scholarly journals A Rare Case of Prostatic Utricle with Crossover Vas Deferens in Children

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 40
Author(s):  
Tsung-Heng Wu ◽  
Yao-Jen Hsu ◽  
Tai-Wai Chin ◽  
Yu-Wei Fu
Keyword(s):  
Urinary Tract ◽  
Vas Deferens ◽  
Incidental Finding ◽  
Voiding Cystourethrography ◽  
Urethral Discharge ◽  
Case Summary ◽  
Prostatic Utricle ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
Lower Urinary

Background: A prostatic utricle (PU) is an unusual pathology with most patients being asymptomatic. However, approximately 29% of patients may show lower urinary tract symptoms, recurrent urinary tract infections (UTI), postvoid dribbling, urethral discharge, epididymo-orchitis, stones, and secondary incontinence caused by urine trapping in the pouch and urinary retention. The standard treatment is through surgical resection, but it is only offered to patients with symptoms. Case summary: We report a case involving a six-year-old boy with congenital hypothyroidism and penoscrotal hypospadias who had previously undergone onlay urethroplasty for the proximal shaft, chordee release, orchidopexy for bilateral undescended testis, and laparoscopic herniorrhaphy for left inguinal hernia. However, the patient later evolved the repetition of UTI and right epididymo-orchitis. Cyclic voiding cystourethrography confirmed the presence of a cystic lesion communicating with the prostatic urethra from the utricle. The PU was then excised laparoscopically. The utricle was identified posterior to the bladder, and insertions of the vas deferens crossover into the utricle were detected by laparoscopy. The post-procedure course was uneventful. Conclusions: Laparoscopic resection of PUs offers a better exposure field, improved wound appearance, complete resection, and reduces the incidence of complications. During laparoscopy, the PU was clearly distinguished from the bladder or other pelvic organs. An incidental finding of vas deferens crossover has rarely been reported. A combined cystoscopy and laparoscopy for PU resection is executable, safe, and valid in this patient population.

scholarly journals Prevalence of lower urinary tract symptoms (LUTS) among young age medical population

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zalina N ◽  
Aruku N ◽  
Azura N ◽  
Shahida N ◽  
Akhmarina N ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Public Awareness ◽  
Young Age ◽  
Personal Hygiene ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
Lower Urinary

Introduction: Frequency of lower urinary tract symptoms (LUTS) in young age women is not well studied. It is said to be common among female elderly and multiparous population. The aim of this study is to obtain the prevalence of LUTS among nulliparous students in relation to their personal hygiene. Materials and methods: This is a prospective cross-sectional study conducted among  200 nulliparous medical and nursing students aged between 18-28 years using standardized questionnaires. Urine samples were also collected from students to detect urinary tract infections. Results: The complete data sets of 146 students were analyzed. All of them were nulliparous, single and not sexually active. The prevalence of LUTS was 52.7% consist of over-active bladder, urinary incontinence (UI) and voiding difficulty respectively (51.3%, 34.9% and 45.2%). The most common type of UI was stress urinary incontinence which was 21.9% followed by 11.6% of urgency incontinence. Conclusion: The prevalence of LUTS among young age population is high at 52.7%. Public awareness regarding LUTS and availability of treatment is needed.

scholarly journals Prostate Artery Embolization—Review of Indications, Patient Selection, Techniques and Results

2021 ◽  
Vol 10 (21) ◽  
pp. 5139
Author(s):  
Sailendra G. Naidu ◽  
Harish Narayanan ◽  
Gia Saini ◽  
Nicole Segaran ◽  
Sadeer J. Alzubaidi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Treatment Options ◽  
Benign Prostatic Hypertrophy ◽  
Clinical Results ◽  
Artery Embolization ◽  
Prostate Artery Embolization ◽  
Urinary Tract Symptoms ◽  
Surgical Options ◽  
Tract Infections ◽  
Lower Urinary

Lower urinary tract symptoms (LUTS) due to benign prostatic hypertrophy (BPH) are a very common problem in men ranging from mild urinary symptoms to recurrent urinary tract infections or renal failure. Numerous treatment options are available ranging from conservative medical therapies to more invasive surgical options. Prostate artery embolization (PAE) has emerged as a novel treatment option for this common problem with clinical efficacy comparable to the current surgical gold standard, transurethral resection of the prostate (TURP). PAE offers fewer complications and side effects without a need for general anesthesia or hospitalization. This review discusses the indications for prostate artery embolization in addition to LUTS, patient evaluation in patients with LUTS, PAE technique and clinical results, with an emphasis on efficacy and safety.

Multiple stones in neobladder: Case report and literature review

2019 ◽  
Vol 86 (4) ◽  
pp. 216-219 ◽  
Author(s):  
Alessandro Tafuri ◽  
Antonio B Porcaro ◽  
Akbar N Ashrafi ◽  
Maria Angela Cerruto ◽  
Nelia Amigoni ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Orthotopic Neobladder ◽  
Radical Cystoprostatectomy ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
Abdominal Fullness ◽  
Lower Urinary

Introduction: Neobladder urolithiasis is a rare but important long-term complication of orthotopic urinary diversion. It may be asymptomatic and can be discovered as an incidental finding on a radiological investigation. However, when symptoms occur, they may include lower abdominal pain, dysuria, hematuria, and lower urinary tract symptoms. Case description: We report the case of a 63-year-old male patient with irritative lower urinary tract symptoms, lower abdominal fullness, urinary incontinence, fecaluria, and urinary loss from the left inguinal fold 12 years after a radical cystoprostatectomy with a orthotopic neobladder. Computed tomography scan and urethrocystography showed a distended pouch with multiple large stones, an enterovesical fistula, and neovesicocutaneous fistula. The fistulae were successfully managed conservatively with the placement of a Foley catheter. After 3 months, open cystolithotomy was performed and approximately 50 stones with dimensions varying from 5 mm to 5 cm, with a total weight of 890 g, were removed. After a 1-year follow-up, the patient did not report pain, urinary tract infections, or symptoms suggestive of fistula and imaging evaluation confirmed no recurrence of neobladder stones. Conclusion: Neobladder stones may present with various symptoms. Our patient had irritative lower urinary tract symptoms, lower abdominal fullness, urinary incontinence, fecaluria, and urinary loss from the left inguinal fold 12 years after a radical cystoprostatectomy with a orthotopic neobladder. Our experience demonstrates that open cystolithotomy is an effective intervention for the removal of large stones in neobladder.

scholarly journals Outcome of Vesicovaginal Fistula Repair at Urology Department STH Swat

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Nizamuddin . ◽  
Fazal Elahi ◽  
Mumtaz Ali ◽  
Fazli Akbar ◽  
Mohammad Hussain ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Success Rate ◽  
Vesicovaginal Fistula ◽  
Abdominal Hysterectomy ◽  
Teaching Hospitals ◽  
Fistula Repair ◽  
Obstructed Labour ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
Lower Urinary

Background: Vesicovaginal fistula is an abnormal passage between the bladder and the vagina , which leads to continuous , involuntary loss of urine through the vagina. It is the most usual type of acquired genitourinary fistulas.Objective: To determine outcomes of vesicovaginal fistula repair at Urology Department, Saidu Teaching Hospital, Swat.Material and Methods: This descriptive study was conducted in Department of Urology, Saidu Group of Teaching Hospitals, Swat from September, 2016 to February, 2019. Patients with age group of 25-65 years, diagnosed with VVF were repaired either through abdominal or vaginal route. These patients were prospectively analysed and the demographic profile, route of surgery and outcomes were noted down.Results: A total of 58 patients were included in the study. The causes were obstructed labour in 26 patients, post-operative trans abdominal hysterectomy and caesarean section in 24 and 6 cases respectively. There was 100% success rate in abdominal repairs as compared to combined approach. Among the post-operative complications, bladder storage dysfunction was on the top, followed by urinary tract infections and wound infections.Conclusion: The most common cause of VVF was prolonged obstructed labour. Overall, the success rate was 96.5%. Irritative lower urinary tract symptoms were most commonly observed post operatively.

scholarly journals An Enlarged and Infected Prostatic Utricle as a Rare Cause of Lower Urinary Tract Symptoms in Adolescent Males

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Rashida Shakir ◽  
Michael G. Packer ◽  
Zarine R. Balsara
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Urine Culture ◽  
Lower Abdominal Pain ◽  
Proximal Hypospadias ◽  
Prostatic Utricle ◽  
Urinary Tract Symptoms ◽  
History Of ◽  
Lower Urinary

Dysuria with lower abdominal pain is a common presentation for a urinary tract infection (UTI), and diagnosis is based on symptoms together with a urinalysis and urine culture suggestive of infection. UTI is uncommon in circumcised males who are not sexually active. When urine culture is negative, alternate diagnoses including, but not limited to, gastroenteritis, severe constipation, appendicitis, or epididymitis need to be considered. In patients with a known urologic history of proximal hypospadias and/or disorders of sexual development, rarer diagnoses also need to be considered. This paper reports the case of a 13-year-old male with a remote history of proximal hypospadias repair, who presented with nonspecific lower urinary tract symptoms. Initially he was treated for UTI. However, urine cultures remained negative despite persistent urinary tract symptoms. On further workup, he was found to have an enlarged and infected prostatic utricle. This report illustrates the importance of considering an enlarged prostatic utricle in the differential diagnoses of patients with chronic lower urinary tract symptoms and a history of hypospadias. Additionally, this case highlights the utility of magnetic resonance imaging (MRI) in clarifying lower urinary tract anatomy in cases where ultrasound is inconclusive.

scholarly journals Mechanisms of Delayed Lower Urinary Tract Stone Formation

2021 ◽  
Vol 4 (1) ◽  
pp. e17-e22
Author(s):  
Fawad Arif ◽  
West Alaiyi
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Stone Formation ◽  
Dystrophic Calcification ◽  
Urinary Tract Symptoms ◽  
Prostatic Fossa ◽  
Urinary Tract Stone ◽  
Tract Infections ◽  
Lower Urinary

Materials and methods:We analysed Holmium Laser Enucleation of Prostate (HOLEP) database consisting of 1300 patients who presented more than 18 months after undergoing the procedure with lower urinary tract symptoms (LUTS-voiding lower urinary tract symptoms, dysuria, haematuria, recurrent urinary tract infections-UTIs) second-ary to delayed lower urinary tract stone formation. Information was gathered from the case notes, imaging modalities, operation notes and pathology reports. Results:Three patients were identified who presented with delayed lower urinary tract stone formation 18 months after undergoing HOLEP. Case 1: A 68-year-old presented with a 4-cm mobile bladder stone on a retained prostatic fragment 29 months after HOLEP.Case 2: A 74-year-old presented with 2.5 cm bulbar urethral stone 18 months after HOLEP.Case 3: A 77-year-old presented with dystrophic calcification of the entire prostatic fossa 60 months after HOLEP. Conclusion:Delayed lower urinary tract stone presentation is unusual after HOLEP. Recurrent urethral pain, recurrent UTI, gross haematuria and voiding lower urinary tract symptoms in the presence of a lower urinary tract stone (bladder, prostate and urethra) with a radiolucent centre on a background of HOLEP should raise the suspicion that this may represent calcification on a prostatic tissue fragment or dystrophic calcification of the residual prostate/prostatic fossa. Careful morcellation, inspection of the prostatic fossa on withdrawing the morcellator  for large residual prostate fragments still attached to the prostatic bed/bladder neck or simply stuck to the fossa (usually in a clot) will reduce the risk of retainment of such a significant prostatic fragment that can potentially cause complications in the future.  

MALAKOPLAKIA OF THE BLADDER MIMICKING MALIGNANCY: REPORT OF CASES AND REVIEW OF THE LITERATURE

2021 ◽  
pp. 121-128
Author(s):  
Lelyavin K.B. ◽  
Zaitseva L.V. ◽  
Raevskaya L.Yu. ◽  
Lelyavina A.K.
Keyword(s):  
Urinary Tract ◽  
Rare Case ◽  
Histopathological Examination ◽  
Final Diagnosis ◽  
Etiologic Agent ◽  
Urinary Tract Symptoms ◽  
Tract Infections ◽  
To Receive ◽  
Infectious Etiology ◽  
Lower Urinary

Malakoplakia is a rare granulomatous disease associated with an infectious etiology, usually involving the urinary tract. Clinical presentation malakoplakia is often non-specific, but is typically characterized by recurrent urinary tract infections and hematuria. The etiology of malakoplakia has not been fully elucidated. Frequent association of bladder malakoplakia with urinary tract infection suggests an infectious etiologic agent Malakoplakia of the genitourinary system is more common in women than in men. It is usually observed between the fifth and seventh decades of life. We report a rare case of isolated bladder malakoplakia in a 25-year-old female patient who presented with lower urinary tract symptoms without any hematuria. Clinically, a 15,0 х 11,0 15,0 mm mass was detected in the bladder, which was confirmed by ultrasound scan and magnetic resonance imaging. Malakoplakia is complicated diagnostic problem, since it occurs very rare and can manifest in a different way. Only histological research allows to determine the correct diagnose. The final diagnosis is confirmed by the presence of Michaelis-Gutmann bodies. The majority of patients after being precisely diagnosed can be successfully cured by the lasting treatment of antibiotics in a smaller dose. Represented clinical observation illustrates highly rare case of malakoplakia of bladder. It demonstrates the possibility of usage low invasive surgery not only for diagnostic, but also for therapy. This case made possible to receive the macro preparate for histological research of excellent quality. Histology is essential, not only to diagnose malakoplakia, but also to exclude other important differential diagnoses, such as malignancy. Histopathological examination of the tumor-like mass revealed malakoplakia. Postoperative course was uneventful. This condition should be included in the differential diagnosis of bladder tumors.

scholarly journals Minimally invasive management of a symptomatic case of Zinner’s syndrome: Laparoscopic seminal vesiculectomy and ipsilateral nephroureterectomy

2019 ◽  
Vol 91 (1) ◽  
pp. 58-59
Author(s):  
Emanuele Corongiu ◽  
Pietro Grande ◽  
Valerio Olivieri ◽  
Giorgio Pagliarella ◽  
Flavio Forte
Keyword(s):  
Urinary Tract ◽  
Seminal Vesicle ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Left Kidney ◽  
Perineal Pain ◽  
Urinary Tract Symptoms ◽  
Patient Reported ◽  
Tract Infections ◽  
Lower Urinary

Introduction: Zinner syndrome is a rare developmental anomaly of the Wolffian (mesonephric) duct which is characterized by a triad of obstruction of the ejaculatory duct, the ipsilateral seminal vesicle cyst, and the ipsilateral renal agenesis. Usually is totally asymptomatic, however it can also determine symptoms such as lower urinary tract symptoms, perineal pain, ejaculatory disorders such as painful ejaculation or hematospermia, and infertility. Case report: We present a case of a 51 years old men with a 3-year history of lower urinary tract symptoms, perineal pain, obstructed defecation, recurrent urinary tract infections and infertility. CT scan showed a voluminous cystic neoformation of the left seminal vesicle, hypoplasia of the left kidney and ipsilateral ureteronephrosis. The mass was removed using laparoscopic “en block” seminal vesiculectomy with associated ipsilateral nephroureterectomy. No post-operative complications occurred. At 2-month post-operative control the patient reported an improvement of urinary and rectal symptoms.

Bladder Neck Contracture with Hem-o-Lok Clips Migration after Robotic-Assisted Radical Prostatectomy: A Case Report and Literature Review

2022 ◽  
pp. 1-4
Author(s):  
Bo-Han Chen ◽  
Jen-Shu Tseng ◽  
Allen W. Chiu
Keyword(s):  
Urinary Tract ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Bladder Neck Contracture ◽  
Robotic Assisted ◽  
Bladder Neck Incision ◽  
Urinary Tract Symptoms ◽  
Robotic Assisted Radical Prostatectomy ◽  
Tract Infections ◽  
Lower Urinary

Hem-o-lok clips are widely used in robotic-assisted radical prostatectomy (RARP). However, clips-related complications have been reported, including intravesical migration. Here, we share a 60-year-old male case with newly diagnosed prostatic adenocarcinoma. With an unfavorable intermediate risk, he was admitted for RARP. He was discharged from hospital without any immediate complications. However, he reported progressive dysuria and slow urine stream 6 months after surgery. Cystoscopy showed severe bladder neck contracture (BNC), and 2 Hem-o-lok clips were found intravesically and removed during bladder neck incision. Subsequently, fiberocystoscopy revealed another 2 clips near the bladder neck with mild BNC after another 6 months. These 2 clips were also removed during bladder neck dilatation. His urination status then improved without further obstruction. Clip migration after RARP is uncommon; however, clinicians must keep this in mind when patients present with new complaints such as lower urinary tract symptoms, hematuria, and recurrent urinary tract infections.

Sign in / Sign up

Export Citation Format

Share Document