Severe Complications of Artificial Urinary Sphincter Placement in a Young Woman With Neurogenic Urinary Incontinence: A Case Report.

This article reports a case of a 40-year-old woman with a history of myelomeningocele and neurogenic urinary incontinence who developed erosion and fistula formation following the placement of an artificial urinary sphincter (AUS) when she was 18 years old. The patient had a long-standing history of urinary incontinence that was unresponsive to prior surgeries for meningomyelocele. She reported the loss of uro-fecal material from the vagina but did not seek further medical evaluation until the age of 40. Clinical examination revealed protruding tubes from the suprapubic region. The administration of a contrast agent through one of the two tubes led to the visualization of intestinal loops, and the administration of a contrast agent through the urethra confirmed the connection between the rectum, urinary bladder, and vagina. Due to the absence of reliable surgical history and in the absence of abdominal discomfort, bilateral nephrostomies were initially performed to prevent further uro-fecal material loss. The patient showed significant improvement, decided to not seek further evaluation and surgical treatment, and remained socially integrated during the follow-up period of 20 years. This case highlights the severe consequences of AUS placement in a young woman with neurogenic urinary incontinence and emphasizes the importance of proper patient selection and management in the presence of underlying neurological disorders.

A case report of urinary bladder carcinosarcoma and review of the literature.

Carcinosarcoma of the bladder is an unusual tumour characterized by a combination of malignant epithelial and soft tissue elements. Most of the reported cases have been case reports or small series. Optimal treatment is uncertain. We herein report our experience in such a case treated with transurethral resection followed by radiotherapy with adverse final outcome. Treatment of bladder carcinosarcomas should be aggressive and multimodal but optional treatment is still unknown. Radiotherapy alone is insufficient as a treatment option of these aggressive tumors.

Osteolytic bone destruction resulting from relapse of a testicular tumour 23 years after inguinal orchiectomy and adjuvant chemotherapy: a case report.

INTRODUCTION: Late relapse of a testicular germ cell tumour is an uncommon occurrence. We report a case of osteolytic bone metastasis appearing 23 years after the initial treatment of a metastatic testicular mixed tumour (choriocarcinoma and embryonal carcinoma). This is one of the longest periods of recurrence reported for testicular germ cell tumours. CASE PRESENTATION: A 52-year-old Caucasian man who underwent a right inguinal orchiectomy due to testicular tumour in 1984 presented to our outpatient clinic in a generally bad condition of health and with severe pain of his right hip joint and os ischii caused by osteolytic metastasis. CONCLUSIONS: This case emphasizes the need for a life-long follow-up of patients with primary metastatic testicular cancer.

Clinical usage of the squamous cell carcinoma antigen in patients with penile cancer.

BACKGROUND: We present our initial experience with the use of the squamous cell carcinoma (SCC) antigen (SCCAg) in 16 men with penile SCC (SCC group), in four men with condyloma acuminatum (benign group), and in 32 blood donors (control group). METHODS: The SCCAg levels were measured at presentation and every 6 months (upper limit was 2 ng/mL). The mean follow-up time was 4 years. RESULTS: All non-SCC patients had normal SSCAg serum levels in contrast with the SCC patients. The presence of nodal and/or distant metastases resulted in statistically significant higher SCCAg levels, both at presentation and during the follow-up. In patients undergoing lymph node dissection with elevated SCCAg levels prior to the procedure, there was a statistically significant decrease of the SCCAg levels after the operation. CONCLUSION: The SCCAg level could be a serum marker that holds promise for clinical use in penile SCC. Sequential monitoring of SCCAg level might indicate developing of nodal and/or distant metastases and could be useful in following the response to treatment.

Metanephric adenoma. A case report and a review of the literature.

Metanephric adenoma is an exceptionally infrequent tumor so far considered benign in nature. Its innocent characteristics are nowadays questionable because of the recently published cases of metastasizing tumors. We present diagnostic and therapeutic approach of such tumor in a 50-year-old woman and discuss about reviewed literature.