Urology
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A 57-year-old female with fatigue presented to our hospital. High-quality contrasted abdominal computerized tomography images demonstrated extensive filling defect within the left renal vein and the inferior vena cava and an enhancing hepatic mass with no obvious mass lesion in the left kidney. The patient underwent a total resection of the left kidney and venous thrombectomy by open surgery; intraoperative hepatic mass biopsy with frozen section confirmed a metastatic disease and right hepalobectomy was conducted in one surgical session. Histopathologic examination revealed a lesion of chromophobe renal cell carcinoma within the left kidney.
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Comparative Study
Factors affecting renal function after open partial nephrectomy-a comparison of clampless and clamped warm ischemic technique.
To analyze factors impacting postoperative renal function after open partial nephrectomy using both the clampless and clamped warm-ischemic technique. ⋯ Body mass index and RENAL score were factors predictive of development of de novo estimated glomerular filtration rate <60 after partial nephrectomy, with increasing warm ischemia time also being predictive in clamped partial nephrectomy patients. Further investigation and long-term functional data are requisite.
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To identify parameters that predict insignificant prostate cancer in 67 radical prostatectomies after biopsy reclassification to worse disease on active surveillance. ⋯ Most men with biopsy reclassification while on active surveillance have significant disease at radical prostatectomy, justifying their treatment. Low prostate-specific antigen at diagnosis or at biopsy reclassification can predict a high probability of insignificant cancer in the absence of Gleason pattern 4/5 on biopsy. These men may be candidates for continuing active surveillance.
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Vesicovaginal fistulae (VVF) caused by cystoceles are very rare. To date, there are no documented cases in English literature. ⋯ A fistula had formed but there was no obvious full thickness necrosis. She underwent a combined vesicovaginal fistula repair with pubovaginal sling.