- Pelvic epidermoid cyst: A rare cause of lower urinary tract symptoms. [Journal Article]
- BCBMJ Case Rep 2018 May 18; 2018
- Pelvic retroperitoneum is a bizarre location of an epidermoid cyst and obstructive voiding caused by it even being stranger. Voiding symptoms related to such an abnormal location of cyst are extremel...
Pelvic retroperitoneum is a bizarre location of an epidermoid cyst and obstructive voiding caused by it even being stranger. Voiding symptoms related to such an abnormal location of cyst are extremely rare and literature that taps into such cases is scarce. We are presenting here a case of 26-year-old man who was presented with obstructive lower urinary tract symptoms and chronic constipation. On evaluation, he was found to have well-defined cyst in pelvic retroperitoneum. Complete excision of the cyst was done; histopathology confirmed it as an epidermoid cyst. His symptoms were completely relieved over a 12-month follow-up.
- Symptoms of Obstructive Sleep Apnea, Nasal Obstruction, and Enuresis in Children With Nonsyndromic Cleft Lip and Palate: A Prevalence Study. [Journal Article]
- CPCleft Palate Craniofac J 2018 Jan 01; :1055665618776074
- CONCLUSIONS: Children with nonsyndromic cleft lip and palate have high prevalence of nasal obstruction and enuresis and are at risk of OSA.
- Utility of ureteric jet: A simple yet useful tool for the evaluation of complex urogenital anomaly. [Journal Article]
- IJIndian J Radiol Imaging 2018 Jan-Mar; 28(1):45-48
- In infants and young children with suspicion of genitourinary tract anomalies, ultrasonography (USG) is usually the first imaging modality. Advantages of USG are well described. In the evaluation of ...
In infants and young children with suspicion of genitourinary tract anomalies, ultrasonography (USG) is usually the first imaging modality. Advantages of USG are well described. In the evaluation of complex congenital urogenital anomalies, ultrasound examination needs to be tailored according to the clinical suspicion and to yield maximum information. Primary megaureter is a congenital anomaly, which is associated with dilatation of ureter above an adynamic segment at the vesicoureteric junction (VUJ). Two different types are described in the literature: refluxing and obstructive. Absence of ureteric jet on USG in conjunction with vesicoureteric reflux (VUR) on voiding cystourethrogram (VCUG) prompts to the diagnosis of refluxing type of obstructed megaureter. Here we describe a case of duplex moiety with refluxing type of obstructed megaureter, where gray-scale USG and real-time color Doppler evaluation of the ureteric jet established the diagnosis. The aperistaltic segment of lower ureter near the VUJ with an absence of ureteric jet for the same moiety suggested the possibility of an obstructed megaureter. VUR was demonstrated on VCUG; thus, pointing toward a diagnosis of obstructed refluxing megaureter.
- Improving clinical outcomes for women with overactive bladder or urinary retention symptoms: a comparison of motor response voltages (1-9 V) during Stage 1 sacral neuromodulation. [Journal Article]
- BIBJU Int 2018 Apr 10
- CONCLUSIONS: Significant improvement was noted (up to 40%) in most clinical voiding parameters in the <3-V patients for both OAB and urinary retention. While <3 V will still statistically improve patient outcomes, a voltage <2 V may elicit self-reprogramming pain with severe bellows and plantar flexion movement, which may discourage patients from therapy adjustments. We recommend randomised, controlled trials to confirm these results.
- Electrical neuromodulation in the management of lower urinary tract dysfunction: evidence, experience and future prospects. [Review]
- TATher Adv Urol 2018; 10(5):165-173
- Lower urinary tract dysfunction (LUTD) is common and causes a spectrum of morbidity and decreased quality of life (QoL) for patients. LUTD can range from urinary retention to urge incontinence, and i...
Lower urinary tract dysfunction (LUTD) is common and causes a spectrum of morbidity and decreased quality of life (QoL) for patients. LUTD can range from urinary retention to urge incontinence, and includes a variety of syndromes, with the most common and widely recognized being overactive bladder (OAB). The classic treatments of LUTD and OAB comprise different strategies including behavioral therapies, medications and minimally invasive or invasive surgical procedures. Generally, once patients have tried behavioral modifications and oral medical therapy, and have not experienced adequate relief of their symptoms, the next step is to consider minimally invasive therapies. In the last two decades since FDA approval, sacral nerve stimulation (SNS) has become an accepted intervention, with increasing use and evidence of effectiveness for LUTD, specifically OAB and non-obstructive urinary retention. SNS has shown both objective and subjective improvement in voiding symptoms in several randomized controlled trials (RCTs) when compared to sham or standard medical therapy. The main limitations for more extensive use include relatively high cost, implantation of a device and possibly reoperation secondary to adverse events (AE). Percutaneous tibial nerve stimulation (PTNS) is a less invasive, less direct and less expensive method for neuromodulation, which has also shown effectiveness in several randomized and non-randomized trials, including comparable improvement rates to anticholinergics in OAB management. However, the efficacy of PTNS is only maintained for a short period after the stimulation is delivered. This technique has a much lower rate of AE compared to SNS, but with the inconvenience of weekly visits for stimulation, although implantable devices are on the horizon. In this article we review the mechanism of action, indications, effectiveness and complications related to SNS and PTNS therapy for LUTD.
- Large sliding inguino-scrotal hernia of the urinary bladder: A case report and literature review. [Case Reports]
- MMedicine (Baltimore) 2018; 97(13):e9998
- CONCLUSIONS: Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.
- Gross Total Resection of Chordoid Glioma of the Third Ventricle via Anterior Interhemispheric Transcallosal Transforaminal Approach at Two Stages. [Journal Article]
- JNJ Neurol Surg B Skull Base 2018; 79(Suppl 3):S281-S282
- Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been desc...
Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages. In this video, we present a case of retrochiasmatic anterior third ventricular tumor that was operated via anterior interhemispheric transcallosal transforaminal approach. The patient is a 42-year-old female who presented with sudden onset of severe headache and depressed level of consciousness. Computed tomography (CT) scan of the head showed a hemorrhage in the third ventricle and suprasellar cisterns. CT angiogram and magnetic resonance imaging (MRI) confirmed diagnosis of hemorrhagic mass lesion in the third ventricle. Upon further questioning of her family, we found out that she was having excessive urination and short-term memory problems for last 2 weeks. First, ventriculostomy was placed for obstructive hydrocephalus. She then underwent surgical resection via anterior interhemispheric transcallosal transforaminal approach. Foramen of Monro was enlarged by performing transchoroidal dissection. Using transforaminal route, tumor was resected. Due to the narrow surgical corridor and high vascularity of the tumor, decision was made to come back at a second stage. Using same surgical approach, in the second stage, gross total resection was performed. Postoperative MRI confirmed gross total resection. Histopathology was chordoid glioma of the third ventricle. She made excellent recovery with persistent diabetes insipidus. Currently, she is completing radiation therapy. In this video, we demonstrate techniques and pitfalls of anterior interhemispheric transcallosal approach to anterior third ventricular tumor. The link to the video can be found at: https://youtu.be/CI5c6Zup8sY .
- Pelvic floor ultrasound in the diagnosis of sling complications. [Journal Article]
- WJWorld J Urol 2018; 36(5):753-759
- CONCLUSIONS: Pelvic floor ultrasound has an emerging role in the assessment of complications following MUS surgery. 3D ultrasound can assist the clinician in assessment of the complex patient with multiple slings or meshes in situ.
- What's New in Rezūm? [Review]
- EUEur Urol Focus 2018 Mar 09
- Management of benign prostatic hyperplasia focuses on relief of lower urinary tract symptoms (LUTSs), improvement of quality of life, and prevention of symptom progression. Minimally invasive surgica...
Management of benign prostatic hyperplasia focuses on relief of lower urinary tract symptoms (LUTSs), improvement of quality of life, and prevention of symptom progression. Minimally invasive surgical treatments (MISTs) offer potential for rapid symptomatic relief, medication independence, and less perioperative risk. The Rezūm system is a novel MIST that uses water vapor thermal therapy to ablate obstructive prostate tissue. In this review, we summarize the data revealing that water vapor thermal therapy provides clinically meaningful, rapid, and durable relief of LUTSs in both storage and voiding functions while providing a minimal impact on sexual function.
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- Affective symptoms and quality of life in patients with voiding or storage dysfunction: Results before and after sacral neuromodulation: A prospective follow-up study. [Journal Article]
- NUNeurourol Urodyn 2018 Mar 05
- CONCLUSIONS: QoL and affective symptoms can significantly improve in LUTS patients who are successfully treated with SNM. When divided per indication, a significant improvement in affective symptoms together with QoL was only reported in successful OAB patients and not in successfully treated NOR patients.