Highlights
The spontaneous rupture of the kidney, however, is rarely the first clinical presentation of RCC.
Neoplastic causes for Wunderlich syndrome accounted for 61.2% of these cases, with benign and malignant causes approximately divided equally.
In treating Wunderlich syndrome, some urologists favor an early or immediate exploratory surgery, others prefer interventional radiology.
Spontaneous perinephric hematoma of unknown etiology should be followed up regularly with CT image for concerning of impending renal tumor.
Background
Approximately 2–10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele.
Results
Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief.
Conclusions
Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.
Introduction and Study Purpose:
Renal pedicle control is a crucial period in laparoscopic donor nephrectomy (LDN). Till now, there is no standardized technique for renal pedicle control. Proper evaluation and investigation of the different ways of renal vessel control have to be done to avoid any calamitous event. We aim to prove the safety and reliability of the Hem-o-Lok clips for the renal vascular control in transperitoneal LDN.
Methods:
All LDNs or hand-assisted LDNs done between January 2016 and December 2018 were collected. The primary outcome was the safety of the Hem-o-Lok clips. The secondary outcomes were blood loss, ischemia time, hospital stay, cost, and operative time. The data were analyzed using SPSS 20, and a statistical package was conducted.
Results:
The data showed that 238 laparoscopic donor nephrectomies were done. The renal pedicle control during the 1
st
year was done using a vascular stapler for the artery (63 cases) and two polymer self-locking clips extra-large (XL) for the vein. Two events were reported in the form of mechanical failure. In the following 2 years, the artery was controlled using polymer self-locking clips large (L) few millimeters distal to the aorta and two metallic clips distal to it to increase the safety and stability of the vascular stump (175 cases). However, the vein was controlled by the two polymer self-locking clips XL. There was no reported intraoperative complications or events related to this way of pedicle control; there was no open conversion or blood transfusion required. There was no postoperative complication or collection in ultrasound.
Conclusion:
Using a combined polymer self-locking clip few millimeters distal to the aorta and two metallic clips distal to it for renal artery control in laparoscopic donor nephrectomies is cost-effective and safe. However, further and broader evidenced base studies are still needed to establish a standard technique for renal pedicle control.
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