YOLK SAC TUMOR, BLADDER
DESCRIPTION Yolk sac tumor of the bladder is very rare and appears to have a predilection for the urachal remnant. It has the same pathologic characteristics as its counterparts in any other part of the body, and it is managed in the same way. (See Section II: “Yolk Sac Tumor, Prostate.”)
REFERENCE
Huang HY, Ko SF, Chuang JH, et al. Primary yolk sac tumor of the urachus. Arch Pathol Lab Med. 2002;126(9):1106–1109.
YOLK SAC TUMOR, PROSTATE
DESCRIPTION Extragonadal GCT located in the prostate, similar to yolk sac tumor also called endodermal sinus tumor) found in the testis. A primary site of presentation in the prostate is extremely rare, with only a few reported cases. An increased incidence of extragonadal GCT is reported with Klinefelter syndrome. α-fetoprotein levels are commonly elevated, and are used as a tumor marker; human chorionic gonadotropin is not elevated. Schiller–Duval bodies are evident on histology. Treatment is multimodal, using cisplatinum-based combination chemotherapy and radical surgery.
REFERENCE
Tay HP, Bidair M, Shabaik A, et al. Primary yolk sac tumor of the prostate in a patient with Klinefelter’s syndrome. J Urol. 1995;153(3):1066–1069.
YOUNG CLASSIFICATION OF POSTERIOR URETHRAL VALVES
DESCRIPTION Young described 3 general types of posterior urethral valves:
• Type I: The valves are continuous with the verumontanum and take an anterior course, dividing into 2 fork-like processes in the region of the bulbomembranous junction. Usually, anterior fusion of the valves is not complete; however, some cases exhibit complete anterior fusion and cleft between the folds posteriorly. A subdivision of type I consists of a single, instead of double, valve. Type I valves are the most common.
• Type II: Same as type I, but the valve, rather than taking an anterior course, tends to pass from the upper aspect of the verumontanum toward the internal sphincter, where it divides into 2 forklike processes. (Note: Type II valves are now thought to be nonexistent.)
• Type III: The valves have no relation to the verumontanum; instead, they are attached to the entire circumference of the urethra at any level, with a small opening in the center; they have been called iris valves due to their resemblance to the iris of the eye. Incomplete varieties of this type (crescentic or semilunar) have been described. Type III valves are a more distal diaphragmatic obstruction, similar to a urethral membrane.
REFERENCE
Young HH, et al. Congenital obstruction of the posterior urethra. J Urol. 1919;3:289.
YOUNG-DEES-LEADBETTER BLADDER RECONSTRUCTION
DESCRIPTION This procedure is used to achieve a functional bladder neck closure (ie, establish continence) in children with exstrophy; and also for urinary incontinence in nonexstrophy conditions, although the technique is generally no longer widely used. Through an anterior cystotomy, a rectangular area between the distal urethra and trigone is demarcated. Flaps lateral to this are developed and used to tubularize a neourethra over a 10-Fr catheter.
REFERENCE
Ouckett JW, Caldamone AA. Bladder and urachus. In: Kelalis P, King L, Belman B, eds. Clinical Pediatric Urology. 2nd ed. Philadelphia, PA: Saunders; 1985:735.
YOUNG SYNDROME
DESCRIPTION Obstructive azoospermia in patients with frequent respiratory infections or bronchiectasis. Motile sperm, with normal cilia and vas deferens are present. The condition is caused by inspissated secretions, causing epididymal obstruction, and treated by vasoepididymostomy; fertility rates remain poor.
REFERENCE
Hughes TM 3rd, Skolnick JL, Belker AM. Young’s syndrome: An often unrecognized correctable cause of obstructive azoospermia. J Urol. 1987;137(6):1238–1240.