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An inguinal bladder hernia (IBH) is an abnormal protrusion of the bladder into the inguinal canal accompanied by a peritoneum sheath that creates the hernia sac. Clinical presentations vary greatly from lower urinary tract symptoms (LUTS) and reduction in scrotal size after voiding to being entirely asymptomatic. Since inguinal bladder hernias are uncommon and often accompanied by varied and nonspecific symptoms, it is challenging to diagnose and rarely included in differentials. Currently, computerized tomography (CT) imaging with contrast or voiding cystourethrography is recommended for diagnosis. There is no consensus on the best treatment for inguinal bladder hernias, with options ranging from laparoscopic repair to catheterization. In this study, we report the case of inguinal bladder hernia in an 86-year-old male presenting with symptoms of recurrent hematuria and two failed voiding trials after a Foley catheter placement from prostatomegaly resulting in bladder diverticula, and IBH. He was treated with prostate artery embolization (PAE) to address LUTS related to benign prostatic hyperplasia (BPH). The resultant decreased prostatic volume resolved his symptoms of IBH, hematuria, and urinary retention.

Abstract Background Clients want to know the ultimate cause of death in their pet after cancer treatment. The cause of euthanasia and investigation of urinary obstruction in treated dogs with urothelial carcinoma (UC) has not been specifically reported in veterinary literature. Hypothesis/Objectives Our hypothesis was that the majority of treated dogs with UC are euthanized secondary to primary tumor factors, such as urinary obstruction. Animals Fifty‐nine client‐owned dogs diagnosed with UC. Methods Retrospective observational study on clinical signs and disease at euthanasia of dogs with UC treated by radiation therapy or chemotherapy or both. Results The median overall survival time (OST) of all dogs was 339 days (range, 17‐1996; 95% confidence interval [CI], 185‐392; interquartile range [IQR], 112‐505). Of dogs deemed to have been euthanized because of UC (50/59, 85%), the primary cause was considered to be local progression in 31/50 (62%), most often because of perceived complete or partial urinary obstruction (24/31, 77%). No variables were found to be predictive of urinary obstruction. The overall documented metastatic rate was 56%. In dogs euthanized because of UC, metastasis was deemed to be the cause in 19/50 (38%) dogs. Conclusions and Clinical Importance Regardless of the type of treatment, UC in dogs has a poor prognosis and there is a continuing need to improve treatments that focus on local control of the primary tumor, given its high contribution to the decision for euthanasia. Proactive management to avoid the high frequency of urinary obstruction may be worthy of future investigation.

This report describes a case of transmural migration of a gossypiboma from the peritoneum into the urinary bladder in a 4-year-old, female spayed, mixedbreed dog. The dog was presented on an emergency basis for complete urethral obstruction with radiographic evidence of urocystolithiasis. An exploratory laparotomy was performed and a 4-5 cm mass was identified which was confluent with the apex of the urinary bladder. The mass and bladder were exteriorized and isolated, and an apical, partial cystectomy was performed to remove the mass and gain access to the uroliths within the lumen of the bladder. A 4x4 surgical sponge was identified within the trigone of the bladder, it had multiple uroliths; another sponge was also found within the mass itself. This case demonstrates an atypical cause of urethral obstruction and serves as the first reported case of transmural migration of a gossypiboma into the urinary bladder of a dog. It also illustrates the importance of establishing routine operating procedures including gauze counts and the use of radiopaquelabeled surgical gauze. [ABSTRACT FROM AUTHOR]

Background/aim: Urethroplasty is the preferred treatment for hypospadias but is affected by the severity of anomalies, making it a complex procedure with potential postoperative complications. Following surgery, parents receive instructions and recommendations, whether from nurses or physicians, regardless of complication rates. However, nurses play a crucial role in educating caregivers before surgery and providing postoperative care during follow-up. The study aims to assess parents' knowledge and practices, as well as the frequency of complications in boys who underwent urethroplasty for hypospadias and received postoperative nurse-led care and whose parents received preoperative education against those of boys who underwent urethroplasty under routine hospital care. Materials and methods: In this retrospective study, Han Chinese boys aged 21--41 months in Western China who underwent urethroplasty for hypospadias were divided into two groups: the NI cohort (n = 103), where they received postoperative nurse-led care and their parents received preoperative education, and the RH cohort (n = 142), where boys underwent routine hospital care. Results: After urethroplasty, higher numbers of caregivers with satisfactory knowledge (96 (93%) vs. 80 (56%), p < 0.0001) and practice (102 (99%) vs. 132 (93%), p = 0.0276) were reported in the NI cohort compared to the RH cohort. Additionally, a higher number of boys in the RH cohort experienced adverse effects such as moderate bleeding (13 (9%) vs. 1 (1%), p = 0.0052), wound infection (17 (12%) vs. 4 (4%), p = 0.0356), urinary obstruction (35 (25%) vs. 10 (10%), p = 0.0049), burning sensation (47 (33%) vs. 15 (15%), p = 0.0019), and urinary stent fall (32 (23%) vs. 6 (6%), p = 0.0008) compared to those in the NI cohort. Conclusion: Preoperative instructions enhance caregivers' knowledge and practices following urethroplasty, while postoperative nurseled care reduces immediate postoperative complications associated with hypospadias in boys. [ABSTRACT FROM AUTHOR]

Background: Clients want to know the ultimate cause of death in their pet after cancer treatment. The cause of euthanasia and investigation of urinary obstruction in treated dogs with urothelial carcinoma (UC) has not been specifically reported in veterinary literature. Hypothesis/Objectives: Our hypothesis was that the majority of treated dogs with UC are euthanized secondary to primary tumor factors, such as urinary obstruction. Animals: Fifty‐nine client‐owned dogs diagnosed with UC. Methods: Retrospective observational study on clinical signs and disease at euthanasia of dogs with UC treated by radiation therapy or chemotherapy or both. Results: The median overall survival time (OST) of all dogs was 339 days (range, 17‐1996; 95% confidence interval [CI], 185‐392; interquartile range [IQR], 112‐505). Of dogs deemed to have been euthanized because of UC (50/59, 85%), the primary cause was considered to be local progression in 31/50 (62%), most often because of perceived complete or partial urinary obstruction (24/31, 77%). No variables were found to be predictive of urinary obstruction. The overall documented metastatic rate was 56%. In dogs euthanized because of UC, metastasis was deemed to be the cause in 19/50 (38%) dogs. Conclusions and Clinical Importance: Regardless of the type of treatment, UC in dogs has a poor prognosis and there is a continuing need to improve treatments that focus on local control of the primary tumor, given its high contribution to the decision for euthanasia. Proactive management to avoid the high frequency of urinary obstruction may be worthy of future investigation. [ABSTRACT FROM AUTHOR]

Endometriosis presents a diagnostic conundrum due to its diverse clinical manifestations, ranging from asymptomatic to acute obstructive uropathy. This is a case of a 30-year-old woman with a history of endometriosis and rapidly progressing left flank pain culminating in rupture of the renal pelvis in her left kidney. Initial investigations revealed left-sided hydronephrosis without evidence of nephrolithiasis. Subsequent imaging showed active extravasation indicative of urinary obstruction attributable to endometriosis. Placement of a left nephrostomy tube alleviated her symptoms, and follow-up imaging revealed a distal ureteral stricture. A stent was subsequently placed, which resolved the obstruction and obviated the need for extensive surgical intervention. In this case, the patient's history of endometriosis prompted consideration of its role in urinary obstruction, despite the absence of typical symptoms, and underscores the importance of considering endometriosis as a potential cause of acute urinary obstruction, particularly in patients with a history of the disease. Physicians in the emergency department should maintain a high index of suspicion for endometriosis-related complications to facilitate timely intervention and prevent adverse outcomes. Awareness of the variable presentations of endometriosis is paramount for ensuring comprehensive patient care and optimal outcomes.

This report describes a case of transmural migration of a gossypiboma from the peritoneum into the urinary bladder in a 4-year-old, female spayed, mixed-breed dog. The dog was presented on an emergency basis for complete urethral obstruction with radiographic evidence of urocystolithiasis. An exploratory laparotomy was performed and a 4–5 cm mass was identified which was confluent with the apex of the urinary bladder. The mass and bladder were exteriorized and isolated, and an apical, partial cystectomy was performed to remove the mass and gain access to the uroliths within the lumen of the bladder. A 4×4 surgical sponge was identified within the trigone of the bladder, it had multiple uroliths; another sponge was also found within the mass itself. This case demonstrates an atypical cause of urethral obstruction and serves as the first reported case of transmural migration of a gossypiboma into the urinary bladder of a dog. It also illustrates the importance of establishing routine operating procedures including gauze counts and the use of radiopaque-labeled surgical gauze.

Objective: This study highlights a case of uroperitoneum from urinary bladder rupture in a bovine calf and further describes the surgical interventions. Materials and Methods: A 7-month-old weaned Brahma bull-calf was presented with a distended abdomen alongside a history of complete absence of urination for 9 days. Previously, the animal suffered from urinary inconsistence and dribbling-type urination. Physical palpation on the ventral aspect of the distended abdomen revealed a fluid-filled condition, and further needle aspiration confirmed the fluid to have a slightly alkaline pH resembling that of urine. The preputial manipulation and urinary catheterization were of no use for the obstruction. A light uremic smell was found in the animal's breathing. Elevated blood urea nitrogen and creatinine were also detected. Clinically, it was assumed to be a ruptured urinary bladder (cystorrhexis) and subsequently diagnosed as a case of uroperitoneum (water belly). Paramedian laparotomic exploration was carried out to detect the ruptured part (perforation) of the bladder, and simultaneous expulsion of the accumulated peritoneal urine was done. A tube cystostomy was performed with Foley's catheter to handle the case after repairing the perforated bladder (cystorrhaphy). In the postoperative phase, supportive medications and good management were ensured. Results: The calf recovered within 2 weeks of surgery and was found to maintain unremitting urine flow through the surgically fixed catheter. However, the calf was culled after 1 month of surgery. Conclusions: Tube cystostomy can be an effective approach for the management of water bellies in calves to save lives. [Vet. Res. Notes 2023; 3(7.000): 58-62]

Objective: This case report will present transurethral resection of double anterior urethral valves in tertiary hospital. Case(s) Presentation: A three-year-old boy who complained of a poor stream of urine and discomfort during micturition. From the radiological examination, the main finding was found on ultrasound (USG), with thickening of the bladder wall without upper tract abnormality. On panendoscopy, we found double anterior urethral valves at bulbar part and trabeculation in bladder. Discussion: The resection of the valves was performed and achieved an excellent result included normal stream of urine and there was no discomfort during micturition. Conclusion: Anterior Urethral Valve is a rare case that can be caused a lower urinary tract obstruction. A good understanding of AUV’s radiological and endoscopic anatomy is required to differentiate it from other diseases, essential to prevent further injury, and also to decide for appropriate management. Keywords: Anterior Urethral Valve, Congenital Anomaly, Urinary Obstruction

Objective: To determine the factors associated with renal function recovery in individuals with kidney failure due to obstruction in the urinary tract. Method: The prospective, descriptive study was conducted July 2020 to August 2021 at the Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, and comprised adult patients of either gender who had renal failure secondary to obstructive urinary tract. Baseline data regarding patients’ variables, including age, gender, duration of symptoms (25 days or 25 days), haemoglobin (9.85g/dl or 9.85g/dl), serum creatinine and renal cortical thickness (16.5mm or 16.5 mm), was noted on a proforma. The variables were stratified to assess impact on renal recovery. Data was analysed using SPSS 23. Results: Of the 126 patients, 43(34.13%) were males and 83(65.87%) were females. The overall mean age was 44.13±14.18 years. Renal recovery occurred in 67(78.8%) patients having duration of symptoms 25 days, and in 13(31.7%) patients with duration of symptoms 25 days (p 0.001). Renal recovery occurred in 41(58.6%) patients having haemoglobin 9.85g/dL and in 39(69.6%) patients having haemoglobin 9.85g/dL (p=0.2). Renal recovery occurred in 26(37.7%) patients with parenchymal thickness 16.5mm and in 54(94.7%) patients with renal cortical thickness 16.5mm (p 0.001). Conclusion: Symptom duration 25 days, and renal parenchymal thickness 16.5mm were found to be predictive factors of good recovery in renal failure cases secondary to obstructive uropathy. Key Words: Urinary obstruction, Obstructive nephropathy, Percutaneous nephrostomy, Renal failure.

Introduction In adults, rhabdomyosarcoma of the prostate is extremely rare and has an unfavorable prognosis. These patients frequently experience urinary obstruction, and cysto‐prostatectomy is a mainstay treatment for localized disease. In contrast, treatment strategies for the primary site for metastatic disease remain controversial. To our knowledge, robot‐assisted surgery for the primary tumor has not been reported. Case presentation A 26‐year‐old man complained of dysuria. Magnetic resonance imaging showed enlarged prostate and computed tomography revealed a pulmonary metastasis. Transurethral resection of the prostate led to the diagnosis of rhabdomyosarcoma. After chemotherapy, robot‐assisted prostatectomy was performed to relieve obstructive urinary symptoms. Although disease progression in the metastatic site was observed after the surgery, urinary obstruction did not occur and quality of life was well maintained. Conclusion Robot‐assisted prostatectomy may be beneficial both for local disease control and palliation of voiding impairment among selected patients with systemic rhabdomyosarcoma of the prostate.

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Sergey V Popov,1– 3 Igor N Orlov,1,4 Daria Yu Chernysheva,1 Sergey M Malevich1 1Urology Department, St. Luke’s Clinical Hospital, Saint-Petersburg, Russia; 2Urology Department, Military Medical Academy Named After S.M. Kirova, Saint-Petersburg, Russia; 3Hospital Surgery Department, Saint-Petersburg State University, Saint-Petersburg, Russia; 4Urology Department, North-Western State Medical University Named After I.I. Mechnikov, Saint-Petersburg, RussiaCorrespondence: Daria Yu ChernyshevaUrology Department, St. Luke’s Clinical Hospital, Chugunnaya Street 46, Saint-Petersburg, 194044, RussiaTel +7921 873 85 60Fax +7812 576 11 55Email Daria.chern@gmail.comAbstract: Cystic formations in the prostate are quite common, but the vast majority are benign. The cystic form of prostate adenocarcinoma can present unexpected symptoms, and management can be difficult because of the local advanced stage of the disease. A unique feature of this case is the surgical local cancer treatment. In this clinical case, we describe the literature surrounding this rare form of neoplasm. We present a clinical case of a rare form of prostate cancer in a 71-year-old male who was admitted to ER with acute urinary retention. A huge obstructing prostatic cyst was revealed. After successful trial-without-catheter, the patient underwent transperineal cyst draining and this restored urination. PSAt was increased up to 55 ng/mL. The cystic wall biopsy revealed adenocarcinoma with a Gleason score of 8 (4+4) (Gleason Group IV), and distant metastasis was noticed with PSMA PET/CT. The patient started androgen deprivation therapy (ADT) with excellent PSA dynamics in three months. Because of lower urinary tract symptoms, he needed local treatment and underwent radical prostatectomy. A three-month follow-up demonstrated a common post-operative period, mild stress incontinence, and PSAt 0.004 ng/mL. Cystic prostatic carcinoma can manifest as urinary retention and be mistakenly taken for a benign obstructing prostate cyst. Despite the locally advanced tumor, it can be successfully treated locally in highly selected patients.Keywords: prostate cancer, cystic adenocarcinoma, urinary obstruction

Objectives: The aim of this study was to determine if male cats treated with 7 days of prazosin following relief of urethral obstruction (UO) experienced decreased rates of recurrent urethral obstruction (rUO) within 30 days vs those treated with 7 days of placebo. Methods: All castrated male cats presenting for the first time with UO from May 2014 to August 2017 were eligible for enrollment. Exclusion criteria included the administration of medications or passage of a urinary catheter prior to referral, the presence of heart disease or hypertension requiring medication, prior treatment with glucocorticoids, non-steroidal anti-inflammatory medications, prazosin or phenoxybenzamine, or radiographic identification of cystoliths. Cats were treated with standardized anesthetic and analgesic protocols, standardized indwelling urinary catheter management, and were hospitalized for care. A random numbers table was generated prior to study initiation and cats were randomized to receive either prazosin (0.5 mg PO q12h for 7 days) or placebo in a blinded fashion. A 30-day follow-up with owners via telephone was performed to identify the rate of rUO. Cats that did not receive the full course of study medication were removed from the analysis. The study was unblinded at the end of data collection. Results: Eighty cats were enrolled and 65 cats completed the study; 12 were excluded because they did not receive the study medication. Sixteen of 65 cats experienced rUO (25%). Of the 16 cats experiencing rUO, five received placebo (n = 5/28 [18%]) and 11 received prazosin (n = 11/37 [30%]). Ten of the cats that experienced rUO reblocked while still hospitalized. There was no significant difference in frequency of rUO in cats treated with prazosin vs placebo (P = 0.27). Conclusions and relevance: Prazosin administered at 0.5 mg PO q12h did not decrease the rate of rUO in this population of obstructed male cats vs placebo. These results further support evidence suggesting that prazosin may not be beneficial in prevention of feline rUO. [ABSTRACT FROM AUTHOR]

Purpose: The diagnosis of xanthogranulomatous pyelonephritis is primarily histological. The mandatory studies that have to be performed are: abdominal echography, excretory urography, CT, and renal angiography. Methods: The current report covers a period of 16 years (1992-2008) and presents clinical material from 9 patients with a long history of nephrolithiasis. In the past, six of them have undergone surgical or extracorporeal lithotripsy. Results and conclusion: The performed preoperative imaging studies showed kidney tumors, and the operative treatment method used was nephrectomy. The post-operative follow-up did not detect any complications in any of these patients.

Abstract Pyelocaliceal obstruction is a diagnostic challenge, and it is important to identify the obstruction cause. Some patients present extra‐renal compressive masses that need further imagiologic investigation and a biopsy, to establish the diagnosis.

Abstract Background Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. Objectives To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. Animals Fifty‐one client‐owned cats. Methods Prospective, randomized clinical trial. Every male cat with FIC‐associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low‐dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. Results Cumulative number (%) of cats with recurrent UO at 10 days, 1‐, 2‐, and 6‐months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ratio [95% confidence interval], 0.63 [0.13‐2.97]; P = .70). All cats were alive at 6 months. Conclusions and Clinical Importance No clinical benefit was detected with the addition of low‐dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies.

Endometriosis presents a diagnostic conundrum due to its diverse clinical manifestations, ranging from asymptomatic to acute obstructive uropathy. This is a case of a 30-year-old woman with a history of endometriosis and rapidly progressing left flank pain culminating in rupture of the renal pelvis in her left kidney. Initial investigations revealed left-sided hydronephrosis without evidence of nephrolithiasis. Subsequent imaging showed active extravasation indicative of urinary obstruction attributable to endometriosis. Placement of a left nephrostomy tube alleviated her symptoms, and follow-up imaging revealed a distal ureteral stricture. A stent was subsequently placed, which resolved the obstruction and obviated the need for extensive surgical intervention. In this case, the patient's history of endometriosis prompted consideration of its role in urinary obstruction, despite the absence of typical symptoms, and underscores the importance of considering endometriosis as a potential cause of acute urinary obstruction, particularly in patients with a history of the disease. Physicians in the emergency department should maintain a high index of suspicion for endometriosis-related complications to facilitate timely intervention and prevent adverse outcomes. Awareness of the variable presentations of endometriosis is paramount for ensuring comprehensive patient care and optimal outcomes., (© 2024 The Authors. Published by Elsevier B.V.)

Condyloma acuminate (CA) is a warty lesion caused by human papilloma virus (HPV) mostly involve the external genitalia. A 65-year-old woman with a compliant of acute urinary retention came to our hospital emergency ward and the retention was resolved by placing a 6 Fr Foley catheter. On physical examination warty lesions on patient's urethral meatus was seen and biopsy was taken. The pathology confirmed the diagnosis of CA. 5-FU was prescribed for a month and the outcome was fully satisfactory. To sum up, CA in female with AUR should be kept in mind.

Introduction. The optimal tension of suburethral tape is an important component of effectiveness and safety of the surgery. By now, there is no common standardized guidance on the tensioning of the sling. There is a limited number of publications, devoted to adjustable systems with the ability to correct tape tension in postoperative period. To evaluate the effectiveness of this method, the long-term results of postoperative adjustment of the sling are necessary.Aim. To evaluate the results of complicated stress urinary incontinence (SUI) surgical treatment using a transobturator adjustable sling Urosling (Lintex).Materials and methods. The study included 89 women with complicated SUI. All patients underwent the transobturator adjustable midurethral tape placement. The tension adjustment was performed during 3 days after surgery. Postoperative evaluation included vaginal examination, cough stress test, 1-h Pad-test, uroflowmetry, bladder ultrasound and post-void residual (PVR) urine measurement, validated questionnaires (UDI-6, UIQ-7, ICIQ-SF, PICQ-12) and visual analogue scale (VAS).Results. Mean operative time was 15.74±7.49 min. The tension adjustment was performed in 45.0% (40/89) patients the next day after surgery. On the second day tension re-adjustment was required in 14,6% (13/89) patients. In 3.4% (3/89) women the tension was also tuned on the 3 day. The loosening of the sling was needed in 13.5% (12/89) patients. After adjustment, all patients were continent without any signs of bladder outlet obstruction (BOO). Mean follow-up was 14.3±2.1 months. The objective cure rate was 92.9%. There was no statistically significant difference in the urodynamic parameters. Assessment of patient satisfaction showed that 95.2% (80/84) of the patients were «very» or «very» satisfied.Conclusion. The adjustable transobturator suburethral tape Urosling allows to achieve high effectiveness of treatment in female patients with complicated SUI and to reduce the risk of postoperative BOO development.

Background: There is paucity of outcome data of patients with cervical cancer presenting with malignant obstructive uropathy. The present retrospective study describes outcomes of patients with cervical cancer who presented with obstructive uropathy at the time of diagnosis and underwent urinary diversion with percutaneous nephrostomy (PCN) before/during treatment.Methods: Patients who underwent PCN from January 2010 to June 2015 were included. Intent of treatment (radical or palliative) was decided within multidisciplinary team depending on disease stage, Karnofsky performance status (KPS), and degree of renal derangement. Treatment and outcome details were retrieved from electronic records. Time to normalization of creatinine, feasibility of delivering planned treatment, and overall survival (OS) were determined. Impact of various prognostic factors on outcomes was determined using univariate or multivariate analysis.Results: After PCN and double-J stenting, 50% were eligible for (chemo) radiation. All radically treated patients (26/52) received brachytherapy. The median EQD2 to point A was 78 Gy (72-84 Gy). The median OS was 10 (0.5-60) months. Patients who completed chemoradiation had median OS of 31 months. Those receiving radical radiation and palliative radiation had median OS of 11 and 6 months, respectively. On univariate analysis, smaller tumor size (p = 0.03), high KPS (P = 0.04), and radical intent of treatment (P = 0.05) predicted for OS.Conclusion: Patients presenting with obstructive uropathy have median OS less than a year despite urinary diversion. Select cohort with good performance status, small tumor size, and serum creatinine of ≤3 mg/dL may be selected for diversion procedures and potential radical treatment. [ABSTRACT FROM AUTHOR]

Purpose: The diagnosis of xanthogranulomatous pyelonephritis is primarily histological. The mandatory studies that have to be performed are: abdominal echography, excretory urography, CT, and renal angiography. Methods: The current report covers a period of 16 years (1992-2008) and presents clinical material from 9 patients with a long history of nephrolithiasis. In the past, six of them have undergone surgical or extracorporeal lithotripsy. Results and conclusion: The performed preoperative imaging studies showed kidney tumors, and the operative treatment method used was nephrectomy. The post-operative follow-up did not detect any complications in any of these patients. [ABSTRACT FROM AUTHOR]

Case series summary: Medical records were reviewed for cats that underwent a perineal urethrostomy performed in dorsal recumbency for the treatment of urethral obstruction. Information, including signalment, reason for presentation, number of previous obstructions, surgery time, and perioperative and postoperative complications, were collected through a review of medical records and owner follow-up. The objective was to evaluate short- and long-term complications in cats that underwent perineal urethrostomy performed in dorsal recumbency for treatment of urethral obstruction. Relevance and novel information: No major or life-threatening complications, such as urethral stricture, re-obstruction, euthanasia due to lower urinary signs or chronic urinary tract infection, were reported. Short-term complications were limited to dysuria in 2/12 (16.7%) cats. Long-term follow-up was available for nine cats. The most common long-term complication seen in this population of cats was a single recurrence of urinary tract infection in 3/9 (33.3%) cats that resolved after a short course of empirical antibiotic therapy. Performing perineal urethrostomy in dorsal recumbency is safe and may have advantages to ventral recumbency due to improved visualization, allowing for more efficient dissection and improved accuracy in tissue apposition during closure. We believe this has been a major contributor to our reported reduced major postoperative complication rate. [ABSTRACT FROM AUTHOR]

Cowper's syringocele is a condition caused by dilatation of the main duct of Cowper's gland. It is a very uncommon cause of urethral obstruction. Closed type causes urinary obstruction. The aim of this article is to report a case of closed type syringocele causing new-onset urinary obstruction in a 10-year-old boy.

Fetal renal pelvis dilation is a common condition, which is observed in 1–4. 5% of pregnancies. In many cases, this finding resolves spontaneously. However, sometimes it may be a signal of significant urinary tract pathologies. The main abnormalities found after birth are uretero-pelvic junction stenosis, primary vesicoureteral reflux, megaureter, duplex kidneys, and posterior urethral valves, with uretero-pelvic junction stenosis and primary vesicoureteral reflux accounting for most of the cases. Diagnosis, management, and prognosis at short and longer term of these conditions will be reviewed in this article.

Chondrosarcoma is the second most common malignant tumor of the bone with an incidence of 1 in 200.000 per year. Axial skeleton is frequently involved showing poorer oncological outcomes than appendicular one: human pelvis is a site predilection. It is rarely associated to urinary obstruction but according to its localization, it can be frequently linked to compression of pelvic organs as bladder, prostate or bowel. We describe the case of a 52 years old caucasian male with history of advanced pelvic chondrosarcoma and severe hydronephrosis due to total bladder dislocation.

Background/aim: Urethroplasty is the preferred treatment for hypospadias but is affected by the severity of anomalies, making it a complex procedure with potential postoperative complications. Following surgery, parents receive instructions and recommendations, whether from nurses or physicians, regardless of complication rates. However, nurses play a crucial role in educating caregivers before surgery and providing postoperative care during follow-up. The study aims to assess parents' knowledge and practices, as well as the frequency of complications in boys who underwent urethroplasty for hypospadias and received postoperative nurse-led care and whose parents received preoperative education against those of boys who underwent urethroplasty under routine hospital care., Materials and Methods: In this retrospective study, Han Chinese boys aged 21-41 months in Western China who underwent urethroplasty for hypospadias were divided into two groups: the NI cohort (n = 103), where they received postoperative nurse-led care and their parents received preoperative education, and the RH cohort (n = 142), where boys underwent routine hospital care., Results: After urethroplasty, higher numbers of caregivers with satisfactory knowledge (96 (93%) vs. 80 (56%), p < 0.0001) and practice (102 (99%) vs. 132 (93%), p = 0.0276) were reported in the NI cohort compared to the RH cohort. Additionally, a higher number of boys in the RH cohort experienced adverse effects such as moderate bleeding (13 (9%) vs. 1 (1%), p = 0.0052), wound infection (17 (12%) vs. 4 (4%), p = 0.0356), urinary obstruction (35 (25%) vs. 10 (10%), p = 0.0049), burning sensation (47 (33%) vs. 15 (15%), p = 0.0019), and urinary stent fall (32 (23%) vs. 6 (6%), p = 0.0008) compared to those in the NI cohort., Conclusion: Preoperative instructions enhance caregivers' knowledge and practices following urethroplasty, while postoperative nurse-led care reduces immediate postoperative complications associated with hypospadias in boys., Competing Interests: Conflict of interest: The authors declared that they have no conflicts of interest or any other competing interests regarding the results and/or discussion reported in the research., (© TÜBİTAK.)

Background: Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. Objectives: To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. Animals: Fifty‐one client‐owned cats. Methods: Prospective, randomized clinical trial. Every male cat with FIC‐associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low‐dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. Results: Cumulative number (%) of cats with recurrent UO at 10 days, 1‐, 2‐, and 6‐months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ratio [95% confidence interval], 0.63 [0.13‐2.97]; P = .70). All cats were alive at 6 months. Conclusions and Clinical Importance: No clinical benefit was detected with the addition of low‐dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies. [ABSTRACT FROM AUTHOR]

Crystalluria can involve the kidney and lower urinary tract, can produce acute and chronic effects, and occurs in all mammalian species. Most commonly urinary crystals contain calcium. Numerous other endogenous and exogenous substances can produce crystalluria. Crystals are identified in kidneys of many species, up to 100% in certain rat strains. More severe renal disease (acute tubular necrosis and chronic renal disease) can be secondary to crystal accumulation, such as observed with melamine–cyanuric acid in cats and dogs. Aggregation of crystals leads to calculi that act as urothelial abrasives with consequent regenerative proliferation. Accumulation in the kidney pelvis or bladder can lead to partial or complete obstruction and hydronephrosis. Long-term presence of urinary tract calculi in rodents leads to increased risk of urothelial tumors, but not in humans. Crystals in the lower urinary tract can act as irritants in rodents, but not in humans. It is critical that specific procedures are followed to optimize the presence of crystals in urine for diagnosis, including not fasting the animals. Numerous factors have been identified which can enhance or inhibit crystal formation. Extrapolation from animals for the threshold toxicity of crystals/calculi is appropriate but is not relevant for cancer risk assessment. [ABSTRACT FROM AUTHOR]

Uterine incarceration is rare, but it can cause serious complications, in which the uterus is trapped in the pelvic cavity behind the sacral promontory. Fibroid uterus can cause urinary frequency and retention, which can result from compression of the urinary bladder with an enlarged fibroid uterus and the compression of the bladder neck or urethra, respectively. To our knowledge, there is no report on prolonged complete urinary obstruction because of an incarcerated uterus in nonpregnant women to date. A 51-year-old woman was referred for uterine myomas. She could not void for 30 months after she received an intradetrusor injection of botulinum toxin for urinary frequency management at the urology department of another hospital. She underwent clean intermittent catheterization for 30 months. She was referred to the gynecologic department for the evaluation of uterine myoma found on using abdominopelvic computed tomography. On physical examination, the uterine cervix was extremely displaced in the upward direction and was not exposed on speculum examination. Sonography and magnetic resonance imaging revealed that the urethra and the bladder neck were compressed by an extremely retroflexed fibroid uterus. Manual reduction of the incarcerated uterus failed; hence, we performed robot-assisted laparoscopic total hysterectomy with left salpingo-oophorectomy. She immediately urinated immediately after the operation and had normal urination at 1- and 48-month follow-up visits. Uterine incarceration by a fibroid uterus can cause complete urinary obstruction, as in this case. Uterine incarceration should be considered in women with urinary frequency or retention to avoid prolonged, serious complications.

INTRODUÇÃO: Cistite glandular é um processo proliferativo benigno e infrequente da mucosa vesical, caracterizado por proliferação do epitélio e, em alguns casos, formação de glândulas intestinais. Alterações metaplásicas na cistite glandular são bem documentadas na literatura, embora sua etiologia não seja totalmente esclarecida. RELATO DO CASO: Relatamos um caso de cistite glandular em um paciente de 55 anos, apresentando sintomas miccionais irritativos e obstrutivos persistentes sem resposta à terapia com alfabloqueadores. Ultrassonografia evidenciou lesão vegetante no trígono vesical e o paciente foi submetido à ressecção endoscópica por duas vezes e evoluiu com ureterohidronefrose bilateral. Dado o extenso acometimento vesical e a persistência dos sintomas, o paciente foi submetido a cistoprostatectomia e neobexiga ileal com boa evolução pós-operatória. DISCUSSÃO: Há duas formas de cistite glandular: típica e intestinal. A forma típica é a mais comum e a intestinal é marcada pela produção de mucina, mais frequentemente associada ao adenocarcinoma de bexiga. A maioria dos casos de cistite glandular é assintomática, sendo que os pacientes sintomáticos normalmente apresentam hematúria, sintomas urinários irritativos e típicos de cistite crônica. Há controvérsias sobre o tratamento precoce agressivo, sendo que vários estudos propõem a ressecção transuretral e o acompanhamento com biópsias.INTRODUCTION: Cystitis glandularis is a rare, benign, proliferative process of the mucosa of the urinary bladder characterized by epithelial proliferation and occasional formation of intestinal glands. Although its etiology is unknown, cystitis glandularis has been associated with chronic stimulation of the mucosa of the urinary bladder due to urinary tract infection, obstruction, and indwelling catheters, which may lead to overproductive changes in mucosal cells and glandular metaplasia of transitional epithelial cells. CASE REPORT: A 55-year-old man was admitted to our hospital with urinary symptoms that did not respond to alpha-blockers. On ultrasound, a vegetating lesion in the vesical trigone was observed. After two unsuccessful endoscopic resections of the lesion, the patient developed bilateral ureterohydronephrosis. Considering the extension of the lesion and the persistence of urinary symptoms, cystoprostatectomy with an ileal neobladder reconstruction was performed. The histopathological examination confirmed cystitis glandularis. DISCUSSION: There are two forms of cystitis glandularis: intestinal and typical. The latter is more frequent, while the intestinal is associated with mucin production and adenocarcinoma of the bladder. Clinically, cystitis glandularis manifests with hematuria and irritative and obstructive urinary complains typical of chronic cystitis. However, most cases of cystitis glandularis are asymptomatic. In the present report, invasive treatment was mandatory, due to failure in transurethral resection and to development of hydronephrosis.

In this study systemic response to intravenous administration of Aspergillus fumigatus conidia was investigated. The intensity of response was evaluated by a survival rate and by histopathological tissue analysis. Administration of all doses (106 - 5x107) of Aspergillus fumigatus conidia caused mortality, but the highest mortality and the shorter time of survival were noted at higher doses applied. At the highest applied dose, the presence of spores and hyphae was noted in lungs and kidneys. Histological analysis revealed the presence of intense inflammatory reaction in lungs, kidneys and spleen. Functional and histological changes observed provide means to study both mechanisms and drug interventions in systemic Aspergillus infection.

Extracorporeal shock wave lithotripsy (ESWL) is an effective and relatively noninvasive mode of treatment for urinary calculi. The aim of this study was to test whether therapeutic ESWL induces changes in renal parenchymatous blood flow and to evaluate shock wave side effects on the renal parenchyma. A total of 45 patients who underwent ESWL for ureteropelvic stone between January 2002 and July 2003 were included in this prospective study. Color Doppler sonography before and 30 minutes after ESWL showed no significant morphologic change. Resistive index (RI) was used to estimate renovascular resistance. The RI significantly increased in obstructed hydronephrotic kidneys. However, no significant change was observed in both treated and untreated kidneys before and after treatment. Hydronephrotic kidneys do not have a higher risk of post-ESWL renovascular resistance interference. The measurement of changes in RI with Doppler ultrasonography may provide useful information for clinical diagnosis of renal tubulointerstitial and vascular damage.