Objective To evaluate the outcome of patients undergoing the immediate insertion of a penile prosthesis as a treatment for acute low‐flow priapism.Patients and methods Eight patients presenting with low‐flow priapism with a mean duration of 91 h (range 32–192) were prospectively evaluated. All had failed conservative management with the instillation of α‐adrenergic agents, and four had already undergone shunt procedures elsewhere. Immediate management consisted of the insertion of a malleable prosthesis in six patients and an inflatable prosthesis in two. One of the malleable prostheses was subsequently changed to an inflatable device.Results There were no early complications, with all patients being satisfied with the end result, and seven having sexual intercourse. One patient developed a penile deformity after surgery, cause by fibrosis around one inflatable cylinder. All patients have maintained their penile length.Conclusions Prolonged low‐flow priapism results in a variable degree of cavernosal fibrosis and a subsequent loss of penile length. The delayed insertion of a penile prosthesis can be difficult, with high complication rates. The immediate insertion of a penile prosthesis in patients with prolonged low‐flow priapism is simple and maintains penile length. This should always be offered to the patient at initial presentation, as the complication rate is low and the subsequent outcome excellent.
Seminal vesicle abscess, a rare urologic entity, is usually diagnosed with computerized tomography (CT) scan. We report a case of seminal vesicle abscess that required a transrectal ultrasonography to confirm the diagnosis. An analysis of 20 cases of seminal vesicle abscess reported in the literature is also reviewed.
Abdominal pain is a common complaint among participants in endurance sports. It may be severe, recurrent, and resistant to treatment. There is no direct evidence of the cause of this phenomenon. This report is of a long distance runner who had severe pain in the upper right abdominal quadrant during strenuous exertion. The symptom had been present for several years and did not respond to conservative treatment. Laparoscopy showed congenital supernumerary ligaments binding the gallbladder to the abdominal wall. The complaint resolved after cholecystectomy and resection of adhesions. There was evidence of chronic cholecystitis on histopathological examination. Two years after the operation, he remains free of symptoms. The differential diagnosis of abdominal pain in athletes is discussed.
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