Management of penile fracture

This prospective study was carried out over a period of one year, and included 12 patients presented by penile fracture. Diagnosis was made clinically and there is no need to perform cavernosography in any case. The most common cause of fracture was trauma to the erect penis during intercourse. Mean age of cases was 29.5 +/- 8.96 years, while mean time of presentation was 15.5 +/- 8.04 hours. Sub-coronal circumferential degloving incision was done in all cases. Nine patients had been operated upon, while three patients refused surgery and treated conservatively. Repair consisted of evacuation of hematoma, repair of the tunical defect with absorbable sutures. The mean operative time was 33.9 +/- 28.2 minutes. Preoperative and postoperative antibiotics was used and all operated cases discharged on the second postoperative day. All operated caws were able to achieve full erection with straight penis, except one in whom mild curvature and pain during erection was observed. In conclusion, fracture penis is a true urologic emergency. It should be treated surgically as early as possible to ensure a better outcome

impact of stone composition on the results of extracorporeal shock wave lithotripsy of renal calculi

This retrospective study included 341 patients with renal stones treated on the Dornier MPL9000 lithotriptor utilizing ultrasound localization. The inclusion criteria were solitary renal pelvic stones with a stone burden of 1-2 cm, normal renal functions, absent or minimal dilatation of the pelvicaliceal system and documented stone composition. The patient's demographic data, ESWL parameters, treatment results and any recorded complications were documented. Fragment sizes were measured on the early post ESWL films and by passing the expelled gravels through a metal sieve with 3 mm pore. The X-ray diffraction technique was used for stone analysis. The final success was calculated on the basis of a stone free status at 3 months from the last ESWL treatment. Whewellite and struvite calculi required higher average number of shock waves and treatment sessions, shelved higher rates of residual gravels > 3 mm in diameter and significantly lower stone free rates compared to other stone compositions. Other stones did not show statistically significant difference among each other regarding these parameters