Robot-assisted video endoscopic inguinal lymphadenectomy is a feasible technique which allows for a similar nodal yield while being associated with lower morbidity than open inguinal lymph node dissection in patients without bulky groin adenopathy.
Penile fracture is a well-recognized but uncommon urological emergency. It is a tear in the tunica albuginea with rupture of corpus cavernosum. It may be associated with injury to corpus spongiosum and urethra. Diagnosis is usually clinical and Urethral injury should be suspected in penile fracture, especially in those cases with urethral bleeding and bilateral cavernosal rupture. Penile fracture is most commonly caused by injury during sexual intercourse. It has also been described with masturbation, rolling over or falling onto the erect penis, and other scenarios. A cracking or popping sound followed by pain, rapid detumescence, discoloration and swelling of penile shaft and urethral bleeding are common presenting symptoms. Prompt surgical intervention with closure of tunica albuginea is the treatment of choice with satisfactory cosmetic and functional results. We report a case of fracture penis in a 25-year-old male who came to emergency department of our hospital.
To assess the surgical outcome of supine percutaneous nephrolithotomy (PCNL) in patients with comorbidities. Materials and methodsWe retrospectively reviewed the data of 15 patients who underwent supine PCNL at our centre from September 2019 to May 2021. Preoperatively, a complete examination of the patients, along with biochemical and radiological investigations, was done. The data, which included patient demographics, comorbidities, complexity of renal calculi, complications, and stone clearance rate, were collected from the patients' medical records. ResultsPatients aged between 31 and 70 years were included in the study. The mean (SD) BMI was 26.01 (2.31).Twelve patients (80%) were overweight with a BMI of 25.3 to 29.3 kg/m 2 . The most common comorbidities were diabetes (33.3%) and hypertension (26.7%). In our study, six patients were American Society of Anesthesiologists (ASA) grade 3 (40%), followed by grade 2 in five patients (33.3%), grade 4, and grade 1 in two patients (13.3%) each. The Guy's Stone score was one in nine patients (60%) and two in six patients (40%). Complete clearance was achieved in 13 (86.7%) patients. Two patients (13.3%) had a stone clearance of more than 80%. Data analysis showed that 14 patients (93.3%) had no perioperative complications. Postoperative abdominal distension was noted in one patient (6.7%), which was managed conservatively (Clavien-Dindo grade 1). We did not encounter any cases of organ injury following supine PCNL. Postoperatively, none of our patients received blood transfusions. ConclusionOur study shows that supine PCNL is a good surgical option, especially for high-risk patients with good stone clearance and low complication rates.
An impaired ability to evacuate the urinary bladder is commonly seen in both men and women with aging. Usually, patients present with a range of storage, voiding, and post-micturition urinary symptoms. It may eventually lead to urinary retention. These symptoms may have a considerable effect on the patient’s quality of life. Despite its common prevalence with advancing age, the etiopathogenesis of the underactive urinary bladder is incompletely understood. There are no widely agreed diagnostic criteria. The urodynamic study (UDS), an invasive investigation is the only accepted modality to diagnose underactive detrusor. There is a lack of effective treatments to improve bladder emptying. The goals of treatment are to improve symptoms and reduce the risk for the complications of impaired bladder emptying. We report a case of a 73 year male who came to us with a history of urinary symptoms and a distended abdomen.
the presence of low grade disease in 102 (69.9%) patients, high grade in 44 (30.1%) patients.Final stage was pTa in 120 (82.2%) patients.At first follow up, 52 patients (35.6%) were recurrence-free, 71 patients (48.6%) had recurrences, 23 patients (15.8%) underwent nephroureterectomy.During follow-up a total 61 patients (41.8%) were continuously recurrence-free, 55 patients (37.7%) had multiple recurrences treated conservatively and a total of 30 patients (20.5%) underwent nephroureterectomy.The Kidney Preserving Rate was 91,8%.No major complication was registered during or after the procedure. The 90.4% of patients were sent home the day after the procedure.CONCLUSIONS: The conservative treatment of UTUC with thulium laser is safe and effective in terms of oncological outcomes. A complete staging of the neoplasia and a close follow-up are mandatory in order to be able to choose the optimal therapeutic strategy for each patient and to have good control of the disease
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