‘Street Urology’: Beyond the Formulary

Coull, Nadine; O’Brien, Tim

doi:10.1111/j.1464-410x.2008.08077.x

Cited by 9 publications

(3 citation statements)

References 14 publications

(12 reference statements)

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“…We have all seen patients with symptoms compatible with these patients’ complaints and many have been treated with a variety of speculative therapies. Increasing awareness of the urological effects of recreational drugs should lead to more doctors asking the questions that will help to identify and treat such syndromes [19].…”

Section: Treatment Regimementioning

confidence: 99%

Recreational ketamine: from pleasure to pain

et al. 2011

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What's known on the subject? and What does the study add? There is a very limited literature on the syndrome described in this review. The largest series comes from Hong Kong and includes 59 patients – this was largely a description of the presenting problems and established the link between these symptoms and ketamine. Prior to this much smaller case series (including one from the same group) were all that exists. An increasing number of UK urologists are reporting seeing these patients and we have formed a collaboration interested in understanding the pathology and establishing an effective treatment pathway for these patients. This paper aims to consolidate this knowledge. Ketamine has become increasingly recognized as a drug of recreational use. Individuals using significant amounts have developed symptoms including a small painful bladder, ureteric obstruction, papillary necrosis and hepatic dysfunction. The present paper examines the current literature on the relationship between ketamine use and these symptoms. Our own clinical experience and the data available clarify the causal relationship, and further data help to elucidate the mechanism of damage. On the basis of continued work and development with patients who are ketamine users we suggest an assessment and treatment regime that includes cessation of ketamine use and adequate analgesia to overcome symptoms. In conclusion, it is important for medical practitioners who encounter patients with these symptoms to ask about recreational drug use. Ketamine remains a safe and effective drug to use under appropriate medical supervision. Patients identified as suffering from this syndrome will need to be referred to a urological unit with an interest in the treatment of the condition.

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Section: Treatment Regimementioning

confidence: 99%

Recreational ketamine: from pleasure to pain

et al. 2011

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“…One publication suggests that sildenafil may be useful in the relief of a sickle cell priapism [51]. It is also worthy of note that in young men using cocaine, there is an increased incidence of priapism both when inhaled and applied topically to enhance sexual performance [52,53]. There also are case reports of PDE-5 inhibitors inducing priapism [54,55,56].…”

Section: Priapismmentioning

confidence: 99%

Penile Anomalies in Adolescence

Wood

Woodhouse

2011

The Scientific World JOURNAL

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This article considers the impact and outcomes of both treatment and underlying condition of penile anomalies in adolescent males. Major congenital anomalies (such as exstrophy/epispadias) are discussed, including the psychological outcomes, common problems (such as corporal asymmetry, chordee, and scarring) in this group, and surgical assessment for potential surgical candidates. The emergence of new surgical techniques continues to improve outcomes and potentially raises patient expectations. The importance of balanced discussion in conditions such as micropenis, including multidisciplinary support for patients, is important in order to achieve appropriate treatment decisions. Topical treatments may be of value, but in extreme cases, phalloplasty is a valuable option for patients to consider. In buried penis, the importance of careful assessment and, for the majority, a delay in surgery until puberty has completed is emphasised. In hypospadias patients, the variety of surgical procedures has complicated assessment of outcomes. It appears that true surgical success may be difficult to measure as many men who have had earlier operations are not reassessed in either puberty or adult life. There is also a brief discussion of acquired penile anomalies, including causation and treatment of lymphoedema, penile fracture/trauma, and priapism.

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“…This review by Coull and O’Brien [1] gave a very interesting and timely overview of the urological effects of illicit drugs, along with a useful mnemonic (CHECKS). However, they did not mention the dramatic vasoconstrictive effect of amphetamines on the penis, reported anecdotally by some patients, known as ‘speed dick’, ‘speed willy’ or ‘whizz dick’.…”

mentioning

confidence: 99%