SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Urology case reports

143

A 19 year old presented with a progressive decline in ejaculate volume over 2 weeks, followed by a complete absence of ejaculate emission. A post-ejaculatory urine specimen demonstrated spermatozoa confirming a diagnosis of retrograde ejaculation. Investigations revealed a raised blood glucose level of 24.5 mmol/L and HbA1c >15%, with positive tests for anti-GAD antibodies and anti-IA2 antibodies consistent with a diagnosis of Type 1 diabetes mellitus. Retrograde ejaculation in diabetes is associated with autonomic neuropathy and is a late feature of the disease. This case is unique with retrograde ejaculation being the primary presenting symptom of Type 1 diabetes mellitus.

Concepts: Diabetes mellitus, Diabetes, Blood sugar, Semen, Orgasm, Ejaculation, Retrograde ejaculation, Anejaculation

141

Genital injury can occur at any age of life but is most common in the pediatric population. Hair-tourniquets and circumcision procedures are the most common causes of penile injury in children. Foreskin trauma, aside from zipper related injuries, is sparsely reported. We describe the case of an 8-year-old male who presented with foreskin entrapment caused by bathing suit mesh. Management and literature review are discussed.

Concepts: Foreskin, Penis, Physical trauma, Circumcision, Glans penis, Masturbation, Frenulum of prepuce of penis, Foreskin restoration

73

Penile ossification, a rare condition, has been linked traditionally to Peyronie’s disease (PD) despite the presence of other less common etiologies. The ossification takes place usually in the mid-shaft of the penis with few cases reporting involvement of the entire shaft. Ultrasound has been the method of choice to demonstrate plaque calcifications. Medical and surgical treatment options exist depending on the extent of ossification and symptoms. This case report discusses the presence of ossification in the entire penile shaft which has been found incidentally on a pelvic x-ray in a patient presenting to the emergency department for a trauma of the knee.

38

Chronic, massive lymphedema of the scrotum can pose therapeutic challenges to the urologist. Uncommonly encountered in developed countries, this dilemma can be amplified in the emergent setting. Along with voiding limitations and pain, lymphedema can lead to recurrent subcutaneous infections. Recurrence of infections can lead to a cycle of worsening lymphedema. We report a case of Fournier’s gangrene complicated by massive lymphedema of the scrotum and right leg in a 43 year-old man from Panama, presumably filarial. This case highlights the surgical management of a patient requiring emergent intervention and multidisciplinary approach of reconstructive repair in the acute care setting.

17

Foreign body in urinary bladder is an unusual finding in urology emergency, which has always caused wide attention. In this case report, we presented a 28-year-old unmarried male who was admitted to the emergency room with magnetic balls in his bladder. An abdominal plain X ray showed metallic dense shadow in the pelvic region. The foreign body was removed under modified cystoscopy and 159 magnetic balls were detected. The patient was discharged without any surgical or postsurgical complications. Cystoscopy is a better option for dealing with a large number of magnetic balls in urinary bladder.

11

A case of Fournier’s gangrene secondary to a self-administered penile augmentation is reported. A 45 year old man from the South pacific islands was successfully treated with surgical debridement, intensive care unit admission and antibiotics after presenting to hospital with Fournier’s gangrene. Two years prior, he had self-administered Vaseline to the shaft of the penis in order to augment penile size. The presentation and management are discussed and a brief literature review has been conducted.

5

Management of blunt scrotal trauma is classically centered upon evaluation of potential testicular ruptures to that expedient surgical intervention can be employed. We present a unique case of blunt scrotal trauma causing bilateral testes rupture in order to illustrate the rationale for societal guidelines. We additionally offer discussion of potential sequelae of afflicted patients and a sparingly used technique to salvage a severely injured testis.

5

Gunshot wounds to the genitourinary system are relatively rare, and it is even rarer a retained bullet migrates into the urinary tract. We describe a case where the bullet migrated into the bladder and formed a bladder stone eighteen years after the injury. This presentation is unique as it is one of the longest times from gunshot wound to presentation in the current literature.

4

A 68 year old lady presented to urology department suffering from acute urinary retention. The U/S revealed hydronephrosis in left kidney and a mass at the left side of the small pelvis which pushed forward the uterus and the bladder. The CT scan confirmed a mixed (solid and cystic) mass, with diameter of 12 cm with interpretation of the left ovary. The patient underwent laparotomy and the mass was excised after a difficult dissection due to severe adhesion with the bowel. The well-capsulated mass was a retained surgical sponge. The patient had undergone cesarean procedure 29 years ago.

Concepts: Kidney, Urology, Urinary incontinence, Urinary bladder, Urinary system, Ureter, Pelvis, Urinary retention

3

Although penile amputation is a rare injury, it may occur caused by self-mutilation with psychiatric disturbances and sexual need, or due to accidents, iatrogenic injuries or revenge and marriage breakdown. A case of successful penile glans replantation by macroscopic repair using vein blood-letting therapy is presented. This case report shows the surgical procedure and postoperative care which may be critical for successful replantation.