interobserver variation in RTQA feedback and allow meaningful interpretation of RTQA results with associated outcomes.RTQA should implement prospective TVD review to identify deviations that require modification prior to treatment delivery.
A radical orchiectomy is one aspect of the definitive treatment of testicular cancer. Testicular cancer generally affects young men between puberty and about 40 years. Successful treatment incorporates a number of modalities, including radical orchiectomy, retroperitoneal lymph node dissection, chemotherapy, and radiation.
We present a case of a 32-year-old male who developed capecitabine-induced phimosis which resolved spontaneously without the need for circumcision within a few days of discontinuation of chemotherapy. The patient was on capecitabine with irinotecan chemotherapy for peritoneal metastasis from adenocarcinoma of the lower esophagus. A detailed literature review showed a few case reports with penile and scrotal erythema, ulceration, and swelling along with hand-foot syndrome, but none reported the occurrence of phimosis with spontaneous resolution.
Comprehensive preoperative evaluation of potential donors is crucial for selecting the right donor, with adequately functioning kidneys, and the best surgical approach for harvesting the organs to prevent donor-related complications and to assure good recipient graft function. Multidetector computed tomography is the choice of imaging in the preoperative evaluation of living renal donors with an accuracy of 95%–100%. The donor must retain one normal kidney. The left kidney is preferred for living donor nephrectomy because it has a longer renal vein and it is technically easier to remove. It is always preferable to choose kidneys with a single artery because both donor and recipient surgeries are less complicated and there is less risk for arterial thrombosis. We report in a case of successful transplantation wherein the donor had an early division of the main renal artery bilaterally as well as bilateral accessory renal arteries.
Changes in anatomy, as well as other metabolic factors, often result in the urinary tract infection and urolithiasis in patients after urinary diversion. The surgical management of stones in patients after urinary diversion is challenging. We report the case of a 21-year-old female presenting with fever. This patient had earlier undergone the creation of a continent urinary reservoir with appendicular catheterizable stoma for a failed exstrophy repair. We report the management of urinary stones occurring in this patient.
Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A total of three (8.10%) children developed an urethrocutaneous fistula needing an additional stage for repair. Uroflowmetry done in all children showed adequate maximum flow rates, with minimal to nil residuals. Conclusions: The majority of hypospadias failures can be salvaged with one stage surgery including Mathieu flip flap Urethroplasty, Tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. A two stage buccal mucosa urethroplasty may be necessary in cases wherein the urethral plate or skin substitute is grossly scarred, or the ventral curvature greater than 30 degrees. Complications do occur following redo procedures but eventually excellent functional and cosmetic results can be achieved.
Renal Angiomyolipoma is a common tumour in clinical practice and mostly follows a benign course. Angiomyolipoma is the most common renal neoplasm associated with spontaneous retroperitoneal haemorrhage due to rupture of micro and macro-aneurysms. Urgent trans-catheter angio-embolization of the bleeding vessel is very effective in patients suffering from life threatening hemorrhage secondary to rupture of Angiomyolipoma. Elective surgery is usually indicated to avoid re-bleeding or abscess formation. We report a case of Spontaneous Rupture of Angiomyolipoma of Right kidney in 63 years old female. The female underwent emergent Trans-arterial Embolization followed by elective nephrectomy.
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