Stokesharder1857

Conclusion To our knowledge, this 22-year-old retained stent is one of the oldest reported in the literature. As observed in our patient, multimodal endourologic techniques are safe and effective in patients with retained ureteral stents to render then stent and stone free.We report the case of a 49-year-old woman affected by bilateral urinary stones. Bilateral semirigid ureteroscopy was performed followed on the left side by a flexible ureteroscopy, caused by localization of the stone. Unfortunately, disinsertion of the left ureter occurred during the intervention. Open conversion was performed in the same single procedure for left ureteral reimplant. After an easy recovery, the patient was rehospitalized on day 9 postintervention for left pyelonephritis. This case report discusses the management of this rare but serious complication, including the necessity for quick thinking and decision making.Background Tamsulosin in a widely used drug in urology practice in treating lower urinary tract symptoms of benign prostatic hyperplasia, distal ureteral stones, and ureteral stent-related symptoms. Ischemic priapism is a rare but serious adverse effect of tamsulosin. We report two cases of tamsulosin-induced priapism and reviewed available literature citing priapism as a complication of tamsulosin. We also reviewed the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database to identify reported cases of tamsulosin-induced priapism. Case Presentation First patient was a 61-year-old African American male with paraplegia of 30-year duration. He developed priapism after taking first dose of tamsulosin for lower urinary tract symptoms. He presented with 18 hours of painful erection and was treated with aspiration and irrigation, followed by phenylephrine injection. The patient maintained potency after treatment. selleck chemical The second patient was a 24-year-old male who received tamsulosin in the emey for ureteral stone and stent-related symptoms.Background Pheochromocytoma is a rare cause of hypertension in pregnancy, which is often overlooked; especially in late pregnancy because of more prevalent pre-eclampsia. It has been associated with significant morbidity and mortality rates in both mother and fetus, if not diagnosed and treated in time. Minimally invasive surgery has been infrequently used for surgical management of pheochromocytoma in pregnancy, with less then 20 reported cases in English literature. Case Presentation A 26-year-old pregnant woman presented at 9 weeks of gestation with complaints of palpitations, sweating, and headache; with past history of first trimester spontaneous abortion caused by accelerated hypertension. She was found to have hypertension and diabetes, but no pedal edema, weight gain, or proteinuria. Ultrasonogram and MRI of abdomen revealed a left adrenal mass and 24 hours urinary catecholamines levels were increased, suggesting a pheochromocytoma. After preoperative optimization in consultations with obstetricians,rly diagnosis. Multidisciplinary coordination is required for effective management of this rare condition. Laparoscopic adrenalectomy is safe in second trimester of pregnancy for both mother and fetus.Background Management of renal calculi in a patient with kidney malrotation can be difficult because of complexity and alteration of collecting system anatomy. Pyelolithotomy, whether open, laparoscopic, or robotic, has been shown to be an effective method of stone removal in this patient population; however, it is not always ideal because of its invasiveness and increased morbidity. Ideally, a percutaneous approach may be less invasive, and if feasible, it can optimize patient safety and stone-free status. Case Presentation Here we present a case of a 68-year-old Caucasian female who presented with 2.7 cm stone in the renal pelvis of a severely malrotated left kidney, which was managed using a combination of fluoroscopy and ultrasound (US)-guided percutaneous nephrolithotomy. Conclusion US-guided access properly delineates the anatomic complexities of a severely malrotated kidney and permits safe percutaneous management of large stones. This is because fluoroscopic guidance alone may lead to inadvertent adjacent visceral organ trauma and increased risk of parenchymal and intrarenal vascular injury.Background There are many nonmalignant complications after urinary reconstruction. Anastomotic strictures and redundancy of an ileal chimney are such. A patient with both issues might necessitate an open surgical approach; yet endoscopic techniques are more attractive for these older frail patients. Case Presentation A 61-year-old woman with a history of bladder cancer who underwent radical cystectomy and neobladder creation now develops left hydronephrosis and a redundant ileal chimney with severe metabolic acidosis. She underwent endoscopic creation of a neochimneycystotomy. Conclusion The refinement of endoscopic techniques moves the field of surgery away from open surgery, which is beneficial for patients. This endoscopic technique treated the anastomotic stricture as well as redundant ileal chimney in a novel way that has not been reported previously in the literature.Background Appropriate surgical management of ureteral strictures is dependent on not only the etiology of the stricture but also its location and characteristics. Stricture length and location play a significant role in potential surgical options, yet accurate evaluation of these features is limited. We present a case of a complex ureteral stricture where employment of an endoscopic tool in a novel manner helped to better evaluate the patient and provide more precise counseling in the preoperative setting. Case Presentation A 65-year-old Caucasian man with a history of nephrolithiasis developed a complex ureteral stricture secondary to his calculus disease and prior instrumentation. His stricture was causing obstruction of his left collecting system and the patient was interested in a reconstructive procedure. We present a novel use for a pre-existing endoscopic tool that helped to more accurately delineate the characteristics of his ureteral stricture and improved preoperative planning. Conclusion Determination of precise stricture length and location is of utmost importance for preoperative patient counseling and surgical planning.