SciCombinator

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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

16

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.

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

Paraphimosis is usually acute painful condition. Delay in medical attention might result in dreaded complications like gangrene and auto-amputation. Very rarely patient might present late with large painless paraphimosis as in our case just because it interrupts intromission despite satisfactory painless erection.

3

Penile strangulation is a disease which causes circulatory failure in the distal part of the penis by the penis strangulated by foreign substances, and it is a rare emergency disease in urology. Most of the motives are for pranks, sexual intercourses and treatments of incontinence. We herein report the clinical course of penile strangulation complicated by penile cancer. Although the treatment was completed in accordance with its clinical stage of the penile cancer without any perioperative complications, it was considered that more case studies and further examinations would be needed to determine the treatment plans.

3

Human heterophile antibodies may develop after infection or contact with animal tissues or animal serum products. These antibodies have the capacity to bind to the animal immunoglobulins used in immunoassays leading to erroneous results. We here report a case of a testicular germ cell tumor patient who developed heterophile antibodies during the surveillance period of his disease. Following false-positive results of human chorionic gonadotropin (hCG) he received unneeded chemotherapy. This article also stresses the problem of using serum tumor markers without no major imaging abnormalities to diagnose a patients' relapse.

Concepts: Immune system, Cancer, Bacteria, Oncology, Germ cell tumor, Human chorionic gonadotropin, Glycoprotein, Heterophile

2

Self-mutilation is the deliberate direct injuring of body tissue, often done without suicidal intention. Genital self-mutilation is a very rare event and self-harm of the penis, especially in the genital system is exceedingly rare. Generally, this kind of behavior is related to psychotic disorders but can sometimes be seen in non-psychotic people due to bizarre autoerotic acts, a desire for to change sex or religious beliefs that view sexual intercourse as a sin. Our case was the reported genital self-mutilation as a result of the bizarre sexual arousal of a young man who is employed as an architect.

Concepts: Sexual intercourse, Religion, Vagina, Penis, Erection, Sexual arousal, Sex organ, Masturbation

1

The early intravesical Instillation of mitomycin C (MMC) is accepted as safe adjuvant therapy after TURBT by non-muscle- invasive bladder cancer if there is no perforation. In our case we report a female patient undergoing resection of papillary recurrent tumor on the anterior bladder wall. In the early postoperative period had the patient no complaints regarding to Instillation of MMC. The clinical manifestation of the necrosis of the anterior bladder wall appeared after one week requiring a long extended unsuccessful conservative therapy in order to save the bladder. Finally we performed a radical cystectomy. This complication is reported by some authors in literature.

1

The ExactVu™ Micro-Ultrasound system is a new high resolution imaging system for visualizing the prostate and has been FDA, CE, and Health Canada approved for visualization and biopsy of the prostate. The PRI-MUS™ (Prostate Risk Identification for Micro-Ultrasound) protocol has previously been demonstrated to correlate with risk of prostate cancer and severity of cancer. Here we present a case where a healthy 50 year old subject with no known risk factors volunteered to test the ExactVu system and was found to harbour multiple PRI-MUS 3-5 lesions. This prompted PSA testing, biopsy and eventual diagnosis of significant prostate cancer.

Concepts: Epidemiology, Cancer, Metastasis, Pathology, Prostate cancer, Radiation therapy, Prostate, Image processing