Use of the appendix as ureteral substitute in a patient with a single kidney affected by relapsing upper urinary tract carcinoma

The treatment of upper urinary tract transitional cell carcinoma (UT-TCC) in single-kidney patients requires the radical removal of cancer, but also, when feasible, the preservation of the continuity of the urinary tract by various surgical techniques. In case of wide resections during ureteral surgery, a ureteral replacement could be advocated. In the literature, the cecal appendix has rarely been used as a ureteral substitute, moreover in benign pathological conditions, showing encouraging early results. The positive functional and oncological outcomes obtained after a lengthy follow-up in a single-kidney patient with UT-TCC treated by ureteral resection and appendix interposition confirm the viability of this surgical option

Use of the appendix as ureteral substitute in a patient with a single kidney affected by relapsing upper urinary tract carcinoma

The treatment of upper urinary tract transitional cell carcinoma (UT-TCC) in single-kidney patients requires the radical removal of cancer, but also, when feasible, the preservation of the continuity of the urinary tract by various surgical techniques. In case of wide resections during ureteral surgery, a ureteral replacement could be advocated. In the literature, the cecal appendix has rarely been used as a ureteral substitute, moreover in benign pathological conditions, showing encouraging early results. The positive functional and oncological outcomes obtained after a lengthy follow-up in a single-kidney patient with UT-TCC treated by ureteral resection and appendix interposition confirm the viability of this surgical option

["Post-actinic pelvic disease" and the ureter: the post-actinic ureter].

A retrospective study was done to analyze late urological complications following curative radiotherapy of primary gynecological carcinomas.From 1990 to 2000, 167 patients with primary gynecological cancer treated with external radiotherapy or intracavitary applications were observed. During the follow-up, all signs, symptoms and therapy of late treatment complications were recorded.Most patients with ureteral stenosis or obstruction required surgical correction. Most patients with bladder fistulas were best served by creation of a cutaneous urinary diversion.Ureteral complications after radiotherapy of the pelvis are rare but severe. Surgical therapy of irradiated tissues has a higher complication rate compared to surgery on non irradiated tissue. A cutaneous urinary diversion may be an acceptable and safe procedure when the bladder is definitely compromised

[Echography versus nuclear magnetic resonance in the preoperative dynamic evaluation of plastic penile induration].

Recently Ultrasonography (US) and Magnetic Resonance Imaging (MRI) has been successfully used as painless and non invasive techniques for depicting dense fibrous connective tissue of Peyronie's Disease (PD). The purpose of this study is to demonstrate the extent of disease and to prove the accuracy of US versus MRI. Twenty patients (aged 20-70; mean 43) with clinical diagnosis of PD were studied. All patients were studied with flaccid and erected penis after an intracavernous injection of Papaverine (variable dose). US and MRI examinations were performed independently by 2 groups of observers who knew clinical findings but not the results of the other technique. Both methods gave satisfactory images: they show the capacity to depict and to measure Peyronie's plaques clinically appreciated. US in 4 patients and MRI in 3 patients identified not palpable lesion which infiltrate the septum. Although the most common area of PD involvement is the dorsal surface of tunica albuginea, sometimes fibrous plaques are along the septum between the corpora cavernosa and the corpus spongiosum. In the present study, US and MRI are too able to identify not palpable lesion in the septum. In our opinion US has to be used for its high accuracy and low cost