scholarly journals Unexpected Small Urinary Bladder Pheochromocytoma: A Nonspecific Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Faouzi Mallat ◽  
Wissem Hmida ◽  
Adel Slama ◽  
Faouzi Mosbah
Keyword(s):  
Urinary Bladder ◽  
Transurethral Resection ◽  
Histopathological Examination ◽  
Hypertensive Crisis ◽  
Published Data ◽  
Radiologic Findings ◽  
Radiological Images ◽  
Laboratory Investigations ◽  
Physical Findings

Objectives. Pheochromocytoma of the urinary bladder is an extremely rare tumor that typically presents with a hypertensive crisis during micturition. Preoperatively, it may be misdiagnosed due to nonspecific symptomatology, physical, and radiologic findings.Method. We report a case of unsuspected small pheochromocytoma which was incidentally found by CT scan and confirmed by the histological aspects after transurethral resection in a 63-year-old woman. Here, we have described the clinical presentation, physical findings, laboratory investigations, and treatment provided in our case. We have also included radiological images and histopathology slides with input from both radiologists and pathologists. Surgical management and postoperative follow-up are discussed, as are details of previous published data.Results. After undergoing surgical treatment (transurethral resection), our patient is asymptomatic, with complete resolution of her pathology.Conclusion. Diagnosis is difficult before histopathological examination and should be considered in patients with no risk factors for usual bladder tumor. Our purpose is to raise clinician's awareness for this condition so that they will be more likely to diagnose it. This will facilitate prompt diagnosis and treatment and especially prevent complications due to pheochromocytoma which may be severe.

scholarly journals Nephrogenic Adenoma of the Urinary Bladder after Kidney Transplantation: Long-Term Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Iftikhar Khan ◽  
Mahmoud Obeid ◽  
Nasreen Hasan ◽  
Fayyad Jaradat ◽  
Bodhisatwa Sengupta ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Urinary Bladder ◽  
Histopathological Examination ◽  
Transitional Epithelium ◽  
Nephrogenic Adenoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
First Case

Nephrogenic adenoma is a rare lesion that consists of epithelial cells arranged in tubular form, resembling tubules in the renal medulla, and is found usually in the urinary bladder although it can occur anywhere in the transitional epithelium of the lower urinary tract. The first case of nephrogenic adenoma of the urinary bladder was reported before the first kidney transplantation, and the lesion has been reported in patients with and without renal transplantation. The origin of cells in nephrogenic adenoma is debated and has been postulated to arise from cells of embryonic origin or from metaplasia secondary to chronic irritation or from implantation of allograft cells in patients with kidney transplantation. The long-term outcome and potential to convert into malignancy are not established, and therefore, there are no recommendations on how to follow up these patients. We present a case of a patient who was found to have nephrogenic adenoma of the urinary bladder during his second kidney transplantation from a cadaveric donor. He had undergone living donor kidney transplantation previously which subsequently failed. The patient did not manifest any symptoms of nephrogenic adenoma. During a follow-up period of 5 years, he has not manifested any symptoms related to nephrogenic metaplasia. Histopathological examination 5 years after the second transplantation did not show any malignant change. It can be concluded that nephrogenic adenoma is likely to behave in benign fashion post kidney transplantation.

scholarly journals Spontaneous prostatic haematoma in a case of benign prostatic hyperplasia

2019 ◽  
Vol 12 (3) ◽  
pp. e228787
Author(s):  
Devanshu Bansal ◽  
Amlesh Seth
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Bladder ◽  
Urinary Retention ◽  
Transurethral Resection ◽  
Obstructive Uropathy ◽  
Prostatic Hyperplasia ◽  
Urinary Flow ◽  
Urethral Catheterisation ◽  
Definitive Surgery

A 61-year-old man presented with urinary retention with obstructive uropathy (urea/creatinine: 126/9.2 mg/dL) secondary to a large prostatic haematoma while being medically managed for benign enlargement of the prostate. The patient did not have any fever or local symptoms and the prostate was enlarged and non-tender on examination. Ultrasound and MRI of the pelvis showed a 9.4×10.4×11.1 cm sized prostatic haematoma seen displacing and compressing the urinary bladder anteriorly with bilateral hydroureteronephrosis. The patient was managed with per-urethral catheterisation, haemodialysis and injectable antibiotics. Percutaneous pigtail placement into the prostatic haematoma led to gradual drainage of the haematoma with improvement in the renal parameters. Definitive surgery in the form of transurethral resection of the prostate was done at a later date. Intraoperatively multiple encapsulated cavities containing organised clots were deroofed. On follow-up, the patient did well and had good urinary flow and normal renal parameters.

scholarly journals Inflammatory myofibroblastic tumor of the urinary bladder: treatment and a two-year monitoring - case report

2021 ◽  
Vol 74 (1-2) ◽  
pp. 41-44
Author(s):  
Stevan Stojanovic ◽  
Zarko Dimitric ◽  
Ivan Levakov ◽  
Mladen Popov ◽  
Sandra Trivunic-Dajko ◽  
...  
Keyword(s):  
Case Report ◽  
Urinary Bladder ◽  
Transurethral Resection ◽  
Inflammatory Myofibroblastic Tumor ◽  
Bladder Tumor ◽  
Inflammatory Pseudotumor ◽  
Histopathological Examination ◽  
Rare Case Report ◽  
Unpleasant Feeling ◽  
First Time

Introduction. Inflammatory myofibroblastic tumor of the bladder or inflammatory pseudotumor is benign in nature. It is also known as a pseudotumor, because it macroscopically mimics infiltrative tumors of the bladder. The first inflammatory pseudotumor ever described was found in the lungs. In the 80s of the last century, it was first described in the urinary bladder. Its etiology is unknown and the incidence is extremely rare. Case Report. We present a case of a 46-year-old man who came to the Emergency Center for the first time due to an unpleasant feeling when urinating, painless hematuria and appearance of blood clots during urination. An urgent diagnosis revealed a tumor mass in the bladder. Additional diagnostics and surgical treatment was performed by transurethral electroresection of the urinary bladder. After the histopathological examination, an inflammatory myofibroblastic tumor of the bladder was diagnosed. The patient was discharged on the third day of admission. On control examinations, the patient underwent only cystoscopy and ultrasonography. No recurrences were observed. Conclusion. A review of the available literature showed that in such cases, after transurethral resection of bladder tumor, most urologists opted for more radical surgical procedures. After a two-year follow-up, we proved that a tumor of the bladder can be kept under control after transurethral resection of bladder tumor, without recurrence, by regular monitoring using ultrasonography and cystoscopy.

scholarly journals Transurethral Resection for the Treatment of an Inflammatory Myofibroblastic Tumor of the Urinary Bladder: A Case Report

2019 ◽  
Vol 12 (2) ◽  
pp. 344-353
Author(s):  
Kamel Fadaak ◽  
Aali Al-Otaibi ◽  
Abdullah Al-Zahrani ◽  
Abdullah Alhaam ◽  
Omran Al-Dandan ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Transurethral Resection ◽  
Inflammatory Myofibroblastic Tumor ◽  
Bladder Tumor ◽  
Treatment Protocol ◽  
Complete Excision ◽  
Standardized Treatment ◽  
Inflammatory Myofibroblastic Tumors ◽  
Bladder Sparing

Inflammatory myofibroblastic tumors (IMT) of the urinary bladder is a remarkably rare bladder tumor. To this day, no standardized treatment protocol has been recognized. Here we report a case of bladder IMT in a 14-year-old girl presenting with urgency, frequency, and gross painless hematuria for a week. Complete excision of the bladder IMT was amenable with transurethral resection of bladder tumor (TURBT). Follow-up cystoscopy did not detect any recurrence. Minimally invasive bladder-sparing treatments are a valid option for treating IMT of the bladder.

Patients with “benign” Chiari I malformations require surgical decompression at a low rate

2019 ◽  
Vol 23 (4) ◽  
pp. 498-506 ◽  
Author(s):  
Tofey J. Leon ◽  
Elizabeth N. Kuhn ◽  
Anastasia A. Arynchyna ◽  
Burkely P. Smith ◽  
R. Shane Tubbs ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Multivariate Logistic Regression Analysis ◽  
Large Cohort ◽  
Initial Evaluation ◽  
Published Data ◽  
Posterior Fossa Decompression ◽  
Signal Abnormality ◽  
Chiari I

OBJECTIVEThere are sparse published data on the natural history of “benign” Chiari I malformation (CM-I)—i.e., Chiari with minimal or no symptoms at presentation and no imaging evidence of syrinx, hydrocephalus, or spinal cord signal abnormality. The purpose of this study was to review a large cohort of children with benign CM-I and to determine whether these children become symptomatic and require surgical treatment.METHODSPatients were identified from institutional outpatient records using International Classification of Diseases, 9th Revision, diagnosis codes for CM-I from 1996 to 2016. After review of the medical records, patients were excluded if they 1) did not have a diagnosis of CM-I, 2) were not evaluated by a neurosurgeon, 3) had previously undergone posterior fossa decompression, or 4) had imaging evidence of syringomyelia at their first appointment. To include only patients with benign Chiari (without syrinx or classic Chiari symptoms that could prompt immediate intervention), any patient who underwent decompression within 9 months of initial evaluation was excluded. After a detailed chart review, patients were excluded if they had classical Chiari malformation symptoms at presentation. The authors then determined what changes in the clinical picture prompted surgical treatment. Patients were excluded from the multivariate logistic regression analysis if they had missing data such as race and insurance; however, these patients were included in the overall survival analysis.RESULTSA total of 427 patients were included for analysis with a median follow-up duration of 25.5 months (range 0.17–179.1 months) after initial evaluation. Fifteen patients had surgery at a median time of 21.0 months (range 11.3–139.3 months) after initial evaluation. The most common indications for surgery were tussive headache in 5 (33.3%), syringomyelia in 5 (33.3%), and nontussive headache in 5 (33.3%). Using the Kaplan-Meier method, rate of freedom from posterior fossa decompression was 95.8%, 94.1%, and 93.1% at 3, 5, and 10 years, respectively.CONCLUSIONSAmong a large cohort of patients with benign CM-I, progression of imaging abnormalities or symptoms that warrant surgical treatment is infrequent. Therefore, these patients should be managed conservatively. However, clinical follow-up of such individuals is justified, as there is a low, but nonzero, rate of new symptom or syringomyelia development. Future analyses will determine whether imaging or clinical features present at initial evaluation are associated with progression and future need for treatment.

scholarly journals 99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S180
Author(s):  
Thana Khawcharoenporn ◽  
Pimjira Kanoktipakorn
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Extended Spectrum Beta Lactamase ◽  
Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

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