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CASE REPORTS
Low-grade liquid silicone injections as a penile enhancement procedure: Is bigger better?
Ramesh Sasidaran, Mohd Ali Mat Zain, Normala Hj Basiron
September-December 2012, 4(3):181-186
DOI:10.4103/0974-7796.102672  PMID:23248528
To report our experience with 5 cases of complications of penile enhancement procedures secondary to liquid silicone injections and our method of management of its debilitating effects. All five patients were treated with excision of penile shaft skin down to buck's fascia followed by resurfacing with split thickness skin grafting. We conclude that penile enhancement procedures with liquid silicone by non-medical personnel could result in devastating consequences. We also demonstrate that a simple method of excision of the entire penile shaft skin and resurfacing with split skin grafting showed improvement in cosmetic as well as functional outcome.
  99,534 1,286 1
ORIGINAL ARTICLES
Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation
Mohammad Reza Namavar, Boroomand Robati
May-August 2011, 3(2):87-92
DOI:10.4103/0974-7796.82175  PMID:21747599
Background and Aim : Premature ejaculation (PE) is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE. Materials and Methods : The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT), patients and their sexual partners' satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment. Results : There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001). The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001). After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001), but it did not change glans penis insensitivity. Conclusions : These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.
  50,617 1,350 10
The efficacy and safety of topical EMLA cream application for minor surgery of the adult penis
Kostis I Gyftopoulos
September-December 2012, 4(3):145-149
DOI:10.4103/0974-7796.102658  PMID:23248519
Background and Objectives : A variety of surgical procedures of the penis can be performed under local anesthesia. We evaluated the efficacy and safety of EMLA cream anesthetic in such procedures. Materials and Methods : In total 330 adult patients were subjected to minor penile surgery including: Complete circumcision (73), short frenulum plasty (168), meatotomy (14), fulguration of penile warts (56) and fulguration of urethral (meatal) warts (19). The level of anesthesia obtained by EMLA cream application along with any adverse effects was recorded. Results: The use of EMLA on mucosal lesions provided excellent level of local anesthesia in almost all patients (245/246, 99.5%). Anesthesia of skin lesions was in part influenced by the site of application. Circumcision patients showed the lowest efficacy of the EMLA cream as the majority (~80%) required some form of further anesthesia until the completion of the procedure. No significant adverse effects were noted. A transient erythema was present in almost all mucosal applications. Conclusions: The topical anesthetic EMLA cream is a useful, efficient and safe tool for minor surgical procedures of the penis at the office setting, with the exception of circumcision, where an additional type of anesthesia is likely to be necessary. Side effects can be kept to a minimum when the suggested doses are respected (especially at mucosal application) and the time allowed for action is carefully tailored to the site of application and the type of procedure.
  39,713 2,472 2
False fracture of the penis: Different pathology but similar clinical presentation and management
Adel Kurkar, Ahmad A Elderwy, Elderwy Orabi
January-March 2014, 6(1):23-26
DOI:10.4103/0974-7796.127015  PMID:24669117
Introduction: Penile fracture is the most common presentation of acute penis. Rupture of the superficial dorsal penile vein (s) may mimic penile fractures with similar clinical presentation but with intact corporeal bodies. Our aim of the study is to highlight superficial dorsal penile vein (s) injury as true emergency with better prognosis. Subjects and Methods: Sixty-eight patients with suspected penile fractures presented to our hospital between June 2007 and January 2013. Out of these, 11 patients showed intact tunica albuginea on exploration with injured dorsal penile vein (s) identified. Records of such 11 cases were reviewed regarding age, etiology, symptoms, physical signs, findings of surgical exploration and post-operative erectile function. Results: All 11 patients were injured during sexual intercourse and presented with penile swelling and ecchymosis and gradual detumescence. Mild penile pain was encountered in 5 cases and the "snap" sound was noted in 2 cases. Examination revealed no localized tenderness, or tunical defect. All the patients regained penile potency without deformity after surgical ligation of the severed vessels. One patient developed penile hypoesthesia. Conclusion: Although the classic "snap" sound and immediate detumescence are usually lacking in the symptomology of dorsal penile vein rupture, its clinical presentation can be indistinguishable from true penile fracture. Surgical exploration is still required to avoid missing tunical tear with possible future complications. The long-term outcome and prognosis are excellent.
  36,845 687 1
CASE REPORTS
Paraurethral Skene's duct cyst in a newborn
Serdar Moralioglu, Oktav Bosnali, Aysenur Cerrah Celayir, Ceyhan Sahin
July-September 2013, 5(3):204-205
DOI:10.4103/0974-7796.115754  PMID:24049387
Paraurethral or Skene's duct cysts are rare causes of interlabial masses in neonates. The diagnosis of Skene's duct cysts in the neonatal period is based on its location, in relation to the urethra, and the demonstration of transitional epithelium in the cyst wall. The distinguishing features of paraurethral cysts are the displacement of urethral meatus by the mass and a cyst containing milky fluid. Thus, we report a case of a Skene's duct cyst in a newborn which was treated by incision and drainage.
  25,865 692 4
Prolonged priapism following single dose administration of sildenafil: A rare case report
Sachit Sharma, Sabyasachi Panda, Shilpa Sharma, Santosh K Singh, Amlesh Seth, Narmada Gupta
July-December 2009, 1(2):67-68
DOI:10.4103/0974-7796.56041  
A case of priapism following the consumption of a single dose of sildenafil is reported. A 25-year-old unmarried healthy man consumed non-prescribed 50 mg sildenafil purchased over the counter. He developed painful priapism 30 min after the drug intake that had lasted for 4 days (96 h) when he sought medical advice as an emergency. The corpus spongiosum and glans was soft and the corpus cavernosa was rigid. Winter's shunt was done. Fifteen milliliters of dark blood was aspirated with 16 G needle. Detumescence was achieved within 30 min. He was discharged after 12 h. On one month follow-up, he had normal morning erections. A genetic basis with cross-reactivity of PDE-3 in addition to PDE-5 resulting in a cumulative erection effect may be possible elucidation for this unwanted side effect in rare cases. However, the number of cases reported with this side effect is still too less to draw further conclusions.
  25,596 948 -
ORIGINAL ARTICLES
Meatal stenosis after surgical correction of short frenulum: Is the “pull-and-burn” method the way to go?
Kostis I Gyftopoulos
October-December 2018, 10(4):354-357
DOI:10.4103/UA.UA_25_18  PMID:30386085
Background and Objectives: The surgical correction of a short frenulum includes several procedures that vary in complexity of the technique and the use of stitches, lasers, or skin grafts. However, little is known about the effect of these procedures on meatal stenosis. A possible association of frenular artery trauma during circumcision and subsequent meatal stenosis has raised concerns regarding the importance of frenulum preservation. We hereby report our experience over 15 years of applying the “pull-and-burn” method for short frenulum correction. Patients and Methods: A total of 236 patients underwent the “pull-and-burn” procedure for short frenulum under local anesthesia on an outpatient basis between November 2002 and November 2017. The method is suture free and involves tearing the frenulum superficially and vertically by the aid of a low-power, high-frequency hyfrecator, avoiding the underlying frenular vessels. Patients were advised for a regular follow-up visit at 2–3 months postoperatively and were reviewed for symptoms and signs suggestive of meatal stenosis. Results: Follow-up files were available for 228 patients (96.6%). No symptoms suggestive of meatal stenosis (dysuria and stream pattern abnormalities) were reported by any patient. Examination of the urethral meatus revealed normal appearance, with no signs of edema or scarring in all the 228 patients. Conclusions: The “pull-and-burn” method is a simple and safe procedure for the correction of short frenulum that respects anatomically the delicate vasculature of the frenular area, resulting in the preservation of the integrity of the urethral meatus.
  26,109 417 1
The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study
Alsayed Saad Abdelaziz, Ayman Mohammed Ghoneem, Emad Ades Elewesy
July-September 2019, 11(3):235-240
DOI:10.4103/UA.UA_138_18  PMID:31413498
Introduction: Erectile dysfunction (ED) is a highly prevalent condition among men all over the world and commonly associated with undiagnosed medical diseases as chronic pelvic pain and hemorrhoid. Objective: The purpose of this study was to study the impact of surgical hemorrhoidectomy on sexual function in men with erectile dysfunction (ED). Materials and Methods: In a prospective manner, we studied the effect of surgical hemorrhoidectomy on erectile function (EF) in male patients with ED. Hemorrhoidectomy was carried out in 82 patients with clinical hemorrhoid associated with ED (Group 1) and compared with 81 patients without operative intervention (Group 2; control). The primary efficacy variable was the mean change in the International Index of Erectile Function (IIEF) questionnaire. Results: In Group 1, the IIEF questionnaire increased significantly after hemorrhoidectomy, from 15.56 to 27.37 (P < 0.001), indicating improvement of EF. Thirty-six patients (41.1%) showed improvement of EF compared to 5.3% in the control group (P < 0.001). In Group I, but not in Group II, IIEF values increased significantly when compared with preoperative values (P < 0.001). Conclusion: We concluded that surgical hemorrhoidectomy is clearly related to improvement of EF in male hemorrhoid patients with ED.
  23,360 427 1
CASE REPORTS
Management of pelvic lymphoceles following robot-assisted laparoscopic radical prostatectomy
Omer A Raheem, Wassim M Bazzi, J Kellogg Parsons, Christopher J Kane
May-August 2012, 4(2):111-114
DOI:10.4103/0974-7796.95564  PMID:22629010
Pelvic lymphocele is a potential complication of radical prostatectomy. Although lymphoceles often regress spontaneously, many may progress, precipitate clinical symptoms, and ultimately require intervention. To date, the best treatment of pelvic lymphoceles has not yet been fully defined. However, laparoscopic marsupialization is a definitive and efficacious surgical alternative to percutaneous drainage. It is effective, results in minimal patient morbidity, and allows for rapid recovery. We report our experience with management of clinically symptomatic pelvic lymphoceles following robotic-assisted prostatectomy using laparoscopic marsupialization.
  18,351 834 5
New compression mechanism in penile-scrotal lymphedema and sexual rehabilitation
Jose Maria Pereira de Godoy, Fernando Nestor Facio, Eleni Cássia Matias de Carvalho, Maria de Fatima Guerreiro Godoy
January-March 2014, 6(1):88-90
DOI:10.4103/0974-7796.127025  PMID:24669133
The objective of this study is to describe a new compression mechanism in the treatment of lymphedema of the penis and scrotum and the ensuing sexual rehabilitation. The patient, a 58-year-old man, had edema of the penile and scrotal region as a result of surgery of the pancreas and spleen and chemotherapy. The patient complained of pain, discomfort, and difficulties to walk and urinate. A clinical diagnosis of lymphedema of the penis and scrotum was reached. Treatment involved the continuous use of a cotton-polyester compression garment for the region together with thorough hygiene skin care. The swelling reduced significantly within a week to almost a normal aspect which was accompanied by clinical improvements of the symptoms. The reduction in penile edema allowed sexual rehabilitation even though erectile dysfunction required the use of a specific medication (sildenafil). In conclusion, simple and low-cost options can improve lymphedema of the penis and scrotum and allow sexual rehabilitation.
  17,798 641 -
Simple cyst of urinary bladder
Yang Bo
July-September 2014, 6(3):244-246
DOI:10.4103/0974-7796.134288  PMID:25125900
Simple cysts are rare in the urinary bladder and can pose a diagnostic dilemma to both the urologist and the histopathologist. No case study was found in the database of Elsevier Science Direct, Spring-Link, or PubMed. We present two cases of subserous cyst in the bladder and discuss the diagnosis and treatment of the condition. The cystic lesion at bladder dome was detected by radiologic examination and confirmed by cystoscopy. In case 1, transurethral resection was first performed which was followed by partial cystectomy; In case 2, the cyst was removed with the urachus using laparoscopic surgery. The patients recovered uneventfully and the histopathology showed cysts in subserous layer of urinary bladder. The bladder cyst should be distinguished from urachal tumor, and laparoscopic partial cystectomy is the preferred operative procedure.
  17,804 541 -
Spontaneous subcapsular renal hematoma: A case report and review of literature
Ramen Kumar Baishya, Divya R Dhawan, RB Sabnis, Mahesh R Desai
January-April 2011, 3(1):44-46
DOI:10.4103/0974-7796.75852  PMID:21346835
Spontaneous subcapsular renal hematoma is not a common entity. We report a 38-year-old lady presenting with sudden onset right flank pain with uncontrolled hypertension and she was found to have subcapsular collection in the right kidney on ultrasonography. Finding was confirmed on computed tomography. Except hypertension, no particular cause for the condition could be found. Symptoms and size of the collection decreased on conservative treatment. They completely disappeared on ultrasonography at 6 months follow-up. She was asymptomatic at 18 months follow-up.
  16,506 1,193 7
ORIGINAL ARTICLES
Chordee without hypospadias: Operative classification and its management
Sunita Singh, Jiledar Rawat, Shiv Narayan Kureel, Anand Pandey
April-June 2013, 5(2):93-98
DOI:10.4103/0974-7796.110005  PMID:23798865
Context: Developing countries. Aims: To propose a operative classification of Chordee without hypospadias (CWH) with its management. Settings and Design: Tertiary referral centre; Retrospective study from January 2000 to January 2011. Materials and Methods: Total 26 patients were classified peroperatively into sixtypes (A: Cutaneous chordee→ Degloving skin and dartos (1/26); B: Fibrous chordee→ chordectomy (4/26);C: Corporocavernosalchordee→ Corporoplasty ± Urethral mobilization (4/26); D: Urethral tethering with Hypoplastic urethra→ Urethral mobilization ± urethral reconstruction because of hypoplastic urethra (14/26); E: Congenital short urethra→ excision of urethra from the meatus and urethroplasty (2/26); and F: Complex chordee→ Degloving ± Corporoplasty ± urethroplasty (1/26 patients).The follow-up over 6 months to 9 years were analyzed. Statistical Analysis : SPSS soft ware version 17.0 for Windows. Results: The mean age of surgery was 5.33 ± 0.11 years. The success rate defined on uroflowmetry and voiding cystourethrography was 65.6%. The coronal urethra-cutaneous fistula developed in 26.9% (7/26) {including 7.7% (3/26) of associated metal stenosis}. The urethral stricture developed in 3.8% (1/26). Conclusions: CWH needs stepwise surgical management. The operative classification may help in better understanding and management of this difficult entity. Meticulous tissue handling and urethroplasty is needed for good and promising results.
  15,998 1,088 1
Penile lichen sclerosus: An urologist's nightmare! - A single center experience
Jitendra Pratap Singh, Vinod Priyadarshi, Hemant Kumar Goel, Mukesh Kumar Vijay, Dilip Kumar Pal, Sudip Chakraborty, Anup Kumar Kundu
July-September 2015, 7(3):303-308
DOI:10.4103/0974-7796.150490  PMID:26229314
Purpose: Penile lichen sclerosus (LS) is a nagging condition and its progression result in devastating urinary and sexual problems and reduction in the quality-of-life. This study has been carried out to present our experience about this disease with simultaneous review of the available literature. Materials and Methods: This retrospective study has been done at a tertiary care center of eastern India. The data of 306 patients affected with LS were analyzed for clinical presentation, physical examination, investigations, and treatment offered. Results: Presenting symptoms were non-specific. The prepuce was most commonly involved location followed by glans and meatus. Urethral involvement was not isolated as the primary site. Circumcision was done in 237 patients, while 63 patients underwent meatotomy. Thirty-six of 39 cases of LS induced stricture were treated with buccal mucosal graft (BMG) either in one stage or in two stages. Conclusion: LS varies from being a highly aggressive disease of the penis and anterior urethra to a burnt out condition affecting just the meatus and surrounding glans. Early diagnosis and treatment are required to prevent its complication and associated morbidity. Management depends on the anatomical location of lesion, extent of involvement, rapidity of progression and its severity. Use of BMG in LS induced urethral stricture has shown encouraging results.
  15,976 464 -
CASE REPORTS
Priapism, pomegranate juice, and sildenafil: Is there a connection?
Subramanian Senthilkumaran, Namasivayam Balamurugan, Ponuswamy Suresh, Ponniah Thirumalaikolundusubramanian
May-August 2012, 4(2):108-110
DOI:10.4103/0974-7796.95560  PMID:22629009
We report the development of low flow priapism in three patients related to simultaneous consumption of sildenafil with pomegranate (Punica granatum) (POM) juice. There were no other concurrent diseases, intake of drugs, and chemicals or other risk factors in these patients. We want to create awareness among patients and practitioners for recognition and timely intervention. Probable mechanisms are highlighted.
  15,223 635 1
ORIGINAL ARTICLES
Self-inflicted foreign bodies in lower genitourinary tract in males: Our experience and review of literature
Nagabhushana Mahadevappa, Gaurav Kochhar, Karthikeyan Senguttuvan Vilvapathy, Sachin Dharwadkar, Sumit Kumar
July-September 2016, 8(3):338-342
DOI:10.4103/0974-7796.184904  PMID:27453657
Objectives: To study retrospectively the frequency, demographic, phenomenological, and psychiatric profile in patients presented with self-insertion of foreign bodies in the lower genitourinary tract in our institute. Materials and Methods: From January 2009 to 2015, the records of patients admitted with self-insertion of foreign bodies into the lower urinary tract were analyzed retrospectively regarding demographic and phenomenological profile, the mode of presentation, diagnosis, management, complications, and possible contributing factors leading to the event. Results: Out of 17,978 inpatients, ten patients (0.055%) presented with foreign body insertion in the lower genitourinary tract in last 6 years. Mean age was 28.1 ± 13.9 (7–50) years. Objects used for insertion were varied from seeds, twigs to the electric wire. The contributing factors were lack of partner, misconception about masturbation, and underlying psychiatric illness. The presenting symptoms were pain and swelling of the penis, difficulty in voiding, and skin ulceration. The diagnosis was possible by simple observation in four patients, X-ray kidney, ureter, and bladder, and sonography of the pelvis in six patients. Five patients had endoscopic retrieval of foreign body, 2 had an open, suprapubic cystotomy, urethrotomy was needed in one patient, and forceps removal in two patients. There were no postoperative complications. Psychiatric profile was evaluated in nine patients. Conclusions: Foreign body insertion to lower urinary tract was rare. A main cause for insertion of foreign bodies was autoerotism, misconceptions regarding masturbation, and underlying psychiatric illness. In addition to suitable method of surgical removal, counseling and psychiatric evaluation are necessary to prevent recurrences or for early detection of psychiatric problems.
  14,456 477 7
NEW HORIZON
Robot assisted laparoscopic retroperitoneal lymph node dissection in testicular tumor
Prem Nath Dogra, Prabhjot Singh, AK Saini, K Subodh Regmi, Bora G Singh, B Nayak
October-December 2013, 5(4):223-226
DOI:10.4103/0974-7796.120289  PMID:24311897
The treatment options in clinical stage I nonseminomatous germ cell tumor (NSGCT) of testis are either surveillance, chemotherapy or retroperitoneal lymph node dissection (RPLND). While open RPLND still serves as the gold standard, laparoscopic and robot assisted laparoscopic approaches are gaining popularity. In this report, we share our experience and technique of robot assisted laparoscopic RPLND in a patient with clinical stage Ib NSGCT of testis.
  4,908 9,747 2
GUIDELINES
Saudi oncology society and Saudi urology association combined clinical management guidelines for urothelial urinary bladder cancer
Mubarak Al-mansour, Ahmad Saadeddin, Sultan Alkhateeb, Ashraf Abusamra, Danny Rabah, Mohammed Alotaibi, Esam Murshid, Abdullah Alsharm, Imran Ahmad, Khalid Alghamdi, Shouki Bazarbashi
October-December 2014, 6(4):273-277
DOI:10.4103/0974-7796.140941  PMID:25371600
In this report, updated guidelines for the evaluation, medical, and surgical management of transitional cell carcinoma of the urinary bladder are resented. They are categorized according the stage of the disease using the TNM staging system 7 th edition. The recommendations are presented with supporting level of evidence.
  4,131 9,760 -
ORIGINAL ARTICLES
A randomized, double-blind, placebo-controlled, crossover trial of "on-demand" tramadol for treatment of premature ejaculation
Adel Kurkar, Ahmad A Elderwy, Sherief Abulsorour, Sara M Awad, Ahmed S Safwat, Ahmed Altaher
April-June 2015, 7(2):205-210
DOI:10.4103/0974-7796.150481  PMID:25835132
Objectives: The objective of this study is to assess the dose-related effects of tramadol on a group of patients with premature ejaculation (PE). Subjects and Methods: During the period of months between June 2010 and July 2012, 180 PE patients presented to outpatient clinic of our hospital. Patients were randomized in a 1:1:1 fashion to receive different sequences of the three medications: placebo, 50 mg of tramadol and 100 mg of tramadol. Every patient received 10 doses of each medication for 2 months. Intra-vaginal ejaculatory latency time (IELT) was recorded in seconds initially and for each arm. Successful treatment of PE is defined if IELT exceeded 120 s. Side-effects of medications were reported. Results: Of patients enrolled, 125 (69.4%) continued the study. Patients' age range was 20-55 years with PE complaint of 1 to 10 years duration. Mean IELT was 72 at presentation, 82 for placebo, 150 for tramadol 50 mg, and 272 for tramadol 100 mg (P < 0.001 for all comparisons). PE was successfully treated in only 2.4% of patients with placebo, in contrast to 53.6% and 85.6% with 50 and 100 mg tramadol, respectively (P < 0.001 for all comparisons). On multivariate logistic regression analysis, baseline IELT was the only predictor of successful treatment of PE with both tramadol 50 mg (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.03-1.07, P < 0.001) and tramadol 100 mg (OR: 1.07, 95% CI: 1.04-1.11, P < 0.001). Postmicturition dribble annoyed 12.8% of those who received 50 mg tramadol and 33.6% of those who received 100 mg tramadol (P < 0.001). Weak scanty ejaculation was the main complaint in 7.2% versus 21.6% of those using 50 and 100 mg tramadol, respectively (P = 0.002). Two patients discontinued tramadol 100 mg due to side-effects. Conclusion: Tramadol hydrochloride exhibits a significant dose-related efficacy and side-effects over placebo for treatment of PE.
  12,534 684 3
CASE REPORTS
Genital self-amputation or the Klingsor syndrome: Successful non-microsurgical penile replantation
Y El harrech, N Abaka, O Ghoundale, D Touiti
October-December 2013, 5(4):305-308
DOI:10.4103/0974-7796.120309  PMID:24311919
Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.
  12,627 534 2
Cavernous hemangioma of the glans penis
Soumya Mondal, Deepak Kumar Biswal, Dilip Kumar Pal
July-September 2015, 7(3):399-401
DOI:10.4103/0974-7796.152037  PMID:26229337
Cavernous hemangioma of the glans penis is a very rare lesion, and only a few cases are reported in the literature. Urologists are in a dilemma to treat such lesion with cosmetic and to obtain good functional outcome. Here, we report a case of cavernous hemangioma of the glans penis in a 22-year-old boy with a successful outcome by intralesional sclerotherapy with 3% sodium tetradecyl sulfate with a review of the literature on the subject.
  12,200 312 -
Tunica vaginalis hydrocele of reposited testis
Manish K Tiwari, Anand A Sinha, Divyang N Dave
January-June 2009, 1(1):25-26
DOI:10.4103/0974-7796.48783  
Tunica vaginalis hydrocele (TVH) is a relatively common entity. The procedure of testicular reposition in a subcutaneous pouch following severe scrotal avulsion injury is also a standard line of care. Though, the occurrence of TVH in such a reposited testis is extremely rare clinical presentation. We herein report a case of 55-year male patient who presented with swelling over medial aspect of left upper thigh which was diagnosed as TVH of reposited testis on detailed assessment. The patient was managed on the usual lines of management protocols of TVH with successful outcome.
  11,495 865 -
REVIEW ARTICLE
Surgical management of adolescent varicocele: Systematic review of the world literature
Omer A Raheem
July-September 2013, 5(3):133-139
DOI:10.4103/0974-7796.115728  PMID:24049372
Historically, idiopathic varicocele is the most commonly diagnosed pre-pubertal andrological condition. The clinical presentation of varicocele may vary from dull and dragging unilateral or bilateral testicular pain to visible varicose veins lying over the hemiscrotum. Over the last decade, significant strides were made in managing symptomatic varicoceles, particularly minimal invasive procedures and surgeries. We sought to review the published literature in a systematic manner to gain an overview and streamline the presentations and main treatment modalities.
  11,253 1,103 3
ORIGINAL ARTICLES
Effect of caffeine on bladder function in patients with overactive bladder symptoms
Supatra Lohsiriwat, Muthita Hirunsai, Bansithi Chaiyaprasithi
January-April 2011, 3(1):14-18
DOI:10.4103/0974-7796.75862  PMID:21346827
Objectives: To evaluate the effect of caffeine at the dose of 4.5 mg/kg on bladder function in overactive bladder (OAB) adults. Materials and Methods: Nine women and three men aged 21-40 years with OAB symptoms were included. Each subject drank 8 ml/kg of water with and without caffeine at two separate sessions. Cystometry and uroflowmetry were performed 30 minutes after each drink. The effects of caffeine on urodynamic parameters were compared. Results: After caffeine ingestion, the mean volume at bladder filling phase decreased at first desire to void and normal desire to void (P<0.05), compared to the mean volume after taking water (control) drink. The mean volume at strong desire to void, urgency and maximum cystometric capacity also tended to decrease. No change in the detrusor pressure at filling phase was found. At voiding phase, the maximal flow rate, average flow rate and voided volume were increased (P<0.05). The urine flow time and time to maximal flow rate were not changed. Conclusion: Caffeine at 4.5 mg/kg caused diuresis and decreased the threshold of sensation at filling phase, with an increase in flow rate and voided volume. So, caffeine can promote early urgency and frequency of urination. Individuals with lower urinary tract symptom should avoid or be cautious in consuming caffeine containing foodstuffs.
  11,022 1,312 26
CASE REPORTS
Perinephric abscess caused by ruptured retrocecal appendix: MDCT demonstration
Nisar Ahmad Wani, Mir Farooq, Tariq Gojwari, Tasleem Kosar
January-April 2010, 2(1):29-31
DOI:10.4103/0974-7796.62923  PMID:20842255
Acute appendicitis may occasionally become extraordinarily complicated and life threatening yet difficult to diagnose. One such presentation is described in a 60-year-old man who was brought to the hospital due to right lumbar pain and fever for the last 15 days. Ultrasonography showed a right perinephric gas and fluid collection. Abdominal computed tomography with multidetector-row CT (MDCT) revealed gas-containing abscess in the right retroperitoneal region involving the perinephric space, extending from the lower pole of the right kidney up to the bare area of the liver. Inflamed retrocecal appendix was seen on thick multiplanar reformat images with its tip at the lower extent of the abscess. Laparotomy and retroperitoneal exploration were performed immediately and a large volume of foul smelling pus was drained. A ruptured retrocecal appendix was confirmed as the cause of the abscess.
  11,510 741 3
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