1/7. Bladder outflow obstruction caused by prostate metastasis in a young male.A 38-year-old male patient presented with symptoms of bladder outflow obstruction. Rectal palpation revealed a giant prostate. Sonography only confirmed the enlarged prostate. magnetic resonance imaging showed, on both T1- and T2-weighted sequences, a large, inhomogenously hypointense, encapsulated prostate tumor encompassing the entire prostate. No capsular penetration or seminal vesicle invasion was seen. Transurethral biopsy of the prostate was performed. histology demonstrated a prostate metastasis of colorectal carcinoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/7. Giant stercoral stone and catheterization difficulty.An unusual case of giant calcification in the midline of the pelvis is reported herein. An 84-year-old male, whose urination was managed by clean intermittent self-catheterization (CIC), presented with catheter insertion difficulty. The patient had a history of transurethral operations for benign prostatic hyperplasia and small bladder stones. kidney, ureter and bladder (KUB) X-ray of post-enhanced computed tomography (CT) suggested a giant ball-shaped calcification in the bladder. A recurrent bladder stone was suspected. However, pelvic CT scan revealed that the giant calcification was, in fact, situated in the rectum. Thus, a diagnosis of giant stercoral stone was made. After the stone was removed manually, the patient had no difficulty in inserting the catheter. His prior complaint may have been caused by urethral bladder neck obstruction due to the giant stercoral stone.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
3/7. Intraoperative catheter management during laparoscopic excision of a giant bladder diverticulum.BACKGROUND: Massive bladder diverticula present a technical challenge to the laparoscopic surgeon. We describe a laparoscopic approach to transperitoneal diverticulectomy, using a specific catheter arrangement to allow excellent control of the various portions of the procedure. methods: A 49-year-old male with longstanding frequency was diagnosed with a 1000 cc bladder diverticulum and bladder neck outlet obstruction. Laparoscopic transperitoneal diverticulectomy was performed using a triple catheter arrangement: endoscopic placement of a Councill catheter in the diverticulum, fluoroscopic positioning of an occlusion balloon catheter in the renal pelvis, and placement of a Cope loop suprapubic tube. Additionally, a transurethral incision of the prostate was performed. RESULTS: The procedure was completed laparoscopically using a four port transperitoneal approach. During the procedure, the diverticulum could be filled and emptied as needed; the catheter across the diverticular neck facilitated subsequent closure of the bladder wall defect. The diverticulum was completely excised. The remaining defect in the bladder was then closed in 2 layers. The patient was discharged on postoperative day 3. CONCLUSION: Careful planning and arrangement of catheters in the bladder, ureter, and diverticulum facilitates laparoscopic transperitoneal diverticulectomy of even a very large volume diverticulum.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
4/7. Haemorrhagic papillary cystadenoma of the seminal vesicle mimicking giant seminal vesicle cyst: MRI appearances.Papillary cystadenoma of the seminal vesicle is very rare. We describe such a case presenting in a 58 year old man with bladder outlet obstruction. Investigations included magnetic resonance imaging (MRI), the usefulness of which in pre-operative diagnosis is highlighted in this case. Seminal vesicle cysts can usually be identified by conventional radiological imaging techniques such as ultrasound and computed tomography; however, identification would be difficult if the cyst is very large, causing distortion of the adjacent anatomy. In such cases, MRI, through coronal and sagittal scanning, can be helpful in localising the lesion, as in this patient. The precise pathological nature of the cyst can only be confirmed by biopsy.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
5/7. Giant urinary bladder calculi.Four patients with giant urinary bladder calculi are presented. All were males with bladder outflow obstruction. The literature on the subject is reviewed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/7. Bladder outlet obstruction after multiple periurethral polytetrafluoroethylene injections.Periurethral polytetrafluoroethylene (Teflon) injections have been reported to be successful for the treatment of urinary incontinence after transurethral resection or radical prostatectomy. However, the use of polytetrafluoroethylene is controversial due to reports of distant migration and granulomatous reaction after periurethral injection. We report on a patient with a history of periurethral polytetrafluoroethylene injection for postoperative stress incontinence in whom bladder outlet obstruction developed and who underwent repeat transurethral resection 9 years later. Pathological examination revealed that the material responsible for the obstruction was almost totally composed of a foreign body giant cell response to the polytetrafluoroethylene implant ("teflonoma").- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/7. Giant hydronephrosis--a diagnostic dilemma.We report a complex case in which the left kidney had undergone giant hydronephrotic change after chronic obstruction at the vesicoureteric junction. Minor blunt abdominal trauma caused rupture of the parenchyma of this expanded and dilated kidney, with bleeding into its collecting system. The mixture of blood and urine remained contained within the kidney's structural layers, so producing a tense, cystic, fluid-filled mass arising from the left hypochondrium. Pathogenesis, differential diagnosis and investigation of giant hydronephrosis and its rupture are discussed. The observation is made that gross distortion of the renal parenchyma by rupture or hydronephrosis impairs arterial inflow to the kidney.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |