Focal xanthogranulomatous pyelonephritis: diagnostic and therapeutic aspects.

The authors report 2 cases of localized xanthogranulomatous pyelonephritis (XGP) in which computed tomography (CT) permitted to raise a motivated clinical suspicion of inflammatory disease: the surgical exploration documented absence of neoplasm and allowed a conservative therapy implying only the removal of the mass. A literature review confirms that some CT signs in XGP permit differentiation from carcinoma. If they are present, in unifocal cases of disease, the authors suggest a limited surgical approach and a therapeutic strategy as conservative as possible.     

Validation of the 3-variable prognostic score (3-PS) in mCRPC patients treated with 223Radium-dichloride: a national multicenter study

Annals of Nuclear Medicine - Radium-223 (223Ra) has been approved for treatment in patients with metastatic castration-resistant prostatic cancer (mCRPC) and bone metastasis. This α-emitting...     

Cystectomy and internal urinary diversion in bladder neoplasm. Role of CT in the follow-up

Fifty-seven patients, with prior cystectomy and continent urinary diversion for transitional cell carcinoma of the bladder, were evaluated with CT. Forty-two of them presented ureterosigmoidostomy and 15 orthotopic ileal bladder. The CT appearance of the normal post-cystectomy pelvis is emphasized. Both early and late surgical and neoplastic complications were detected. Early surgical complications, including urinary fistulae, urinomas, seromas, lymphoceles, and abscesses, were diagnosed over a 6-month postoperative period. Late surgical complications included hydroureteronephrosis, calculosis, and pyelonephritis. Hydroureteronephrosis, due to stenosis of the ureteral anastomosis, was the most frequent complication. All such neoplastic complications as local recurrence, lymphnode distant metastases, were identified. In 83% of cases they were observed over a 2-year postoperative period. Distant metastases in the upper abdomen were never detected. The authors' experience suggests the following as the optimal follow-up: a) CT examination over a 6-month postoperative period; b) yearly CT examinations and urography over 4 postoperative years; c) yearly US examination over the first 2 years after surgery, to depict renal pelvis dilatation. Skeletal scintigraphy is often necessary to detect metastatic bone lesions. It should be performed no later than 2 years after cystectomy.     

Self-introduction of foreign bodies into the urethra: A multidisciplinary problem

A 36-year-old man was hospitalized for self-insertion of a metallic body into the urethra. The self-inserted foreign body (SFB) was removed by endoscopic means; psychiatric evaluation of the patient showed a disturbed schizoid personality. After a review of the current literature, including clinical features, diagnostic manoeuvres and methods of treatment of SFB, the authors suggest that a psychiatric evaluation is always recommended in order to discover mental underlying disorders, thus reducing the risk of recurrence.     

Bladder explosion during transurethral resection of the prostate

A case of bladder explosion with wide rupture during transurethral resection of the prostate (TURP) is reported. Immediate cystography was performed and the patient was promptly operated; the postoperative course was uneventful. Intravesical explosion is caused by explosive gas formation and the more dangerous combination is the mixture of air and hydrogen; therefore, the introduction of air during TURP is necessary in order to produce a bladder explosion. This unusual complication of a common urological procedure is rare but serious, and should it arise always requires immediate surgical correction.