Open radical cystectomy (ORC) remains the gold standard for the treatment of muscle-invasive and high-risk non-muscle invasive bladder cancer unsuitable for bladder preservation techniques.Despite improvements in operative technique and perioperative care, it continues to be associated with significant complications. We analyzed our series of prospectively collected data of patients that underwent ORC at a tertiary referral academic center and evaluated early and late postoperative complications and mortality. The records of 391 ORCs with ileal diversion performed at our institution between January 2008 and July 2018 for non-metastatic transitional bladder carcinoma and other distinct pathological types were analyzed. Perioperative mortality was determined and 30day and 90-day complications were reported according to the Martin Criteria and the European Association of Urology and graded according to the five-grade Clavien-Dindo classification.Univariate and multivariate analyses were used to evaluate predictors of complications and mortality. Gastrointestinal and infectious complications represented 41% and 43% of the total complications observed at 30 and 90 days from the surgery, respectively. The strongest predictor of infectious complications was the ch Diabetes was a predictor of the overall, major and major infectious complications (p < 0.05). The 30-day mortality rate was 1% while the 90predictor of mortality at both 30-days (p-value 0.003) and 90-days (p-value 0.01) in univariate and multivariate analyses. ORC is a morbid procedure, associated with a high mortality rate. Elderly patients should have proper counseling before indication of this procedure. Gastrointestinal and infectious complications represent the most common and serious complications, and the study of their predictors is of the utmost importance.
Introduction Mondor reported the first superficial venous thrombosis on the chest wall in 1939 (1). This condition is usually a benign and self-limited process, requiring only symptomatic treatment. Mondor's disease of the penis is an uncommon condition, which usually involves the superficial dorsal veins, it was first described by Braun-Falco in 1955 (2). Isolated superficial dorsal vein-thrombosis was reported in 1958 by Helm et al. (3) since then 42 cases have been reported (4, 5). In the last seven years 11 more cases have been reported (6-13). Patients experience a cord or string-like induration along the penile superficial dorsal vein, which is often painful and accompanied by localized inflammatory changes. This condition is benign and self-limited in most patients with complete resolution after 6 to 8 weeks of conservative management although sometimes surgery is indicated when it is associated with chronic or severe local pain (4). We report on two patients with Mondor's disease of the penis following intense masturbation using unusual devices. Case presentation and management Patient 1: A 31-year-old white man presented to the outpatient clinic complaining of subcutaneous cord induration along the dorsal region of the penis which was painful following intensive masturbation using toothpaste for lubrication purposes a few days before. The patient, with significant anxiety, complained that he could not have an erection because of the pain. The patient denied recent fevers, voiding symptoms, a medical history of blood dyscrasia, phlebitis, sexually transmitted disease or intravenous drug abuse. Patient 2: A 33-year-old white man previously presented to the emergency department for a penile strangulation due to the abnormal use of an unusual device for masturbation (adhesive
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