Demetrios Radopoulos

Bilateral synchronous occurrence of three different histological types of renal tumor: a case report

IntroductionRenal cell carcinomas account for 85% of all renal neoplasms. With the introduction of modern imaging modalities, there has been an increased diagnosis of renal tumors. Recent studies have shown that partial nephrectomy can be as safe as radical nephrectomy for smaller renal tumors. Renal cell carcinomas are usually unilateral, however, they can be bilateral in 2% to 4% of sporadic cases and considerably more common in familial cases.Case presentationIn this case report, we describe an unusual case of two bilateral synchronous chromophobe renal cell carcinomas accompanied by an oncocytoma and an angiomyolipoma, that were all treated by open partial nephrectomy.ConclusionsTo the best of our knowledge, this is the first case report on the synchronous occurrence of bilateral chromophobe renal cell carcinomas associated with an oncocytoma and an angiomyolipoma.

Unilateral urinothorax can occur contralateral to the affected kidney

Abstract Urinothorax is a rare cause of transudative pleural effusion with biochemical characteristics of urine, usually secondary to obstructive uropathy. Urine usually moves into the pleural space from the retroperitoneal or peritoneal space via diaphragmatic lymphatics or an anatomical diaphragm defect. A total of approximately 70 cases have been previously described in the literature, and in the vast majority of cases urinothorax is unilateral and ipsilateral to the side of obstructive uropathy, trauma or malignancy. This report describes a rare case of unilateral urinothorax occurring contralateral to the side of obstruction.

A rare case of renal oncocytoma associated with erythrocytosis: case report

BackgroundOncocytomas are benign tumors of the kidney that are usually diagnosed postoperatively due to differential diagnostic problems from renal cell carcinoma. Although the latter are neoplasms that have been associated with erythrocytosis in 3.5% of cases, there are no reports in the literature about a similar occurrence in oncocytomas.Case presentationIn this case report we present a unique case of a right lower pole oncocytoma associated with erythrocytosis. Erythrocytosis subsided after partial nephrectomy.ConclusionErythrocytosis can sometimes occur in association with renal oncocytomas.

Solitary multilocular cystic renal cell carcinoma in adults: Diagnostic problems, pathological features and treatment

Multilocular cystic renal cell carcinoma represents a rare clinical entity in adults. This report describes the authors’ experience with seven tumours, including the first two tumours in the literature diagnosed during pregnancy.

Application of Dorsal Preputial Island Flap in Meatoplasty

Introduction and Objectives: Meatal stenosis usually presents in adults with a history of urethral trauma or inflammation or as a complication after hypospadias repair. The objective of this study is to present the correction of meatal stenosis using a preputial island flap, created on the dorsal surface of the penis. Methods: During the last 3 years 12 patients were subjected to meatoplasty using a preputial flap. A meatotomy was performed and a preputial island flap was raised on the dorsal surface of the penis, that was brought to the ventral surface and anastomosed to the opened fossa navicularis. Results: Mean follow-up is 22.3 (range 6–40) months and urethral meatus remains normal with good caliber in routine examination mainly with dilators and uroflowmetry. Conclusions: The described method was based on the on-lay preputial island flap procedure (Duckett’s method) for correction of anterior hypospadias. The cosmetic result is excellent and normal penile morphology and function are well preserved.

Assessment of Obstruction in Adult Ureterocele by Means of Color Doppler Duplex Sonography

Aim: The purpose of this study is to present a method for identifying a ureteral obstruction in unilateral orthotopic ureterocele by means of conventional sonography and color Doppler duplex sonography. We focus on the measurement of the ureterocele dimensions, the degree of dilation it causes to the ipsilateral upper urinary tract, the registration of urine out-flow from the ureteral orifice into the bladder and its spectral analysis. Material and Method: Over 2 years at our institutions, 8 adult patients (7 women, 1 man) were diagnosed as having a single system orthotopic ureterocele. Four of them presented with lumbar pain, dysuria and recurrent urinary tract infections, while the remainder were asymptomatic and diagnosed accidentally. The diagnosis was based on serial sonography of the upper and lower urinary tract confirmed by intravenous pyelography and cystoscopy. We also performed color Doppler duplex sonographic evaluation of the urine jets ejected from both ureteral orifices into the bladder. Using the flow spectral study we analyzed the waveforms and measured their duration and flow rate. The study was completed with a comparative analysis of the data obtained from both ureteral orifices. Results: Cystic dilation of the lower ureteric extremity into the bladder was presented in all cases. Upper urinary tract dilation, of various grades, was present in 4 of 8 patients. Differences in urine jets between those derived from the ureterocele and those from the healthy contralateral ureteral orifice were significant in those patients with dilation of the upper urinary tract. The differences concerned mainly the frequency and symmetry of the jets as well as the pattern, duration and velocity of their waves. The 4 above-mentioned patients, with dilated upper urinary tracts and waveforms differentiated from the contralateral ones, were characterized as obstructive. On the other hand, the remaining 4 patients with subclinical ureterocele showed insignificant differences in urine jets and waveforms, and were found to be non-obstructive. Conclusion: Conventional sonography of the urinary tract in combination with color Doppler duplex sonography of the ureteral jets can be used in an attempt to diagnose and evaluate a unilateral orthotopic (single system) ureterocele and assess the necessity of intervention to identify the obstruction.

S11 Urodynamic features of Hautmann orthotopic ileal neobladder using standard and ambulatory urodynamics. Preliminary results

A cohort of 14 patients (13 men and 1 woman ) who received an orthotopic “W” ileal substitution of their bladder after radical cystectomy are enrolled into this study. Operations were performed between 2002 and 2008 and the time from surgery to urodynamic investigation ranged from 1 to 6 years. All patients after completing an ICIQ-UI (Short form) questionnaire were subjected to conventional urodynamics (pressure flow study) and then to ambulatory urodynamics for an approximately 18 hour record of their voiding patterns and habits.