larly soft. Histology showed invasive carcinoma with Case report transitional, squamous and mucus-producing diCerentiation. Three weeks after the diagnosis, pelvic lymphad-A 48-year-old man who had undergone ureterosigmoidostomy and cystectomy for bladder exstrophy at age 2 enectomy was performed and the remnant of the exstrophy bladder was removed together with the pros-years presented with intermittent bleeding from a 'seminal fistula' (Figs 1 and 2) at the annual routine tate. A small undescended testicle was discovered on the left side and exstirpated. A large defect in the abdominal follow-up. Physical examination revealed a firm, nontender mass underneath the lesion. Under general anaes-wall was filled using a 20×30 cm Marlex mesh. The patient recovered uneventfully. The final histopathology thesia, a biopsy was taken from the irregular wart-like area. On bimanual palpation, the prostate was irregu-report confirmed the result of the biopsy, describing carcinoma with transitional, squamous and glandular diCerentiation invading the prostate. A prostatic origin of the tumour was excluded immunohistochemically.The surgical margins and lymph nodes were free of tumour. CommentAdvances in paediatric medicine and urology have led to a dramatic decrease in mortality of patients with bladder exstrophy. In 1926, 67% of patients suCering from this condition died before the age of 20 years. Within the last four decades only a few deaths related to malignancy in exstrophy bladders have been reported [1]. In these cases, the tumours showed the histological Fig. 1. Seminal fistula in a previous bladder exstrophy 46 years Fig. 2. Staging CT of the abdomen, showing an irregular defect in front of the prostate and ureterosigmoidostomy. after cystectomy.173
a marked delay in excretion and hydronephrosis on the Case report left. A voiding cysto-urethrogram failed to detect VUR and a renal scan showed no function in the left kidney. A 37-year-old man presented with a left-sided scrotal swelling, dysuria and fever consistent with the clinical CT of the abdomen showed a hydronephrotic left kidney with a dilated tortuous ureter (Fig. 2) involving the left diagnosis of acute epididymitis. During the last few years he had experienced similar episodes of epididymitis on seminal vesicle and ending ectopically in the prostate. On cystoscopy, the right ureteric orifice was positioned the left, with no further investigation. The patient was married and had fathered four children. Urine analysis normally, but no left orifice could be identified. The epididymitis resolved completely under treatment with showed white blood cells (WBC, 500/mL) and no bacteriuria; urine culture was sterile and cultures for Chlamydia, oral antibiotics. After 4 weeks, a left nephroureterectomy and resection of the left seminal vesicle Ureaplasma, Mycoplasma and tuberculosis were negative. Haematology and biochemical screens were within was performed, revealing a trifid ureter passing the left seminal vesicle and ending blindly in the prostate (Fig. 3). normal limits apart from a WBC count of 17 500/mL. Ultrasonography revealed a normal right kidney but onThe post-operative course was uneventful and the patient has had no recurrence of epididymitis for 12 months. the left there was marked hydronephrosis with no evidence of a renal cortex; a dilated and tortuous ureter could be followed down to the bladder base. TRUS was
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.