Peyronie's disease (PD) is an inflammatory disorder characterized by an abnormal collagen deposition in the tunica albuginea of the penis, leading to fibrous and non-compliant plaques that can impede normal erection. Although pharmacological treatments are available, only intralesional injection therapy and surgical reconstruction have demonstrated tangible clinical efficacy in the management of this condition. Intralesional injection of collagenase clostridium histolyticum (CCH) has come to the forefront of minimally invasive treatment of PD. In this review, the authors provide an update on the safety, efficacy, and indications for CCH. The efficacy of CCH will be assessed on the basis of improvement in the severity of penile fibrosis, curvature, and pain. Numerous well-designed clinical trials and post-approval studies involving more than 1,500 patients have consistently demonstrated the efficacy and tolerability of CCH in the treatment of PD. CCH significantly decreases penile curvature and plaque consistency, as well as improves quality of life. Post-approval studies continue to demonstrate the efficacy of CCH despite broader inclusion criteria for treatment, such as the case with acute phase disease and atypical plaque deformities (i.e., ventral plaques, hourglass narrowing). CCH continues to be the gold standard for non-surgical management of stable phase PD, in the absence of strong evidence supporting oral therapy agents and ongoing evaluation of extracorporeal shockwave therapy. However, recent studies are beginning to provide precedent for the use of CCH in the management of acute phase and atypical PD.
Collagen ; Collagenases* ; Congenital Abnormalities ; Fibrosis ; Humans ; Injections, Intralesional ; Male ; Microbial Collagenase* ; Penile Induration* ; Penis ; Quality of Life ; Treatment Outcome ; Urologic Diseases

We report a case of epidermolysis bullosa simplex, Dowling-Meara type (EBS-DM), which was associated with congenital pyloric atresia (PA) and various urologic abnormalities, a diagnosis confirmed by immunofluorescence mapping and electron microscopic findings. Immunofluorescent mapping showed the serum from a patient with bullous pemphigoid faintly binding to the floor of the blister, and monoclonal antibodies against type IV and VII collagens were also stained on the floor of the blister. Electron microscopy showed epidermolytic cleavage and prominent clumping of tonofilaments in the basal and suprabasal keratinocytes. An abdominal radiograph and barium swallow showed a complete obstruction at the pyloric channel level. The widespread bullae healed without any scar formation and the bullae formation was localized on the extremities after 3 months of age without any specific treatment. Multiple urologic abnormalities such as bilateral hydronephrosis, hydroureter and a distended bladder with trabeculation were observed at 12 months of age. Currently, with the patient at 4 years of age, bullae still appear on the hands and feet and nail shedding can be observed. The patient's father, a paternal uncle and a paternal aunt had had similar bullous eruptions in infancy, all of which had improved spontaneously by the age of one.
Case Report ; Collagen/metabolism ; Epidermolysis Bullosa Simplex/pathology ; Epidermolysis Bullosa Simplex/metabolism ; Epidermolysis Bullosa Simplex/complications* ; Human ; Infant, Newborn ; Male ; Pylorus*/radiography ; Stomach Diseases/radiography ; Stomach Diseases/complications* ; Urologic Diseases/congenital* ; Urologic Diseases/complications*

This review article comprehensively discusses multidetector CT urography protocols and their role in imaging of the urinary tract in patients with hematuria.
Hematuria/etiology/*radiography ; Human ; Incidental Findings ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods/standards ; Urinary Tract/abnormalities ; Urography/methods/standards ; Urologic Diseases/complications/congenital/radiography

Congenital renal arteriovenous malformations are very rare benign lesions. They are more common in women and rarely manifest in elderly people. In some cases, they present with massive hematuria. Contemporary treatment consists of transcatheter selective arterial embolization which leads to resolution of the hematuria while preserving renal parenchyma. Despite the emergence of the minimally invasive procedures, open surgery in the form of partial nephrectomy or nephrectomy remain viable options. This paper aimed to report a rare case of congenital renal arteriovenous malformation, its clinical manifestations and the surgical treatment chosen.

Human ; Female ; Middle Aged ; Arteriovenous Malformations- General Surgery, treatment, management ; Vascular Malformations ; Cardiovascular Abnormalities ; Cardiovascular Diseases ; Nephrectomy ; Urologic Surgical Procedures ; Surgical Procedures, Operative ; congenital ; Hematuria ; Recurrence

PURPOSE: The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. METHODS: Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. RESULTS: Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. CONCLUSION: SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.
Child ; Congenital Abnormalities ; Creatinine ; Follow-Up Studies ; Humans ; Kidney ; Kidney Diseases ; Kidney Failure, Chronic ; Male ; Retrospective Studies ; Ultrasonography, Prenatal ; Urinary Tract Infections ; Urogenital Abnormalities ; Urologic Diseases ; Vesico-Ureteral Reflux

Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO). The L-shaped fusion variety is even rarer. We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management. Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.
Adolescent ; Female ; Humans ; Kidney/*abnormalities ; Kidney Diseases/*complications/congenital/surgery ; Kidney Pelvis/*surgery ; Laparoscopy/*methods ; Reconstructive Surgical Procedures/*methods ; Ureter/*surgery ; Ureteral Obstruction/etiology/*surgery ; Urologic Surgical Procedures/methods

OBJECTIVE: A Study was undertaken to assess the family background of abandonment and clinical and social aspects in an institute for foreign adoption. The results were compared to the previous two reports from the institute. METHOD: A sample of 1,728 children from 1987 to 1992 formed the subjects of the study by the medical records in the institution. RESULTS: 1) The unmber of girls were more than that of male and ratio of male to female was 1:1.1, which was reduced compared to previous study. 2) The distribution less than one month of age was most commonly and increased compared to previous study. 3) The Place at birth was hospital most commonly. 4) The type of delivery was full-term one(61.5%) and tend to be increased. 5) Age distribution of monthers was from 16 years to 25 years mainly, 1,081 of them(62.5%) were from unmarried one and 409(37.4%) were from married one. 6) By classifying the cause of adoption, unmarried mothers occupied main one(62.5%), poverty(13.4%) extramarital relations(5.2%), divorce(2.9%) and death of parents in the order of frequency, tend to increased in unmarried mothers. 7) Disease pattern showed respiratory disease, jaundice, acute gastroenteritis, pneumonia, urinary tract infection, conjunctivitis in order of frequency. By care of foster mother at private home since 1988, the incidence of the transmissible disease was reduced. 8) Congenital anomalies were cleft and palate, hydrocele, umbilical hernia and congenital heart disease in order frequency. 9) Three hundred and eighty two babies were admitted to general hospital. The main disease were bhaline membrane disease. Jaundice, pneumonia and urinary tract disease, sepsis in the order of frequency. CONCLUSIONS: The ratio of male to female in the institution showed no definite difference and the age was tend to be younger. The cause of adoption was unmarried mother mainly. Respiratory disease in the institution and hyaline membrane disease in the hospitalized was most common.
Age Distribution ; Child* ; Child, Institutionalized ; Conjunctivitis ; Female ; Gastroenteritis ; Heart Defects, Congenital ; Hernia, Umbilical ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Illegitimacy ; Incidence ; Infant, Newborn ; Jaundice ; Male ; Medical Records ; Membranes ; Mothers ; Palate ; Parents ; Parturition ; Pneumonia ; Sepsis ; Single Person ; Urinary Tract Infections ; Urologic Diseases