Electronic Cigarettes as a Cause of Stuttering Priapism: A Case Report.

BACKGROUND Having painful intermittent penile erections that last less than 4 h is known as stuttering priapism. Sickle cell disease is a well-known risk for stuttering priapism; although, other causes could be related to this disorder. To date, no study has examined the relationship between stuttering priapism and electronic cigarettes (e-cigarettes). CASE REPORT We present a case of a 31-year-old man who came to our clinic with recurrent stuttering priapism. He had no chronic medical illnesses. He had smoked half a pack of cigarettes per day for the past 6 years but had shifted to vaping e-cigarettes for which he used several e-fluids and brands. His stuttering priapism started approximately 1 week after he began vaping. A detailed history and physical examination were unremarkable. Laboratory results showed a normal complete blood count and metabolic panel along with a normal testosterone level and negative sickle cell screening test. The chest X-ray and abdominal and pelvic ultrasound were normal. Initially, we reassured the patient; however, his condition persisted with no significant changes in his general health or lifestyle. We asked him to stop using e-cigarettes, and after he stopped, his stuttering priapism surprisingly completely resolved. He has not experienced a single episode of stuttering priapism in the 3 months since the cessation of e-cigarettes use. CONCLUSIONS The relationship between stuttering priapism and e-cigarettes remains largely unexplored in the literature. Whether e-cigarettes and e-fluids represent a risk factor for priapism in novice e-cigarette smokers warrants further investigation.

Age at presentation of undescended testicles: a single-center study in Saudi Arabia.

BACKGROUND: The undescended testis (UDT) is the most common genital anomaly encountered in pediatrics with an estimated incidence of 1% to 4% in full-term and 1% to 45% in preterm newborn boys. Over the years, studies on progressive histological deterioration and cancer risk has led to a change in recommendations for when orchidopexy should be done. OBJECTIVES: Determine age at presentation of patients for UDT to a specialist in Saudi Arabia, age of operation and whether the recommended targeted time frame has been met. DESIGN: Descriptive retrospective medical record review. SETTINGS: University hospital setting in urban location. SUBJECTS AND METHODS: The records of patients presenting to our center with UDT between the years 1996-2015 were reviewed for data on the age at presentation and age of operation. MAIN OUTCOME MEASURES: Age at time of evaluation and at time of surgical intervention compared with the international standard. SAMPLE SIZE: 331 cases. RESULTS: Out of the cases included, 195 met the inclusion criteria. The median age of presentation was 13.7 (range: 0-123.2) months. The median age at time of orchiopexy was 25 (range: 7.5-130.2) months. The median waiting time for elective surgery was 4.8 months ( less than 1 day to 49.4 months). CONCLUSION: Despite the international recommendation of carrying out orchidopexy between the ages of 6-12 months, the targeted recommended time frame is not met in Saudi Arabia. This is mainly related to late referral age and the long waiting time for elective surgery. LIMITATIONS: Small sample size and retrospective design. CONFLICT OF INTEREST: None.