[Impacted battery in the nose of a four-year-old girl].

In this case report, it was suspected that a four-year-old girl had an impacted toy in her nose. Initially, she was refused consultation due to a COVID-19 positive parent. Three days later she presented with nasal secretion and facial oedema. At the hospital, an examination revealed an impacted battery and consequent necrosis of nasal structures. The battery was removed in general anesthesia. Afterwards, the girl made fine recovery but developed a permanent septal perforation. Frequent alterations in COVID-19 guidelines challenge doctors to distinguish conditions crucial for evaluation. Batteries are uncommon for nasal impaction but may lead to severe morbidity if left undiscovered.

A Randomized, Single-Blinded Clinical Trial Evaluating the Effect of Extracorporeal Shockwave Treatment (ESWT) as Add-On Therapy to Vacuum Erectile Device on Peyronie's Disease.

PURPOSE: The aim of this study was to investigate whether ESWT with a higher energy as an add-on therapy to vacuum-pump followed by manipulation exercises could reduce the penile curvature, pain and improve IIEF-5 score. MATERIALS AND METHODS: Men aged >18 and <80 years and diagnosed with PD in stable phase with no history of penile surgery or previous ESWT treatment were eligible to participate. They were randomised to either active ESWT (n = 16) or sham ESWT (n = 16). Both groups were treated once a week for five weeks. Each treatment session consisted of 2000 shockwaves at 0.5mJ/mm2. All patients in both groups used a vacuum pump followed by manipulation exercises. RESULTS: Thirty men completed the study protocol. Mean age in the treatment group was 61.7 (SD 8.3) and 63 (SD 7.35) in the control group. After six months, mean change in penile curvature was -12.8 (SD 13) degrees in the treatment group and -6.6 (SD 8.9) in the control group (p = 0.204). Mean IIEF-5 score decreased by 0.17 (SD 3) in the treatment group and 3.06 (SD 5.5) in the control group (p = 0.086) at six-month follow-up. Pain was assessed using both VAS and PDQ and demonstrated no difference between the groups after six months (p = 0.648). CONCLUSION: In the treatment group, we observed a greater but non-significant change in penile curvature and no adverse effects.

Erectile Dysfunction A Prospective Randomized Placebo-Controlled Study Evaluating the Effect of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Men With Erectile Dysfunction Following Radical Prostatectomy.

INTRODUCTION: Previous studies have indicated that low-intensity extracorporeal shockwave therapy (Li-ESWT) may improve male erectile dysfunction (ED) of vascular aetiology. AIM: To investigate penile rehabilitation of Li-ESWT in a randomized, placebo-controlled trial in men with ED following robotic nerve-sparing radical prostatectomy (RARP). METHODS: Included were men with ED following nerve-sparing RP with a score <22 in the 5-item International Index of Erectile Function (IIEF-5) questionnaire. Participants were divided into an active A (n = 20) and a placebo/sham B group (n = 18). They were randomized consecutively upon study entry. Each study arm had one treatment a week for 5 weeks. MAIN OUTCOME MEASURES: Sexual outcomes were assessed by international validated questionnaires, Erection Hardness Score (EHS) and IIEF-5 at baseline and at 4 and 12 weeks after treatment. RESULTS: A total of 38 (n = 38) participants were enrolled; there were no dropouts. A significant increase was observed in IIEF-5 and EHS in group A at both 4 and 12 weeks. At 12 weeks, the mean IIEF-5 score had increased by 3.45 points (P = .026), while the mean EHS score had increased by 0.5 points (P= .019). CONCLUSION: This randomized study indicates that Li-ESWT for ED in men undergone RP might be effective and safe. However, further and more robust research is needed before Li-ESWT can be characterized as a reliable treatment modality. Ladegaard PBJ, Mortensen J, Skov-Jeppesen SM, et al. Erectile Dysfunction A Prospective Randomized Placebo-Controlled Study Evaluating the Effect of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Men With Erectile Dysfunction Following Radical Prostatectomy. Sex Med 2021;9:100338.

[Intrauterine necrotizing enterocolitis in premature newborns].

Necrotizing enterocolitis (NEC) is a severe disorder associated with increased morbidity and mortality when found in premature infants. This report is about two cases of NEC initiated in utero but without a prior knowledge to neither parents nor health professionals. Both cases had similar courses postnatally, which included abdominal distension and nutritional problems. The surgical findings: case I was a classical NEC in 20-25 cm of distal ileum, and case II was a 1.5-cm necrosis with perforation in proximal ileum. The proposed aetiology was somehow dissimilar in the two cases, which led to the suggestion that the cases represented two various disease entities.