A Rare Cause of the Rare Condition: Paratesticular Fibrous Pseudotumor

Benign fibrous proliferations of the spermatic cord are uncommon and mostly arise from the paratesticular region. Although benign, they often clinically mimic malignancy and usually remain undiagnosed preoperatively. Here, we report a case of fibrous pseudotumor arising from the right spermatic cord encountered in a 26-year-old male who presented with a palpable right inguinal mass

Fever and Systemic Inflammatory Response Syndrome Seen After Percutaneous Nephrolithotomy: Review of 1290 Adult Patients

Aim: Although accepted as minimally invasive, percutaneous nephrolithotomy (PCNL) still poses a significant risk of complications. Recent studies suggest that the incidence of sepsis may be higher than previously reported. The systemic inflammatory response syndrome (SIRS) seen in the subset of patients with or without bacteremia, is a life threatening complication and the purpose of this study is to give an insight to the relation between a post-operative fever episode and the risk of developing SIRS. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1290 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden had a statistically significant correlation with SIRS (p= 2 complications were seen to increase the hospitalization period (p= 120 min. was the only operative variable that had correlation with both fever and SIRS (p2 g/dl (Delta haemoglobin-Hb) and Clavian 5 complications had statistically significant correlations with fever. ASA score >= 3, operation time >120 min. Delta Hb > 2 gr/dl, stone size and Clavian 5 complications had statistically significant correlations with the development of SIRS. The incidence of a fever episode, which was seen in 181 patients (14%), to progress to SIRS, which leaded to death, was found to be 1.6%. Discussion: Postoperative fever has a low risk of progressing to a life threatening condition. But special attention should be given to patients that also have the other SIRS criteria; blood loss more than 2 g/dl and/or operation time more than 120 minutes. Although only encountered in a small subset of patients, multiple organ dysfunctions can develop leading to death

Predicting Surgical Outcome of Percutaneous Nephrolithotomy: Validation of the Guy's Stone Score and Nephrolithometric Nomogram in Terms of Success and Complications

This single institution retrospective study aims to validate the ability of Guy's stone score and the nephrolithometric nomogram to predict the success of PCNL and to assess the correlation of the scoring systems with the complications encountered. Material and Method: Medical files of 1646 adult patients to whom a PCNL operation was performed were reviewed. A total of 1325 patients fulfilled the needed criteria and were included in the study. Study variables were recorded from the medical files for statistical analysis. Results: Stone burden was the only pre-operative, operative and post-operative variable that had a statistically significant correlation both with success and also with the complications encountered (p 120 minutes, presence of a staghorn stone, intra-and post-operative blood transfusion, duration of the nephrostomy catheter, Delta Hg more than 2 gr/dl and and positive post-operative urine/blood culture were the other associated variables related to the complications encountered (p< 0.05). ROC curve analysis performed to the nephrolithometric nomogram data showed that with a cut of value of 80.5% for success, the nomogram has a sensitivity of 71% and specificity of 74% (ROC AUC= 80%). The nomogram was further analyzed for an association between the complications encountered and showed that the association is not strong enough to predict a possible complication (ROC AUC= 67%). Discussion: This study shows that the nephrolithometric nomogram has a good predictive accuracy for success (AUC= 0.80) and the Guys's stone score has a good correlation both with success and with complications (p< 0.05) and can be used for pre-operative counseling and decision making

Bilateral renal leiomyoma with 5 year follow-up: Case report

Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas

Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence

Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asyptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy

Retroperitoneal Schwannoma: A Case Report

Schwannomas are benign tumors originating from Schwann cells of the neural sheaths. Only 0.3% to 3% of the schwannomas are located the retroperitoneal space. Most schwannomas are asymptomatic and often found incidentally. The ideal treatment is complete surgical excision. Here, we report a case of a 49-year-old woman with retroperitoneal schwannoma

Comparison of Ho:Yag laser and pneumatic lithotripsy combined with transurethral prostatectomy in high burden bladder stones with benign prostatic hyperplasia

To compare the efficacy and reliability of Ho:YAG laser lithotripsy (HLL) and pneumatic lithotripsy (PL) in the treatment of bladder stones in patients with benign prostatic hyperplasia and stones ≥ 20 mm who were transurethrally treated in the same surgical session. We studied the data of patients with benign prostatic hyperplasia and ≥20 mm bladder stones who were treated with transurethral resection of the prostate and cystolithotripsy in the same session, obtained between January 2010 and February 2014 from three urology clinics. All patients underwent bipolar plasmakinetic (PK) transurethral resection of the prostate. For treatment of the bladder stone, either HLL or PL was applied. A total of 62 patients were divided into two groups: PK-PL (Group 1, n = 29) and PK-HLL (Group 2, n = 33). The data of both groups were analyzed for stone dimensions, stone fragmentation time, total operating time, hospitalization duration, prostate dimensions, success rates, and complications. Group 1 included 29 patients with a mean age of 70 ± 7.6 (range, 57–85) years, whereas Group 2 included 33 patients with a mean age of 67.5 ± 10.5 (range, 45–84) years. In Group 1, five patients had mucosa injury, one patient had residual stone, and one patient had bladder perforation. In Group 2, three patients had mucosa injury, three patients had postoperative fever, and one patient had residual stone. Total operation time and stone fragmentation time were significantly lower in Group 2 (p 0.05). PK-HLL using a single shaft without the need for repeated access has the advantages of shorter fragmentation and operation time

Comparison of Ho:Yag laser and pneumatic lithotripsy combined with transurethral prostatectomy in high burden bladder stones with benign prostatic hyperplasia

Objectives: To compare the efficacy and reliability of Ho:YAG laser lithotripsy (FILL) and pneumatic lithotripsy (PL) in the treatment of bladder stones in patients with benign prostatic hyperplasia and stones >= 20 mm who were transurethrally treated in the same surgical session. Methods: We studied the data of patients with benign prostatic hyperplasia and >= 20 mm bladder stones who were treated with transurethral resection of the prostate and cystolithotripsy in the same session, obtained between January 2010 and February 2014 from three urology clinics. All patients underwent bipolar plasmakinetic (PK) transurethral resection of the prostate. For treatment of the bladder stone, either HLL or PL was applied. A total of 62 patients were divided into two groups: PK-PL (Group 1, n = 29) and PK-HLL (Group 2, n = 33). The data of both groups were analyzed for stone dimensions, stone fragmentation time, total operating time, hospitalization duration, prostate dimensions, success rates, and complications. Results: Group 1 included 29 patients with a mean age of 70 +/- 7.6 (range, 57-85) years, whereas Group 2 included 33 patients with a mean age of 67.5 +/- 10.5 (range, 45-84) years. In Group 1, five patients had mucosa injury, one patient had residual stone, and one patient had bladder perforation. In Group 2, three patients had mucosa injury, three patients had postoperative fever, and one patient had residual stone. Total operation time and stone fragmentation time were significantly lower in Group 2(p 0.05). Conclusion: PK-HLL using a single shaft without the need for repeated access has the advantages of shorter fragmentation and operatidn time. Copyright (C) 2015, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved