scholarly journals Endoscopic incision of protruding right ureterocele in a single collecting system: a case report

2017 ◽  
Vol 25 (4) ◽  
pp. 240-44
Author(s):  
Rinto Hariwibowo ◽  
Harrina E. Rahardjo
Keyword(s):  
External Genitalia ◽  
Excretory Urography ◽  
Voiding Cystourethrography ◽  
System A ◽  
Grade 5 ◽  
Grade Ii ◽  
The Right ◽  
Collecting System ◽  
Endoscopic Incision

Protruding ureterocele is a very rare case found in the literature. We are reporting a 21 year-old female with an intermittent protruding mass from urethra, accompanied by dysuria, hematuria, and recurrent urinary tract infection. Inspection of the external genitalia revealed a protruding mass from the urethra which could be reduced manually. Excretory urography showed bilateral single collecting systems, grade II hydronephrosis of the right kidney, and a cobra head appearance of the lower right pelvis. The patient was diagnosed with a protruding right ureterocele in a single collecting system, and thus, endoscopic incision of a ureterocele was performed. Ultrasonography which was carried out three weeks after the procedure confirmed no residual hydronephrosis or ureterocele in the bladder. Voiding cystourethrography (VCUG) underwent at a three-month-follow up revealed a grade 5 vesico-ureteral reflux (VUR) on the right side. Surgical reimplantation was then considered. In conclusion, endoscopic incision was safe and yielded good result for protruding ureteroceles, but the need for secondary surgery in several conditions should be considered.

Laporan Kasus Ureterocele dengan Double Collecting Sistem Bilateral

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Suci Syamsiah Ramdhini ◽  
Freedy L.P. Tambunan ◽  
Ristaniah D. Soetikno
Keyword(s):  
Complicated Urinary Tract Infection ◽  
External Genitalia ◽  
Surgical Excision ◽  
Cystic Mass ◽  
Duplex System ◽  
System A ◽  
First Child ◽  
History Of ◽  
The Right ◽  
Collecting System

Ureterocele adalah kelainan kongenital pada ureter terminal. Ureterocele berupa massa kistik yang berdilatasi pada segmen ureter intravesikal dapat berkaitan baik dengan ureter tunggal maupun dupleks. Kelainan kongenital berupa obstruksi pada meatus dan timbulnya ureterocele merupakan efek hiperplasia akibat obstruksi ini. Ureter dupleks dapat terjadi pada 75% pasien ureterocele, sementara single ureter hanya 20%. Insidensi ureterocele sebesar 1:4.000 anak dan 4–7 kali lebih sering pada perempuan. Kami melaporkan kasus seorang bayi perempuan berusia lima bulan yang dibawa ke Rumah Sakit Hasan Sadikin tanggal 27 Maret 2019 dengan keluhan utama massa yang tampak menonjol dan hilang timbul pada lubang tempat keluar urine disertai nyeri dan mengedan saat buang air kecil dan demam dalam waktu satu bulan terakhir. Pasien merupakan anak pertama, lahir dari ibu P1A0 riwayat kehamilan cukup bulan. Pada pemeriksaan fisis genitalia eksterna, tampak benjolan berwarna putih dan lunak yang hilang timbul di daerah meatus uretra eksterna. Hasil pemeriksaan BNO-IVP, USG dan CT urologi tampak duplikasi sistem pelvokalises ginjal bilateral dan gambaran berbentuk kantung di daerah vesika urinaria menyokong ureterocele. Berdasar atas hasil anamnesis, pemeriksaan fisis dan pemeriksaan penunjang, pasien didiagnosis ureterocele dekstra, double collecting system bilateral, infeksi saluran kemih komplikata, dan bakteremia. Penatalaksanaan berupa pembedahan eksisi ureterocele dekstra dan reimplantasi ureter. Pencitraan radiologi memiliki peranan penting dalam menegakkan diagnosis ureterocele secara dini untuk menghindari komplikasi dan morbiditas, serta menentukan penatalaksanaan yang tepat. URETEROCELE WITH BILATERAL DOUBLE COLLECTING SYSTEM: A CASE REPORTUreterocele is a congenital abnormality in the terminal ureter. Ureterocele is dilated cystic mass in the intravesical ureteral segment may be associated with a single or duplex system. Duplex ureters occur in 75% of ureterocele patients, while single ureters are only 20%. The incidence of ureterocele is 1: 4,000 children and 4–7 times more common in girls than boys. We are reporting a five month female infant with an intermittent protruding mass from urethra, accompanied by dysuria and fever in the past one month. The baby was the first child, born by P1A0 mother with a history of term pregnancy. External genitalia examination showed protuding soft white lump in the external urethral meatus. The results of BNO-IVP, ultrasound and CT urology revealed duplications of the bilateral renal pelvocalises system and the appearance of sacs inside bladder sugesting an ureterocele. Based on history, physical and medical examination, the patient was diagnosed as right ureterocele, bilateral double collecting system, complicated urinary tract infection and bacteremia, the management was surgical excision of the right uroterocele and ureter reimplantation. Radiological imaging has a important role in obtaining an early diagnosis of ureterocele, to avoid complications and morbidity and determine an appropriate management.

First-Stage Long Buccal Mucosal Graft (BMG) Urethroplasty on Adult Failed Hypospadia Surgery Repair: Our Initial Experience

2018 ◽  
Vol 24 (8) ◽  
pp. 6151-6154
Author(s):  
Adistra Imam Satjakoesoemah ◽  
Prahara Yuri ◽  
Yonas Hutasoit
Keyword(s):  
External Genitalia ◽  
Complication Rates ◽  
Initial Experience ◽  
Long Term Outcomes ◽  
Penile Shaft ◽  
Buccal Mucosal Graft ◽  
Male External Genitalia ◽  
The Right

Hypospadia is one of the most common congenital anomalies of male external genitalia and the only proper management for most cases is repair surgery. Nevertheless, initial hypospadia repair could end up failed, followed by subsequent various complications. BMG has gain popularity due to its good long-term outcomes and favourable complication rates, especially for residual hypospadia. A 24-year-old male came to our outpatient department complaining his urethral orificium was located on the penile shaft since birth. He had a previous hypospadia repair surgery conducted by non-urologist surgeon at the age of seven. Several months after the repair surgery, his penis slightly rotated to the right side and urine remain came out through the hole on his ventral penile shaft. We performed first-stage inlay BMG urethroplasty using a long (6×1 cm) and short (2×1 cm) graft patch. The graft patches were quilted in proximal-distally fashion rather than side-by-side. No scarring or contracture on the neourethral plate was noted during two months of follow-up. We have successfully performed our initial experience on first-stage inlay BMG urethroplasty using a long and short graft patch. Within two months, the graft were completely take without any complications. The second-stage urethroplasty, consisting of tubularization and glansplasty will be performed 6 months after the first procedure.

Unilateral leg swelling in a newborn

2020 ◽  
pp. edpract-2020-320450
Author(s):  
Luisa Cortellazzo Wiel ◽  
Irene Berti ◽  
Meta Starc ◽  
Flora Maria Murru ◽  
Egidio Barbi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Subcutaneous Tissue ◽  
External Genitalia ◽  
Lower Limbs ◽  
List Type ◽  
Laboratory Findings ◽  
Magnetic Resonance Scan ◽  
The Right ◽  
Klippel Trenaunay Syndrome

A female neonate was born with asymmetric lower limbs, the right leg appearing enlarged, with thickened, reddish-purple skin and ectasic superficial reticulum (figure 1A,B). Limb pulses were present and symmetrical. The girl’s family history and prenatal scans were unremarkable. Laboratory findings were within the normal range, except for a mild thrombocytopenia (90 000/μL), which spontaneously resolved during the next few days. A leg X-ray and the Doppler analysis ruled out the presence of calcifications and venous varices, respectively. Ultrasound showed significant skin thickening, with marked dermal hypertrophy and hyperechogenicity. Magnetic resonance showed circumferential thickening of the derma, with mild hypertrophy of some perforating vessels (figure 2). A biopsy of the right thigh showed capillary malformations on histology.Figure 1(A, B) Hypertrophy of the right lower limb, with large capillary malformation extending to the gluteus and the external genitalia.Figure 2Axial THRIVE magnetic resonance scan of the thighs’ proximal third, showing circumferential dermal thickening and inhomogeneity of the right leg’s subcutaneous tissue.QuestionsBased on the clinical picture and investigations results, which is the most likely diagnosis?Beckwith-WiedemannCLOVES syndromeKlippel-Trenaunay syndromeKaposiform hemangioendotheliomaHow can the diagnosis be confirmed?CT with PETLymphoscintigraphyGenetic testingNone of the above, the diagnosis is clinicalWhat is the mainstay of management?Conservative with follow-upPharmacotherapySclerotherapySurgeryWhich of the following complications can occur?ScoliosisGlaucomaUrinary and gastrointestinal bleedingAll of the aboveAnswers can be found on page 02.

Oligodendroglioma arising in the glial component of ovarian teratomas: a series of six cases and review of literature

2012 ◽  
Vol 65 (7) ◽  
pp. 631-634 ◽  
Author(s):  
Nasir Ud Din ◽  
Aisha Memon ◽  
Kanwal Aftab ◽  
Zubair Ahmad ◽  
Rashida Ahmed ◽  
...  
Keyword(s):  
Review Of Literature ◽  
Ki 67 ◽  
Who Grade ◽  
Long Term Follow Up ◽  
Grade Ii ◽  
The Right ◽  
Rule Out ◽  
Ovarian Teratomas

AimsTo report the exceedingly rare occurrence of oligodendroglioma in the glial component of ovarian teratomas.MethodsSix cases of oligodendrogliomas arising in the glial component of ovarian teratomas were studied and the literature was reviewed. Immunohistochemistry was performed by the Flex technique.ResultsThe ages of the patients ranged from 12 to 28 years (mean 21 years). Four tumours were located in the right and one in the left ovary. The size of the ovarian cysts ranged from 7 cm to 29 cm (mean 19.6 cm). Four cases arose in immature and two cases in mature teratomas. In all cases, oligodendroglioma was WHO grade II. On immunohistochemistry, glial fibrillary acidic protein stain was positive in all cases. The Mib 1 (Ki 67) proliferative index was low and the tumour cells were negative for synaptophysin. Follow-up was available in five patients and ranged from 1 to 42 months. Two patients died of disease after 1 and 36 months of diagnosis, respectively. In both these cases oligodendroglioma arose in an immature teratoma. The remaining three patients are alive with a follow-up of 4–42 months.ConclusionsOligodendroglioma arising in the glial component of ovarian teratomas is exceedingly rare. Ovarian teratomas should be extensively sampled and carefully evaluated to rule out the possibility of a glial tumour. This is the single and largest series of oligodendrogliomas arising in ovarian teratomas. The prognosis is good for oligodendrogliomas arising in mature teratomas compared with those arising in immature teratomas, although long-term follow-up is needed to determine the exact behaviour.

scholarly journals Successful Endoscopic Management of a Renal Fungal Ball using Flexible Ureterorenoscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Mahmoud Abuelnaga ◽  
Sadegh Khoshzaban ◽  
Mahmoud Reda Badr ◽  
Aasem Chaudry
Keyword(s):  
Obstructive Uropathy ◽  
Kidney Injury ◽  
Current Treatment ◽  
Endoscopic Management ◽  
Flexible Ureterorenoscopy ◽  
Fungal Ball ◽  
System A ◽  
The Right ◽  
Fat Stranding ◽  
Collecting System

Background. Candida as a cause for urinary tract infection in healthy individuals is unusual. The extension of fungi into the urinary collecting system rarely leads to formation of bezoars or fungus balls. This can in turn lead to hydronephrosis, obstructive uropathy and sepsis. Case Presentation. An eighty years old gentleman presented to A&E with confusion, severe urosepsis and acute kidney injury. CTKUB demonstrated significant right sided hydronephrosis, perinephric fat stranding and gas in collecting system. A year prior to this admission he has become known to the urology team for a fungal ball that was noted in the upper pole of the right kidney which was picked up following elective flexible ureterorenoscopy for right kidney stones. Flexible ureterorenoscopy and successful retrieval of fungal ball by basket was performed. Conclusion. We advocate this technique to be considered as an alternative to the current treatment offered to patients with fungal ball infections and especially so in cases were a nephrostomy is either contraindicated, unavailable, or not possible.

scholarly journals Rapid recurrence of a malignant meningioma: case report

2017 ◽  
Vol 31 (2) ◽  
pp. 178-181
Author(s):  
Oguz Baran ◽  
Sima Sayyahmeli ◽  
Taner Tanriverdi ◽  
Pamir Erdincler
Keyword(s):  
Short Report ◽  
Malignant Meningioma ◽  
Total Removal ◽  
Ki 67 ◽  
Simpson Grade ◽  
Surgery Patient ◽  
Extent Of Surgery ◽  
Grade Ii ◽  
The Right

Abstract This short report presents a case that developed rapid recurrence of a malignant meningioma. The meningioma was located on the right temporal lobe and total removal (Simpson grade-II) was performed. Radiotherapy was not given and the lesion recurred within four months. The MIB-1 (Ki-67) index was 30 % and the tumor fulfilled all the criteria of anaplasia. After the second surgery, patient was transferred to the Radiation Oncology for radiotherapy. Should we questioned the extent of surgery? Neurosurgeons should be careful and close follow-up the patients with malignant meningioma.

scholarly journals Ipsilateral robot assisted laparoscopic side to side ureteroureterostomy in a duplex collecting system – A video case report with 1 year follow up

2020 ◽  
Vol 33 ◽  
pp. 101325
Author(s):  
Usman M. Haroon ◽  
Paul C. Ryan ◽  
Robert A. Keenan ◽  
Nicholas Hegarty ◽  
David Mulvin ◽  
...  
Keyword(s):  
Case Report ◽  
Robot Assisted ◽  
System A ◽  
Video Case Report ◽  
Collecting System

Technical Considerations and Functional Outcome of 22 Major Replantations (The BSSH Douglas Lamb Lecture, 2005)

2007 ◽  
Vol 32 (5) ◽  
pp. 488-501 ◽  
Author(s):  
S. RAJA SABAPATHY ◽  
H. VENKATRAMANI ◽  
R. R. BHARATHI ◽  
J. DHEENADHAYALAN ◽  
V. R. BHAT ◽  
...  
Keyword(s):  
Well Being ◽  
Major Amputation ◽  
Ischaemia Time ◽  
Bone Shortening ◽  
Radical Debridement ◽  
Grade Ii ◽  
Technical Details ◽  
The Right ◽  
Technical Considerations

Twenty-two consecutive major replantations carried out over a 5-year period were assessed with a minimum follow-up of 2 years. Only two patients suffered guillotine amputations. The remainders were either crush, or crush avulsion amputation. Replantation was successful in 20 cases. When analysed by Chen’s criteria, there were three Grade I, nine Grade II, six Grade III and two Grade IV results. Most patients with successful replants put the hand to greater use with time and replantation greatly added to the overall well-being of the patient. We consider major replantation as a worthwhile procedure. Radical debridement, bone shortening and well laid out protocols to reduce the ischaemia time are important for success. The technical details which we believe to be important for success are outlined. With decreasing numbers of such injuries in most countries, this paper may help surgeons faced with an occasional patient with a major amputation to make the right decisions.

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

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