Cases reported "Urination Disorders"

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1/41. Neurogenic bladder dysfunction due to Behcet's disease.

    BACKGROUND: Behcet's disease is a chronic multisystem condition of unknown origin. Genitourinary tract involvement with genital apthous ulcers, epididymitis, urethritis and recurrent cystitis is encountered commonly. Neurogenic bladder dysfunction due to neural involvement of the syndrome, has been reported extremely rarely. methods: A case of neurogenic bladder dysfunction due to Behcet's disease is presented. The patient was 17-year-old young male with a long history of the disease and neurological affection, but with neglected lower urinary tract symptoms and urinary incontinence. The patient was diagnosed urodynamically to have hyperreflexic detrusor. RESULTS/DISCUSSION: After failure of medical treatment (oxybutynin chloride) the patient submitted to augmentation clam-type sigmoidocystoplasty. Four years postoperatively, the patient is dry, on clean intermittent self catheterization twice daily and he is practically asymptomatic from lower urinary tract symptoms.
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keywords = operative
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2/41. Lumbar herniated disc presenting with cauda equina syndrome. Long-term follow-up of four cases.

    BACKGROUND: cauda equina syndrome is a relatively rare presenting symptom of lumbar herniated discs. Early operative decompression is advocated, but it may not always restore the bladder function. In such cases, knowing the long-term outcome of bladder or sphincter disturbances is quite useful in planning the management of these patients. methods: hospital records of patients operated on for lumbar herniated discs were reviewed. charts and imaging studies of those patients who presented with classic cauda equina syndrome were analyzed. RESULTS: There were 4 patients (2.8%) of 144 consecutive surgical series of lumbar disc herniation, whose presenting symptom was classic cauda equina syndrome. Postoperatively, the patients had been followed at the clinic for a mean period of 6.4 years. Certain characteristic findings were noted on patients' neurological and radiological examinations. Although the recovery process of bladder function was very slow, taking months to years, all four patients achieved almost normal voiding with no major impairment of daily activities. CONCLUSIONS: Even if short-term recovery of bladder function is poor after lumbar disc surgery for cauda equina syndrome, the long-term outcome is not necessarily so. We should follow up on these patients with such measures as intermittent self-catheterization and drug therapy, expecting slow but steady recovery of bladder and sphincter function.
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ranking = 2
keywords = operative
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3/41. Neuropathic pain syndrome as an occult manifestation of injury of the spinal cord after surgical repair of aortic coarctation.

    Injury to the spinal cord injury with paraplegia, is a rare complication of surgical repair of aortic coarctation recognized immediately post-operatively. We present the case of a 41-year-old male undergoing surgery for restenosis at the site of a repair. Intra-operatively, he suffered inadvertent injury to an intercostal arterial branch during isolation of the aorta below the graft. Over the following months, he developed unusual symptoms involving the legs and genitourinary tract which, only after extensive investigations, were attributed to ischemic damage to the spinal cord related to the surgery. We suspect that similar syndromes reflecting injury to the spinal cord injury may be unrecognized following surgical repair of coarctation.
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ranking = 2
keywords = operative
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4/41. Congenital urethrocutaneous fistula.

    BACKGROUND: A 3-year-old boy visited our hospital for aberrance of urination. He had a fistula on his ventral penile shaft. Our diagnosis was congenital urethrocutaneous fistula. methods/RESULTS: We performed one-stage repair transverse preputial onlay island flap urethroplasty. Postoperatively, the patient was voiding comfortably with no recurrence of fistula. CONCLUSIONS: Congenital urethrocutaneous fistula is rare. Eighteen cases of congenital urethrocutaneous fistula have been reported previously. We consider the etiology of congenital urethrocutaneous fistula as a deficiency of the urethral plate and fusion of urethral folds.
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ranking = 1
keywords = operative
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5/41. Pelvic neurilemmoma.

    A case of a 37-year-old man admitted to our Department of internal medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of oscillating hypertension prior to admission, however, with no major subjective complaints, except for pollakisuria. Clinical and biochemical assessment revealed no damage to target organs. Laboratory parameters showed normal values, except for hyperlipidemia. On routine ultrasonography of the pelvis confirmed a pelvic tumor of uncertain etiology, with no abdominal lymph node enlargement. No signs of metastasis were found. The patient was transferred to the Department of Surgery, where the tumor was removed in toto. Histopathologic analysis of the tumor, 11 x 8 x 8 cm in size, composed of cellular and mixoid areas with traces of collagenous connective tissue, necrosis, and tiny calcifications with scattered palisading nuclei and Verocay bodies, pointed to the diagnosis of a benign tumor, i.e. neurilemmoma. Postoperatively, the patient's subjective state was excellent, with normal blood pressure values, and without pollakisuria. A very large space-occupying lesion was responsible for compression of the neighboring organs, especially urinary bladder, resulting in pollakisuria. To our knowledge, pelvic localization of neurilemmoma, particularly a large one, is rare.
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ranking = 1
keywords = operative
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6/41. Recording the bladder electromyogram for bladder activity evaluation during post-operative urinary urgency.

    When the intravesical pressure cannot be measured because of continuous drainage, bladder electromyography is an alternative means of evaluating the functional condition of the urinary bladder. However, many problems that accompany this procedure have not been solved. In the present study we tried bladder electromyography with a newly-developed carbon fiber electrode in a patient who underwent an open prostatectomy. It was helpful in recognizing the relationship between urinary urgency and the spasmic activity of the vesicular detrusor muscle.
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ranking = 4
keywords = operative
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7/41. Benign retroperitoneal schwannoma: a case series and review of the literature.

    OBJECTIVES: To present our experience with four retroperitoneal schwannomas treated by surgical excision and review the current literature. Retroperitoneal schwannomas are rare, benign tumors and infrequently present to the urologist. methods: From 1997 through 2002, the charts of 164 patients with a diagnosis of benign retroperitoneal soft tissue mass were reviewed. Of those, four had a pathologic diagnosis of retroperitoneal schwannoma. RESULTS: Three of the 4 patients were women, with a median age of 54 years (range 46 to 80). The average tumor size was 13.7 cm (range 8.8 to 20). All patients underwent magnetic resonance imaging, computed tomography, or ultrasonography, and 3 of the 4 patients underwent a computed tomography-guided fine needle aspiration biopsy (all were either inaccurate or inconclusive). All patients underwent complete tumor excision with free margins of resection and tolerated surgery without any complications. None of the patients have had any evidence of recurrence at a mean follow-up of 26 months (range 10 to 48). CONCLUSIONS: Retroperitoneal schwannomas are difficult to diagnose preoperatively. Computed tomography-guided fine needle aspiration biopsy does not appear to provide an accurate preoperative diagnosis. The surgical approach should focus on complete excision of the mass. patients undergoing complete surgical resection tend to do well without evidence of early recurrence.
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ranking = 2
keywords = operative
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8/41. Crush cytology of Rosai-Dorfman disease of the central nervous system. A report of 2 cases.

    BACKGROUND: Rosai-Dorfman disease (RDD) of the central nervous system (CNS) is rare. There is no previous report on intraoperative crush cytology of this disorder. CASES: A 70-year-old man presented with headache and was found to have 2 intracranial extraaxial masses. A 62-year-old man presented with cauda equina syndrome secondary to a mass lesion in the sacral canal. The crush smears, prepared intraoperatively from a small portion of the biopsy specimen in each case, showed scattered lymphoid aggregates in a lighter background with a loose admixture of lymphocytes, plasma cells, usual histiocytes and RDD histiocytes. The RDD histiocytes contained single but sometimes multiple nuclei that were larger and more hyperchromatic than those of the usual histiocytes. Many RDD histiocytes had voluminous, pale pink cytoplasm. Lymphophagocytosis by RDD histiocytes was observed. The findings in the crush smears reflected the histology of the lesions. The lymphophagocytosis and nuclear details in the RDD histiocytes were more visible in the crush smears than in the frozen sections. CONCLUSION: Crush cytology appears useful, alone or in conjunction with frozen sections, in the intraoperative diagnosis of CNS RDD.
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ranking = 3
keywords = operative
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9/41. Splenic lymphangioma and presentation with frequent urination: a case report.

    lymphangioma of the spleen is a rare disorder with a clinical manifestation ranging from incidental findings of an abdominal mass to symptomatic abdominal pain. The authors reported a case of splenic lymphangioma with the presenting symptom of frequent urination in a 9-year-old boy. A large firm mass was found at the left upper quadrant, 12 cm in diameter. The diagnosis was confirmed by ultrasonography and computerized tomographic (CT) scan. The symptoms of frequent urination disappeared after operative splenectomy. No evidence of recurrence occurred over a 3-year follow-up.
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ranking = 1
keywords = operative
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10/41. Ultrasound diagnosis of intra-urethral tension-free vaginal tape (TVT) position as a cause of postoperative voiding dysfunction and retropubic pain.

    Intra-urethral Prolene tape erosion is a rare postoperative complication of tension-free vaginal tape (TVT) plasty. In cases reported in the literature, intra-urethral tape positioning has been diagnosed by urethroscopy as late as 3-12 months after the procedure. Introital ultrasound using a vaginal sector scanner allows for the non-invasive assessment of the position of the Prolene tape in relation to the urethra. Postoperative introital ultrasound might shorten the interval between surgery and the time of diagnosis of an intra-urethrally placed tape and thus significantly shorten the duration of symptoms. We present a patient with urethral pain syndrome and dysuria following TVT plasty. In this case, introital ultrasound was not performed until 8 months after surgery, when it demonstrated intra-urethral Prolene tape positioning as the cause of the patient's complaints. All symptoms disappeared after surgical removal of the intra-urethrally placed parts of the tape. The patient is continent, suggesting that the remaining para-urethral portions of the Prolene tape depicted sonographically ensured adequate stabilization of the mid-urethra in this case. The case report emphasizes the role of introital ultrasound in assessing Prolene tape position relative to the urethra on sagittal and transverse angulated views in the postoperative diagnostic evaluation of functional disturbances occurring after TVT plasty.
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ranking = 7
keywords = operative
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