Submit to Special Issue Submit Abstract to Special Issue Review for Reports Propose a Special Issue

Journal Menu

Journal Browser

► Journal Browser

When Urology Surprises: Educational and Rare Clinical Cases

Print Special Issue Flyer
Editors
Special Issue Information
Benefits of Publishing in a Special Issue
Published Papers

A Special Issue of Reports (ISSN 2571-841X) belonging to the section "Nephrology/Urology".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 7395

Share This Special Issue

Editors

Dr. Aris Kaltsas

E-Mail Website
Guest Editor

Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Interests: male infertility; non-obstructive azoospermia; sperm retrieval (micro-TESE/TESE); male reproductive tract microbiome; oxidative stress and inflammation; biomarkers and predictive models (including AI/ML); hypogonadism and testosterone therapy; translational and molecular urology/andrology
Special Issues, Collections and Topics in MDPI journals

Dr. Timoleon Giannakas

E-Mail Website
Guest Editor Assistant

Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
Interests: urology; intrarenal foreign body; percutaneous retrieval; retrograde intrarenal surgery

Special Issue Information

Dear Colleagues,

Reports—Clinical Practice and Surgical Cases provides an ideal platform for high-quality, peer-reviewed medical case reports, images, and videos. This Special Issue will curate memorable urology cases that sharpen clinical reasoning at the bedside and in the operating theatre: atypical presentations, diagnostic traps, unexpected imaging or pathology, innovative minimally invasive solutions, and complication “rescue” strategies. The emphasis will be on clear decision-making and practical take-home messages that translate immediately to daily practice.

We welcome case reports, small case series, clinical images, and video/technical notes spanning the full breadth of urology, including (but not limited to) the following:

Uro-oncology: Rare tumor entities, diagnostic mimics, unusual metastatic patterns, and treatment-related complications;
Endourology and stone disease: Anatomical variants, complex access, novel laser or PCNL strategies, and unexpected complications;
Functional and female urology: Complex incontinence and voiding dysfunction, neuro-urology, and fistulae;
Reconstructive urology and trauma: Urethral and penile injuries, salvage reconstruction, and complex wound complications;
Andrology and male reproductive surgery: Rare presentations, emergencies, and postoperative pitfalls;
Pediatric urology: Congenital anomalies, atypical presentations, and perioperative challenges;
Infectious and inflammatory conditions and emergencies: Atypical pathogens, emphysematous infections, septic obstruction, and rapidly progressive disease;
Iatrogenic complications across open, laparoscopic, robotic, and endoscopic surgery, including management and outcomes.

Priority will be given to submissions with strong educational value: well-documented clinical timelines, high-quality imaging (e.g., ultrasound, CT, MRI, endoscopy, and pathology), a concise yet rigorous differential diagnosis, and a short ‘lessons learned’ section. Video clips illustrating key operative steps or complication management are particularly encouraged when they materially enhance educational impact.

By assembling these practice-changing cases in one curated collection, this Special Issue will serve as a rapid-reference teaching resource for urologists, trainees, and multidisciplinary teams, while highlighting real-world decision points that are often underrepresented in large trials.

Dr. Aris Kaltsas
Guest Editor

Dr. Timoleon Giannakas
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Reports is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (9 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Other

8 pages, 2145 KB

Open AccessCase Report

Page Kidney: An Unusual Cause of Acute Onset Hypertension—A Case Report

by Konstantinos Koutsoulas, Evangelos Karagiannis, Dimitrios Kouroupis, Ioannis Vlachos, Spyros Papadopoulos, Panagiotis Pateinakis, Athina Pyrpasopoulou, Ioannis Vouros and Ioannis Goulis

Reports 2026, 9(3), 273; https://doi.org/10.3390/reports9030273 - 14 Aug 2026

Viewed by 263

Abstract

Background and Clinical Significance: Renal disease is the leading cause of secondary hypertension in children and adolescents. Among younger patients presenting with severe hypertension, renovascular and renal parenchymal disorders should be considered promptly; Case presentation: We describe the case of a 16-year-old male who presented with severe fatigue and was found to have resistant arterial hypertension (180/120 mmHg). His medical history was notable for blunt epigastric trauma sustained during football training approximately 6 months before presentation. Magnetic resonance imaging of the kidneys and retroperitoneum demonstrated a large right-sided perinephric hematoma compressing the kidney. Plasma renin activity and aldosterone levels were markedly elevated, establishing the diagnosis of Page kidney. Percutaneous drainage was performed by placement of a drainage catheter into the perinephric collection, resulting in evacuation of a substantial volume of liquefied hematoma. Following the procedure, arterial blood pressure gradually normalized, accompanied by resolution of the hormonal abnormalities; Conclusions: Page kidney is a rare but important cause of secondary hypertension resulting from activation of the renin-angiotensin-aldosterone system due to external renal compression and impaired intrarenal perfusion. Although its clinical presentation may be insidious, delayed recognition can lead to severe cardiovascular and renal complications. Management includes percutaneous drainage or surgical decortication of the affected kidney, together with antihypertensive treatment targeting the renin-angiotensin-aldosterone system. Early diagnosis and treatment are essential to optimize clinical outcomes and preserve renal function. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

10 pages, 5433 KB

Open AccessCase Report

Acute Kidney Injury After Endoscopic Ureterocele Incision in a Duplex System with Contralateral Multicystic Dysplastic Kidney: From Obstructive Complication to Surgical Resolution—A Case Report

by Konstantinos Gkialas, Anna Papakonstantinou, Evangelos Fragkiadis, Napoleon Moulavasilis and Panagiotis Mitsos

Reports 2026, 9(3), 251; https://doi.org/10.3390/reports9030251 - 3 Aug 2026

Viewed by 298

Abstract

Background and Clinical Significance: Endoscopic ureterocele incision is the preferred initial treatment for ureteroceles associated with duplex collecting systems due to its capability for rapid decompression via a minimally invasive technique with generally favorable outcomes among pediatric patients. However, the postoperative trajectory in children with solitary functioning renal units remains inadequately characterized. We present a severe, yet reversible, case of postrenal acute kidney injury (AKI) following endoscopic ureterocele incision in an infant with a contralateral multicystic dysplastic kidney (MCDK). This case emphasizes the pathophysiological implications of failed ureterocele decompression and the vital importance of rigorous postoperative monitoring. Case Presentation: A female infant with a right MCDK and a left duplex collecting system featuring an upper pole ureterocele underwent transurethral endoscopic incision due to progressive hydronephrosis. Within 24 h following surgery, the patient exhibited oliguria, oedema, worsening hydronephrosis, hyponatremia (125 mmol/L), metabolic acidosis, and increasing serum creatinine levels, indicative of postrenal AKI. Arterial blood gas analyses indicated severe renal-driven metabolic acidosis with bicarbonate levels of 13.9 mmol/L, accompanied by respiratory compensation and normal lactate levels. Imaging studies revealed deteriorating hydronephrosis of the upper and lower poles of the left kidney. Emergency open nephrostomy placement in the lower pole, after failed jj insertion in the lower pole ureteral orifice, resulted in the immediate restoration of urinary drainage and progressive biochemical recovery. The patient required a brief period of intensive care monitoring, followed by hospitalization in pediatric and urological departments. Longitudinal imaging demonstrated persistent but stable upper pole dilatation with preserved parenchyma. Definitive management was later achieved through right nephrectomy of the non-functioning MCDK. Conclusions: In patients with solitary functioning renal units, the endoscopic ureterocele incision may result in postoperative local oedema, potentially leading to clinically significant obstructive AKI. This case underscores the necessity for intensified surveillance and individualized postoperative management strategies in anatomically complex pediatric patients. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

4 pages, 1254 KB

Open AccessInteresting Images

Seminal Vesicle Mass Fistulising to the Rectum: A Rare Urological Presentation of Lung Cancer Metastasis

by Margarida André, Francisco Vara-Luiz, Luísa Moreira, João Paulo Rosa and Miguel Carvalho

Reports 2026, 9(3), 213; https://doi.org/10.3390/reports9030213 - 4 Jul 2026

Viewed by 435

Abstract

Metastatic involvement of the male genitourinary tract by lung cancer is exceedingly rare. We report a 56-year-old man with metastatic lung adenocarcinoma (initial stage T3N2M1b) under pembrolizumab, who presented with severe pelvic pain. Pelvic magnetic resonance imaging and computed tomography demonstrated a large mass with an imaging epicentre favouring the left seminal vesicle, involving the prostate and fistulising to the distal rectum, without pelvic ascites or peritoneal disease. A total PSA of 0.81 ng/mL and a previous negative prostate biopsy made a primary prostatic malignancy less likely. Biopsy of the rectal component revealed a poorly differentiated carcinoma with an immunophenotype (CK7+, TTF-1+, p40−, CDX2−, NKX3.1−, PAX8−) consistent with metastatic adenocarcinoma of pulmonary origin. The patient underwent palliative pelvic radiotherapy, with improvement of pelvic pain; he subsequently developed pneumaturia and faecaluria and died eight months later from disease progression. Seminal vesicle metastasis from lung carcinoma has been reported previously; to our knowledge, however, this is the first report presenting with rectal fistulisation. This case highlights a diagnostically challenging presentation and the need to consider metastatic disease when evaluating atypical seminal vesicle masses in oncological patients. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

8 pages, 5489 KB

Open AccessCase Report

Successful Endourological Management of Encrusted Metallic Ureteral Stents: A Case-Series of Three Patients

by Georgios-Eleftherios Anagnostopoulos, Theodoros Spinos, Vasileios Tatanis, Angelis Peteinaris, Evangelos Liatsikos and Panagiotis Kallidonis

Reports 2026, 9(3), 206; https://doi.org/10.3390/reports9030206 - 29 Jun 2026

Viewed by 488

Abstract

Background and Clinical Significance: Metallic stents represent a breakthrough in the treatment of ureteric obstruction, improving patient quality of life. Despite their advantages, management of encrustation remains a difficult complication to address. This case series highlights the rare occurrence of permanent ureteral Wallstents remaining indwelling for over 20 years. It emphasizes that the function of these older devices can be successfully preserved using minimally invasive techniques. Case Presentation: This case series details three patients, two males, aged 75 and 69 years, diagnosed with colon cancer, and one female, aged 67 years, with cervical cancer, who presented with obstructive uropathy due to extrinsic malignant compression. As a therapeutic strategy, permanent ureteral Wallstents were placed in all three patients. Over time, the stents developed significant encrustation, leading to secondary obstruction. Clinical manifestations of this complication varied, ranging from asymptomatic hydronephrosis to acute symptomatic uropathy characterized by fever and localized pain. All cases were treated endoscopically with Ho:YAG laser lithotripsy, and urine flow was successfully restored. During the follow-up period, one patient experienced two recurrences that were managed with the same technique, another remained completely symptom-free, and the third was lost to long-term follow-up. Remarkably, the stents have remained functional for over 20 years post-implantation. Conclusions: This is a rare report documenting permanent ureteral Wallstents with such prolonged indwelling time. Furthermore, our findings suggest that through minimally invasive techniques, the function of these devices can be successfully preserved. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

14 pages, 11573 KB

Open AccessCase Report

Spontaneous Bilateral Renal Forniceal Rupture Secondary to Acute Urinary Retention in a Patient with Prior Prostate Radiotherapy: A Case Report

by Timoleon Giannakas, Dimitrios Deligiannis, Panagiotis Mitsos, Anna Papakonstantinou, Marios Stavropoulos and Aris Kaltsas

Reports 2026, 9(2), 184; https://doi.org/10.3390/reports9020184 - 12 Jun 2026

Viewed by 924

Abstract

Background and Clinical Significance: Spontaneous renal forniceal rupture is an uncommon complication of obstructive uropathy and is classically associated with ureteric calculi rather than distal urinary retention. Bilateral retention-related rupture appears to be exceptionally rare and may be diagnostically challenging when renal function begins to improve after bladder decompression; Case Presentation: An 82-year-old man with a history of prostate cancer treated five years earlier with external beam radiotherapy and androgen deprivation therapy presented with acute abdominal pain radiating to both flanks and inability to void. Bedside ultrasonography showed urinary retention and bilateral hydronephrosis, and a 16-Fr Foley catheter drained 900 mL of urine. Admission evaluation showed severe acute kidney injury, microscopic hematuria, minimal leukocyturia, and elevated inflammatory markers. Post-obstructive diuresis developed after bladder decompression. CT urography with excretory-phase imaging on hospital day 3 demonstrated severe bilateral hydroureteronephrosis with bilateral renal forniceal rupture and associated urinomas, including a larger left-sided collection extending toward the psoas compartment. Bilateral percutaneous nephrostomies were placed on hospital day 4 for upper-tract diversion. Immediate nephrostography showed no active contrast extravasation. At one-month follow-up, combined CT and nephrostographic assessment confirmed complete resolution of the bilateral urinomas without persistent leak, and the nephrostomy tubes were removed; Conclusions: This case suggests that urinary retention in an older man with prior prostate radiotherapy may reflect radiation-associated outlet pathology and/or impaired detrusor function rather than simple prostate enlargement. Delayed-phase CT urography was essential for diagnosis, and active bilateral diversion was justified by bilateral rupture, acute kidney injury, and the extent of urinary extravasation. The report expands the limited PubMed-indexed literature on retention-related upper urinary tract rupture and supports cautious follow-up aimed at defining the underlying mechanism of retention. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

15 pages, 1094 KB

Open AccessCase Report

Synchronous Prostate Adenocarcinoma and Bladder Carcinoma In Situ Detected During Evaluation of Incidental PSA Elevation: A Case Report Illustrating Multimodal Diagnostic Correlation and Long-Term Follow-Up

by Simona Maria Borta, Adrian Silviu Crișan, Imola Miklos, Dana Zdremtan and Roxana Andra Coman

Reports 2026, 9(2), 166; https://doi.org/10.3390/reports9020166 - 22 May 2026

Viewed by 1795

Abstract

Background and Clinical Significance: The coexistence of synchronous urologic malignancies may present diagnostic and therapeutic challenges, particularly when symptoms are minimal or nonspecific. This case illustrates the role of multimodal diagnostic correlation in identifying a second primary urologic malignancy during the evaluation of incidental PSA elevation. Case presentation: Case Presentation: We report the case of a 56-year-old male presenting with minimal lower urinary tract symptoms who underwent stepwise diagnostic evaluation including PSA (prostate specific antigen), free PSA, urinary SelectMDx RT-PCR testing (reverse transcription polymerase chain reaction), multiparametric MRI (magnetic resonance imaging), transrectal biopsy and inflammatory biomarker assessment. PSA was 17.69 ng/mL with a free PSA ratio of 6.56%. SelectMDx indicated a 90% probability of prostate cancer and a 65% risk of Gleason ≥ 7 disease. mpMRI demonstrated two suspicious lesions without extracapsular extension. Biopsy confirmed acinar adenocarcinoma Gleason 7 (3 + 4), Grade Group 2. Persistent post-biopsy hematuria led to additional imaging that revealed bladder wall thickening, and cystoscopy confirmed multifocal carcinoma in situ. Radical cystoprostatectomy with orthotopic ileal neobladder reconstruction was performed. Conclusions: This case illustrates the importance of diagnostic vigilance and multimodal correlation in a minimally symptomatic patient, particularly when persistent clinical findings are not fully explained by the initial diagnosis. The findings should be interpreted as illustrative and cannot be generalized beyond the single-case context. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Graphical abstract

7 pages, 1519 KB

Open AccessCase Report

Spontaneous Multiple Knotting of a Feeding Tube Urinary Catheter in an Infant with Crouzon Syndrome: A Case Report

by Konstantinos Gkialas, Anna Papakonstantinou, Dimitrios Deligiannis, Aris Kaltsas and Panagiotis Mitsos

Reports 2026, 9(2), 165; https://doi.org/10.3390/reports9020165 - 22 May 2026

Viewed by 702

Abstract

Background and clinical significance: Catheter knotting is a rare but potentially serious complication of urethral catheterization in neonates and infants, particularly when feeding tubes are used due to small urethral caliber. Case Presentation: We report the case of a 6-month-old male infant with Crouzon syndrome who underwent cranioplasty. Intraoperatively, a 6 Fr feeding tube was inserted for bladder drainage. On postoperative day 6, resistance was encountered during catheter removal. Radiography revealed a double knot in the distal urethra and a single knot in the proximal urethra. The catheter was successfully removed surgically via cystotomy, and the infant recovered uneventfully with normal voiding function. Conclusions: This case demonstrates the exceptional occurrence of simultaneous double and single knots in a urinary catheter. Awareness of this rare complication, careful control of insertion length, and prompt intervention upon resistance are essential to prevent urethral trauma and ensure patient safety. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

10 pages, 5201 KB

Open AccessCase Report

Rare Case of Delayed Bleeding Occurring 8 Years After Percutaneous Nephrolithotomy and Angioembolization: A Case Report and Current Literature Review

by Răzvan Alexandru Dănău, Răzvan-Ionuț Popescu, Aida Petca, Viorel Jinga and Răzvan-Cosmin Petca

Reports 2026, 9(2), 135; https://doi.org/10.3390/reports9020135 - 27 Apr 2026

Viewed by 925

Abstract

Background and Clinical Significance: Over recent decades, percutaneous nephrolithotomy (PCNL) has emerged as a primary treatment, firmly establishing itself as the cornerstone approach for managing large kidney stones. Postoperative bleeding commonly stems from an arteriovenous fistula (AVF), a connection between a damaged artery with high flow and a damaged vein with low flow, or from a pseudoaneurysm (PA), which involves arterial blood leaking into the tissue, causing a localized hematoma. The preferred technique for addressing such vascular complications is selective trans-arterial angioembolization, widely regarded as the gold standard. Case Presentation: In this article, we present the case of a 42-year-old woman who experienced delayed bleeding eight years after PCNL and a previous angioembolization. The patient presented with macroscopic hematuria, and further investigations, including cystoscopy, contrast-enhanced abdominal-pelvic CT, and angiography, were performed. To stop the bleeding, we identified and performed selective angioembolization (SAE) of a small arterial branch arising from an inferior branch of the right renal artery. Conclusions: To the best of our knowledge, this is the initial documented instance of delayed bleeding manifesting eight years post-PCNL and angioembolization. This occurrence is exceptionally rare, given that the patient exhibited no urological signs or symptoms over the intervening years, and no predictive or risk factors were identified. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Figure 1

8 pages, 3146 KB

Open AccessCase Report

Urothelial Bladder Carcinoma Incidentally Coexisting with an Ileovesical Fistula Caused by Perforation of Meckel’s Diverticulum: A Case Report

by Atsushi Yamamoto, Shohei Kawaguchi, Satoko Urata and Sotaro Miwa

Reports 2026, 9(2), 119; https://doi.org/10.3390/reports9020119 - 13 Apr 2026

Viewed by 806

Abstract

Background and Clinical Significance: Enterovesical fistulas are uncommon and are most often caused by inflammatory conditions. Cases caused by Meckel’s diverticulum are exceptionally rare, with only a few cases reported in the literature. To our knowledge, no previous reports have described an ileovesical fistula due to Meckel’s diverticulum coexisting with urothelial carcinoma. Case Presentation: A 74-year-old man was evaluated after presenting with fever and diagnosed with an ileovesical fistula. Since cystoscopy findings could not completely exclude bladder cancer, transurethral resection of the bladder tumor (TUR-Bt) was performed 1 month after the infection subsided. Histopathological examination confirmed the diagnosis of bladder cancer. Partial small intestine resection was performed 1 week after TUR-Bt to treat the ileovesical fistula. Histopathological examination of the resected specimen revealed perforation due to Meckel’s diverticulitis. TUR-Bt was repeated 3 months after the initial surgery, and no residual tumor was detected. At 6 months postoperatively, no recurrence of bladder cancer or fistula was observed. Conclusions: This case highlights an extremely rare coexistence of ileovesical fistula due to Meckel’s diverticulum and urothelial carcinoma. Given the potential for malignancy in or around fistulous lesions, careful diagnostic evaluation and appropriate management are essential. Full article

(This article belongs to the Special Issue When Urology Surprises: Educational and Rare Clinical Cases)

► Show Figures

Journal Menu

Journal Browser

When Urology Surprises: Educational and Rare Clinical Cases

Share This Special Issue

Editors

Special Issue Information

Benefits of Publishing in a Special Issue

Published Papers (9 papers)

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI