Penile emergencies: two years experience at our centre

Background: Many men with penile injuries opt out of medical treatment for ethical or psychological reasons, which means the true incidence is likely substantially lower than reported. Urgent medical attention is usually required for acute penile illnesses, which are rare but serious. A vascular, viral, or trauma-related event is usually to blame. Methods: The study was carried out at Narayana medical college in Nellore for a duration of two years, from January 2022 to April 2024.There were four groups vascular group with priapism and spontaneous penile gangrene (n=9) and those with penile fractures, degloving injuries, amputations, and entrapment (n=16) were part of the infected group, whereas patients with penile myiasis were part of the trauma group. The last group consisted of four patients who had paraphimosis. Results: The results showed that 60% of patients who had penile fractures within 6 hours presented for treatment. Every single patient has a torn tunica and one of them even has urethral involvement. Idiopathic causes 62.5% of the eight cases of priapism, and 37.5% of patients presented within six hours. Aspiration with intra-cavernous phenylephrine was the. If they fail to respond, employ the grey hack and water shunt techniques. Conclusions: The incidence of penile injuries is underreported; patients may appear to healthcare providers far later than necessary, and this is largely attributable to psychological and ethical factors, such as shame and fear. However, early and rapid management led to better outcomes.

Case series to study the clinical features, risk factors, prognostic factors, and to assess the different management modalities of EPN and its outcomes

Background: Emphysematous pyelonephritis is an acute necrotising infection of the kidney, often associated with high rate of renal loss and mortality. EPN mostly present with triad of fever, flank pain and nausea. The diagnostic tool of choice is CT KUB. E. coli is the most common pathogen. Methods: It was prospective study done on 52 patients who were diagnosed to have EPN from department of nephrology and urology in Narayana Medical College, Nellore from March 2022 to January 2024. The diagnosis of EPN was confirmed by plain CT KUB scan. Results: Among 52 patients 48 patients had diabetes mellitus (DM). left kidney involved in 28 patients and right kidney involved in 16 patients and bilateral kidney involvement in 8. Fever (92%), flank pain (88%) are the most common presentation in patients. Shock during initial presentation was seen in 19.5% of patients. E. coli growth was seen in 26.9% cases. 8 patients were treated conservatively with antibiotics according to culture and sensitivity. 32 patients required double J stenting, 7 patients required percutaneous nephrostomy. Nephrectomy was done in 5 patients. Mortality rate in our study was zero. Conclusions: Nephrectomy should be promptly attempted for patients not responding to conservative methods. Pre-existing CKD status, shock at presentation and altered sensorium are the factors determining the prognosis and management.