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INTRODUCTION AND IMPORTANCE: This case report describes the successful use of a latissimus dorsi muscle flap attached to the femoral vessels to cover a large mass loss in a 27-year-old woman with bladder exstrophy. The two-stage reconstruction showed excellent results six months after surgery. CASE PRESENTATION: A 27-year-old woman with bladder exstrophy and previous enterocystoplasty with Mitrofanoff-type urinary diversion combined with a late fascial flap presented 10 years later with disembowelment near the pubic symphysis. A two-stage reconstruction using a latissimus dorsi flap and polypropylene mesh was performed with excellent aesthetic and functional results. CLINICAL DISCUSSION: The latissimus dorsi muscle flap, described by J.M. Servant in 1984 as the "apple turnover" technique, is highly reliable for reconstructing large substance losses with minimal functional sequelae. The procedure in this case resulted in very satisfactory aesthetic and functional results at six months postoperatively. This approach provided a safe and effective technique of last resort. CONCLUSION: the two-stage latissimus dorsi flap technique was a reliable, safe and effective solution for this complex reconstructive challenge.
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INTRODUCTION: Dog bites are a common presentation in emergency departments. However, scrotal injuries with complete testicular avulsion are exceedingly rare. CASE PRESENTATION: We present a case of a dog bite to the scrotum with complete detachment of the testis and right hemiscrotum in an intoxicated 48-year-old man, who was treated with wound irrigation, debridement, antibiotic prophylaxis, tetanus and rabies vaccination, and a covering scrotoplasty. DISCUSSION: Testicular avulsion following a dog bite to the scrotum is a urologic emergency. Management requires a multidisciplinary approach to address bleeding control, testicular function preservation, infection prevention, and scrotal reconstruction. CONCLUSION: Dog bites to the scrotum can lead to serious and irreversible complications, underscoring the need for every urologist to be aware and prepared to manage such injuries.
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Although germ cell tumours can appear in childhood, they are most common around the age of 30. These tumours are highly responsive to chemotherapy, and even cases of relapse have relatively high cure rates. There is limited literature on patients diagnosed after the age of 50, and no specific trials have been carried out in this context. These patients, considered 'elderly', are treated with the same cisplatin-containing combinations as younger patients, despite the higher toxicity. This report presents an observation of a giant testicular mixed germ cell tumour discovered in a 75-year-old patient.
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Bladder injuries, although rare, can occur as a complication of hip surgery, particularly when a hip prosthesis migrates into the bladder. We present the case of a 75-year-old woman with a bladder rupture secondary to prosthesis migration requiring repair via a transvesical approach. While total hip arthroplasty (THA) is common, intrapelvic complications such as bladder injury are less commonly reported. Early recognition and appropriate treatment are essential to avoid serious consequences. The management of prosthesis migration into the bladder is complex and requires detailed anatomical knowledge. Awareness of this potential complication is essential for both orthopaedic surgeons and urologists.
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An intravesical ureterocele is a rare condition in which a terminal ureter terminates in a cystic dilation of the bladder. We present the case of a 42-year-old female who presented with irritative lower urinary tract symptoms and left lower back pain. Computed tomography (CT) urography revealed ureteral duplication with a ureterocele complicated by upper tract obstruction. Treatment involved endoscopic ureterocelotomy, which successfully relieved symptoms and resolved renal obstruction.
