Laparoscopic orchiectomy seems to be advantageous and well received by patients. We preferred the laparoscopic approach for the obvious benefits of less pain, better cosmesis, and early discharge.
Paraphimosis is an acute condition characterized by all the signs of inflammation. Here we describe a 'chronic' variant of paraphimosis where patients often present many days after the initial injury. The aim of this study is to identify and possibly classify this new variation of paraphimosis - the chronic condition. We studied 68 patients with this condition between 1997 and 2005. In all, the prepuce was fibrous and bunched up behind the glans penis and, in some cases, with ulcerations. All patients were treated by excision of the fibrous flap and circumcision, under local anaesthesia. Patients were discharged on the same day on which the excision was done. Follow-up was on the third, seventh and ninetieth days. Long-term follow-up was possible in only 22 patients. This technique of modified circumcision was effective in treating this condition and we think a new classification of paraphimosis is warranted - acute and chronic.
Spontaneous rupture of the urinary bladder is a rare condition, especially due to squamous cell carcinoma. Less than 10 cases have been reported so far. The patient was a 30-year-old male presenting with difficulty passing urine, dribbling, dysuria and right loin pain of 4 days duration and constipation for 2 days. He then developed features of intestinal obstruction with peritonitis. Laparotomy revealed advanced urinary bladder carcinoma adherent to the ileum and urine in the peritoneal cavity. There was a perforation of the urinary bladder separate from the area of adherence. Palliative surgery was performed. Histopathology report was squamous cell carcinoma. The present case is being reported, as it is a diagnostic dilemma and is a rare condition, this being only the seventh case reported in the literature. The mortality rate is high and even though the patient had postoperative problems, he survived.
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