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Conclusion The patient subsequently recovered and was discharged and seen at our facility where he was definitively treated with percutaneous endoscopic marsupialization of the cyst into the collecting system and fulguration of the infected cyst wall with complete resolution.Background Anti-incontinence suspension procedures in women include Burch colposuspension or needle suspension procedures. Even though bladder injury is a known complication of any needle urethral or colposuspension procedure in women, it is rare. Delayed presentation may occur with lower urinary tract symptoms or hematuria. However, synechiae formations in bladder have rarely been reported. In this study, we report two cases presenting late with synechiae formation inside the bladder as a result of the suspension suture actually passing through the bladder and thus sewing the posterior and anterior walls of bladder together. Case Presentation Two ladies presented late after Burch colposuspension with nonresolving urinary symptoms. Both these ladies demonstrated a "smiley bladder sign" caused by a filling defect on cystogram. Cystoscopy revealed a synechial pillar attaching the anterior and the posterior walls, reminiscent of stalagnate-like column in the bladder cavity in both cases. Both cases were managed endoscopically with laser incision avoiding injury to the ureteral orifices. Conclusion A rare previously undescribed complication of Burch colposuspension and its typical appearance on cystogram is reported along with its endoscopic management. These cases highlight the use of intraoperative cystoscopy to prevent such complications.Background A giant vesical calculus is one weighing >100 g. A long-standing vesical calculus can be associated with squamous cell carcinoma of bladder. Case Presentation In this study, we report an unusual association of giant vesical calculus (weight 570 g) with adenocarcinoma of urinary bladder in a young man. We could find only two such cases in the literature. Conclusion Rarity of the association of giant vesical calculus and adenocarcinoma of the bladder and their management issues warrant this presentation.Background Symptomatic ureteral obstruction from a nonurologic metachronous metastatic malignancy is an unusual phenomenon that is underreported in the literature. This potential etiology for ureteral obstruction warrants consideration by the practicing urologist during a comprehensive evaluation as it may alter prognosis and management options for the afflicted patient. Case Presentation An 80-year-old Caucasian man with a remote history of prostate cancer and colon cancer presented with new unilateral ureteral obstruction characterized by hydronephrosis, acute kidney injury, and right-sided abdominal pain. A high clinical index of suspicion ultimately leads to the diagnosis of metastatic colon cancer on ureteral biopsy specimen. Conclusion Evaluation of symptomatic ureteral obstruction in a patient with a significant cancer history should include nonurologic malignant obstruction. Diligence in evaluation of the etiology of the ureteral stricture with repeat biopsies should be undertaken if there is clinical concern. Nephroureterectomy should be part of patient counseling for management of long segment malignant ureteral stricture disease.Background A juxtaglomerular cell tumor (JGCT), or a reninoma, is a rare renal tumor that can cause secondary hypertension. This is the first reported JGCT that was resected through robotic surgery. Case We present a case of a 27-year-old female patient with 1.35-cm-sized JGCT in the lower pole of the right kidney. We effectively removed a JGCT through robot-assisted partial nephrectomy without any complications. Conclusion The robot-assisted partial nephrectomy procedure could be a suitable choice for JGCT resection.Background Renal transplantation is a common surgical intervention for end-stage renal failure. Arterioureteral fistula (AUF) is a rare but important cause of gross hematuria that can be difficult to diagnose and associated with high morbidity and mortality. selleck products Case Presentation We report a case of a 68-year-old woman presenting with acute or chronic hematuria on a background of two renal transplants. Her initial renal transplant failed 8 years after the initial surgery but was left in situ. Her hematuria was initially investigated with cystoscopy; however, this did not identify a bleeding point and during which the patient became hemodynamically unstable. After transfer to the interventional radiology suite, the patient underwent fluoroscopic angiography. This did not immediately demonstrate a bleeding point. However, a CT angiogram was subsequently undertaken that identified an AUF between the native left ureter and the failed transplant renal artery. This was effectively managed with placement of a covered endovascular stent. Conclusion Owing to efficacy and safety, endovascular management is an attractive option for treatment of AUF. Furthermore, endovascular treatment may provide a transplant sparing option, in those with functioning organs.Background Urethral catheterization is a common procedure, with a low complication rate. Aberrant catheterization into a ureter is a rare complication. We present a case of an aberrant urethral catheterization into the right ureter in a postpartum female. Case Presentation An 18-year-old primigravida female presented with loin pain and catheter bypassing after a postpartum urethral catheterization. Examination under anesthesia and cystoscopy revealed the catheter leading into the right ureter, which was confirmed by subsequent CT urogram. Multiple attempts to remove the catheter failed. A rigid ureteroscopy was performed, revealing "kinking" of the catheter just distal to the balloon, as a result of an asymmetrical inflated balloon. A laser fiber inserted through the ureteroscope punctured the balloon, allowing balloon deflation and catheter removal under screening. A relook ureteroscopy 8 weeks later confirmed a healed ureter. Conclusion Asymmetric catheter balloon inflation causes kinking of a catheter and occlusion of the balloon port that will prohibit balloon deflation. During rigid ureteroscopy, a laser fiber can be used to puncture the catheter balloon, allowing balloon deflation and catheter removal.
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