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Background: Extra-adrenal pheochromocytomas are rare. Minimally invasive techniques have been utilized for incidentally discovered masses with successful results., Methods: We present a case of a 64-year-old female with a 3.5-cm mass located between her left renal artery and vein, treated by a 4-port robot-assisted transperitoneal laparoscopic approach., Results: Careful dissection of the tumor away from the renal hilum was accomplished without major vascular injury. A pedicle to the tumor was identified and ligated. The pathology demonstrated a benign pheochromocytoma. To our knowledge, this is the first report of a peri-hilar excision of a pheochromocytoma using this approach., Conclusion: Extra-adrenal pheochromocytomas are rare and can present in difficult locations. While surgical excision may be challenging, the da Vinci Robot may be used effectively and safely for the treatment of these perihilar masses.

Misplacement of an inferior vena caval (IVC) filter is an infrequent event. We describe a patient who underwent IVC filter placement after lower extremity trauma. Fourteen years later, the presence of microscopic hematuria prompted evaluation. Computed tomography urography revealed an IVC filter within the right renal vein. Ureteroscopy revealed penetration of a filter tine into the collecting system. The patient is being followed conservatively.

Even nerve-sparing radical prostatectomy damages the cavernous nerves and leads to temporary erectile dysfunction (ED) in men recovering from prostate cancer surgery. Historically, patients recovering from prostate cancer surgery have been advised that the return of erectile function (EF) can take from 6 to 18 months, or even longer. Unfortunately, the return of sexual function in these patients remains variable, but is generally thought to be dependent on the individual patient's pre-surgery EF, as well as the degree of cavernous nerve disruption during prostate removal. Recently, there has been a growing movement to proactively treat patients postoperatively for presumed nerve damage to stimulate nerve recovery and possibly reduce the degree of irreversible damage. This would reduce the on-demand therapy these patients would require, and hopefully remove the requirement for an implantable prosthesis. The underlying hypothesis is that the artificial induction of erections shortly after surgery facilitates tissue oxygenation, reducing cavernosal fibrosis in the absence of nocturnal erections, potentially increasing the likelihood of preserving EF. Vacuum erection devices (VED), because of their ability to draw blood into the penis regardless of nerve disturbance, have become the centerpiece of penile rehabilitation protocols. This review will discuss the pathophysiology of radical prostatectomy induced ED and the rationale for rehabilitation. It will then discuss current protocols, including those involving the VED.

Purpose: To identify systemic factors associated with the development of central serous chorioretinopathy (CSCR)., Design: Retrospective, case-control study., Participants and Controls: 312 cases and 312 controls., Results: By use of a multivariate analysis, the previously described risk factors, systemic steroid use (odds ratio [OR], 37.1; 95% confidence interval [CI], 6.2-221.8), and pregnancy (OR, 7.1; 95% CI, 1.0-50.7), were strongly associated with CSCR. Additional risk factors identified by this study include antibiotic use (OR, 6.2; 95% CI, 1.0-37.9), alcohol use (OR, 4.9; 95% CI, 1.5-16.3), untreated hypertension (OR, 3.3; 95% CI, 1.3-8.5), and allergic respiratory disease (OR, 2.5; 95% CI, 1.2-5.1)., Conclusions: A wide variety of systemic factors are associated with CSCR. Prospective studies are warranted to evaluate the nature and significance of these associations further.

Perineal trauma can occur in both genders, however, data supporting the relationship between sexual dysfunction and blunt perineal trauma in women is lacking. This study reviewed the patient characteristics of women with sexual dysfunction who also had a history of blunt perineal trauma. A neurogenic form of sexual dysfunction has been implicated, with primary complaints of orgasm disorder and abnormalities noted on genital sensory testing. Further research in this area is needed.