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Nephrectomy for No Metastatic Renal Cell Carcinoma with Venous Tumor Thrombus About One Case and Literature Review
Smith Giscard Olagui,
Mariette Nsa Bidzo,
Ulrich Davy Ngabou,
Ernest Belembaogo
Issue:
Volume 6, Issue 2, December 2022
Pages:
66-70
Received:
6 March 2022
Accepted:
25 May 2022
Published:
20 July 2022
DOI:
10.11648/j.ijcu.20220602.11
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Abstract: Introduction: Extended total nephrectomy (ENT) is the treatment for localized or locally advanced renal cancer with vena cava tumor thrombus. The existence of a vena cava thrombus imposes a vascular surgery time which increases the intraoperative mortality and morbidity. Purpose: the purpose of this clinical case and to evaluate our surgical management of non-metastatic renal cancer with subdiaphragmatic vena cava thrombus. Observation: This was a 63-year-old patient who had presented disabling right low back pain associated with macroscopic haematuria no signs of deglobulization on biological examination. The morphological assessment was carried out using an abdominal computed tomography, which revealed a right kidney tumor classified as T3bN1. A tumor extension assessment by thoracic computed tomography was performed afterwards. There were no remote secondary lesions (M0). After CPR discussion, we performed ENT with lymph node dissection associated with inferior vena cava thrombectomy. The post-operative follow-up had been simple. Controls were carried out at 1 month then every 6 months for 1 year and every year for 5 years. There was no local, loco regional or distant recurrence. Conclusion: Kidney cancer with non-metastatic vena cava thrombus represents a locally advanced form whose surgical management must be well assessed, in terms of the increased risk of perioperative morbidity and mortality.
Abstract: Introduction: Extended total nephrectomy (ENT) is the treatment for localized or locally advanced renal cancer with vena cava tumor thrombus. The existence of a vena cava thrombus imposes a vascular surgery time which increases the intraoperative mortality and morbidity. Purpose: the purpose of this clinical case and to evaluate our surgical manage...
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Efficacy and Safety Outcomes of Monopolar Transurethral Resection of the Prostate in Abuja, Nigeria
Muftau Jimoh Bioku,
Ayoleke Ogunrinde,
Emmanuel Ugwu,
Olatunde Olawoye,
Izuchukwu Benerdin Achusi,
Quadri Sanni,
Ahmed Saad Aliyu
Issue:
Volume 6, Issue 2, December 2022
Pages:
71-75
Received:
23 June 2022
Accepted:
11 July 2022
Published:
28 July 2022
DOI:
10.11648/j.ijcu.20220602.12
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Abstract: Introduction: Benign prostatic hyperplasia (BPH) is the most common disease in older men. Its clinical manifestations as lower urinary tract symptoms (LUTS) negatively impact patients’ quality of life. Transurethral resection of prostate (TURP) has held a unique position as the front-line endoscopic treatment of BPH for many decades in developed nations. However, there are few literatures on its use in this environment. Objective: To document the 5-year efficacy and safety outcome of monopolar TURP for the treatment of the LUTS secondary to BPH at Federal Medical Centre (FMC), Abuja. Patients and Methods: A retrospective study of all men who had monopolar TURP with histologic confirmation of BPH between June 2016 and May 2021. The information retrieved includes age, prostate specific antigen (PSA), preoperative and postoperative International Prostate Symptom Score (IPSS), ultrasound prostatic weight, post-void residual (PVR), indications for TURP, operation time, postoperative complications, and histological reports. These data were analyzed using SPSS version 27.0. Results: A total of 142 patients who had M-TURP met the inclusion criteria. The age range was 49-88 years with a mean of 66.04 years. The mean Prostatic weight was 61.27g (range 21-81g) while serum PSA ranged from 1.0 to 10.1ng/ml (mean = 3.73 ng/ml). The average operation time was 59.29 minutes (range= 46-73 minutes). The most common indication for TURP was recurrent acute urinary retention (n=65,45.8%) while bleeding is the leading complication (n=9, 6.3%). There was no TUR syndrome or intraoperative death. However, the transfusion rate was 6.3%. We recorded improvements in IPSS from 21.53 to 3.43. Histological reports revealed BPH only in 82.4% of cases (n= 117) and BPH with prostatitis in 17.6%(n=25). Conclusions: With appropriate patient selection and organized resection technique, monopolar TURP is a feasible, safe and effective surgical option in the management of BPH-related LUTS.
Abstract: Introduction: Benign prostatic hyperplasia (BPH) is the most common disease in older men. Its clinical manifestations as lower urinary tract symptoms (LUTS) negatively impact patients’ quality of life. Transurethral resection of prostate (TURP) has held a unique position as the front-line endoscopic treatment of BPH for many decades in developed na...
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Feasibility of Laparoscopic Pyeloplasty in Children Since Infancy
Sergio Landa Juarez,
Iris Saldana Sanchez,
Ileana Mendez Gamboa,
Carlos Garcia Hernandez
Issue:
Volume 6, Issue 2, December 2022
Pages:
76-83
Received:
17 July 2022
Accepted:
8 August 2022
Published:
31 August 2022
DOI:
10.11648/j.ijcu.20220602.13
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Abstract: Background: For children with ureteropelvic junction obstruction, minimally invasive techniques offer better results for patients, but the traditional laparoscopic approach continues to be a surgical challenge, especially in infants, for which the benefit of this approach as a first-line choice is still being discussed. A retrospective analysis was performed on patients diagnosed with ureteropelvic junction obstruction (UPJO) treated by laparoscopic pyeloplasty (LP) from January 2014 to December 2019. The ages ranged from 3 months to 16 years; most patients had a primary obstruction, and only five had a previous pyeloplasty. Clinical success was defined as: the resolution of symptoms, diminished hydronephrosis on ultrasound, and improved excretion assessed through a nuclear renal scan. Throughout six years, 71 LPs were performed, of which only 57 met the inclusion criteria. The mean age was 3.5 years old. We divided the patients into two groups, group A for 1 year or less, and Group B for children 1 year and older. 16 children presented with hydronephrosis on the right kidney, and 41 on the left. 47 children presented with intrinsic obstruction, and 10 were extrinsic due to an aberrant polar artery. Prenatal hydronephrosis was detected in the majority of patients. The remaining cases presented predominantly with abdominal pain and urinary tract infection. The total mean operative time was 171 min for Group A, and 190 min for Group B. None of the children required conversion to open surgery. There was one major complication in our cohort. Our success rate of 93% was similar to that of the current literature. Our retrospective study reported shorter operative times and less complications through laparoscopic approach in infants. We attribute the shorter operative times to initiating laparoscopic intervention in young children after surpassing the initial learning curve. We recommend prospective studies in comparing both age groups in order to assert the feasibility of this procedure in all ages.
Abstract: Background: For children with ureteropelvic junction obstruction, minimally invasive techniques offer better results for patients, but the traditional laparoscopic approach continues to be a surgical challenge, especially in infants, for which the benefit of this approach as a first-line choice is still being discussed. A retrospective analysis was...
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Urinary Myiasis in a Girl Due to a Telmatoscopus albipunctata Larva: Case Report
Rosalinda Jimenez-Aguilar,
Ernesto Maravilla-Franco,
Dora Carranza-Salazar,
Javier Martinez Bautista,
Mauricio Cantellano Orozco,
Willebaldo Tenorio Gutierrez
Issue:
Volume 6, Issue 2, December 2022
Pages:
84-87
Received:
26 August 2022
Accepted:
13 September 2022
Published:
27 September 2022
DOI:
10.11648/j.ijcu.20220602.14
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Abstract: Myiases are parasitic infestations of humans or animals by fly larvae that infest skin, necrotic tissues, and natural cavities. They can be associated with nosocomial infections and cases of nasopharyngeal, testinic, and urinary myiasis have been reported. We presented a clinical case of urinary bladder myiasis and figure out the mechanism that allow the disease. The female patient arrived at Pediatric Intensive Care Unit at epilepsy condition so we have to induct to barbituric coma. The proper lab studies were conducted based on clinic practice guide; however, no positive results were found. She stops to pee and we identified a vesical balloon, then we decided to change the urinary catheter and then a lot of fly larvae were thrown, then we made the analysis of the fly specie. We notified to the Epidemiology Unit due to the patient was 15 days before in a small river at Morelos State in Mexico in a visit from a boy scout group. We made the lab studies to the other visitors to identify root cause and found out this was the contagion. We provided epidemiology hygienic recommendations at home to family. Finally, the patient was healed using antiparasitic medicine. As far as we know, there are no report of this type of myiasis in our country.
Abstract: Myiases are parasitic infestations of humans or animals by fly larvae that infest skin, necrotic tissues, and natural cavities. They can be associated with nosocomial infections and cases of nasopharyngeal, testinic, and urinary myiasis have been reported. We presented a clinical case of urinary bladder myiasis and figure out the mechanism that all...
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Updates on Irrigation Fluids in Endourology and TUR Syndrome - A Systematic Review
Issue:
Volume 6, Issue 2, December 2022
Pages:
88-94
Received:
19 July 2022
Accepted:
2 August 2022
Published:
18 October 2022
DOI:
10.11648/j.ijcu.20220602.15
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Abstract: Endourological procedures are considered to be the minimally invasive procedure among all urological strategy and cause dreadful complication even in experienced hands. Endourological procedure requires irrigating fluid to dilate mucosal space, to remove the blood clots, fragments, resected tissue from the surgical field and enhance the vision properly. Various irrigating fluids are available in the market, but few plays an important role based on price, properties, and availability. A detailed review of the various irrigating fluids used in Endourological procedures that have lesser adverse effects, different modalities of treatment and the current state of TUR syndrome was performed. A detailed review was performed of medical literature to identify the articles relevant to irrigation fluids and TUR syndrome in Endourology. Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed while conducting this study. Two authors reviewed all the articles confirming to search criteria. All non-English, conference poster presentations, letters to editor, and case reports were excluded. Articles remaining after exclusion were analyzed under one of these heads: Properties of irrigation fluids, Patho –physiology of TUR syndrome, management of TUR syndrome. This article reviews the various irrigant solutions used in endourology in the present day practice, and their advantages and limitations.
Abstract: Endourological procedures are considered to be the minimally invasive procedure among all urological strategy and cause dreadful complication even in experienced hands. Endourological procedure requires irrigating fluid to dilate mucosal space, to remove the blood clots, fragments, resected tissue from the surgical field and enhance the vision prop...
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A Detailed Analysis of a Pharmacokinetic Model for Testopel® Implants
David T. Seitman M. S. BME,
M. D.,
Joe J. Fallon M. D.
Issue:
Volume 6, Issue 2, December 2022
Pages:
95-113
Received:
1 September 2022
Accepted:
12 October 2022
Published:
29 October 2022
DOI:
10.11648/j.ijcu.20220602.16
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Abstract: A novel pharmacokinetic model used to titrate therapy for implantable testosterone pellets (Testopel®) in a clinical patient is presented. The model accurately reflects measurements by the Esoterix Laboratory’s serum testosterone assay. The difference between the model’s predictions and the measured levels were clinically insignificant (mean absolute % difference = 2.9%, mean % difference = 0.40%, SD = 4.6%, n = 9), during the early, development phase of the model, and remained small (mean absolute % difference = 5.2%, mean % difference = -1.3%, SD = 7.7%, n = 13) even when newer data points were included. The model was used to predict the peak (900-1100 ng/dL), trough (>300 ng/dL), and average total serum testosterone levels at steady state. Subsequently, the model was used to alter the treatment regimen to yield a specific average serum testosterone level (“area under the curve” ~600 ng/dL), to keep the serum peak under a target amount (<800 ng/dL), and to keep the serum trough above a certain amount (> 400 ng/dL). Targeted levels were reached by the next cycle of Testopel® therapy. This represents the first time such a close correlation between a predicted and a measured serum testosterone has been shown using any assay. Because of the accuracy of the model, the authors recommend using it to provide a quantitative approach to the initiation and maintenance of Testopel® therapy instead of the traditional, more qualitative trial-and-error technique. Clinicians can now target average, peak, and trough testosterone levels and we can reach those levels by the second cycle of therapy. It is likely the model can be extended to aid treatment with implantable testosterone pellets other than Testopel®. This paper presents a detailed analysis of our pharmacokinetic model and its usage as a clinical aid.
Abstract: A novel pharmacokinetic model used to titrate therapy for implantable testosterone pellets (Testopel®) in a clinical patient is presented. The model accurately reflects measurements by the Esoterix Laboratory’s serum testosterone assay. The difference between the model’s predictions and the measured levels were clinically insignificant (mean absolu...
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Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele
Sarah Johnson,
Samuel Huff,
Thomas Barefoot,
Kellen Choi
Issue:
Volume 6, Issue 2, December 2022
Pages:
114-118
Received:
21 August 2022
Accepted:
28 October 2022
Published:
4 November 2022
DOI:
10.11648/j.ijcu.20220602.17
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Abstract: To investigate the presentation and management of ureteroceles remaining asymptomatic until adulthood. A ureterocele is a congenital cystic dilation of the distal ureter upon its entry point into the bladder. This birth defect obstructs urine flow and can negatively impact proper renal function. Treatment options vary widely depending on the type of ureterocele and the presence or absence of a duplicated collecting system. We present a rare case of a 59-year-old female with a symptomatic left intravesical single system ureterocele successfully managed with endoscopic resection. Ureteroceles are commonly diagnosed in utero or within the first few years of life. However, primarily due to her asymptomatic nature until nearly 60 years of age, our patient offers an unusual presentation of a ureterocele diagnosed initially in adulthood. Various classification systems are employed in the diagnosis of ureteroceles, however the Ericsson and Glassberg classification systems are most widely used. A duplex kidney is a common finding in ureterocele cases and typically necessitates a more complex treatment plan. The management of ureteroceles varies based on classification, presence of symptoms, age, severity, and concurrent complications. As seen with our patient, a significant symptomatic presentation may warrant surgical intervention via endoscopic resection of the ureterocele. Ureteroceles can be managed using conservative treatment or surgical intervention via endoscopic resection, as seen in our patient. If surgical intervention is pursued, patients should be continually monitored for postoperative complications including hydronephrosis and urinary tract infections.
Abstract: To investigate the presentation and management of ureteroceles remaining asymptomatic until adulthood. A ureterocele is a congenital cystic dilation of the distal ureter upon its entry point into the bladder. This birth defect obstructs urine flow and can negatively impact proper renal function. Treatment options vary widely depending on the type o...
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Congenital Anterior Urethrocutaneous Fistula: A Case Report and Review of Literature
Smith Giscard Olagui,
Steevy Ndang Ngou Milama,
Christelle Mezene,
Dimitri Mbethe,
Adrien Mougougou,
Gloire Allogho Mbouye,
Mariette Nsa Bidzo,
Fatou Moutsinga,
Jean Placide Owono Mbouengou,
Eric Jacob Benizri
Issue:
Volume 6, Issue 2, December 2022
Pages:
119-121
Received:
8 May 2022
Accepted:
28 October 2022
Published:
8 December 2022
DOI:
10.11648/j.ijcu.20220602.18
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Abstract: Introduction: Congenital anterior urethro-cutaneous fistula (CAUF) is an extremely rare abnormality that can register as a malformative entity with hypospadias or cord, or present in an isolated form. Purpose: The purpose of our observation is to present our surgical management of a case of CAUF. Observation: We describe the clinical case of a 10-year-old patient, who presented with CAUF in the ventral mid-penile position, diagnosed at birth. He underwent urethroplasty using Mathieu's technique with simple consequences. The uretral catheter removed at 21 days post-surgery. No complications at 30 days post-operatively. Discussion: CAUF is an extremely rare condition. The etiology is unknown, and several pathogenetic theories have been used to explain its causes.The clinical characteristics are not well defined. An overall assessment of the disease can be carried out in search of other associated abnormalities. CAUF also associated with other congenital anomalies, such as deficient distal urethra, distal hypospadias, ventral penile curvature, anorectal malformations, stenosed bulbar urethra, epispadic urethral duplication, and megalourethra. Abdominal ultrasound and cystoscopy and/or cystography may be performed Therapeutically, surgery remains the only treatment, it includes many methods of surgical repair. Mathieu's technique is the most practiced and gives excellent results. Conclusion: CAUF is a rare anomaly, which must be diagnosed in order to be treated. Surgical treatment offers satisfactory results.
Abstract: Introduction: Congenital anterior urethro-cutaneous fistula (CAUF) is an extremely rare abnormality that can register as a malformative entity with hypospadias or cord, or present in an isolated form. Purpose: The purpose of our observation is to present our surgical management of a case of CAUF. Observation: We describe the clinical case of a 10-y...
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Contribution of Histopathology to the Diagnosis of Buschke-Löwenstein Tumour in a Cameroonian Child and Suspected Child Abuse
Coralie Reine Bertine Mendouga Menye,
Emmanuel Armand Kouotou,
Jean Cedrick Fouda,
Rene Ghislain Essomba,
Frantz Guy Epoupa Ngalle,
Paul Jean Adrien Atangana
Issue:
Volume 6, Issue 2, December 2022
Pages:
122-125
Received:
11 November 2022
Accepted:
2 December 2022
Published:
27 December 2022
DOI:
10.11648/j.ijcu.20220602.19
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Abstract: Introduction: Buschke-Löwenstein tumour (BLT) is a rare sexually transmitted infection of the skin caused by the Human Papilloma Virus with common involvement of the types 6 and 11. The preferential location being the genital area. It is very rare in children and mostly affects males over the age of 40. The diagnosis is mostly clinical. The goal standard for management is surgery. This is a case report of BLT in a Cameroonian child. Case History: A skin sample was received at the anatomy and pathology laboratory of the Centre Pasteur in Cameroon. It came from a 13 year old child with no prior history who initially presented with a large genitoscrotal tumour. In the light of these clinical facts that did not tie to a certain diagnosis, a histopathological analysis was carried out which revealed a Buschke-Löwenstein tumour. Discussion: This case history describes an original case of a clinically unsuspected BLT in a Cameroonian child aged 13-year-old, with no prior history. This case was diagnosed on histology and confirms the importance of histopathological analysis to this diagnosis which remains difficult for non-dermatologists. Conclusion: To our knowledge and according to the data at our disposal, this is the first time that BLT has been described in a child in Cameroon.
Abstract: Introduction: Buschke-Löwenstein tumour (BLT) is a rare sexually transmitted infection of the skin caused by the Human Papilloma Virus with common involvement of the types 6 and 11. The preferential location being the genital area. It is very rare in children and mostly affects males over the age of 40. The diagnosis is mostly clinical. The goal st...
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