https://doi.org/10.4081/aiua.2021.1.120

Unusual clinical scenarios in Urology and Andrology

Vol. 93 No. 1 (2021)
Published: March 22, 2021
Submucosal ureteral stone; Burened-out testicular cancer; Ogilvie’s Syndrome; Acute Colonic Pseudo-Obstruction (ACPO); Acute Idiopathic Scrotal Edema (AISE); Ultrasound guided testis sparing surgery
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Authors

Lucio Dell'Atti
dellatti@hotmail.com
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Andrea Fabiani
Urology Unit, Surgery Department, Macerata Civic Hospital, Area Vasta 3 Asur Marche, Italy.
Erika Palagonia
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Agostini Edoardo
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Maria Pia Pavia
Urology Unit, Surgery Department, Macerata Civic Hospital, Area Vasta 3 Asur Marche, Italy.
Simone Scarcella
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Valentina Maurelli
Urology Unit, Surgery Department, Macerata Civic Hospital, Area Vasta 3 Asur Marche, Italy.
Emanuele Principi
Urology Unit, Surgery Department, Macerata Civic Hospital, Area Vasta 3 Asur Marche, Italy.
Marco Tiroli
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Giulio Milanese
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.
Lucilla Servi
Urology Unit, Surgery Department, Macerata Civic Hospital, Area Vasta 3 Asur Marche, Italy.
Andrea Benedetto Galosi
Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy.

This collection includes some unusual cases and how they were diagnosed and treated.

Case 1: A case of a patient with primary hyperthyroidism presenting with a submucosal ureteral stone after endoscopic lithotripsy was described. After multiple endoscopic treatment, the stone was successfully removed by open ureterolithotomy recovering ureteral patency and normal renal function.

Case 2: A case of burned-out testicular cancer with atypical lymphatic spread (stage II A) was presented. After right orchiectomy and complete remission of tumor markers, due to atypical metastases location and uncertain histology, the patient was treated with systemic therapy based on bleomycin, etoposide and cisplatin (PEB). At re-staging after chemotherapy computed tomography showed reduction of all node metastases and an observation protocol was proposed.

Case 3: A patient was readmitted to hospital after 12 days from an uneventful Robot-Assisted Radical Prostatectomy (RARP) for prostate cancer due to lower abdominal pain plus abdominal distension, nausea and constipation not responsive to medical therapy. Computed Tomography showed colon and small bowel dilatation without any evidence of anatomical or mechanical obstruction. Laparoscopic abdominal exploration confirmed bowel distension without evidence of obstructing lesions. Ogilvie’s Syndrome or acute colonic pseudo-obstruction (ACPO) was diagnosed. The patient fully recovered and was discharged six days after the procedure.

Case 4: A case of recurrent Acute Idiopathic Scrotal Edema (AISE) was diagnosed on clinical signs together with the decisive help of pathognomonic ultrasound findings as the “fountain sign”.

Case 5: Small bilateral testicular nodules were diagnosed in a 30-years old patient undergoing scrotal ultrasound in follow up of acute lymphoblastic leukemia. Ultrasound guided testis sparing surgery was performed demonstrating Leydig cell tumors.

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How to Cite

Dell’Atti, L., Fabiani, A., Palagonia, E., Edoardo, A., Pavia, M. P., Scarcella, S., Maurelli, V., Principi, E., Tiroli, M., Milanese, G., Servi, L. ., & Galosi, A. B. (2021). Unusual clinical scenarios in Urology and Andrology. Archivio Italiano Di Urologia E Andrologia, 93(1), 120–126. https://doi.org/10.4081/aiua.2021.1.120

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