Small bowel obstructions are commonly caused by bowel adhesions from previous intra-abdominal surgeries.1 Bowel obstructions in adults that are caused by the presence of vestigial embryonic structures are unusual.2 Omphalomesenteric duct and urachus are primitive embryonic structures, which normally involute between the 5th and 12th week of gestation.3 4 Failure to involute leads to anomalies such as patent ducts and omphalomesenteric cysts.2 5 6 7 Omphalomesenteric duct remnants are present in at least 2% of the population.2 Among the urachal remnants, a patent urachus is less common, only accounting for 15% of the cases.8 Simultaneous occurrence of both remnants is rare.5 Diagnostic imaging, such as ultrasonography, is usually performed to facilitate planning for subsequent management of patients who present with chronic symptoms related to the persistence of these remnants.9 Computed tomography may also be done to determine the location, size and patency of ducts and cysts, while voiding cystourethrograms can be used to determine bladder wall involvement.8 However, among undiagnosed patients who present with acute bowel obstruction, the presence of these remnants is usually established intraoperatively during exploratory laparotomy. The approach to treatment involves excision of the remnants and appropriate surgical management of the bowel obstruction.1 2 5 6 10 11 Prognosis is often good with uneventful postoperative recovery.1 2 5 A 29-year-old male came to our emergency room complaining of generalized, vague abdominal pain, gradual abdominal distension, post-prandial vomiting of previously eaten food, obstipation, and fever within 48 hours before consultation. The patient did not report any history of weight loss or gastrointestinal symptoms prior to the onset of the present problem. On physical examination, the patient was tachycardic and showed signs of an acute abdomen. Digital rectal examination showed an empty rectal vault, with no masses or bleeding noted. Laboratory findings revealed leukocytosis at 18.3 x 103/µL and normal serum electrolyte levels. Upright and supine abdominal x-rays showed dilated bowel loops with thickened serosa and multiple air-fluid levels (Figure 1A, 1B). We did an exploratory laparotomy with a working diagnosis of complete intestinal obstruction. Intraoperatively, we noted torsion of the ileum (Figure 1C) around a band, which runs from the ileum approximately 80 cm from the ileocecal valve, to the umbilicus. The band, an omphalomesenteric remnant, contains a cyst measuring 10 x 4.7 x 3 cm. (Figure 1D). We also noted a patent urachus inferior to the omphalomesenteric remnant, connecting the bladder to the umbilicus (Figure 1E). We detorted the bowels manually, resected the portion of the ileum where the omphalomesenteric remnant was attached, and did a double-barrel ileostomy. We excised the urachal remnant and performed cystorrhaphy and umbilicoplasty. The patient had an unremarkable postoperative recovery. Ileal anastomosis was planned to take place around 6 weeks postoperatively. Given the unexpected intraoperative findings of persistent embryonic structures, we asked the patient postoperatively about history of related symptoms. The patient denied of recurrent urinary tract infections in the past, but he claimed to have intermittent umbilical wetness with non-foul-smelling discharge, which spontaneously resolved after a few years, when he was a teenager. Omphalomesenteric remnants can be a cause of intestinal obstruction in adults with no previous history of surgery. A history of symptoms related to the presence of the remnants is rarely elicited preoperatively. Excision of the remnants with appropriate repair of affected structures and adequate management of the intestinal obstruction usually resolves the problem.
Intestinal Obstruction ; Urinary Bladder Diseases

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient’s state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.
Biomarkers* ; Central Nervous System ; Humans ; Implantable Neurostimulators ; Reflex ; Urinary Bladder Diseases ; Urinary Bladder* ; Urinary Tract ; Urination

Cholesteatoma of the urinary tract is an extremely rare disease occurring in the bladder and renal pelvis. We report the radiologic findings in two cases of renal cholesteatoma involving the renal pelvis, calyces and ureter, and correlate these with the histopathologic findings.
Cholesteatoma* ; Kidney Pelvis ; Rare Diseases ; Ureter ; Urinary Bladder ; Urinary Tract

Primary ureteral carcinoma is a rare disease comprising 1% of all urinary tract tumors. Primary adenocarcinoma of the ureter is extremely rare. We report a case of primary ureteral adenocarcinoma associated with long-standing ureteral stone in 40-year-old man, who was treated by nephroureterectomy with bladder cupping, with a brief review of the literatures.
Adenocarcinoma* ; Adult ; Humans ; Rare Diseases ; Ureter* ; Urinary Bladder ; Urinary Tract

Ultrasound is effective in evaluating pathologic entities of renal and bladder diseases. The advantage of the ultrasound scanning is no harmful, not need preparation, more comfortable and cheaper than other diagnostic methods with relative high diagnostic accuracy. Also ultrasound seems good primary screening test with I.V.P. in urologic diseases. So we made a brief clinical observation and reported with review of literature.
Hydronephrosis ; Mass Screening ; Ultrasonography* ; Urinary Bladder Diseases ; Urinary Bladder Neoplasms ; Urologic Diseases*

Ultrasound is effective in evaluating pathologic entities of renal and bladder diseases. The advantage of the ultrasound scanning is no harmful, not need preparation, more comfortable and cheaper than other diagnostic methods with relative high diagnostic accuracy. Also ultrasound seems good primary screening test with I.V.P. in urologic diseases. So we made a brief clinical observation and reported with review of literature.
Hydronephrosis ; Mass Screening ; Ultrasonography* ; Urinary Bladder Diseases ; Urinary Bladder Neoplasms ; Urologic Diseases*

Human ; Male ; Cholinergic Antagonists ; Urinary Bladder, Overactive ; Urinary Bladder Diseases ; Urologic Diseases ; Male Urogenital Diseases ; Prostatic Diseases

We evaluated the results of urine cytology and urine flow cytometry in 33 patients with transitional cell carcinoma of the bladder and 15 patients with other urologic diseases. The sensitivity of voided urine cytology, washed urine cytology, voided urine flow cytometry and washed urine flow cytometry was 39%, 54%, 57% and 66%, respectively. The specificity of voided urine cytology. washed urine cytology, voided urine flow cytometry and washed urine flow cytometry was 100%, 93%. 86% and 73%, respectively. Washed urine cytology or flow cytometry was more sensitive, but less specific than void urine cytology or flow cytometry. Flow cytometric measurement was superior to conventional cytology in sensitivity. Combination of voided urine cytology and flow cytometry significantly increased the sensitivity from 39% to 66% equal to that of washed urine flow cytometry. Combination of washed urine cytology and flow cytometry also increased the sensitivity from 54% to 75% but the difference was not significant. These results indicate that combination of voided urine cytology and flow cytometry is non-invasive and more sensitive method than conventional voided urine or washed urine cytology.
Carcinoma, Transitional Cell ; Flow Cytometry* ; Humans ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urologic Diseases