• Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 4-2002. A 75-year-old man with acute

• Noncontrast computed tomography in obstructive anuria: a prospective study.

• Synchronous transitional cell carcinoma in both moieties of an incomplete duplex system.

• Late ureteral conduit urinary leak as a presentation of urothelial carcinoma of the ureter.

• [Urinary BTA-TRAK in the follow-up of superficial transitional-cell bladder carcinoma]

• Implantation metastasis in ureter from a colonic adenocarcinoma.

• [A case of adenocarcinoma arising in female urethral diverticulum]

• [Tuberculous epididymitis following intravesical Bacillus Calmette-Guerin therapy]

1
UI - 11821513
AU - Bazari H; Mauiyyedi S
TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 4-2002. A 75-year-old man with acute renal failure five months after cystoprostatectomy and urethrectomy for carcinoma.
SO - N Engl J Med 2002 Jan 31;346(5):353-60

2
UI - 12031369
AU - Shokeir AA; Shoma AM; Mosbah A; Mansour O; Abol-Ghar M; Eassa W; El-Asmy
TI - A Noncontrast computed tomography in obstructive anuria: a prospective study.
SO - Urology 2002 Jun;59(6):861-4
AD - Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
OBJECTIVES: To evaluate the role of noncontrast computed tomography (NCCT) in the determination of the cause of obstructive anuria and to compare its accuracy with that of the traditional methods of combined plain abdominal x-ray (KUB) and gray-scale abdominal ultrasonography (US). METHODS: The study included 40 consecutive patients with obstructive anuria. In addition to the routine evaluation, which included history, clinical examination, biochemical profile, KUB, and US, all patients underwent NCCT. The study patients were tested against an age and sex-matched control group that included the normal contralateral kidneys of 57 consecutive patients who underwent KUB, US, and NCCT for acute flank pain during the same study period. The reference standard for the determination of the cause of obstruction was retrograde or antegrade ureterography with or without ureteroscopy or open surgery. The absence of obstruction in the control group was confirmed by nonequivocal normal intravenous urography of the side free of flank pain. Both NCCT and combined KUB and US were compared regarding the sensitivity, specificity, and overall accuracy. RESULTS: The study group had 48 renal units, because obstruction was bilateral in 8 patients and of a solitary kidney in 32. Of the 42 renal units with calculus obstruction, the site of stone impaction was identified in all renal units by NCCT (sensitivity 100%) and in only 25 by combined KUB and US (sensitivity 59.5%)-a significant difference (P = 0.0001). Of the 6 renal units with noncalcular obstruction, both NCCT and US diagnosed the cause of obstruction in 3. The overall sensitivity of NCCT in the determination of the cause of obstructive anuria was 94% and that of combined KUB and US was 58%-a significant difference (P = 0.0001). The specificity of NCCT was not significantly different from that of combined KUB and US (96.5% versus 93%, respectively). The overall accuracy of NCCT was 95% and that of combined KUB and US was 77%-a significant difference (P = 0.0003). CONCLUSIONS: In patients with obstructive anuria, conventional KUB and US could not identify the cause of ureteral obstruction in about 40% of the patients. Under such conditions, NCCT can accurately provide the diagnosis, obviating the need of invasive and expensive diagnostic procedures.

3
UI - 12031387
AU - Li JD; Lin JS; Yao WJ
TI - Synchronous transitional cell carcinoma in both moieties of an incomplete duplex system.
SO - Urology 2002 Jun;59(6):944-5
AD - Department of Diagnostic Radiology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.

4
UI - 12031389
AU - So A; Hickey L; Norman R
TI - Late ureteral conduit urinary leak as a presentation of urothelial carcinoma of the ureter.
SO - Urology 2002 Jun;59(6):946
AD - Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.
Urinary leakage at the ureteroenteric anastomosis in patients with urinary diversion is a rare complication that usually occurs in the early postoperative period, regardless of the indication for surgery. To our knowledge, ureteroenteric urinary leaks that occur late in the postoperative period have not been described. We present a unique case of a late ureteroenteric anastomotic leak within an ileal conduit that occurred as a result of recurrent urothelial carcinoma of the ureter at the site of anastomosis.

5
UI - 11957750
AU - Fernandez Gomez JM; Garcia Rodriguez J; Escaf Barmadah S; Raigoso P;
TI - Rodriguez Martinez JJ; Allende MT; Casasola Chamorro J; Rodriguez Faba O; Martin Benito JL; Regadera Sejas FJ [Urinary BTA-TRAK in the follow-up of superficial transitional-cell bladder carcinoma]
SO - Arch Esp Urol 2002 Jan-Feb;55(1):41-9
AD - Servicio de Urologia, Hospital Central de Asturias, Facultad de Medicina, Universidad de Oviedo, Oviedo, Asturias, Espana. rosalin@interbook.net
OBJECTIVE: To determine the efficacy of urinary BTA-TRAK as a marker in monitoring superficial transitional cell carcinoma of the bladder and to compare urine cytology with urinary sediment testing. METHODS: 700 consecutive determinations using BTA-TRAK to monitor unselected patients that had undergone surgery for transitional cell carcinoma of the bladder were analyzed. Cystoscopy, urinary sediment and urine cytology were performed during follow-up. Urography was performed yearly or when tumor of the upper urinary tract was suspected. (positive cytology or hematuria with no bladder tumor). Cystoscopy was performed a few days after determination of BTA-TRAK and voiding urine cytology and urinary sediment analyses (considered positive when microhematuria was observed) were both requested. RESULTS: Of the 700 determinations, 95 (13.6%) were urothelial carcinomas (93 bladder, 2 upper urinary tract) that had been discovered during patient monitoring. Of the 93 bladder tumors, 39 were Ta (37 TaG1 and 2 TaG2), 29 T1 (4 T1G1, 20 T1G2 and 5 T1G3), 5 Tis and 20 muscle-infiltrating tumors (progression from T2-4 during monitoring). The sensitivity of urine cytology to detect urothelial tumor was 41.1% and the specificity was 97.3%. The urine cytologies were negative in 48.4% and inflammatory in 9.5% of the tumors. The sensitivity was 19% in low grade tumors. The sensitivity of urinary sedimentation testing to detect urothelial tumor (microhematuria) was 40% and the specificity was 96.7%. When associated with pyuria, it was considered to be a urinary infection or urothelial inflammatory condition, which was observed in 10.6% of the cases. Considering the proposed normal reference value for BTA-TRAK (< or = 14 U/ml), we have found a sensitivity of 62.1% and a specificity of 68.4%. A logistic regression model was developed, including BTA-TRAK, urinary sedimentation and cytology, to identify the independent variables that are useful for tumor detection during follow-up of superficial carcinoma of the bladder in this series. The combination of three variables showed an odds ratio of 18.5 (8.9-38.5) for urinary cytology, 11.8 (5.9-23.5) for urinary sedimentation and an odds ratio for BTA-TRAK that did not fall within the equation. CONCLUSIONS: Although overall the sensitivity of BTA-TRAK is higher than that of urine cytology and urinary sedimentation testing, it provides no additional information than that obtained from the combination of urine cytology and urinary sedimentation testing in the detection of tumor recurrence during monitoring for superficial bladder cancer.

6
UI - 11771872
AU - Thorup B; Fabrin K; Lund L
TI - Implantation metastasis in ureter from a colonic adenocarcinoma.
SO - Scand J Urol Nephrol 2001 Oct;35(5):420-1
AD - Department of Surgery, Viborg Hospital, Denmark.
Metastasis to the ureter is very rare. In most published cases, the diagnosis is only made at postmortem examination or when gross metastasis is present. This report presents a case in which the metastasis from a colonic tumour occluded the ureteral lumen from inside.

7
UI - 12048938
AU - Kanno T; Moroi S; Okuno H; Terai A; Kakehi Y; Ogawa O
TI - [A case of adenocarcinoma arising in female urethral diverticulum]
SO - Hinyokika Kiyo 2002 Apr;48(4):235-7
AD - Department of Urology, Graduate School of Medicine, Kyoto University.
An 81-year-old woman was admitted with a chief complaint of bloody discharge from the urethra. On physical examination an elastic-soft mass was palpable beneath the anterior vaginal wall. Magnetic resonance imaging and computed tomographic scan revealed the mass around the urethra. Transvaginal needle biopsy was performed and the histopathologic finding was adenocarcinoma. The tumor was excised with the uterus, the ovary and the anterior vaginal wall. The macroscopic appearance suggested that the tumor arose in the urethral diverticulum. She had intravesical recurrence at 8 months after the operation, and partial cystectomy was performed. However there was recurrence again, and radical cystectomy was performed finally. We review 81 cases of urethral diverticular carcinoma in the literature.

8
UI - 12056045
AU - Okadome A; Takeuchi F; Ishii T; Hiratsuka Y
TI - [Tuberculous epididymitis following intravesical Bacillus Calmette-Guerin therapy]
SO - Nippon Hinyokika Gakkai Zasshi 2002 May;93(4):580-2
AD - Department of Urology, Chikushi Hospital, Fukuoka University, Chikushino, Japan.
Bacillus Calmette-Guerin (BCG) immunotherapy is increasingly being accepted for management of some bladder transitional cell neoplastic lesions. Mild adverse reactions occur frequently. However, an unusual complication of tuberculous epididymitis is reported. A 64-year old man presented with bilateral epididymal mass. Four months earlier he had seven treatments with intravesical BCG instillation (Tokyo 172 strain) for a grade 2 transitional cell carcinoma in situ. Bilateral epididymectomy was performed. Microscopic examination of the epididymis revealed chronic inflammation and necrosis with granulomas and Langhans' giant cells. After the operation, there were no further complications.

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