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Robotic assisted partial nephrectomy is the gold standard treatment for small renal masses. Ureteric stricture is a rare but serious complication that significantly increase the morbidity and worsens the quality of life for cancer patients. Definitive treatment such as surgical reconstruction or ureteroureterostomy is not always feasible as in patients with significant morbidity or high-risk patients. Other options include ureteric double J stent or nephrostomy tube placement with regular exchange. We present a case of iatrogenic upper ureteric stricture post robotic assisted partial nephrectomy for right renal mass that was discovered on postoperative follow up imaging treated with metallic ureteral stent (Memokath) as reconstructive surgery was difficult due to proximity to the tumor bed. We found that if reconstructive surgery is not feasible, metallic ureteral stents has good durability, better quality of life than ureteric double stents for the management of ureteric stricture.

The use of cryoablation in the management of small renal masses is widely acceptable. Although rare but ureteral injury during the procedure with subsequent stricture formation can result in devastating effects on renal function. On the other hand, the management of such strictures requires reconstructive surgery as gold standard. Unfortunately, in some cases the reconstructive surgery might not be feasible, and the treatment usually is ureteral stent insertion that need to be changed regularly. Here we present a case of a 53-year-old gentleman who developed an upper ureteric iatrogenic stricture post cryoablation in which the reconstructive surgery was not feasible due to high procedural risk. We used metallic ureteral stent (Memokath) instead of regular ureteral double J stent. We found that if the reconstructive surgery is not possible the usage of Memokath in treating iatrogenic ureteral strictures is associated with better quality of life, lower costs and a similar functional outcome when compared to ureteral double J stent that needs regular frequent changes.

Testicular seminomas are the most common type of testicular tumor; atypical presentations can make diagnosis more challenging, leading to delayed treatment. Here, we present a 40-year-old previously healthy male who presented to the emergency department with severe right-sided scrotal swelling and pain. He had a diagnosed but untreated inguinal hernia. Physical examination revealed a large irreducible right inguinoscrotal swelling and tenderness. Doppler ultrasound reported herniated content in the right inguinal area, extending to the scrotum. Upon surgical exploration, a large right testicular tumor was discovered, surrounded by hematoma. A radical orchiectomy was performed, and the tumor was identified as a stage pT2 testicular seminoma. This case illustrates the diagnostic challenges posed by atypical presentations of testicular seminomas. A high index of suspicion and thorough clinical and radiological assessments are crucial for accurate diagnosis and management. In conclusion, large testicular seminomas presenting with acute pain mimicking strangulated hernias are rare. Comprehensive clinical and radiological evaluations are essential to avoid misdiagnosis and ensure appropriate surgical planning and patient management.

Testicular Large cell calcifying Sertoli cell tumours (LCCSTs) are extremely rare. The primary challenge in benign LCCSTs, which are typically multifocal and bilateral tumours affecting young males, is to confirm the diagnosis to avoid radical intervention and preserve fertility potential. Patient clinical presentation, laboratory results, diagnostic radiological tests along with confirmatory histopathological studies, are the cornerstones in such cases, nevertheless genetic testing is warranted, as LCCSTs can be part of genetic syndrome such Carney complex. We present a case of bilateral benign LCCSTs in young male managed with testicular preservation approach with characteristic clinical, radiological and histopathological features.

Male pelvic cyst rarely causes symptoms; here, we are presenting a case of a 48-year-old gentleman who presented with acute urinary retention stemming from a pelvic cyst. This presentation has been recurrent despite undergoing repeated TRUS aspiration of the cyst to relieve the symptoms. We performed a robotic pelvic cyst excision with peritoneal window in an attempt to cure the patient. Based on the MRI and histopathology, it was likely a seminal vesicle cyst that is causing these recurrent episodes. On 3 months follow-up, the patient was symptom free without any complaints.