Between 2% and 9% of malignant tumours are metastasizing to the skin. Cutaneous metastases from carcinoma of the prostate occur infrequently. Their presence is associated with poor prognosis. We report the case of a 65-year-old man with carcinoma of the prostate, presenting multiple metastases in the scrotal skin region.
The Mainz pouch II is a well tol er ated form of con ti nent uri nary di ver sion in terms of mor bidity, pro tec tion of the up per uri nary tract and conti nence rate, even in pa tients aged >65 years. Mainz pouch II was de scribed by Fisch and Hohenfellner in 1991. They viewed the sim plic ity and reproducibility of the op er a tion as one of its ma jor ad van tages. A good con ti nence rates between 93%-100% af ter this pro ce dure has been shown in pre vi ous stud ies. The longer follow up will show whether these high rates of con ti nence can be maintained with increasing age. The Mainz Pouch II serves as a sat is fy ing con ti nent uri nary di ver sion for both sexes in se lected pa tients in terms of qual ity of life. Evalu a tion of over all qual ity of life in pa tients with Mainz pouch II uri nary der i va tion has given en cour ag ing results. Com pli ance and co op er a tion of the pa tients, together with pre op er a tive tests for anal com pe tence, are man da tory to avoid com pli ca tions. The Mainz group re ported that the over all com pli ca tion rate was low and comparable with other tech niques of con tinent uri nary di ver sion. Dur ing the past years mod i fica tions of the orig i nal tech nique have been de scribed. These repre sent an in creas ing in ter est in the procedure. To day, the tech niques of low-pres sure and reservoirs have com pletely re placed clas si cal ureterosigmoidostomy. In this re view ar ti cle the main fo cus is aimed at his tory, com pli ca tions, con ti nence and qual ity of life of pa tients with Mainz pouch II.
Laparoscopic nephrectomy is indicated in the treatment of many benign conditions of the kidneys. Hydronephrosis caused by obstruction of the ureter, either internal, or external, is one of the main indications for laparoscopic reconstruction. If an obstruction is prolonged, consequently, it leads to chronic inflammatory process accompanied by persistent and recurrent pain with fever, which eventually become resistant to therapy. If not operated sufficiently fast to resolve the causes, as a consequence it leads to hypofunction and ultimately afunction of affected kidney. In such a situation, the only therapeutic option is surgical treatment. By analyzing the case, we will try to illustrate the diagnostic algorithm and therapeutic treatment modality.
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