ABSTRACT
Background: Peyronie’s disease is an inflammatory, fibroticpenile disorder affecting men in age range of 19-83 years. Itoccurs as an acute or chronic phase and rarely cases resolveon their own. Several treatment options are available includingoral, intralesional and surgery. Although several clinical trialshave been performed, they lack significant and corroboratedresults hence there is a need to attempt prospective researchto elucidate the most effective therapies. The aim of this studyis to determine the efficacy of intralesional injection ofverapamil over normal saline.Methods: This was a randomized parallel group studyconducted between March 2013 and February 2017 whichrandomized patients with Peyronie’s disease into two groups toreceive verapamil or normal saline intralesional injections, withinclusion criteria of penile curvature with or without plaque.After 6 biweekly injections, all above parameters andsatisfaction score was reexamined. Patients were evaluated byhistory, physical examination, questionnaire, ultrasonographyand color Doppler study of the penis.Results: A total of 53 patients were enrolled (verapamil, n=28;control, n=25). Overall, among verapamil group attenuatedcurvature, erectile dysfunction and reduced plaque size werefound in 82%, 64.2%, 67.8% of and 60.7of patientsrespectively. Pain decreased in both groups considerable to97% and 91%. Overall satisfaction level was higher inverapamil group that is82% to control group of 40%.Conclusion: Intralesional verapamil is a good treatmentchoice with absence of invasive procedures and overall goodsuccess rate and patient acceptability.
ABSTRACT
Purpose: To compare the functional effects and complicationsof transvesical prostatectomy (TVP) and bipolar transurethralresection of prostate (TURP) in patients with benign prostatichyperplasia (BPH) more than 100 gms.Method: Hundred and five patients participated at the SPMCMedical College, Bikaner, India with complaints of BPH withprostate size of 100-150 gm over study duration from June2015 to May 2018. Patients were grouped according to theireligibility for the two surgical procedures namely TVP (n=56)and bipolar TURP (n=49).Results: Of the total 105 patients, 56 (53.33%) patients weresurgically treated with TVP while the remaining 49 (46.67%)were managed with TURP. We did not observe any statisticallysignificant difference between the two groups with regards theIPSS, Qmax, residual urine volume. The numbers of postoperative complications were higher in TURP group (n=9) ascompared to TVP (n=3). Even the late complications such asstricture formation, need for redoing the surgery were higher inTURP group compared to TVP group.Conclusion: Open prostatectomy is a safer and more effectivesurgical treatment option for patients with BPH more than 100gms as compared to bipolar TURP. Even the reports of postoperative complications were higher in TURP group.
ABSTRACT
In neuropathology, anatomic landmarks and topographic relationships bear particularly on issues of differential diagnosis. A case of central neurocytoma of the vermis of the cerebellum is being reported in this article. A 45-year-old male with features of hydrocephalous and a posterior fossa space-occupying lesion was diagnosed as having central neurocytoma upon a microscopy of Hematoxylene and Eosin stained sections. The diagnosis was confirmed by a positive immunohistochemical reaction for Neuron Specific Enolase (NSE) and Synaptophysin. This case report is being made to emphasize that a high index of suspicion is required even for reporting neuropathology where the site does not match the conventional location of the lesion seen and also to emphasize the importance of immunohistochemistry in proving such unusually located lesions.