Archivio Italiano di Urologia e Andrologia 2019-12-10T17:51:41+01:00 Emanuela Fusinato Open Journal Systems <p>The <strong>Archives of Italian Urology and Andrology</strong> publishes papers dealing with the urological, nephrological and andrological sciences. <em>Original Articles</em> on both clinical and research fields, <em>Reviews</em>, <em>Editorials</em>, <em>Case Reports</em>, <em>Abstracts </em>from papers published elsewhere, <em>Book Reviews</em>, <em>Congress Proceedings</em> can be published.</p> Ureteral realignment with combined access as a treatment of complete ureteral transection 2019-12-10T17:51:40+01:00 Jorge Panach-Navarrete Marcos Antonio Lloret-Durà María Medina-González José María Martínez-Jabaloyas <p>Ureteral realignment using a ureteral stent can be an alternative treatment in cases of complete ureteral transection and may avoid the need for reconstructive surgery. The combined access can help the passage of the guidewire through the injured area and the threading of the urinary system of the patient. We present a case of a 38-year-old man with multiples abdominal surgeries, who underwent a complete ureteral section treated with ureteral realignment with combined access. The subsequent evolution was favourable, with resolution of the ureteral injury at the acute time, and without the presence of long-term obstruction. Although we must accept that the standard treatment of the complete ureteral transection is reconstruction and anastomosis, in cases such as the one prsented, with multiple abdominal surgeries and whenever it is technically feasible, ureteral realignment may be a treatment option.</p> 2019-10-02T12:04:32+02:00 ##submission.copyrightStatement## Vena cava defect repair using a polytetrafluoroethylene graft after a radical nephrectomy and vena cava resection: A case report 2019-12-10T17:51:40+01:00 Volkan Izol Mutlu Deger Mustafa Zuhtu Tansug <p><em>Introduction:</em> The gold standard treatment for large renal masses is a radical nephrectomy and the removal of tumor thrombi from the large vessels. Here, we discussed the repair of a vena cava defect using a polytetrafluoroethylene (PTFE) graft after a radical nephrectomy and vena cava resection. <br><em>Case:</em> A 69-year-old male patient presented to our clinic with right-sided pain and 10 kg of weight loss over the previous 3 months. The computed tomography showed that the right kidney was 23 x 13 cm in size, with a 7 x 6 x 7 cm contrast-enhanced mass at the renal ilum level. The patient underwent a radical nephrectomy, and the vena cava defect was repaired using a PTFE graft. There was also tumor infiltration in the proximal third of the left renal vein. The renal vein defect was also repaired using a PTFE graft, and the end of the graft was sutured to the vena cava graft at a right angle. The histopathological examination showed a Fuhrman grade 4 renal cell carcinoma (RCC) with focal sarcomatoid differentiation areas. <br><em>Conclusions:</em> The management of patients with RCCs and inferior vena cava (IVC) tumor thrombi should be planned with an experienced team, including a cardiovascular surgeon and liver transplantation team. In these patients, the comorbidities, life expectancy, and imaging methods should be considered for treatment planning in experienced centers. The tumor stage, probability of invasion, and patient’s performance status should also be determined using magnetic resonance imaging during the preoperative period. Finally, the needs for a graft or tubular patch, sternotomy, and chemotherapeutic agents after the nephrectomy should be discussed using a multidisciplinary approach.</p> 2019-10-02T11:59:19+02:00 ##submission.copyrightStatement## A complicated case of recurrent Cowper’s gland abscess 2019-12-10T17:51:41+01:00 Pietro Pepe Ludovica Pepe Astrid Bonaccorsi Paolo Panella Michele Pennisi <p>A Caucasian man 64 years old was admitted to our department for fever, strangury, frequency and pain in the perineum secondary to the relapse of Cowper’s gland abscess previously treated by antibiotic therapy and trans-perineal ultrasound-guided aspiration. At admission, the clinical parameters were suggestive of sepsis; moreover, the trans-perineal ultrasound detected an hypoechoic mass suspicious for the recurrence of Cowper’s gland abscess. A suprapubic catheter was positioned and a targeted antibiotic therapy (Colistin 9000.000 U intravenously every day for 8 days plus meropenem 500 mg intravenously every 8 hours for 10 days) was administered. The patient during the follow up presented long fibers of mucus in the urine and recurrent positive urine culture, therefore two months later underwent trans-perineal surgical asportation of the left Cowper’s gland. One month after surgery the patient was readmitted for the presence of a urinary fistula between bulbar urethra and perineum. A new suprapubic catheter was positioned and after three months was removed because a complete restitutio ad integrum was shown by retrograde cystourethrogram and uroflowmetry. In conclusion, the abscess of Cowper’s gland could represent a very rare but severe clinical event that need aggressive therapy and close follow up for its potentially high rate of early and late clinical complications; in the presence of recurrence the surgical asportation of the Cowper’s gland should be considered.</p> 2019-10-02T11:52:59+02:00 ##submission.copyrightStatement##