized for prediction of radiographic characteristics was 630HU at which urinary calculi were not seen at CT-scout film and were KUB X-ray radio-opaque. The set HU cut-off was established of ideal accuracy with an overall sensitivity of 82.2%, specificity of 96.9% and a positive predictive value of 96.5% and negative predictive value of 83.5%. Conclusion: Urolithiases identified on the CT-scout film were also seen as radiopaque on the KUB radiograph while those stones not visible on the CT-scout film, but above the optimal HU cut-off value of 630 are also likely to be radiopaque.
  3,368 426 -
Dermatofibrosarcoma protuberans of penis: Case report and literature review
Hamid Raashid, Zaroo Inaam, Hafeez Aadil, MA Darzi, Ataf Rasool, Hamid Abdul, Afrozah Akhter
July-September 2014, 6(3):258-260
DOI:10.4103/0974-7796.134297  PMID:25125905
Dermatofibrosarcoma protuberans (DFSP) is a rare mesenchymal skin tumor with intermediate to low grade malignancy and occasional distant metastasis and high rate of recurrence locally. It mostly involves trunk, extremities, scalp, and neck. This article describes a middle-aged married male with a DFSP lesion involving ventral aspect of glans and distal shaft of penis who underwent local excision and primary closure. The patient was tumor-free at three years of follow-up.
  3,263 245 -
Primary Diffuse large B-Cell lymphoma of testis: A single centre experience and review of literature
Kadabur Nagendrapp Lokesh, Vishwanath Sathyanarayanan, C Lakshmaiah Kuntegowdanahalli, TM Suresh, Lokanatha Dasappa, Govinda Babu K Kanakasetty
July-September 2014, 6(3):231-234
DOI:10.4103/0974-7796.134277  PMID:25125896
Background: Primary testicular lymphoma constitutes 1-2% of Non-Hodgkin's lymphomas affecting elderly men >60 years of age. Most often it is a Diffuse large B cell lymphoma (DLBCL) and treatment involves multimodality approach involving surgery, chemotherapy and radiotherapy. Outcome remains poor in spite of aggressive therapy. Materials and Methods: We retrospectively reviewed 286 registered cases of DLBCL (aged >14 years) from 2007 to 2011 and found nine primary testicular involvement patients. These cases were analyzed for baseline clinical features, investigations, staging, treatment and outcome. Results: Median age was 58 (46-76) years. All patients presented with testicular swelling, two had the presence of B symptoms, and three with abdominal lymphadenopathy. Six had stage IE disease and three patients had stage IIE. All patients underwent orchiectomy. Eight patients received combination chemotherapy and six completed three or more cycles. Four achieved complete response, among these three relapsed after 32, 42, 70 months and one was lost to follow up. Two had a progressive disease, among these one died of disease and one alive with disease. Complete follow up was available from five patients and median survival was 36 months (11-78 months). Conclusion: Primary testicular DLBCL is uncommon, needs multimodality treatment and central nervous system prophylaxis to improve the survival. The outcome needs to be further investigated using biological approaches (Rituximab based) and/or more aggressive management.
  2,739 590 -
Stentless laparoscopic pyeloplasty: A single center experience
Abdul Rouf Khawaja, Tanveer Iqbal Dar, Farzana Bashir, Ajay Sharma, Vipin Tyagi, Mohammad Sajid Bazaz
July-September 2014, 6(3):202-207
DOI:10.4103/0974-7796.134258  PMID:25125891
Aim: To assess the effectiveness of laparoscopic stentless pyeloplasty for congenital ureteropelvic junction obstruction. Materials and Methods: This was a prospective comparative study conducted over a period of 5 years. The study included 35 cases of primary ureteropelvic junction obstruction (UPJO) with mean age of 29.5 years, divided in two groups- Group A (stent-less, 18 patients) and Group B (stented, 17 patients). Follow up ranged from one to 4years (mean 2 years). Transperitoneal laparoscopic Anderson- Hyene's pyeloplasty was standard for both the groups. Perioperative and postoperative complications were prospectively collected and analyzed by Statistical Package for Social Sciences (SPSS) 17 version using Pearson chi square test. Results: Both the groups were comparable with respect to preoperative differential renal function (DRF) and time required for maximum activity in minutes (t max .min). Average post operative DRF was significantly higher than preoperative DRF in both the groups. Average t max was significantly lower after pyeloplasty than pre operative t max . Mean operative time, mean duration of urethral catheter, and mean duration of drain removal were comparable in both the groups. However bothersome irritative lower urinary tract symptoms (LUTS) and hematuria were significantly more in group B patients (P < 0.0001 and <0.013 respectively). Conclusion: In experienced hands, laparoscopic stentless pyeloplasty is as effective method for treating UPJO as its stented counterpart. It is cost effective, avoids stent-related morbidity, and could be performed without compromising the success rate. However, more randomized studies are needed to evaluate the safety of stentless pyeloplasty.
  2,769 372 -
Safety of latex urinary catheters for the short time drainage
Mehrdad Hosseinpour, Saeed Noori, Mahdieh Amir-Beigi, Mohammad Hassan Pourfakharan, Hassan Ehteram, Mohadese Hamsayeh
July-September 2014, 6(3):198-201
DOI:10.4103/0974-7796.134257  PMID:25125890
Background: In this study, we attempt to identify the most appropriate catheter (silicone vs. latex) for short-term urinary catheterization. We compared the post-operative clinico-pathological complications between latex and silicone for short term catheterization in rabbits with hypospadias. Materials and Methods: Forty rabbits were used in our study to compare complications of catheterization. They were divided in two groups. Hypospadias like defect was created by a 1 cm long excision of the ventral urethra. For urethroplasty, we used tubularized incised plate technique. Latex and silicon catheters were used in groups 1 and 2, respectively.Post-operatively, routine laboratory urine test and complications (allergy, infection, bleeding) were compared in groups. Results: A total of 40 rabbits underwent hypospadias repair. Findings showed that there were no significant differences between groups based on urine test indices (P = NS). Urinary tract infection rate was 10% (2 rabbits) in latex and 0% in silicone groups (P = NS). There were no significant differences between groups regarding of cystitis grades between study groups (P = NS). Conclusion: It seems that urinary tract catheterization with latex catheters is a safe, feasible, and in-expensive procedure for short-term post-operative course in hypospadias surgery in patients without latex hypersensitivity.
  2,587 393 -
Effects of hydrochlorothiazide on kidney stone therapy with extracorporeal shock wave lithotripsy
Ali Tehranchi, Yousef Rezaei, Mohammadreza Mohammadi-Fallah, Mohammadreza Mokhtari, Mansour Alizadeh, Farzad Abedi, Masoud Khalilzadeh, Parisa Tehranchi
July-September 2014, 6(3):208-211
DOI:10.4103/0974-7796.134261  PMID:25125892
Objective: The aim of this investigation was to assess the efficacy of hydrochlorothiazide as a hypocalciuric diuretic on stone-free rate of renal pelvic calculi after extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: A double-blind, placebo-controlled randomized clinical trial was conducted and 52 patients with renal pelvic calculi (diameter ≤2 cm) were enrolled from February 2010 to September 2010. ESWL protocol was performed by 2,500 shocks per session. The patients were randomized into two groups: (1) 26 patients who were given 25 mg hydrochlorothiazide twice daily; and (2) 26 patients who received placebo. The stone-free rate was defined as residual calculus size ≤4 mm in controlled ultrasound on 2 nd week, 1 month and 3 months after ESWL. Results: 19 (78%) of the first group and 9 (42.9%) of the second group were stone-free after one session of ESWL (P = 0.02). 88% of the group 1 and 47.8% of the group 2 were stone-free on 1 month after ESWL (P = 0.003); however, this effect of hydrochlorothiazide was not related to the patients' body mass index, age and gender. The accessory treatment procedures were applied in 24% of the group 1 compared with 19% of the group 2 during 3 months (P = 0.68). All patients in both groups were stone-free on 3 months following lithotripsy. Conclusions: Hydrochlorothiazide did not impact on the stone-free rate and using accessory procedure within 3 months; however, it decreased duration of stone-free status and number of ESWL sessions.
  2,522 376 -
Percutaneous nephrolithotomy in children: A preliminary report
Ahmad A. Elderwy, Mohamed Gadelmoula, Mohamed A. Elgammal, Ehab Osama, Hamdan Al-Hazmi, H. Hammouda, Esam Osman, Medhat A. Abdullah, Khalid Fouda Neel
July-September 2014, 6(3):187-191
DOI:10.4103/0974-7796.134255  PMID:25125889
Objectives: The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL) in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. Materials and Methods: During the period of the month between May 2011 and April 2013, 38 children (47 renal units) underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24). Results: The median age at presentation was 8-year (range: 3-12). The operative time ranged from 30 to 120 min (median 90). Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3). Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6%) of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1) and were managed conservatively. Conclusions: Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.
  2,375 470 1
Congenital anterior urethrocutaneous fistula: Two case reports and review of literature
Hamdan H Alhazmi
July-September 2014, 6(3):239-241
DOI:10.4103/0974-7796.134285  PMID:25125898
Congenital anterior urethrocutaneous fistula (CAUF) of the male urethra is a rare anomaly. CAUF can be defined as a urethral fistula in which the urethra and external urethral meatus are intact, typically with intact prepuce and no history of any penile trauma (including surgical trauma).We report 2 cases of CAUF to highlight this pathology with hints of the published similar cases in the literatures and discuss the surgical reconstruction ways for management.
  2,522 299 -
Utility of urine cytology in evaluating hematuria with sonographically suspected bladder lesion in patients older than 50 years
Hussam Eldin Helmy Mady, Abd Alhady Mohammad Omar, Mohamed Abd-Alla Elgammal, Ghada Hosny Mohamed Ibrahim
July-September 2014, 6(3):212-217
DOI:10.4103/0974-7796.134264  PMID:25125893
Purpose: Investigate the utility of urine cytology (UC) in patients older than 50 years with hematuria and sonographically suspected bladder lesion. Patients and Methods: Between April 2010 and June 2012, 152 patients above 50 years suffering from hematuria were included in this study. In all patients, ultrasound revealed a lesion suspected to be bladder cancer. Voided urine specimens were taken from all patients and transported to Pathology laboratory and processed within 1-3 h. All patients have undergone a cystoscopy examination and biopsy was taken from any suspicious lesion. The cytological diagnosis was reported as one of three categories, positive or negative or suspicious for malignancy. Results: One hundred thirty three (87.5%) patients in this study proved to have bladder carcinoma in histopathological examination. The sensitivity of UC was 53.4% and only five patients were suspicious. Percentage of positive cytology was highest among patients having gross hematuria (51.3%), posterior wall lesions (75%), papillonodular configuration (81.8%), invasive cancer (59.1%) and bilharzial affection (52.5%). Conclusion: Hematuria in patients older than 50 years with sonographically suspected bladder lesion mandates cystoscopy and biopsy. UC does not add more significant information in this group of patients.
  2,317 325 -
The expression of vascular endothelial growth factor-C correlates with lymphatic microvessel density and lymph node metastasis in prostate carcinoma: An immunohistochemical study
Gyftopoulos Kostis, Lilis Ioannis, Kourea Helen, Papadaki Helen
July-September 2014, 6(3):224-230
DOI:10.4103/0974-7796.134275  PMID:25125895
Aim: To evaluate the expression of two different lymphatic vascular density (LVD) markers (D2-40 and LYVE-1) and a lymphangiogenic cytokine (Vascular Endothelial Growth Factor-C, [VEGF-C]) in prostate carcinoma and to investigate their relationship with the lymph node status. Settings and Design: Archival material study of 92 non-consecutive radical prostatectomy specimens. Materials and Methods: The mean LVD was assessed immunohistochemically in 24 prostate carcinoma specimens from patients with clinically localized disease, who were found to have nodal metastasis (pN1), and was compared with 68 pN0 cases. Furthermore, the mean LVD, VEGF-C expression, and lymphatic invasion were examined in relation to lymph node involvement. Results: Peritumoral (but not intratumoral) mean LVD assessed by D2-40 was higher in pN1 tumors (P = 0.015). LYVE-1 expression was limited and not associated with lymph node status. The VEGF-C expression was higher in the N1 cases and also correlated with the increased mean LVD in both the peri- and intratumoral compartments. Lymphatic invasion was strongly associated with nodal metastasis and higher VEGF-C expression. Conclusions: Our results indicate that increased peritumoral (but not intratumoral) LVD in the tumor specimen is associated with lymph node metastasis. Increased expression of VEGF-C is associated with higher LVD (in both intratumoral and peritumoral compartments) and with positive lymph node status, indicating a possible dual role in both lymphangiogenesis and lymphatic vessel invasion.
  2,028 304 -
Urinary bladder radiotherapy-related chondroblastic osteosarcoma: Rare case report and review of literature
Noorah Almadani, Khaled O. Alsaad, Hamoud Al-Matrafi, Abdulrahman Al Hadab, Nouf Abdullah, Abdulmohsen AlKushi
July-September 2014, 6(3):247-250
DOI:10.4103/0974-7796.134289  PMID:25125901
Radiation-related osteosarcomas are well described malignant mesenchymal neoplasms, yet their pathogenesis is not fully understood. They are generally classified into either skeletal osteosarcomas, or their and rare soft tissue counterpart. The occurrence of osteosarcoma in the urinary bladder (UB) following radiotherapy is exceedingly rare. To the best of our knowledge, only two cases of radiation-related urinary bladder osteosarcoma have been published; we herein describe another case of an 85-year-old man who developed post radiotherapy chondroblastic osteosarcoma of the urinary bladder four years following initial surgical resection and radiotherapy for bladder urothelial carcinoma. We believe that this is the first case of radiation-related chondroblastic osteosarcoma arising in the urinary bladder. In addition, we review the literature and explore the possible histogenesis of this rare neoplasm.
  1,930 275 -
Rectourethral fistula: A rare complication of injection sclerotherapy
Raman Tanwar, Santosh Kumar Singh, Devendra Singh Pawar
July-September 2014, 6(3):261-263
DOI:10.4103/0974-7796.134298  PMID:25125906
In the modern era, the incidence of rectourethral fistula (RUF) has been on a rise due to an increasing number of surgeries being performed for prostatic carcinoma. Other causes of this condition still remain rare and their management differs from that of post prostatectomy RUF. We report a rare case of a young man who presented with leakage of urine per rectum 4 weeks after injection sclerotherapy for haemorrhoids. A Micturating Cystourethrogram/Retrograde Cystourethrogram revealed the presence of RUF arising at the level of prostrato-membranous urethra and the urine examination did not show any fecal contamination of urine. A fistula at the level or verumontanum along with stricture of the distal penile urethra was demonstrated on urethroscopy. The patient was successfully managed by dilatation of the stricture segment and urethral catheterization. RUF can rarely result from injection sclerotherapy and must be thoroughly evaluated. Cases which present early and have minimal contamination of urine by fecal contents can be conservatively managed with a simple Foleys catheterization for 4-6 weeks after ruling out any obstruction distal to the fistulous tract.
  1,866 261 -
Comparison between helical computed tomography angiography and intraoperative findings
Abijit Shetty, Kishore Thekke Adiyat
July-September 2014, 6(3):192-197
DOI:10.4103/0974-7796.134256  PMID:25136246
Background: Live donor nephrectomy has gained popularity on account of the laparoscopic technique, to overcome a small donor pool. Laparoscopic donor nephrectomy requires a precise study of the vascular and morphological renal anatomy, as laparoscopy is technically challenging due to the limited field of vision. In-depth knowledge of the renal anatomy before a laparoscopic procedure is essential for a successful transplant. The left kidney is preferred over the right even in cases of multiple vessels because of the long renal vein, which requires precise preoperative vascular mapping. Helical computerized tomography (CT) angiography, with its axial, coronal, and 3D reconstruction, gives a better understanding of renal anatomy. There are instances where the helical CT findings are misleading and less informative in a small number of cases. This study highlights a case study of the helical CT findings compared with the intraoperative findings of 200 live donors, who underwent laparoscopic donor nephrectomy, and the renal anatomy has been understood at the same time. Aims: 1. To compare the helical CT findings on the operated side with the intraoperative findings. 2. To analyze the CT findings Materials and Methods: Two hundred cases of laparoscopic transperitoneal donor nephrectomy were included in this study. Statistical Method Used: Chi square test was the statistical test used to compare the findings between CT and the intraoperative data. Results: The axial, coronal, and 3D images of the CT findings were on par with the intraoperative findings in most of the cases. Incidental findings help in the better planning of surgery. Multiple vessels on the left side are preferred over the right sided normal anatomy; with not much technical difficulty with the aid of a helical CT. Male donors had more incidences of multiple vessels, gonadal vein, Retroaortic Renal Vein (RARV), lumbar vein, and duplication of ureter, compared to females. Furthermore, these variations are more in the left side donors. Ninety-two percent of the cases in this study are left-sided donors. The helical CT finding shows that renal vein variations are more on the right side. Conclusions: Helical CT is important in delineating the arterial, venous, and ureteral anatomy and can show the important incidental findings. Left renal donors and males have more variations in their renal anatomy. Technically challenging laparoscopic nephrectomy on the multiple-vessel-side donor is possible with the aid of helical CT. The importance of the CT in evaluating donor renal anatomy for a technically challenging laparoscopic donor nephrectomy is commendable.
  1,831 281 -
Renal cell carcinoma and plasma cell myeloma: Unique association and clinical implications
Somanath Padhi, Pradyumna Kumar Sahoo, Debashis Banerjee, Rabindra Nath Ghosh
July-September 2014, 6(3):252-256
DOI:10.4103/0974-7796.134292  PMID:25125903
Several case series, in the recent past, have postulated an association between plasma cell myeloma (MM) and renal cell carcinoma (RCC). Population-based data have revealed a bi-directional association between these two malignancies, which points to shared risk factors, similar cytokine (Interleukin-6, IL-6) requirements for growth and survival, and overlapping clinical presentation. The presence of lytic lesions in a patient with prior RCC may simulate bone metastasis; thus, leading to a diagnostic pitfall with potentially adverse clinical implications. Besides these, therapeutic strategies employed for MM have been tried for RCCs with partial success. We aimed to describe two patients, aged 64 and 54 years, with RCC-MM association, with review of relevant literature; and create awareness among pathologists/hematologists, and oncologists. Elucidating a common genetic basis might throw some light in understanding the pathobiology of these tumors and development of newer targeted therapies.
  1,792 286 -
Solitary extramedullary plasmacytoma of the penis
Kyle Scarberry, Armin Jegalian, Jason Valent, Hadley M. Wood
July-September 2014, 6(3):242-243
DOI:10.4103/0974-7796.134286  PMID:25125899
Solitary extramedullary plasmacytomas are rare plasma cell malignancies, particularly outside the upper aerodigestive tract. A 90-year-old male presented with a penile mass suspicious for penile carcinoma. Pathology revealed the tumor to be an Epstein-Barr virus-associated plasmacytoma with no radiographic evidence of bone or other soft tissue involvement. There was no laboratory evidence of multiple myeloma.
  1,748 293 -
Long-term outcome of transobturator suburethral tape procedure for treatment of female stress urinary incontinence
Sayed M. El-Eweedy, Ahmed F Abd El-Rahim, Mohamed A. Abd-Alkhalek, Ashraf H. Abdellatif, Ahmed S. Anwer
July-September 2014, 6(3):235-238
DOI:10.4103/0974-7796.134281  PMID:25125897
Objective: The aim is to evaluate the long-term safety and efficacy of transobturator tape (TOT) procedure in the treatment of women with stress urinary incontinence (SUI) by subjective and objective measures. Patients and Methods: A total 48 women with SUI underwent the TOT procedure during the period from December 2005 to February 2008. The follow-up period ranged between 60 and 84 months (mean 71 months). Mean age was 44.21 ± 7.52 (range: 30-58). Preoperative and early postoperative data were retrieved from the patient's medical files. Follow-up evaluation was carried out every 3 months during the 1 st year and yearly afterwards by history taking (including incontinence and quality-of-life questionnaire), clinical examination, urine analysis, abdominopelvic ultrasonography, and urodynamic studies when indicated. Results: At 12-month follow-up, the cure, improvement, and failure rates were 39 patients (81.25%), 5 (10.42%) and 4 (8.33%), respectively. The corresponding rates at the last follow-up were 38 (79.15%), 5 (10.42%) and 5 (10.42%) respectively. The postvoid residual urine and peak flow rates did not differ significantly between the preoperative values and at the last follow-up. The complication rates after a mean 71-month included one patient with voiding difficulty and two patients with de novo urgency. No case was recorded with retention of urine or erosion. Conclusions: Transobturator tape procedure appeared to be effective minimally invasive procedure for SUI with low rate of complication and good long-term outcome.
  1,733 307 -
Renal allograft transplant recipient with ruptured hydatid native kidney
Riyaz Ahmad Bhat, Imtiyaz Wani, Imran Khan, Muzaffar Wani
July-September 2014, 6(3):267-269
DOI:10.4103/0974-7796.134302  PMID:25125908
Echinococcosis of the kidneys in a renal transplant recipient is extremely rare and its occurrence being related to immunosuppression is a possibility which needs further characterisation. Ruptured renal hydatid in a renal transplant recipient is not reported so far to our best knowledge. We present a 42-year-old renal allograft receipient who presented one year after transplant with left flank pain, palpable left lumbar mass and gross hydatiduria. Investigations revealed a ruptured native hydatid kidney. Patient was managed with a combination of chemotherapy and left native nephrectomy and discharged in a satisfactory condition.
  1,748 237 -
Recurrent dermatomyositis manifesting as a sign of recurrent transitional cell carcinoma of urinary bladder: Long-term survival
John Fitzpatrick, William A. Wallace, Stephen Lang, Omar M. Aboumarzouk, Phyllis Windsor, Ghulam Nabi
July-September 2014, 6(3):264-266
DOI:10.4103/0974-7796.134299  PMID:25125907
The association between urological malignancies and paraneoplastic syndromes has been well documented. We report a case of recurrent dermatomyositis manifesting as a sign of metastatic recurrence of non-muscle-invasive transitional cell carcinoma of the bladder, a relationship which has only been referred to in a few reports. The case highlights a few important clinical challenges; firstly, the importance of thorough investigation for underlying malignancy in patients with dermatomyositis, as successful treatment of such malignancy can lead to resolution of paraneoplastic symptoms, and secondly, a high index of suspicion of recurrence in cases where paraneoplastic manifestations recur. Metastatic pulmonary recurrence without local evidence of disease at a follow-up of 4 years makes this case unique. Moreover, in the light of our experience and reported literature, a framework is suggested to approach such a diagnostic dilemma in the future. Description of the case will guide clinicians in the future, in case they encounter such an unusual clinical scenario. This could also serve as a hypothesis-generating source for designing future research as well.
  1,692 245 -
Atypical isolated urethral tuberculosis associated with inflammatory stenosis and fistulas
Ahmed-Amine Bouchikhi, Abdelhak Khallouk, Mohammed Jamal El Fassi, Moulay Hassan Farih
July-September 2014, 6(3):270-271
DOI:10.4103/0974-7796.134307  PMID:25125909
  1,607 193 -
Hemorrhagic cystitis: A rare manifestation of organophosphate poisoning
Manish Jain, Dekid Palmo, Vivek Agrawal, Pankaj Kumar Garg
July-September 2014, 6(3):271-272
DOI:10.4103/0974-7796.134309  PMID:25125910
  1,292 227 -
Renal cell carcinoma and plasma cell myeloma: Coincidence or true association?
Muhammed Mubarak
July-September 2014, 6(3):256-257
  1,227 197 -
Radiation induced sarcoma: Everything comes with a price
Pankaj Kumar Garg, Anjay Kumar
July-September 2014, 6(3):250-251
  1,178 180 -