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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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INTRODUCTION: Renal pelvis bifidity, ectopic pelvic kidney, and ureteropelvic junction obstruction are rare urinary tract anomalies resulting from embryological developmental variations. Their coexistence in one kidney is exceedingly uncommon. CASE PRESENTATION: An 18-year-old male with no prior medical history presented with right-sided lumbar pain. A CT scan revealed bilateral hydronephrosis, with the left kidney being malrotated and ectopically positioned in the pelvis. Dynamic renal scintigraphy confirmed bilateral ureteropelvic junction obstruction. Surgical management involved laparoscopic pyeloplasty for the right UPJ and open surgery for the left ectopic kidney with bifid pelvis. DISCUSSION: The combination of pelvic kidney, renal pelvis bifidity, and bilateral ureteropelvic junction obstruction is exceptionally rare. Diagnosis often occurs incidentally or when symptoms related to these anomalies emerge. Imaging and dynamic renal scintigraphy play crucial roles in diagnosis. Individualized surgical management is essential for positive outcomes. CONCLUSION: This case highlights the need for individualized management in complex urological cases involving rare anatomical variations. Surgeon experience and a comprehensive understanding of such anomalies are crucial for successful outcomes.
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Chronic pelvic pain syndrome (CPPS) in men is a complex pathological entity with a delicate nosological diagnosis and multiple etiological hypotheses dominated by urological causes. The Müllerian cyst has an embryological origin and is part of an organic anomaly of the male urogenital tract, incidentally detected during an initial infertility examination or in the presence of non-specific urinary symptoms. By its mass effect, it puts tension on the pelvic floor muscles and induces a stimulation of nerves which could explain its implication in the CPPS. Through this case report and literature review, we will clarify the etiopathogenesis and the diagnosis of CPPS as well as the approach to follow for better therapeutic management.
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Urethral caruncle is a rare condition. Although relatively common in postmenopausal women, its occurrence after a urological endoscopic procedure is unusual. Here, we report the case of a postmenopausal woman who presented with a symptomatic urethral caruncle two weeks after a ureteroscopy for a right ureteral calculus. Treatment consisted of surgical excision of the mass after the failure of local estrogen application, and the postoperative aesthetic and functional result was satisfactory. Through a review of the literature, the etiological, diagnostic, and therapeutic aspects of this pathology will be discussed.
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Introduction: Primary diffuse large B-cell lymphoma (DLBCL) of the female urethra is a highly uncommon malignancy. Case report: A 78-year-old woman presents with urethrorrhagia and dysuria. Clinical examination revealed a protruding mass at the urethral meatus, accompanied by bilateral inguinal adenopathies. Imaging studies confirmed the presence of a 2.2 cm mass and widespread adenopathies. Treatment involved surgical removal and adjuvant systemic chemotherapy with a favorable six-month follow-up outcome. Conclusion: Our case report aims to raise awareness of this rare disease. Early diagnosis and treatment may improve the patient survival.
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Priapism is a rare condition in paediatrics. Although its association with scorpion envenomation has been documented, cases involving an associated penile haematoma are extremely rare. To the best of our knowledge, we hereby present the first documented case of this unique association in a nine-year-old boy following a scorpion sting. The purpose of this observation is to discuss the diagnostic difficulties, management strategies, and possible mechanisms associated with this unusual manifestation, and to highlight the importance of prompt recognition and appropriate management of priapism and penile haematoma in children, particularly those living in areas where scorpion stings are endemic.
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Spontaneous hematoma of the iliopsoas is a rare pathological circumstance; in the majority of cases published in the literature, it is associated with disorders of hemostasis due to anticoagulant treatment or coagulopathies. We present a case of a 64-year-old man on acenocoumarol, an anticoagulant of the vitamin K antagonist family, for atrial fibrillation, who presented with a severe left hip and flank pain with a huge ecchymosis on the left flank and a partial inability to extend the left thigh. A CT scan confirmed the diagnosis of iliopsoas hematoma. Given the hemodynamic stability of the patient, he benefited from a conservative treatment with a favourable evolution. This case highlights the underlying conditions, diagnosis, and treatment of this uncommon complication.
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Penile abscesses are rare and mainly interest the corpora cavernosa or soft tissue of the external genitalia, while involvement of the corpus spongiosum is unusual, with only a few cases published in the literature. We report the case of an abscess of the corpus spongiosum secondary to a documented urinary tract infection in a young immunocompetent patient with no particular pathological history. To our knowledge this is the first case reported in this context.
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Penile self-mutilation is a challenging situation that often jeopardizes sexual and voiding functions. Surgical treatment is currently based on penile replantation, nevertheless its requirements of time, conservation, and quality of amputated phallus and microsurgical expertise are not constantly available. Here, we present a case of penile self-inflicted amputation in a 28-years-old patient suffering from a psychotic disorder, who did not preserve the amputated phallus. In the first clinical examination, we have attested a hemorrhagic total penile section, 6cm from the penoscrotal angle. We performed immediate surgical management. Rudy and Borden technique is a reconstructive surgery procedure with interesting functional results, by performing a dorsal vascularized split-thickness skin flap to cover the penile shaft. The aim of this technique is to avoid perineostomy which compounds significantly the quality of life.
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Pene/lesiones , Procedimientos de Cirugía Plástica/métodos , Trastornos Psicóticos/psicología , Automutilación/psicología , Adulto , Humanos , Masculino , Pene/cirugía , SíndromeRESUMEN
We here report the case of a 75 year old patient, with lower urinary tract obstructive syndrome such as dysuria, nocturnal pollakiuria and dribbling. Clinical examination showed good general condition by examining the rectum with the finger, soft, painless prostate increased in volume with obliteration of the median sulcus. PSA level was 2,1ng/ml, prostatic weight was 240 g on ultrasound. The patient underwent surgery: transvesical adenomectomy with extraction of a giant adenoma weighing 246 g. Histologic examination showed adenomyofibroma.
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Adenoma/diagnóstico , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico , Adenoma/cirugía , Anciano , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Neoplasias de la Próstata/cirugíaRESUMEN
Scrotales fistulas are rare and often represent secondary lesions of tuberculosis. Mucinous adenocarcinomas are tumors containing at least 50% of extracellular mucus. They occur most commonly in the rectosigmoid; scrotal location is rare. We report the case of a 54-year old patient, with no particular past medical history, with secondary mucinous adenocarcinoma of the scrotum revealed by scrotal fistulas. The patient had suffered from recurrent scrotal fistulas for two years, with no other associated signs. Clinical examination showed multiple scrotal fistulas with discharge of thick pus. Rectal examination was normal. Urological examinations (IVU, UCRM, cystoscopy, ) were normal, the assessment of infectious diseases as well as the detection of BK virus in urine and sputum were negative. Biopsy of sample of scrotal tissue was in favor of moderately differentiated mucinous adenocarcinoma. Immunohistochemical examination was in favor of primary colorectal cancer. Patient's evolution was marked by the occurrence of complex anal fistulas, which appeared on MRI as active, supplying several pelvic peritoneal collections resulting in fleshy buds. There is no consensus on the therapeutic approach due to the rarity of this cancer. Surgical resection is the treatment of choice for this disease. Preoperative chemotherapy and radiation therapy are recommended for this type of cancer, but their role is not well established. The patient underwent primary neoadjuvant chemotherapy and radiation therapy, before abdominoperineal excision.
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Adenocarcinoma Mucinoso/diagnóstico , Fístula/patología , Neoplasias de los Genitales Masculinos/diagnóstico , Escroto/patología , Adenocarcinoma Mucinoso/patología , Adenocarcinoma Mucinoso/terapia , Neoplasias de los Genitales Masculinos/patología , Neoplasias de los Genitales Masculinos/terapia , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana EdadAsunto(s)
Hematuria/etiología , Papiloma Invertido/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Papiloma Invertido/patología , Papiloma Invertido/terapia , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
Schwannoma is usually a benign tumor of nervous origin arising from Schwann sheath cells. It is an extremely rare tumour because of its low incidence and its retrovescical localization. Histological and immunohistochemical examinations confirm the histological type as well as the benign or malignant origin of schwannoma. Because of the risk of recurrence and malignant transformation, excision must be complete. We report the case of a 39 years old patient, hospitalized for chronic pelvic pain accompanied by a sensation of heaviness, lower urinary tract irritation and urinary hesitancy. Diagnostic imaging (ultrasound, CT scan, MRI) of the pelvis showed a left-lateralized retrovescical mass with a thin wall, measuring 68x70x70 mm exerting mass effect on the bladder and the sigmoid. The surgical procedure, a midline laparotomy, allowed the removal of a well encapsulated retrovesical mass. Histological and immunohistochemical examinations concluded to a benign schwannoma. Recidivism and malignant transformation, although rare after surgery, impose postoperative clinical monitoring and annual CT scanning.