Fratura de pênis com trauma uretra / Penile fracture with urethral trauma

We reported a case of a twenty-nine-year-old male who presented a penile fracture associated with urethral injury caused by a sexual intercourse. An ideal anamnesis and a special physical examination were determinant to correct diagnostics. Ultrasonography and uretrocistography must be performed for confirmation. The treatment is based on the presence of associated urethral injury. The surgical repair of cavernous body and urethra can produce good results, with a favorable prognosis and minimal rate of complications.

Characterization of the deposition of collagen fibers and Lithogenic potential in bladder of rats submitted to a sugar cane biopolymer graft

OBJECTIVES: Suture materials are widely used in urology. The interaction of these materials with the extracellular matrix in the inflammatory process can be estimated by stereology of collagen fibers and the present study was designed to determine the behavior of the bladder tissue of rats to grafts of the biopolymer of sugar cane (BPCA), and the inflammation and intravesical stone formation compared to the polyglactin 910. MATERIALS AND METHODS: 42 Wistar rats were divided in four groups: Group I (n = 10) rats submitted to bladder implantation of ~4-0 BPCA suture graft and euthanized at 4 weeks; Group II (n = 10) rats submitted to bladder implantation of 4-0 polyglactin 910 suture graft and euthanized at 4 weeks; Group III (n = 12) rats submitted to bladder implantation of ~4-0 BPCA suture graft and euthanized at 8 weeks; Group IV (n = 10) rats submitted to bladder implantation of 4-0 polyglactin 910 suture graft and euthanized at 8 weeks. Bladders collected at necropsy were analyzed for their weight and the presence of grafts and calculi. Sections were prepared for stereological analysis of collagen fibers. RESULTS: The bladder weight was higher in group I, particularly in the presence of bladder stones. The presence of the graft was observed in 100% (group I), 80% (group II), 91.6% (group III) and 30% (group IV); polyglactin 910 showed an absorption of 70% in this period. The stereological analysis showed a higher volume density of collagen fibers in group I versus other groups (p < 0.001). CONCLUSION: The BPCA was a material with good integration into the bladder of rats; its absorption was slower than that of the polyglactin 910. The presence of urinary stones was lower in bladders with implantation of BPCA, particularly after 8 weeks. There was a greater initial inflammatory response to BPCA graft that was directly related to the increase in bladder weight and the presence of urinary stones, but that equalized the results of polyglactin 910 after 8 weeks.

Estudo comparativo entre sling pubovaginal de parede vaginal e sling de fáscia do reto abdominal no tratamento da incontinência urinária de esforço / Comparative study between vaginal wall sling and rectus fascia pubovaginal sling in the treatment of stress urinary incontinence

OBJETIVO: A cirurgia de sling pubovaginal é utilizada no tratamento da incontinência urinária de esforço (IUE) do tipo III e como resgate na falha de procedimentos anteriores. Tem índice de sucesso variando de 73 a 89 por cento. Podem ser utilizados diversos materiais autólogos e sintéticos com semelhantes resultados. Nosso objetivo foi comparar o sling de parede vaginal com o de fáscia do reto abdominal quanto à eficácia e às complicações. MÉTODO: Foram estudadas 27 pacientes no período de 04/98 a 09/00, divididas em dois grupos: grupo I com nove pacientes submetidas a sling de parede vaginal; grupo II com 18 pacientes submetidas a sling de fáscia do reto abdominal. Todas foram submetidas a um estudo urodinâmico completo, classificadas quanto ao tipo de IUE, e seguidas no ambulatório de urologia. RESULTADOS: grupo I com média de idade de 51,4 anos, tempo de seguimento médio de 14,3 meses. Pressão de Perda aos Esforços (PPE) variando de 50 a 100cmH2O com média de 81,1cmH2O. Houve 66 por cento de complicações. Taxa de sucesso de 88,8 por cento e índice de satisfação 85 pontos. Grupo II com média de idade de 54,2 anos, seguimento médio de 19,3 meses. PPE variando de 45 a 92cmH2O, média de 65,5cmH2O. Houve 72 por cento de complicações e sucesso de 88,8 por cento. Índice de satisfação de 74 pontos. CONCLUSÕES: Os dados encontrados estão de acordo com a literatura, sendo os dois grupos comparáveis quanto à eficácia em período curto de seguimento. O grupo II apresentou maior número de complicações, assim como maior tempo de cateter vesical e menor índice de satisfação geral.

BACKGROUND: Pubovaginal sling is being currently used for the treatment of type III Stress Urinary Incontinence (SUI) and for recurrences after previous procedures. Success rates vary from 73 to 89 percent. Many autologous and allogênic materials have being used with a variable rate of complications. Our objective was to compare the vaginal wall sling to the rectus fascia pubovaginal sling concerning effectiveness and complications. METHOD: Twenty seven patients submitted to pubovaginal sling between 04/98 and 09/00 were divided into two groups: Group I includes 9 patients submitted to vaginal wall sling while Group II with 18 patients submitted to rectus fascia pubovaginal sling. All patients underwent a complete urodinâmic study. They were classified according to the type of SUI and followed at the urology clinic where complications and patient satisfaction index were registered. RESULTS: Group I: The mean age was of 51.4 years. The a mean follow-up period was 14,3 months. The Valsalva leak point pressure (VLPP) varied from 50 to 100cmH2O, with a mean pressure of 81.1cmH2O. Six patients (66 percent) presented postoperative complications. Curative rate was 88.8 percent and patient satisfaction index was 85 points. Group II: The mean age was of 54.2 years; the mean follow-up period was 19,3 months. The VLPP varied from 45 to 92cmH2O, with a mean pressure of 65,5cmH2O. Thirteen patients (72 percent) presented postoperative complications. The curative rate was 88.8 percent and the patient of satisfaction index was 74 points. CONCLUSIONS: Both techniques have a comparable effectiveness during a short follow-up period. The use of rectus fascia pubovaginal sling was associated with more postoperative complications, longer urethral catheterization and lawer patient satisfaction index.

Acidentes ofídicos por surucucu (Lachesis muta rhombeata): relato de dois casos atendidos no HU / Two cases of Lachesis muta rhombeata bites victims

Relatam-se dois casos de ofidismo por surucucu (Lachesis muta rhombeata) em vítimas com 20 e 39 anos de idade residentes na zona da mata. As serpentes apresentavam 1,78 e 1,85 metros de comprimentos. Os pacientesapresentaram reaçöes inflamatórias no local da picada(edema) e sobreviveram, tendo recebido alta, com boa evoluçäo, após total remissäo da sintomatologia. a terapêutica instituída foi soro antibotrópico-antilaquésico