Easy Suprapubic Tube Placement Using a Van Buren Sound.

OBJECTIVE: To place a suprapubic tube without using specialized instruments. Suprapubic cystostomy is a straightforward urological procedure, which nevertheless may become complicated if the equipment needed to perform the operation is unavailable. Nowadays, in most operating rooms, control of urological instruments has been taken away from a small cadre of dedicated urology nurses, and instead is delegated to a central sterilization department or is even outsourced, leading to an increased rate of instrument misplacement or breakage. Disposable kits are useful, but may not be stocked at all facilities. Hence, the tools needed by the urologist to perform suprapubic cystostomy may not be readily available when they are needed. This reality was the impetus for the development of the following technique for suprapubic tube placement, which relies only upon ordinary instruments. METHODS: A simple method is described for placing a suprapubic catheter using a curved Van Buren sound, a cystoscope, and a minor surgical set. RESULTS: Not only is the operation is easy to do, but is also advantageous in that the catheter may be exchanged over a wire, if necessary, before the establishment of a suprapubic tract. The technique depends on the presence of an intact urethra; therefore, it is contraindicated in the setting of pelvic trauma. CONCLUSION: This suprapubic cystostomy method may be used either as a primary technique or as a back-up procedure if the urologist's preferred instrumentation is not available.

A case of congenital unilateral absence of the vas deferens.

BACKGROUND: Congenital unilateral absence of the vas deferens occurs in 0.5%-1.0% of males. It has been associated with various genitourinary abnormalities, including renal agenesis. We report a case of congenital unilateral absence of the vas deferens found incidentally during vasectomy in a patient with known unilateral renal agenesis. CASE PRESENTATION: A 24-year-old male presented to our urology clinic requesting vasectomy. His past history was significant for left renal agenesis. Following successful right vasectomy, several attempts to locate the left vas deferens were unsuccessful. We diagnosed congenital unilateral absence of the vas deferens. Follow-up semen analysis showed azoospermia. CONCLUSION: As vasectomies are increasingly performed in outpatient settings, it is imperative that physicians be aware of this condition, which can be recognized by a simple physical exam. Recognition could prevent unnecessary surgery and prompt providers to investigate for associated abnormalities.

Cello scrotum, 1974-2009: history of a medical hoax.

UNLABELLED: News services recently broke the story of a medical hoax perpetrated through the literature involving purported urological symptoms of cellists, referred to as "cello scrotum". The background of this affair was researched in order to place it in an historical perspective. METHODS: The originators of the hoax were interviewed. Literature and internet searches were performed to sift fact from fiction. RESULTS: "Cello scrotum" was a descendant of some very legitimate musicians' maladies, which have been described over the past three centuries. From 1974, when it was first described, until 2009, when it was officially retracted, "cello scrotum" approached the status of an urban legend. CONCLUSIONS: The "cello scrotum" affair should not detract from the very real medical ailments of serious musicians. The entire subspecialty of performance medicine has evolved to treat patients with these concerns.