Retrograde ejaculation following open ureteric reimplantation: a case report

Abstract Introduction Retrograde ejaculation is not a recognized complication of ureteric reimplantation surgery. We describe this unusual complication in a 25-year-old man, with no other cause for his ejaculatory dysfunction. Case presentation A 25-year-old Caucasian man presented with left hydronephrosis ascribed to a megaureter. Following open reimplantation of the ureter, the patient developed retrograde ejaculation that did not respond to medical therapy. Conclusion The key result reported here is that retrograde ejaculation is a possible complication of open pelvic surgery, for which patients should receive counselling. This is relevant for both urologists and general physicians who consult relatively young men with ejaculatory difficulties.</p

Carcinoma in situ is significantly underdetected by prenephroureterectomy ureteroscopy in the management of upper tract urothelial cancers

Objective. Diagnostic reliability of prenephroureterectomy ureteroscopy (PNU) for the detection of upper tract carcinoma in situ (CIS) remains unproven in particular and underreported in general. Methods. Patients who underwent radical nephroureterectomy (RNU) in a large multicentre retrospective study for upper tract transitional cell carcinoma (UT-TCC) between January 2002 and December 2013 were identified from our hospitals databases. PNU appearances, stage, and grade of ureteroscopic biopsy were compared with final histology results of RNU to assess the diagnostic reliability of PNU for carcinoma in situ (CIS). Results. Three hundred patients underwent RNU for UT-TCC. 106 (106/300; 35.3%) of the cohort had PNU using white light with biopsies taken in most (92/106; 86.7%). Postnephroureterectomy histology of the cohort showed CIS in 65 (65/300; 21.6%) patients. Thirty nine of patients with CIS (39/65; 60%) had prenephroureterectomy ureteroscopy biopsies. Out of ten patients with CIS on ureteroscopic biopsies, six did not show CIS on final histopathology (6/10; 60%). Moreover, grading and staging on PNU biopsies of obvious tumours showed a significant nonconcordance with final histopathology of RNU specimen (P=0.02). Overall survival was also shorter in patients with CIS compared with those without; this showed strong statistical significance (P=0.004). Conclusions. There is a high incidence of CIS in upper tract with significant underdetection and discordance rate between the histopathology of biopsy samples obtained by white light PNU and resected specimen of radical nephroureterectomy. The presence of concomitant CIS and high stage disease in the upper tract TCC carried a poor prognosis following radical nephroureterectomy

Shockwave lithotripsy compared with ureteroscopic stone treatment for adults with ureteric stones : the TISU non-inferiority RCT

Acknowledgements The authors wish to thank the patients who participated in the TISU trial.We also thank Stanley Coutts (patient representative) and Charles Clark (patient representative and co-applicant) for their contribution to the design of the participant-facing documents (patient information sheet and questionnaires); Sharon Wren for her secretarial support and data management; previous data co-ordinators, Jessica Wood and Margery Heath, for their data and trial management support; the CHaRT programming team led by Gladys McPherson (to 2016) and Mark Forrest (2016–present); other staff within CHaRT and the HSRU for their assistance with the trial (Cynthia Fraser); members of the PMG for their ongoing advice and support of the trial, plus the independent members of the TSC and DMC; and the staff at the recruitment sites who facilitated the recruitment, treatment and follow-up of trial participants (all listed below); and, finally, we would like to thank the National Institute for Health Research and the Health Technology Assessment programme for funding the TISU trial. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 19. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

Urinary Tract InfectionClinical Perspectives on Urinary Tract Infection /

XIII, 77 p. 9 illus. in color.online resource