A Rare Case of Bladder Perineurioma.

Perineuriomas are benign, rare neoplasms of the nerve sheath, basically in two forms: intraneural and extraneural. Extraneural forms are mainly found in the trunk and limbs, while visceral organs are rarely affected. To date, there have been no previous reports in the literature of bladder perineurioma. In this case, we report a young adult with hematuria and bladder tumor which after surgical resection and immunohistochemical study was confirmed to be a perineurioma. Therefore, this should be included in the differential diagnosis during the analysis of resections of bladder tumors.

Anti-fibrotic effect of mycophenolate mofetil on Peyronie's disease experimentally induced with TGF-ß.

The aim of the present study was to evaluate the histological, histochemical, and stereological changes caused by mycophenolate mofetil (MMF) on the tunica albuginea of rat penises submitted to an injection of transforming growth factor beta (TGF-ß) for the induction of Peyronie's disease (PD). Twenty adult male Wistar rats were divided into four groups: Control group; TGF-ß group (TGF-ß injection); MMF-7d group (treated with MMF 7 days after induction with TGF-ß); and MMF-30d group (treated with MMF 30 days after induction with TGF-ß). The steorological evaluation included the relative volume of different types of connective fibres of the tunica albuginea. The histochemical analysis revealed the fragmentation and degradation of elastin in the tunica albuginea. This process was partially reversed in the MMF-7d group and a situation very close to normality was observed in the MMF-30d group. In the collagen III/collagen I ratio it was observed increase in this ratio in the TGF-ß (59.4 ± 5.53) and MMF-7d (49 ± 18.2) groups and a decrease in the MMF-30d group (28.7 ± 4), approaching normality. The injection of TGF-ß promoted fibrotic alterations in the penile tunica albuginea in Wistar rats corresponding to PD. In this model, MMF acts as a regenerating anti-fibrotic agent.

Is hypogonadism the cause of penile self-amputation in a patient with prior testes self-mutilation?

INTRODUCTION: This paper presents a rare event of genital self-mutilation and few cases are reported in the literature. CASE DESCRIPTION: We report on a patient who performed partial self-penectomy 18 months after bilateral testicular amputation, as a form of self-mutilation. CONCLUSIONS: The main hypotheses to explain the recurrence of self-mutilation would be hypogonadism.

Inguinal hernia with ureter in patient with single kidney.

Inguinal hernias are a common disease in adults, but involvement of extraperitoneal structures is rare. This condition is usually asymptomatic and an incidental finding during the surgical correction of inguinal hernias, often resulting in iatrogenic damage. We present a rare case of left renal agenesis and right inguinal hernia, with the ureter being the only organ protruding as an inguinal hernia, diagnosed in the preoperative period.

Risk factors for acute renal failure in nephrectomized patients treated in a university hospital.

BACKGROUND: New surgical techniques for nephrectomy mainly related to early diagnosis made possible by advances in imaging studies have been developed in recent decades. However, postoperative renal dysfunction is a constant concern because of the major problems faced by healthcare services and by the patients themselves. To assess risk factors for developing acute renal failure (ARF) in patients submitted to nephrectomy in a university hospital. METHODS: Seventy-seven patients submitted to nephrectomy for benign and malignant diseases in a university hospital were evaluated in respect to preoperative and postoperative creatinine clearance. Demographic (gender, age), clinical (cancer, diabetes, high blood pressure, chronic kidney disease) and surgical (anesthesia time, open or laparoscopic surgery) variables were also analyzed. RESULTS: Of the 77 patients, 72 met the inclusion criteria. Of these, ten (13.8%) had a diagnosis of chronic renal failure (CRF), 30 (48%) had stage I ARF and one (16.1%) had stage II ARF. The anesthesia time, type of surgery (open or laparoscopy), total or partial nephrectomy, the side of the procedure, hypertension, diabetes, CRF, renal cancer, preoperative and postoperative creatinine concentrations were analyzed. Only the difference between preoperative and postoperative creatinine clearance was clinically significant (P<0.001). CONCLUSIONS: An altered preoperative renal function is a risk factor for the development of ARF in nephrectomized patients.

Clinical Treatment of Penile Fibrosis After Penoscrotal Lymphedema.

Genital lymphedema in men can affect the penis and/or scrotum, causing deformity and causing sexual limitations, social isolation, poor quality of life and recurrent subcutaneous infections due to difficulties in hygiene. There are few studies in the literature emphasizing the treatment of penile fibrosis after penoscrotal lymphedema. The purpose of this report is to describe a case of penile fibrosis treated using a new compression method.

Association of Hypertension With Erectile Function in Chronic Peripheral Arterial Insufficiency Patients.

BACKGROUND: Risk factors may influence the improvement or worsening of erectile dysfunction (ED). The aim of the current study was to evaluate the effect of systemic hypertension on ED in patients with peripheral arterial disease. METHODS: The effect of hypertension on ED was assessed in 125 consecutive patients in a cross-sectional quantitative study. The ages of the patients ranged from 19 to 88 years old (mean: 59.82 ± 10.48 years). The only exclusion criterion was the amputation of one or both legs. The ankle-arm index was assessed and the international index of ED questionnaire was applied to all participants in the study. RESULTS: Of the 125 patients, 22 (17.6%) had mild (grade 1), 50 (40.0%) had moderate (grade 2) and 53 (42.4%) had severe (grade 3) ED. Hypertensive patients have more ED, with ED in hypertensive patients being associated to chronic arterial disease. However, in comparison with normotensive patients, hypertension exerts an immediate protective effect on erectile function. CONCLUSIONS: In conclusion, although erectile function is initially protected by systemic arterial hypertension in patients with chronic arterial disease, both chronic arterial disease and ED deteriorate over the long term in hypertensive patients.

Incidental Diagnosis of Nonfunctional Bladder Paraganglioma.

Nonfunctional bladder paragangliomas may present clinical, radiology and pathological features similar to bladder cancer, so knowledge of this generally benign neuroendocrine neoplasm is of great importance to avoid misdiagnosis. We present the case of a patient with no clinical symptoms of paraganglioma and with radiological and cystoscopy examination results suggestive of urothelial carcinoma but with pathological diagnosis of paraganglioma.