ABSTRACT
Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.
Subject(s)
Urologic Diseases/diagnosis , Urologic Diseases/therapy , Acute Disease , Emergencies , Female , Female Urogenital Diseases/diagnosis , Female Urogenital Diseases/therapy , Fournier Gangrene/diagnosis , Fournier Gangrene/therapy , Humans , Male , Male Urogenital Diseases/diagnosis , Male Urogenital Diseases/therapy , Nephrolithiasis/diagnosis , Nephrolithiasis/microbiology , Nephrolithiasis/therapy , Paraphimosis/diagnosis , Paraphimosis/therapy , Penis/injuries , Priapism/diagnosis , Priapism/therapy , Referral and Consultation , Rupture , Spermatic Cord Torsion/diagnosis , Spermatic Cord Torsion/therapy , Urinary Retention/diagnosis , Urinary Retention/therapyABSTRACT
Proximal corporospongiosal shunts are used for the most refractory cases of priapism. Here, we present the case of a 58-year-old man whose priapism was only partially responsive to phenylephrine injections and distal shunting. Proximal shunting was required, and he subsequently developed fistulization of the proximal penile urethra into the skin and the corpora cavernosa. The formation of simultaneous urethrocutaneous and urethrocavernous fistulae is a rare complication of proximal corporospongiosal shunts that can be initially managed with urinary diversion with a suprapubic tube.
