No abstract

Hydroceles are one of the most common causes of scrotal swelling affecting around 1% of the adult population. While hydroceles are usually asymptomatic, some hydroceles can lead to infertility. We will present a case of a 34-year-old man who was referred to our center as a case of primary infertility (sever oligospermia 1.1 million/ml) for 4 years and was found to have bilateral hydroceles (infected right hydrocele). At 18 months post bilateral hydrocelectomy, the patient's total sperm count improved to 43 Million/ml. Therefore, we highly recommend considering hydrocele as an etiology in any patient with idiopathic infertility.

Osteoporotic vertebral fractures are common among the geriatric population and are managed by vertebral augmentation procedures. Pulmonary cement embolism is a relatively rare complication of these procedures and can range from mild, transient respiratory sequelae to a more severe pulmonary infarction. We discuss the case of a 75-year-old woman, identified with osteoporotic thoracolumbar vertebral fractures, found to have pulmonary cement embolism four days following multi-level balloon kyphoplasty. We attempt to highlight, pulmonary cement embolism as a potential complication following a vertebral augmentation procedure and that systematic pulmonary imaging after surgery may be helpful to facilitate its detection and further management.

Objective: The aim of this study was to determine the feasibility and safety of the skin bridge loop technique for colostomy and ileostomy in a gynecological oncology unit. Design: The study's design is a prospective observational case series of skin bridge loop stoma formation. Materials and Methods: All patients in a gynecologic oncology unit requiring defunctioning ileostomy or colostomy as an independent surgical procedure from October 2010 to February 2012 were included in this study. The setting was a tertiary referral center for gynecological oncology and minimal access surgery in Dublin, Ireland. The skin bridge loop enteric and colonic stoma formation technique involves carving a permanent skin bridge within the stoma site. The skin bridge is then fashioned under the loop and tensioned to the required level of elevation. Results: No stomal complications arose in this series of 16 patients in follow-up to 73 weeks. Stomal education was commenced from the first postoperative day, and self-care was achieved in a median of 5 days. Conclusions: The skin bridge stoma is easy to fashion and facilitates early patient self-care education, progression to other treatment, and/or discharge from hospital. We recommend its application in gynecologic oncology. ( J GYNECOL SURG 29:47)