[Penile fracture epigrams from our experience in 15 Sudanese patients]

To review clinical pattern and outcome of fracture penis retrospectively from January 2000 to January 2008 in Gezira hospital for renal diseases and surgery, Sudan. Total number of patients were 75 and the range of age was 15-45 years with a mean age of 25 years. Diagnosis was established mainly through clinical work up. Most patients were subjected to a surgical intervention. The defects in the tunica was approximated by the used 2-0 proleine with inverted knot and/or delayed absorbable sutures and Foley catheter was routinely fixed after insurance of the integrity of the urethra. Most of cases presented with penile pain [13 patients, 87%], swelling due to extension of a haematoma [9 patients, 60%], bruises and detumescence [10 patients, 67%], curvature and fracture of erection were the presenting claim for the delayed patients [3 patients, 20%]. Most of them developed complications [8 patients, 53%], this included [4 patients, 27%] developed erectile, dysfunction, [2 patients, 13%] developed curvature and one patients [6%] developed calcification urethral stricture. We concluded that early surgical intervention, antibiotics administration and early seeking of medical advice are recommended in order to preserve penile function in cases of fracture penis. Investigations got minor role in the diagnosis of fracture penis

Prostate specific antigen versus digital rectal examination as screening for CA prostate in Sudanese patients

Objectives: The aim of this study is to compare the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer among Sudanese patients presenting with lower urinary tract symptoms (LUTS). Material and Methods: A prospective study was carried out in Gezira Hospital for Renal Diseases and Surgery in the period of June 2003- May 2005. Patients presenting with LUTS, had been screened for prostate cancer using PSA and DRE examination.. Serum PSA and DRE were measured in all patients. Trans rectal biopsy was performed if the PSA was over 4ng and /or abnormal DRE. Results: A total of 194 elderly male pa3ents presen3ng with lower urinary tract symptoms (LUTS), 140 of them were at last diagnosed as benign prostate hyperplasia (BPH) and 54 pa3ents were been confirmed with prostate cancer (PCa). Their mean age was 65 years (range 45-90). Elevated level of PSA (> 4 ng/ml) was found in all the patients with prostate cancer (n= 54) and 68.6% (n= 96) of BPH patients. The rate of prostate cancer detection showed to be 25.7% for PSA > 4ng/ml, 13.31% for abnormal (positive) finding of DRE, and 27.8% for combination of the positive DRE and PSA > 4 ng/ml. The rate of BPH detec3on showed to be 68.6% for PSA > 4ng/ml, 28.6% for posi3ve finding of DRE, and 4.1% for combination of the positive DRE and PSA > 4 ng/ml. Conclusion: It was found that PSA determination detects a considerable proportion of tumors missed by DRE. And the combination of PSA and DRE escalates the probability of prostate cancer detection,