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Spontaneous occurrence and expulsion of a massive Steinstrasse

2024-01-01T00:00:00Z

Title: Spontaneous occurrence and expulsion of a massive Steinstrasse Authors: Kundargi, Vinay; Patil, Santosh; Patil, Siddanagouda B

A rare cause of epididymo-orchitis

2024-01-01T00:00:00Z

Title: A rare cause of epididymo-orchitis Authors: Patil, Siddanagouda Abstract: Epididymo-orchitis is an inflammatory lesion of the testis and epididymis with a lymphocytic exudate. Patients with acute epididymo-orchitis typically present with scrotal pain, swelling, tenderness and fever. Here, we present a patient with scrotal pain and hemiscrotal swelling as the main complaints; however further investigations revealed a completely different and rare diagnosis. Zinner’s syndrome is a very rare developmental anomaly of the Wolffian duct. To date, only about 200 cases have been diagnosed. It is a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Some patients remain asymptomatic and discovered incidentally, while others present with symptoms related to seminal vesicle cysts or ejaculatory duct obstruction: voiding or ejaculatory difficulty or pain. Treatment options include transurethral or transrectal aspiration and percutaneous drainage, however both are linked to an increased risk of recurrence. Symptomatic, complicated and recurrent cyst will require excision of the cyst, either laparoscopically or robotically.

rare prostatic tumour masquerading clinically as benign prostatic hyperplasia

2024-06-01T00:00:00Z

Title: rare prostatic tumour masquerading clinically as benign prostatic hyperplasia Authors: Kundargi, Vinay S. Abstract: Prostatic tumours are usually benign. Malignant tumours are usually adenocarcinoma. Rare benign prostate tumours include inflammatory myofibroblastic tumours, which can be found in various body parts and are frequently identified in the lung or abdominal cavity of children and young adults. Inflammatory myofibroblastic tumours of the urinary tract present more often in kidneys. Prostatic inflammatory myofibroblastic tumours are sporadic and rare. Presenting 44 years old male with complaints of gross hematuria for 15 days with recurrent urine retention. Per rectal examination revealed, grade II prostate enlargement was firm in consistency. PSA was mildly raised (4.4 ng/ml). Ultrasound abdomen showed enlarged prostate (volume -40 cc) with irregular margins and heterogeneous echo texture showing increased flow on colour Doppler. Transrectal ultrasound (TRUS) showed a well-defined irregular heterogeneously echoic mass in the transitional zone, but TRUS biopsy showed no malignancy. After TURP, prostate chip examination showed inflammatory myofibroblastic pseudotumour of the prostate. Differentiation of inflammatory myofibroblastic prostate tumours from malignant tumours through imaging and laboratory tests is difficult. A case of prostatic inflammatory myofibroblastic tumour observed after transurethral resection of the prostate to treat prostate hyperplasia in a 44-year-old man is presented in this report.

Prostate Disease Severity Score: In the management of benign enlargement of prostate

2024-01-01T00:00:00Z

Title: Prostate Disease Severity Score: In the management of benign enlargement of prostate Authors: Patil, Santosh Abstract: Objective: Developing a simple, user-friendly objective severity scoring system for symptomatic benign enlargement of prostate (BEP) and comparing with International Prostate Symptom Score (IPSS). Subjects and Methods: In this prospective study, patients with BEP completed IPSS proforma. A grading system was developed for peak flow of urine (Qmax), transitional zone index (TZI), detrusor wall thickness (DWT) and intravesical prostatic protrusion (IPP). Prostate Disease Severity Score (PDSS) was developed as sum of the variables. Results: Among 115 patients, obstructive voiding (70.43%) was predominant symptom followed by storage symptom (10.44%). Among predominant obstructive voiders, grades 1–3 TZI was common (97.53%), followed by IPP (64.19%) and DWT (62.96%) of varying grade. IPP, DWT, TZI and Qmax proved to be strong determinants of obstructive voiding (p < 0.05). The components of PDSS correlated well with total score (p < 0.05), positively correlated with IPP, DWT and TZI, and negatively with Qmax (p < 0.05); correlation with IPSS was statistically significant (p < 0.05). According to PDSS, 92.5% (37/40) patients with severe, 73.02% (46/63) with moderate, 8.33% (1/12) with mild degree of obstruction needed surgical intervention. Conclusion: The objective nature, comparable correlation with IPSS, potentiality to predict future need for surgical intervention, makes PDSS, a potential user-friendly assessment tool in management of BEP. Level of evidence: Not applicable