Fish bone perforation into a patent urachus mimicking urachal carcinoma: Case report.

Ingestion of foreign body may induce complications such as perforation, impaction, or penetration. Diagnosis rarely made preoperatively due to clinical symptoms are usually nonspecific and can mimic other surgical conditions. A 69-year-old male presented to emergency department with vague abdominal pain for few days. Following a clinical evaluation and computed tomography scan of the abdomen, provisional diagnosis of urachal carcinoma was made. As the result of urachal excision with partial cystectomy including fishbone were resected, pathology revealed benign urothelium.

Successful surgical treatment of giant scrotal lymphedema associated with Hodgkin's lymphoma: A rare case report.

Scrotal lymphedema is a rare disease, caused by obstruction of the lymphatic vessels draining into the scrotum, and may be induced by malignant lymphoma. A 27-year-old male, who was treated for Hodgkin's lymphoma, presented with scrotal swelling for 3 years. We observed huge scrotal swelling with extension to the suprapubic region and lower right limb, a significantly thickened scrotal wall, and nonpalpable testes. The patient underwent scrotal lymphedema excision followed by surgical scrotal and penile reconstruction. Treatment of scrotal lymphedema is challenging. However, we were satisfied with our surgical result. Our patient experienced both physical and psychological improvements.

Microscopic subinguinal varicocelectomy for testicular pain: a retrospective study on outcomes and predictors of pain relief.

BACKGROUND: Approximately 2-10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele. RESULTS: Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief. CONCLUSIONS: Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.

RéSUMé: CONTEXTE: Environ 2 à 10 % des patients porteurs de varicocèle se plaignent de douleur. La varicocèlectomie pour douleur testiculaire est un choix chirurgical lorsque le traitement conservateur ne parvient pas à soulager la douleur. Différentes variables ont été rapportées comme facteurs pronostiques du soulagement de la douleur après ligature de la varicocèle. Par ailleurs, le taux de réussite de la varicocèlectomie pour douleur testiculaire varie selon les études. Cette étude rétrospective visait à étudier les facteurs prédictifs et le taux de réussite de la varicocèlectomie subinguinale microscopique réalisée pour traiter une varicocèle douloureuse. RéSULTATS: Parmi les 132 patients opérés, 83,3% ont rapporté le soulagement de la douleur. Une association significative a été identifiée entre la varicocèlectomie pour douleur testiculaire unilatérale et la résolution de la douleur (P <0,0001) ; aucun autre facteur n'était prédictif du soulagement de la douleur. CONCLUSIONS: La varicocèlectomie subinguinale microscopique pour douleur testiculaire est une alternative chirurgicale efficace. La varicocèlectomie pour douleur testiculaire unilatérale peut prédire le soulagement postopératoire de la douleur chez les patients convenablement choisis.

Management of proximal penile prosthetic cylindrical complications: a novel direct crural approach.

INTRODUCTION: Patients with proximal penile prosthetic cylindrical complications (PPPCC) can be treated with a direct crural technique without using the original traditional approach. In this article we present our novel direct crural approach for management of patients with PPPCC. MATERIALS AND METHODS: Between 2014 and 2019, data were retrospectively collected from 13 patients who underwent surgical revision using our novel direct crural approach for PPPCC. The procedure commences with identification of the affected zone. The patient is in a low lithotomy position. A 2-centimeter longitudinal incision is made directly over the affected site. Dissection is carried down through Colles' fascia, followed by a longitudinal incision through the tunica albuginea at the proximal part of the affected cylinder. Via the incision we can deliver out the cylinder and manage its problem. RESULTS: Mean operative time was 40 min. No intra or post-operative complications were reported. All patients (Mean age = 57) were discharged on the same day. Postoperative follow-up found correction of all existing deformities at month 1, 3 and 6. All patients were satisfied and reported less pain and faster recovery than the first procedure. CONCLUSION: Our technique, which can be used for all types of penile prosthesis, is both feasible and safe. It may simplify PPPCC revision by avoiding adhesions below the original incision, without jeopardizing the already implanted materials or the urethra. It may also improve patients' safety and satisfaction, by reducing iatrogenic injury and post-operative recovery time.

Alternative surgical approach for inflatable penile prosthesis removal.

BACKGROUND: The Inflatable penile prostheses (IPP) are used as definitive treatment for severe erectile dysfunction. Removal of an IPP can be challenging, especially for the non-andrologists and junior urologists. The classic penoscrotal incision for explanation can disrupt anatomy, which increases the risk of complications and makes future re-implantation difficult. This article aims to describe a simple surgical method for the removal of IPP, which avoids the penoscrotal incision and reduces the risk of urethral damage and additional fibrosis. MATERIAL AND METHODS: Between November 2015 and February 2019, 15 patients underwent IPP removal using the same technique. Multiple incisions were performed directly over each component of the IPP for their removal. Four incisions of 2 cm each were made at the following sites: one incision on both sides of the ventral base of the penis, one inguinal incision, and one scrotal incision. Each incision provides direct access to one component of the IPP (cylinders, reservoir, and pump). RESULTS: The mean duration of the surgery was 41 min (between 35 and 48 min). All procedures were completed successfully with a smooth course. None of the patients had any residual component of the IPP at the time of surgery. Neither complications (urethral or intestinal injury) nor excessive bleeding (> 100 mL) were documented in all patients. CONCLUSION: Our approach provides direct exposure of all components of the IPP. It reduces the risk of urethral iatrogenic injury and the local fibrosis (which is greater with the penoscrotal incision) that may impair future reinsertion of IPP. It is simple, safe, reproducible and easy to be performed by junior or unexperienced urologists in urgent cases. CONTEXTE: Les implants péniens hydrauliques (IPH) constituent le traitement définitif des dysfonctions érectiles. Le retrait de ces prothèses peut être difficile, surtout pour les jeunes urologues. L'incision classique péno-scrotale est. peu anatomique. Elle est. associée à un risque de plaies urétrales et de fibrose pouvant limiter l'insertion ultérieure de nouvelles prothèses. Nous présentons dans cet article une méthode alternative simple pour le retrait des IPH qui permet d'éviter l'incision péno-scrotale et les risques qui s'y associent. MATÉRIEL ET MÉTHODES: Entre novembre 2015 et février 2019, 15 patients ont été opérés pour extraction d'IPH infectés, en utilisant la même technique chirurgicale. Une incision de 2 cm est. réalisée en face de chaque élément de l'IPH pour permettre son extraction: une incision scrotale, une autre inguinale et une de chaque côté de la base ventrale du pénis. RÉSULTATS: La durée moyenne de l'intervention était de 41 min (entre 35 et 48 min). Toutes les interventions ont été bien tolérées. Les éléments des IPH ont été retirés sans fragments résiduels. Aucune complication n'a été notée. CONCLUSION: L'approche décrite permet l'exposition directe des composantes des IPH. Elle permet la réduction du risque des lésions urétrales iatrogène et de fibrose ultérieure. Celle-ci est. plus fréquente avec l'incision péno-scrotale et peut limiter l'éventuelle insertion de nouveaux implants. Notre technique est. reproductible et simple pour être appliquée sans danger par les jeunes urologues peu expérimentés.