Splenogonadal fusion: Report of a case and review of the literature

We report a case of splenogonadal fusion masquerading as a testicular tumor and review the etiology, the pathogenesis and the management of this rare disease. A 20-year-old male patient presented with clinical and radiological findings of a left testicular mass for which he underwent a left radical inguinal orchidectomy. Histopathology of the removed testicle revealed no tumor. The gonad was fused to ectopic splenic tissue, the later forming a distinct encapsulated mass attached to the lower pole of the testicle inside the tunica vaginalis. Splenogonadal fusion, although a rare condition, may account for a non-malignant testicular mass and should be suspected in young patients with other congenital anomalies

Unreliable residual volume measurement after increased water load diuresis

Background: The aim of the present study was to examine whether increased water load intake prior to ultrasound examination of the lower urinary tract, affects the measurement of postvoid residual urine volume. Patients and methods: Ninety four male patients with postvoid residual volumes after increased water load diuresis of more than 100 mL (PVR1) were included in the present study. All patients underwent a second PVR measurement by an urologist with a portable transabdominal bladder ultrasound scan without having received an increased water load (PVR2). A comparison of the measurements was performed and the PVR values were also correlated with other parameters, such as age, International Prostate Symptom Score, prostate volume and serum prostate-specific antigen (PSA) values. Results: Postvoid residual urine volume after increased water load diuresis (PVR1) differed from that recorded after normal bladder filling and voiding at first desire (PVR2), with the former being larger than the later in every patient (P < 0.001). The PVR values, PVR1 and PVR2, were independent to patient age, symptom score prostate volume and PSA value. Conclusions: Measurement of postvoid residual volume in a relaxed patient, who voids at first desire, represents everyday life and should be the correct method of testing

Feedback microwave thermotherapy with the ProstaLund((R)) compact device for obstructive benign prostatic hyperplasia: 12-month response rates and complications

Purpose: To evaluate the effectiveness of the ProstaLund (R) Compact Device in the treatment of benign prostatic hyperplasia (BPH). Patients and Methods: A series of 38 consecutive patients with a mean age of 72.6 +/- 8.2 years, 19 with an indwelling catheter, underwent transurethral microwave thermotherapy (TUMT) with the ProstaLund Compact Device. Pretreatment evaluation included transrectal ultrasonography (TRUS), urodynamics, and cystoscopy for all patients and flow rate (Q(max)), postvoiding residual urine volume (PVR), International Prostate Symptom Score (IPSS), and quality-of-life (QoL) assessment for those without a catheter. The mean prostate volume was 63.5 +/- 30 cc. The Q(max), IPSS, and QoL studies were repeated at 3, 6, and 12 months, while urodynamics, cystoscopy, and TRUS were repeated at 6 and 12 months. Results: The treatment lasted a mean of 43.1 +/- 17.1 minutes, achieved a maximal intraprostatic temperature of 58.7 +/- 7.2 degrees C, and destroyed 18.4 +/- 14.3 g of prostatic tissue. Twelve months post-treatment, for the patients without a catheter preoperatively, the IPSS was improved from 21.5 +/- 6.3 to 6.5 +/- 3.1 (P < 0.001), Q(max) from 7.2 +/- 3.1 mL/sec to 18.1 +/- 7.4 mL/sec (P < 0.001), detrusor pressure at Q(max) from 87.5 +/- 15 cm H2O to 48.4 +/- 16.4 cm H2O (P < 0.001), and PVR from 113.2 +/- 78.2 mL to 34.6 +/- 36.7 mL (P < 0.01). The good-response rates for IPSS (<= 7 or >= 50% improvement), Q(max) (>= 15 mL/sec or >= 50% improvement), PVR (< 50 mL or >= 50% decrease), and QoL (:52) were 73.7%, 84.2%, 73.7%, and 94.7%, respectively. For the patients with a catheter preoperatively, the IPSS improved from 9.5 +/- 6 at 3 months to 5.1 +/- 5.3 (P < 0.05) at the end of the follow-up period. The Q(max) was 13.2 +/- 6.4 mL/sec at 3 months and remained stable throughout the follow-up period. Patient good-response rates for IPSS (:57), PVR (< 150 mL), and QoL (:52) were 75%, 87.5% and 75%, respectively. Only two patients were unable to void after the treatment. Complications were similar to those presented in the literature, and bladder stone formation was noted as well (five patients). Conclusions: ProstaLund thermotherapy is a highly promising alternative treatment for BPH, improving substantially both objective and subjective measures of bladder outflow obstruction