Introduction:Stricture urethra has been always a surgical challenge. Different opinions regarding time require healing at anastomotic site after urethroplasty, so various strategies are there regarding time for post-operative catheter removal. In this study, healing was assessed by pericatheter retrograde urethrogram (PUG) before the catheter removal.Materials and Methods:Prospective study was conducted from January 2006 to December 2009. Twenty eight cases of short-segment urethral stricture (<2 cm) who underwent urethroplasty were included and divided into two groups depending upon etiology; post-traumatic group (road traffic accident/straddle type injury) and iatrogenic stricture group (due to prolong catheterization/after cystoscopy/Faulty Foleys balloon placement). Post-operative PUG was done on 14th post-operative day in all patients for healing assessment. Extravasation of dye on PUG was taken as anastomotic leak. If the patient had not showed extravasation, the catheter was removed. Otherwise it was kept further for next one week and again PUG was done for healing assessment.Results:Extravasation of dye was noted in 4 patients (33%) of iatrogenic group and 14 patients (87.5%) of the post-traumatic group on 14th post-operative day PUG. (P ≤ 0.05). The decision to remove catheter was depended upon PUG finding and it was safe, no complication was developed in any patient.Conclusion:Iatrogenic strictures have better healing than post-traumatic stricture in the post-operative period. PUG is a safe and simple procedure and can guide about safe removal of catheter in the post-operative period.
Female urethral injuries associated with Pelvic fracture are not as uncommon as it was previously thought. Primary endoscopic realignment of proximal urethra and catheterisation on guide-wire is very good procedure in early presentation. Every female patient with urethral injury due to pelvic fracture should be referred for primary repair to decrease the avoidable morbidity of these patients.
Squamous cell carcinoma of scrotum is not common. It was the first cancer directly associated with a specific occupation i.e. chimney sweeps. We report a case of squamous cell carcinoma of scrotum developed in a patient of stricture urethra with multiple perineal urinary fistulas treated with lay open urethra with buccal mucosal graft. Tobacco exposed buccal mucosa graft can act as a carcinogen for scrotal cancer in patients with multiple fistula and poor hygiene.
An 11-month-old infant presented with acute urinary retention. He had presented 3 months earlier with complaints of an enlarging abdominal mass that was initially diagnosed as a mesenteric cyst on ultrasonography. Voiding cystourethrogram revealed a large bladder diverticulum. Bladder diverticulum should be a differential diagnosis in children, especially male, presenting with urinary retention, fever and an abdominal mass.
We report herein a clinical case of a patient with femur fracture due to metastasis from penile squamous cell carcinoma. A young man, who was treated for carcinoma penis, presented with pathological fracture of femur and lung metastasis from metastatic carcinoma penis after 18 months. Long bone metastasis from penile cancer is extremely rare, to the best of our knowledge; this is the first report of a patient with penile cancer spread to the femur from primary squamous cell carcinoma of the penis.
Introduction:Transurethral resection of prostate (TURP) remains the golden standard therapy since decades. There are various minimally invasive therapies (MITs) for the treatment of benign prostatic hyperplasia (BPH). Still, there is a need for therapy with lesser side effects and better outcome. We had studied the effect of intraprostatic ozone injection (IPOI) as an MIT for patients with BPH who have failed trial without catheter (TWOC).Materials and Methods:Thirty elderly patients with BPH with a prostate size of 30 g or more were enrolled for the study. Forty milliliters of ozone at a concentration of 30 μg/dl was injected in prostate (20 ml in each lateral lobe) per rectally. Prostate volume (PV) by ultrasonography was assessed after catheter removal on the 7th day and after 1 month.Observations and Results:Totally thirty patients (mean age - 67.8 years) with mean prostatic volume (MPV) of 46.10cc received IPOI. MPV came as 44.96cc on the 7th day of postozone therapy (P = 0.008). Successful voiders showed a significant reduction in PV (mean = 13.12cc) as compared to unsuccessful voiders (mean = 2.61cc) after 1 month.Conclusion:Intraprostatic ozone injection helps to reduce the PV to some extent and can be helpful in patients who have failed TWOC even on alpha blockers and are unfit for TURP. Larger studies are required to assess the efficacy and long-term results of this technique.
The aim of this case report was to present a rare case of bony metastases originated from squamous cell carcinoma of the mid esophagus, thus, underline the need for early diagnosis and possible treatment of suspicious bony lesions among patients with esophageal malignancy. A 35-year-old man with esophageal carcinoma underwent esophagectomy whose pathology revealed stage III-C disease. During follow up, he was diagnosed to have bony hand metastasis. The patient died after some time. Therefore, follow-up of patients who are diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages as esophageal cancer is emerging as leading cause of cancer mortality worldwide. Complete resection of esophageal cancer and adjacent malignant lymph nodes is the only potentially curative treatment. Accurate preoperative staging and assessment of therapeutic response after neoadjuvant therapy are crucial in determining the most suitable therapy and avoiding inappropriate attempts at curative surgery.
Background: Reconstruction of male urethra poses a continuing urological challenge. The ideal material for substitution urethroplasty remains controversial. Candidate tissues have included split and full thickness skin graft from scrotum, penis and extra-genital areas like bladder mucosa and buccal mucosa. This study was done to evaluate the short term and long-term results of buccal mucosal urethroplasty and analyzed them with different variables like etiology of stricture, length of stricture, operative procedure and associated complications and success rate. Material and Methods: All the Cases of anterior stricture urethra who had stricture length more than 1 cm and who underwent buccal mucosal substitution urethroplasty were included in this study. The short term and long-term results of buccal mucosal substitution urethroplasty were assessed. Patients were divided into two groups according to their length, patients with stricture length up to 6 cm and 7 cm or more and the results of buccal mucosal substitution urethroplasty were assessed in terms of etiology of stricture, length of stricture, operative procedure and its associated complications and success rate. Results: In the present study, the success rate of long segment strictures was inferior (77%). The success rate of two staged BMGU for long segment strictures was satisfactory (80%) if not associated with proximal urethral stenosis. Success rate of urethral strictures associated with BXO was lower (75%) as compared to others. Success rate of BMGU with almost tube (50%) was very poor. Conclusion: Buccal mucosa gives a good and viable option for substitution urethroplasty for long segment stricture. It is easy to harvest and handle, is resilient to infections and accustomed to a wet environment. As of date, it provides good material for substitution for treating all types of strictures with fairly good results and fewer complications.
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