Bilateral testicular torsion is a very uncommon emergency, with a challenging differential diagnosis. We describe the case of a 15-year-old patient with a left testicular torsion of 48 hours of duration and a sudden onset of right scrotum pain during his stay at the emergency area. Bilateral testicular torsion was diagnosed after repeat physical examination and doppler ultrasound, which had been normal for right testis in a first evaluation. Surgical exploration was performed with orchiectomy in left testis and fixation in right testis. In previous literature, there are reported bilateral torsion only in four adolescents and five adults. With this case, we demonstrate that bilateral spermatic cord torsion may be easily overlooked in a patient with acute scrotum and we emphasize the importance of bilateral exploration in testicular torsion.

Objective To analyse the mid‐term safety and efficacy of the ALTIS® single‐incision sling (Coloplast Corp., Minneapolis, MN, USA) for female stress urinary incontinence (SUI). Patients and Methods We conducted a prospective, single‐arm, unsponsored, observational single‐centre trial in a cohort of patients undergoing SUI surgery with the ALTIS procedure. All patients were diagnosed according to clinical reports, physical exploration and urodynamics. Body mass index (BMI) was categorised according to World Health Organization classification. Valsalva leak‐point pressure (VLPP) was categorised in three groups: <60, 60–90 and >90 cmH2O. Patients were evaluated postoperatively at 1, 6, 12 and 24 months with physical examination, International Consultation on Incontinence Questionnaire Short Form (ICIQ‐SF), and satisfaction visual scale (SVS; score 0–10). Adverse events were assessed at each visit. Multivariate analysis for risk factors of surgery failure was performed. Results We recruited 110 women, with a mean (SD) follow‐up of 22.34 (10.34) months. Regarding efficacy, 91 patients (82.7%) were objectively cured and 97 (88.2%) were subjectively cured. Regarding VLPP and BMI, no differences were seen between groups (P > 0.05). There was a ~20% decrease in urge UI (P = 0.04). No variable showed to be an independent risk factor for ALTIS failure (P > 0.05). Overall, nearly 96% of the women reported 9 or 10 points on the SVS. A total of 24 patients (21.8%) had some kind of complication. No mesh erosion was reported in any patient. Conclusions The ALTIS sling demonstrated to be an effective and safe procedure for SUI in the mid‐term setting. Objective and subjective cure rates are at least comparable to ‘gold standard’ procedures with a minimal rate of self‐limiting non‐surgical complications.

In this small pilot study we found a high prevalence of csLUTS in ALS which are mainly related to a combination of voiding and storage symptoms. In most patients, symptoms are caused by overactive detrusor combined with non-relaxing sphincter. Severity of symptoms and impact in QoL is only moderate but in a subset of patients can be considerable. Neurourol. Urodynam. 36:626-631, 2017. © 2016 Wiley Periodicals, Inc.

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