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Moazin M, Altulayqi W, Tolah H, Alkeraithe F. A successful open neocystolithotomy in studer neobladder with Mitrofanoff for multiple large neobladder stones: A case report and review of the literature. Urol Case Rep 2023; 50:102474. [PMID: 37455777 PMCID: PMC10338960 DOI: 10.1016/j.eucr.2023.102474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/03/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Urolithiasis is a rare complication of orthotopic neobladder after cystectomy. We report a case of a 25-year-old female with studer neobladder and Monti valve presenting with recurrent urinary tract infections, abdominal pain, and difficult catheterization. Imaging revealed multiple large stones in the neobladder. Neocystolitholapaxy and neocystolithotripsy failed, leading to an open neocystolithotomy with retrieval of 14 large stones. Stone composition analysis showed struvite (30%), carbonate apatite (46%), and whitlockite (24%). Neobladder repair with omental interposition was performed. Follow-up confirmed an intact neobladder without leaks. Neobladder stones may be asymptomatic, and open neocystolithotomy is an effective treatment for multiple neobladder stones.
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Affiliation(s)
- Maher Moazin
- Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Waleed Altulayqi
- Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hamza Tolah
- Alrayan Medical Colleges, Medina, Saudi Arabia
| | - Fawaz Alkeraithe
- Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
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Owaidah MT, Bakir M, Moazin M, Aldaham N, Alqasem SR, Alfakri A, Almustanyir S. Painless Left Scrotal Mass: A Rare Case of Paratesticular Angiofibroma. Cureus 2022; 14:e24286. [PMID: 35607559 PMCID: PMC9123334 DOI: 10.7759/cureus.24286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 11/07/2022] Open
Abstract
Angiofibromas, also known as angiomyofibroblastoma-like tumors or AMF-like tumors, refer to a collection of rare, benign yet highly cellular tumors of the vulva, scrotum, perineum, or inguinal region. In this paper, we present a 34-year-old Saudi man who presented with findings of a testicular tumor on physical examination and imaging and tested negative for all the markers associated with testicular tumors.
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Moazin M, Almousa S, Alqasem S, Alhazmi A, Naif aldhaam, Alfakhri A. Management of iatrogenic ureteral injury: Ureteral reimplantation with a bilateral Boari flap. Urol Case Rep 2020; 31:101136. [PMID: 32257818 PMCID: PMC7118292 DOI: 10.1016/j.eucr.2020.101136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022] Open
Abstract
Reconstruction of the ureter is still regarded as a sophisticated approach demanding absolute dedication of the urologists. Similarly, iatrogenic ureteral injuries, as well as strictures, are quite common complexities of the pelvic and gynecological surgeries which if left untreated could lead to short as well as long-term issues. Presently, a case of a post-caesarian section along with hysterectomy of 40 years old woman has been presented that has resulted in distal left ureteral injury. A bilateral Boari flap was performed for the mobilization of the bladder.
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Almousa S, Alqasem S, Albraidi H, Alfadhel S, Alfakhri A, Moazin M. Robot-assisted hysterectomy in a 41-year-old male: A rare case report. Urol Case Rep 2020; 30:101121. [PMID: 32042594 PMCID: PMC7000811 DOI: 10.1016/j.eucr.2020.101121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/18/2022] Open
Abstract
Persistent Müllerian Duct Syndrome (PMDS) is regarded as a rare genetic disorder influencing internal sexual male development. PMDS is commonly diagnosed incidentally either during any pelvic surgery or examination of undescended testis. Currently, we have presented a case focusing on the phenotype individual who was presented to our institute with primary infertility as well as bilateral undescended testis, who underwent Robotic-assisted hysterectomy, left orchidectomy, and right orchiopexy.
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Affiliation(s)
- Saud Almousa
- Urology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saad Alqasem
- Urology Department, King Fahad Medical City, Riyadh, Saudi Arabia
- College of Medicine, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
- Corresponding author. College of Medicine, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia.
| | - Hamad Albraidi
- Urology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shoog Alfadhel
- King Saud bin Abdulaziz University for Health Sciences Riyadh, Saudi Arabia
| | | | - Maher Moazin
- Urology Department, King Fahad Medical City, Riyadh, Saudi Arabia
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Alqasem S, Alhamdan A, Alhefzi A, Alhazmi A, Moazin M, Alfakhri A. Acute scrotum in elderly; is it torsion ! Urol Case Rep 2020; 28:101032. [PMID: 31709147 PMCID: PMC6833350 DOI: 10.1016/j.eucr.2019.101032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/01/2019] [Indexed: 11/25/2022] Open
Abstract
Testicular torsion occurs most frequently in a preadulthood age. In geriatric people, it is very rare and should not be an exclusion criterion for the diagnosis. Lack of awareness about testicular torsion in elderly people may end up with delayed or misdiagnosis. In this article, we report a case of testicular torsion in 62 years old Saudi man.
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Almousa S, Moazin M, Alhazmi A. [89] Robot-assisted hysterectomy and bilateral orchidopexy for a patient with persistent Müllerian duct syndrome. Arab J Urol 2018. [DOI: 10.1016/j.aju.2018.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Munshi S, Moazin M, Abu-Daff S, Urrahman MA, Alamoudi OJ, Almehrej AH. Renal mucormycosis in immunocompromised patient, treated with Robotic Nephrectomy: Case report and review of articles. Urol Case Rep 2017; 15:53-55. [PMID: 28971022 PMCID: PMC5612790 DOI: 10.1016/j.eucr.2017.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 11/30/2022] Open
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Alamoudi O, Alsulaiman W, Aldhaam N, Moazin M. Incidental Finding of Adrenal Oncocytoma After Right Robotic Adrenalectomy: Case Report and Literature Review. Urol Case Rep 2017; 12:14-16. [PMID: 28271050 PMCID: PMC5328911 DOI: 10.1016/j.eucr.2017.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/20/2017] [Indexed: 11/25/2022] Open
Abstract
Oncocytic neoplasms occur in several organs and are most commonly found in the thyroid, kidneys and salivary glands. Oncocytic neoplasms of the adrenal cortex are extremely rare and are usually non-functioning, benign and incidentally detected. However, histologically, they are characterized by cells with eosinophilic granular cytoplasm and numerous packed mitochondria. We report a case of 33 year old lady medically free complain of right flank pain radiated to the lower abdomen, not associated with any aggravating or relieving factor or any other symptom there was no evidence of hypertension symptom, by the Magnetic resonance imaging (MRI) showed that she has large heterogeneous mass seen at the right adrenal gland, and it was managed successfully by Robot-Assisted Right Adrenalectomy.
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Affiliation(s)
| | | | - Naif Aldhaam
- King Fahd Medical City, Algader, Riyadh 11525, Saudi Arabia
| | - Maher Moazin
- King Fahd Medical City, Algader, Riyadh 11525, Saudi Arabia
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Abstract
Adrenal incidentalomas is a term increasingly used now and applied to any adrenal mass that is found incidentally on an imaging of a patient with complaints not related to adrenal pathology. This case report presents a patient with incidental adrenal mass that was evaluated according to proposed recommendations and planned for robotic-assisted laparoscopic adrenalectomy. There is increasing number of literatures on the advantages of robotic surgery for adrenal resection; however, there is controversy regarding the hemodynamic stability of patients during these procedures especially with patient suspected to have pheochromocytoma. We included literature reviews on the role of robotics and use of laparoscopy for adrenalectomy and the anesthetic considerations in these procedures aiming to raise awareness and draw attention to this increasingly emerging disease entity.
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Affiliation(s)
- Reema M Al-Hadhrami
- Department of Anesthesia and Operating Theatres, and Urology, King Fahad Medical City, Riyadh, Kingdom of Saudia Arabia
| | - Nehal Gahndour
- Department of Anesthesia and Operating Theatres, and Urology, King Fahad Medical City, Riyadh, Kingdom of Saudia Arabia
| | - Sherine Qudeera
- Department of Anesthesia and Operating Theatres, and Urology, King Fahad Medical City, Riyadh, Kingdom of Saudia Arabia
| | - Maher Moazin
- Department of Anesthesia and Operating Theatres, and Urology, King Fahad Medical City, Riyadh, Kingdom of Saudia Arabia
| | - Razan Nafakh
- Department of Anesthesia and Operating Theatres, and Urology, King Fahad Medical City, Riyadh, Kingdom of Saudia Arabia
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Rassweiler J, Wagner AA, Moazin M, Gözen AS, Teber D, Frede T, Su LM. Anatomic nerve-sparing laparoscopic radical prostatectomy: Comparison of retrograde and antegrade techniques. Urology 2006; 68:587-91; discussion 591-2. [PMID: 17010729 DOI: 10.1016/j.urology.2006.03.082] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Revised: 12/16/2005] [Accepted: 03/23/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare the anatomic retrograde and antegrade preservation of the neurovascular bundle (NVB) during laparoscopic radical prostatectomy. METHODS Anatomic studies were reviewed, focusing on the fascial layers surrounding the prostate and NVB and the terminology used as described by Walsh and colleagues. Important operative steps have been illustrated using video clips. For the retrograde technique, after incision of levator fascia, the NVBs were released from the apex before division of the urethra. Along the plane between the laterally incised Denonvilliers and perirectal fascia, the prostate was mobilized from the rectum. Isolated clipping of the seminal vesicle arteries was performed in an antegrade manner, followed by control of the lateral pedicles, and identification of the course of the NVB. For the antegrade technique, after dissection of the seminal vesicles, the levator fascia was incised to develop a lateral NVB groove. After bladder neck division and lateral pedicle ligation, the lateral NVB groove was used as a guide for antegrade preservation of the NVB. During anastomosis, the NVBs located at the 5-o'clock and 7-o'clock positions were avoided in both techniques. RESULTS A questionnaire-based potency rate of 67% and 76%, respectively, was reported after bilateral nerve sparing using retrograde and antegrade laparoscopic radical prostatectomy techniques. CONCLUSIONS Both techniques allowed replication of open surgical principles. The video magnification enabled excellent demonstration of the periprostatic anatomy. The principles of interfascial dissection of the NVB, use of task-specific instrumentation, and avoiding energy sources around the NVB may be more important than the actual nerve-preservation technique used.
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Affiliation(s)
- Jens Rassweiler
- Department of Urology, SLK Kiniken Heilbronn, University of Heidelberg, Heidelberg, Germany
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Gözen AS, Teber D, Moazin M, Rassweiler J. Laparoscopic transvesical urethrorectal fistula repair: A new technique. Urology 2006; 67:833-6. [PMID: 16618569 DOI: 10.1016/j.urology.2005.10.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 09/16/2005] [Accepted: 10/14/2005] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Urethrorectal fistulas are rare, and several open operative approaches and techniques have been used in treatment. We report our preliminary experience with laparoscopic transvesical urethrorectal fistula repair after iatrogenic urethrorectal fistula. A 65-year-old man with insulin-dependent diabetes mellitus and peripheral vascular disease was hospitalized 6 months after transurethral resection of the prostate for benign prostatic hyperplasia with a recurrent urinary tract infection, fecaluria, and urine leakage from the rectum during voiding. Urethrocystoscopy revealed a urethrorectal fistula in the prostatic fossa. Primary conservative treatment failed. TECHNICAL CONSIDERATIONS The patient was placed in the lithotomy position, and the suprapubic tract was dilated to allow a 10-mm telescope. Carbon dioxide gas was used to distend the bladder (15 mm Hg, flow rate 3 L/min). Next, two 3-mm pediatric trocars were inserted under direct vision. The fistula was identified and the edge of the fistula excised. A running suture (3-0 PDS, RB needle) was used to close the fistula. Finally, a 16F Foley urethral catheter was passed under direct vision, followed by a suprapubic catheter. On postoperative day 12, retrograde cystography revealed no contrast leakage from the rectum. Follow-up after 3 months showed no recurrence of the fistula. CONCLUSIONS A transvesical laparoscopic technique might be useful for selective cases of urethrorectal fistula. Other methods of laparoscopic urethrorectal fistula repair have included bivalving of the bladder and omental interposition. The laparoscopic transvesical approach provides many advantages, including easy access and identification of the fistula tract, good surgical exposure, and minimal tissue manipulation.
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Affiliation(s)
- Ali S Gözen
- Department of Urology, SLK Kliniken Heilbronn, University of Heidelberg, Heilbronn, Germany
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Mai KT, Moazin M, Morash C, Collins JP. Transitional zone and anterior peripheral zone of the prostate. A correlation of small-volume cancer in the biopsy cores and high psa with positive anterior margins in radical prostatectomy specimens. Urol Int 2001; 66:191-6. [PMID: 11385304 DOI: 10.1159/000056613] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Prognostically significant prostatic adenocarcinomas (PAC) may pose diagnostic problems if they were localized in the anterior peripheral zone (APZ) or transitional zone (TZ). MATERIALS AND METHODS 108 cases of PAC were reviewed along with serum PSA and TRUS biopsies. The PACs were divided into 22 TZ, 17 APZ and 69 posterior peripheral zone (PPZ) PACs according to the location of the main tumor mass in the TZ and anterior or posterior half of the peripheral zone in the radical prostatectomy (RP) specimens. RESULTS In comparison with PPZ PAC, TZ PAC had a higher cancer volume in RP specimens (4 +/- 2.1 vs. 2.5 +/- 1.7 cm3, p < 0.01), a higher serum PSA (16.5 +/- 9.8 vs. 8.4 +/- 4.5 microg/l, p < 0.001), a biopsy with a small cancer volume (3.8 +/- 2.1 vs. 11.8 +/- 9.4 mm, p < 0.005), and a lower Gleason's score (4.8 +/- 2.1 vs. 6.5 +/- 1.7). APZ PAC was characterized by the cancer volume in RP and biopsy and PSA intermediate between those of TZ and PPZ PAC. Among 24 PACs with a total cancer core length of <3 mm, 19 cases were from the TZ and APZ groups and also had a higher cancer volume and PSA than those from the PPZ group (2.9 +/- 1.8 vs. 1.5 +/- 1.3 and 13.7 +/- 8.3 vs. 9.6 +/- 4 microg/l, respectively). Furthermore, there was a better correlation coefficient (r(2)) of tumor volume in the biopsy and RP for PPZ than for all zones PAC (r2 = 0.75 vs. 0.29). TZ and APZ carcinomas were associated with extension or satellite nodules of PAC in the PPZ that may be diagnosed with biopsies. These PACs were associated with positive anterior resection margin due to extracapsular extension of the carcinoma or intracapsular dissection in 6 and 5 cases respectively. CONCLUSIONS TZ and APZ PACs accounted for the poor correlation between the tumor volume in the biopsy and the RP, and were associated with positive anterior resection margins. One core biopsy with a total cancer core length of <3 mm and PSA >10 microg/l are suspicious for TZ and APZ PCA in patients with undetectable tumors with DRE or TRUS. Clinically insignificant PACs tend to be associated with cancer core <3 mm and PSA <10 microg/l.
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Affiliation(s)
- K T Mai
- Division of Anatomical Pathology, Department of Laboratory Medicine, The Ottawa Hospital, Civic Campus, University of Ottawa, Ottawa, Ont., Canada.
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