The Discovery of an S-shaped Kidney in a Patient With Prostate Cancer: A Rare Finding.

Crossed fused renal ectopia (CFRE) constitutes a rare congenital anomaly of the urinary tract, typically characterized by its predominantly asymptomatic nature and frequent incidental discovery. This case report delineates the clinical profile of a 56-year-old male admitted to our Prostate Cancer Outpatient Clinic due to elevated prostate-specific antigen (PSA) levels, ultimately leading to the diagnosis of prostate cancer. The patient was asymptomatic, with no family or surgical background. Notably, a fused ectopic kidney was incidentally identified during the staging process involving abdominal computed tomography (ACT) scanning. Remarkably, no additional abnormalities of the urinary tract or renal dysfunction manifested in this specific case. The significance of this report lies in the underscored emphasis on the importance of employing precise imaging techniques and tailored management strategies for patients harboring such anatomical variations.

Giant Scrotal Fibrolipoma.

Fibrolipoma, an infrequent histological subtype of lipoma, is considered a benign mesenchymal neoplasm. Fibrolipoma of the scrotum is an even more rare entity. We report a case of a 55-year-old male complaining for a slow-growing, painless mass in his left hemis-crotum. Imaging with ultrasonography and magnetic resonance imaging was inconclusive regarding the nature of the tumor and the tumor was excised, sparing the testis. The surgical specimen was a well-defined, yellowish white, solid, and firm mass, measuring 19.5×7×5 cm. There was no cytological atypia or mitosis and no lipoblasts recognized. On immunohistochemistry, MDM2 and CDK4 were not expressed. The histopathology report was fibrolipoma of the scrotum. To the best of our knowledge, this is only the fourth case of fibrolipoma originating from the scrotal components, spermatic cord or testis that has been reported in the English literature.

Conservative management of post-radical prostatectomy incontinence.

Radical prostatectomy is currently the mainstay of treatment for localized prostate cancer. Although there is evidence that the evolution in surgical technique with the introduction of laparoscopic and robot-assisted radical prostatectomy has resulted in an improvement of functional outcomes, a significant percentage of patients are still bothered by post-prostatectomy incontinence. However, the majority of patients will find improvement in their continence status from conservative measures and a small cohort will require more invasive therapeutic options. Conservative treatment includes pelvic floor muscle training with or without biofeedback techniques and pharmacotherapy. There is evidence that immediate initiation of physiotherapy after surgery will help in early restoration of continence, while additional benefit can be provided from pharmacotherapy mainly from duloxetine. The present review aims to provide an update on the epidemiology of post-prostatectomy incontinence, identify risk factors for incontinence after surgery and suggest current trends for conservative treatment.

Abordaje conservador de la incontinencia post-prostatectomía radical / Conservative management of post-radical prostatectomy incontinence

La prostatectomía radical es actualmente uno de los tratamientos estándar para el cáncer de próstata localizado. Aunque no existe evidencia de que la evolución en la técnica quirúrgica, con la introducción de la prostatectomía radical laparoscópica asistida por robot, haya dado lugar a una mejora en los resultados funcionales, un porcentaje significativo de pacientes padecen la secuela de la incontinencia posterior a la prostatectomía. Aún así, la mayoría de los pacientes encuentra mejoría en su estado de continencia con relación a las medidas conservadoras y una pequeña cohorte requerirá opciones terapéuticas más invasivas. El tratamiento conservador incluye rehabilitación muscular del suelo pélvico con o sin técnicas de “biofeedback” y farmacoterapia. Existen pruebas de que el inicio inmediato de la fisioterapia después de la cirugía ayudará en el restablecimiento precoz de la continencia, mientras que la farmacoterapia puede proporcionar un beneficio adicional, principalmente la duloxetina. La presente revisión tiene como objetivo proporcionar información actualizada sobre la epidemiología de la incontinencia post-prostatectomía, identificar los factores de riesgo de la incontinencia después de la cirugía y sugerir las tendencias actuales para el tratamiento conservador (AU)

Radical prostatectomy is currently the mainstay of treatment for localized prostate cancer. Although there is evidence that the evolution in surgical technique with the introduction of laparoscopic and robot-assisted radical prostatectomy has resulted in an improvement of functional outcomes, a significant percentage of patients are still bothered by post-prostatectomy incontinence. However, the majority of patients will find improvement in their continence status from conservative measures and a small cohort will require more invasive therapeutic options. Conservative treatment includes pelvic floor muscle training with or without biofeedback techniques and pharmacotherapy. There is evidence that immediate initiation of physiotherapy after surgery will help in early restoration of continence, while additional benefit can be provided from pharmacotherapy mainlyfrom duloxetine. The present review aims to provide an update on the epidemiology of post-prostatectomy incontinence, identify risk factors for incontinence after surgery and suggest current trends for conservative treatment (AU)

Mixed epithelial and stromal tumor of the kidney (MEST) simulating an upper tract TCC.

We present a rare and interesting case of a mixed epithelial and stromal tumour (MEST) of the kidney. The case is unique as it involves a male patient with no history of hormonal therapy presenting with a filling defect in the renal collecting system and positive urine cytology. The patient was diagnosed with transitional cell carcinoma of the renal pelvis and subjected to nephroureterectomy, which revealed a solid tumour arising from the lower calyces and extending into the renal pelvis and upper ureter. Pathology revealed a MEST. The patient was disease-free at the 6-month follow-up.