- Field evaluation of the safety, acceptability, and feasibility of early infant male circumcision using the AccuCirc device. [Journal Article]
- PlosPLoS One 2018; 13(2):e0191501
- CONCLUSIONS: This evaluation of the AccuCirc device is the largest to date and indicates that the device is safe and acceptable, achieving high levels of parental satisfaction. The AccuCirc device should be considered for WHO prequalification to increase options for safe and sustainable provision of EIMC.
- Epididymo-orchitis causing testicular infarction: a serious complication of a common disorder. [Journal Article]
- JSJ Surg Case Rep 2017; 2017(10):rjx207
- One of the most common differentials for the acute scrotum is an epididymo-orchitis (EO), which can mimic the presentation of testicular torsion. We present a case of a 37-year-old man presented to t...
One of the most common differentials for the acute scrotum is an epididymo-orchitis (EO), which can mimic the presentation of testicular torsion. We present a case of a 37-year-old man presented to the Emergency department with a 3-day history of progressive left testicular pain. A Doppler ultrasound was done which revealed increased flow to the left testicle with no evidence of testicular torsion and he was discharged. He was re-admitted with worsening pain and a repeat scan showed that the penile arterial diastolic flow had reversed, indicating testicular infarction. This was confirmed at exploration and an orchidectomy was performed. EO causing severe complications is an uncommon manifestation of a common disorder. Features suggesting a lack of response to antibiotics include sepsis, pronounced scrotal oedema, severe testicular pain and scrotal wall inflammation. The presence of a positive urine culture has also been highlighted as a poor prognostic factor.
- Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial. [Journal Article]
- FPFront Psychiatry 2017; 8:260
- Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women's sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as redu...
Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women's sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce.
- Isolated Involvement of Penis in Fournier's Gangrene: A Rare Possibility. [Journal Article]
- JCJ Coll Physicians Surg Pak 2018; 28(2):164-165
- skin and subcutaneous tissue. Penis may be secondarily affected in some cases; however, primary isolated involvement of penis is rare. A 48-year male smoker presented with pain and blackish discolora...
skin and subcutaneous tissue. Penis may be secondarily affected in some cases; however, primary isolated involvement of penis is rare. A 48-year male smoker presented with pain and blackish discoloration of the distal part of penis for the last 4 days which developed following rupture of a papulo-vesicular lesion over the prepuce of penis. It rapidly progressed to involve half of the skin of the penis. The patient was hospitalized and broad spectrum antibiotics were administered parenterally. Emergency wound debridement and urinary diversion by suprapubic cystostomy was done. After repeated wound debridement and dressings, the wound healed. Our case was unusual as the penis was the sole site of affection, which is very unusual and only few such cases are reported in the literature.
- [CUTANEOUS METASTASIS OF UROTHERIAL CARCINOMA FOR WHICH MOHS PASTE WAS USEFUL: A CASE REPORT]. [Journal Article]
- NHNihon Hinyokika Gakkai Zasshi 2017; 108(1):41-44
- The patient was a 71-year-old man referred to our department because of asymptomatic gross hematuria. Detailed examination led to a diagnosis of bilateral ureteral cancer and prostate cancer. Total n...
The patient was a 71-year-old man referred to our department because of asymptomatic gross hematuria. Detailed examination led to a diagnosis of bilateral ureteral cancer and prostate cancer. Total nephroureterectomy was performed for bilateral ureteral cancers on separate occasions, while prostate cancer was managed with hormone therapy. Because multiple bladder tumors were found by cystoscopy conducted after 3 months, total cystectomy was performed. Neither distant metastasis nor local recurrence had developed, 2 years later, when the patient visited our department again because of glans enlargement and received a diagnosis of penile cancer. Partial penectomy was performed, and a 1-cm indurated nodule was found in the skin of the hypogastric region during surgery and treated by simultaneous wedge-shaped excision. Histopathologically, the lesions were urothelial carcinomas. Multiple metastatic foci occurred in the skin postoperatively centering on the hypogastric region, growing rapidly and accompanied by bleeding and exudate causing a bad odor. Topical application of Mohs paste resulted in dramatic improvement of the pain and exudate, which thereby improved the patient's quality of life (QOL) to a level enabling discontinuation of narcotic drug therapy for cancer-related pain. Thereafter, hepatic metastasis was found and chemotherapy with gemcitabine and paclitaxel was administered. The patient did not respond to this chemotherapy and died of cancer 3 months later. Cutaneous metastasis of urothelial carcinoma, which is a very rare condition, is often managed with palliative therapy due to the lack of response to anticancer chemotherapy. In such cases, the use of Mohs paste appears to be of great value for maintaining the patient's QOL which otherwise might deteriorate markedly.
- Multispecialty retrospective review of the clinical utility of pelvic magnetic resonance imaging in the setting of pelvic pain. [Journal Article]
- TATransl Androl Urol 2017; 6(6):1155-1158
- CONCLUSIONS: Chronic pelvic pain is a multispecialty complaint that is difficult to treat. We were surprised to find the large number of both specialists and generalists invested in the management of pelvic pain. The increasing availability of MRI technology makes it a likely candidate to test for a clinically significant anatomic reason for pain. Though MRI is a test with minimal adverse effect and no increased risk of radiation exposure, the cost on the healthcare system should be offset by a clear clinical utility. We found total utility to be 34% across all ordering providers and an increase in positivity with concern of oncologic disease. Therefore, we would recommend pelvic MRIs in the evaluation of patients with refractory pelvic pain.
- Deep Vein Thrombosis: A Rare Cause of Acute Testicular Pain. Case Report: Literature Review. [Journal Article]
- UIUrol Int 2018 Jan 17
- CONCLUSIONS: Spontaneous thrombosis of the pampiniform plexus is a rare entity where the management remains controversial. The clinical case we report here shows that surgery may be considered an effective option.
- Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. [Journal Article]
- ICInvestig Clin Urol 2018; 59(1):61-65
- CONCLUSIONS: PRFM appears to be a safe and feasible treatment modality in patients with urologic disease. Further placebo-controlled trials are warranted.
- Local Anesthetic Systemic Toxicity: A Review of Recent Case Reports and Registries. [Journal Article]
- RAReg Anesth Pain Med 2018; 43(2):124-130
- This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intrav...
This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intravenous lipid emulsion (ILE) therapy. The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. Local anesthetic systemic toxicity events occurred as a result of penile blocks (23%), local infiltration (17%), and upper/lower extremity, torso, and neuraxial blockade. Twenty-two patients (47%) were treated with ILE, and 2 patients (4.3%) died. During the same time period, 11 cases submitted to lipidrescue.org were treated with ILE and survived. The incidence of LAST reported in registries is 0.03% or 0.27 (95% confidence interval, 0.21-0.35) per 1000 peripheral nerve blocks (denominator of 251,325). Seizure (53% and 61% from case reports and registries, respectively) was the most common presenting feature.
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- Pudendal Nerve Block Versus Penile Nerve Block in Children Undergoing Circumcision. [Journal Article]
- UJUrol J 2018 Jan 03
- CONCLUSIONS: Pudendal nerve block provided additional analgesic free period and had better analgesic efficiency compared to the penile nerve block lasting until 24 hours after operation.