Bladder erosion and stone as rare late complication of laparoscopic hernia meshplasty: is endoscopic management an option?

As laparoscopic hernia repair is slowly becoming the norm in the management of inguinal hernia, its remotely possible long-term complications have started becoming evident. We report an asymptomatic hanging anterior bladder wall calculus, formed over a migrated hernia mesh into the bladder 16 years after laparoscopic hernia repair and managed using holmium laser while performing transurethral resection of the prostate. There are only a few case reports in the literature regarding this issue, and the management suggested has been either periurethral cystoscopic pulling for extraction of the mesh or resection of mesh along with the bladder wall and cystorrhaphy. This is the first report of holmium laser being used for complete successful endourological management with a 2-year follow-up of protruded mesh in the bladder.

Neonatal priapism associated with spontaneous bilateral pyocavernositis

<p><b>INTRODUCTION</b>Neonatal priapism is known to be associated with a wide range of aetiologies, but an association with spontaneous purulent cavernositis has not been reported in the paediatric literature. We report the first of such case.</p><p><b>CLINICAL PICTURE</b>A 24-day-old neonate was brought with the history of persistent erection of penis since day 4 of life and swollen penis of 4 days' duration, which revealed frank pus on cavernosal aspiration bilaterally.</p><p><b>TREATMENT</b>The child was treated with closed aspiration drainage; cross-irrigation with antibiotic solution under systemic antibiotic cover helped in achieving complete detumescence.</p><p><b>OUTCOME</b>On follow-up, child demonstrated normal full bladder tumescence and colour doppler revealed bilateral normal corporo-cavernosal appearance and blood flow, indicating good functional and anatomical recovery.</p><p><b>CONCLUSION</b>This case report describes the presentation, successful management and excellent functional and anatomical outcome, on follow-up, of this rare association of neonatal priapism with spontaneous bilateral pyocavernositis. An attempt has been made to describe the underlying pathophysiology.</p>