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ABSTRACT: The urachus is a vestigial obliterated structure derived from the alantois. Failure of this involution process originates patent urachal remnants. Surgery is the treatment of choice as it prevents both recurrence of symptoms and malignant transformation. The purpose of this study is to present our experience in the laparoscopic management of this pathology.
Three male patients (mean age 39 years) underwent laparoscopic excision of urachal remnants. Two patients were diagnosed with an asymptomatic cyst and one patient with urachal sinus presenting with umbilical discharge. A three-port technique was used to remove the whole urachus tract from the umbilicus to the bladder dome, together with a small bladder patch.
Mean operating time was 94 min and blood loss was minimal. One patient had small intra-operative bladder rupture, successfully managed with adequate closure. No post-operative complications were observed and all patients were discharged on the second postoperative day. Two years later there was no evidence of recurrence.
Urachal remnants can be successfully treated by laparoscopic surgery, with advantages in terms of morbidity, recovery and cosmetic outcome. Large number, comparative studies are still needed to definitely establish it as the gold standard treatment.
Actas urologicas españolas 10/2011; 36(5):320-4. · 0.46 Impact Factor
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ABSTRACT: Renal cancer with vena cava tumour thrombus is relatively rare (4 to 10%). Because of the poor results obtained with any kind of alternative therapy (e.g. radiation, hormonal, chemotherapy and immunotherapy) operation with complete removal of the vena cava tumour thrombus continues to be the better method of treatment. The prognostic significance of the cephalic extent of an inferior vena caval tumor thrombus associated with renal cell carcinoma is controversial. Long-term survival after surgical treatment is possible in patients with localized renal cell carcinoma (survival 50% at five years). The authors report a case of vena caval extension of renal cell carcinoma in a 70-years-old man. The patient presented with a history of right lumbar pain and pedal edema. Magnetic Resonance demonstrated the presence and the level of tumoral thrombus. The patient was submitted to a radical nephrectomy and complete removal of tumor thrombus from vena caval.
Actas urologicas españolas 10/2001; 25(8):596-9. · 0.46 Impact Factor
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ABSTRACT: Incidental discovery of vesical hernias during herniorrhaphy is quite common. In such cases, patients are usually asymptomatic since the hernia portion is small and easily repairable. On the other hand, vesical solid protrusion to the scrotum is quite unusual, and is generally found associated to obstructive urinary symptoms. Management involves basically the correction of any associated obstructive conditions, correction of the vesical hernia and herniorrhaphy.
Actas urologicas españolas 06/1997; 21(5):514-8. · 0.46 Impact Factor
