ABSTRACT

Objectives: This article’s purpose is to review and discuss the relationship between urinary tract symptoms (LUTS) and renal damage, bearing in mind the epidemiology and pathophysiology of benign prostatic hyperplasia (BPH) and potential association.

Methods: Concerning the increasing number of elderly patients in urology clinics and the incidence of LUTS, the relationship between renal damage and LUTS should be an important issue. The authors searched literature in PubMed in order to correctly identify the pathophysiology and clinical correlation connecting these 2 entities.

Results: BPH is a common disease in adult men and its incidence is age related. Clinical BHP usually refers to the palpable enlargement of the prostate, which can be detected by physical or imaging examination, or by the presence of urinary symptoms loosely defined as LUTS. Despite the many possible causes of obstructive kidney disease, in studies of elderly patients with acute renal failure, the most common cause among all patients was BPH. Considering the high prevalence of BPH in older men with chronic kidney disease (CKD) it is invaluable to take into consideration the relationship between these 2 clinical entities.

Conclusion: Clinical and scientific findings show a worrisome and undiagnosed number of silent urinary obstruction symptoms that can lead to renal damage. This paper emphasizes that renal damage secondary to BPH, clinically manifested by lower urinary tract symptoms, is a preventable disease and must be under the care of physicians.

Ricardo Leao, Bruno Pereira, Hugo Coelho

Submitted August 6, 2012 - Accepted for Publication September 12, 2012

KEYWORDS: Benign prostate hyperplasia (BPH), chronic kidney disease (CKD), lower tract urinary symptoms (LUTS), renal disease

CORRESPONDENCE: Ricardo Leao, MD, Department of Urology and Renal Transplantation, University Hospital Center, Quinta dos Vales, Sao Martinho do Bispo, Coimbra, Portugal (romaoleao@gmail.com)

CITATION: UroToday Int J. 2012 December;5(6):art 56. http://dx.doi.org/10.3834/uij.1944-5784.2012.12.01

 

ABSTRACT

A 20-year-old female presented with upper abdominal pain. The renal function tests and liver function tests were within normal range. The abdominal ultrasound revealed a complex cystic mass in the left kidney. The contrast-enhanced CT scan showed a hypoattenuating, left-sided cystic renal mass at the upper pole with a well-defined margin and fine areas of calcification. Immunological tests for hydatid disease were positive. The patient was pre- and postoperatively managed with 10 mg/kg per day of albendazole for 2 weeks, and the hydatid cyst was excised through the retroperitoneal route. The cut section and histopathological examination were consistent with a hydatid cyst. Follow-up with a renal ultrasound showed normal findings and no evidence of new cyst reappearance. The patient is doing well in follow-up care.

 Vishwajeet Singh, Rahul Janak Sinha, Dheeraj Kumar Gupta, Ajay Singh, Mohit Pandey, Sanjay Bhat

Submitted July 13, 2012 - Accepted for Publication July 23, 2012

KEYWORDS: Hydatid cyst, renal hydatid, isolated renal hydatid, echinococcus cyst, cystic renal mass

CORRESPONDENCE: Vishwajeet Singh, MS, MCh (Urology), Chhatrapati Shahuji Maharaj Medical University (Formerly KGMC), Lucknow, Uttar Pradesh, India (vishwajeeturo@sify.com)

CITATION: UroToday Int J. 2012 October;5(5):art 55. http://dx.doi.org/10.3834/uij.1944-5784.2012.10.14

ABSTRACT

A middle-aged woman presented with a right labial mass that had been gradually increasing for 2 years. There were no other associated symptoms. The local examination of swelling showed a right labial mass of approximately 10 cm x 10 cm, which was not tender, firm, and had side-to-side mobility. Fine-needle aspiration cytology was negative for malignant cells. The contrast computed tomography (CT) scan of the pelvis showed a large, well-encapsulated homogenously enhancing mass. The patient was planned for excision of the mass through the transvaginal route. The histopathological examination was consistent with nodular fasciitis.

Nodular fasciitis is a common reactive mesenchymal proliferation that mimics some of the benign and malignant soft-tissue masses. The labium is the preferred location for a number of mesenchymal tumors and tumor-like lesions, including the postoperative spindle cell nodule, aggressive angiomyxoma, angiomyofibroblastoma, and nodular fasciitis. The urologist/gynecologist must have awareness about this rare lesion, and it must be differentiated from other mesenchymal lesions because of its benign nature.

Herein, we present a case of labial nodular fasciitis that was large, in comparison to those reported in English literature. The patient is asymptomatic and doing well in 1 year of follow-up care.

Vishwajeet Singh, Dheeraj Kumar Gupta, Rahul Janak Sinha

Submitted June 11, 2012 - Accepted for Publication July 23, 2012

KEYWORDS: Nodular fasciitis, benign vulvar lesion, labial mass

CORRESPONDENCE: Vishwajeet Singh, MS, MCh (Urology), Chhatrapati Shahuji Maharaj Medical University (Formerly KGMC), Lucknow, Uttar Pradesh, India (vishwajeeturo@sify.com)

CITATION: UroToday Int J. 2012 October;5(5):art 56. http://dx.doi.org/10.3834/uij.1944-5784.2012.10.15

ABSTRACT

Blunt abdominal trauma with an isolated abnormal kidney rupture is a rare clinical entity. The correct preoperative diagnosis may be difficult and challenging because of the insidious onset, lack of obvious bleeding, and, frequently, lack of urinary symptoms.

We present a case of a 22-year-old female with isolated pelvic rupture of a hydronephrotic left kidney secondary to a strong punch in the flank. She underwent a computerized tomography that showed a large retroperitoneal collection, with a poor functioning left kidney. Surgical exploration revealed a large rupture of the renal pelvis. She underwent nephrectomy.

Hydronephrosis may be a fortuitous discovery after blunt trauma. The diagnostic features at presentation and the decision-making of surgical management are discussed. The medicolegal aspects of the case are evaluated.

Sallami Satáa, Ben Rhouma Sami, Hmidi Mohamed, Chtourou Meher

Submitted March 20, 2012 - Accepted for Publication May 7, 2012

KEYWORDS: Kidney, congenital, renal pelvis, rupture, abdominal trauma, hemorrhage, retroperitoneal space

CORRESPONDENCE: Sallami Satáa, MD, La Rabta Hospital-University, Tunis, Tunisia (sataa_sallami@yahoo.fr)

CITATION: UroToday Int J. 2012 October;5(5):art 53. http://dx.doi.org/10.3834/uij.1944-5784.2012.10.12

ABSTRACT

Ureteric injury is a potential complication in various surgical procedures. The incidence varies between 0.5 and 10%. The risk of such complications is mainly related to the complexity of the surgical procedure and the presence of eventual periureteric pathology.

The most effective measure to prevent iatrogenic injury is to have a sound knowledge of abdominal and pelvic anatomy, meticulous surgical technique, and an identification of factors that increase the likelihood of developing such complications. As soon as the injury is identified, prompt urological referral is recommended.

We present a case of unusual ureteric stenosis and fistula after an open appendectomy.

Sallami Satáa

Submitted July 13, 2012 - Accepted for Publication July 23, 2012

KEYWORDS: Appendicitis, appendectomy, ureteric injury, stenosis, fistula

CORRESPONDENCE: Sallami Satáa, MD, La Rabta Hospital-University, Tunis, Tunisia (sataa_sallami@yahoo.fr)

CITATION:UroToday Int J. 2012 October;5(5):art 54. http://dx.doi.org/10.3834/uij.1944-5784.2012.10.13