Non-Medical Urethral Sounding: A review of literature and rare case of sounding with a live firearm round.

Management of urethral sounding related injuries continues to be a challenge due to the wide breath of objects implicated, the rarity of cases, and chance of significant complication. We present a particularly challenging and novel case where a patient inserted a round of live ammunition into his urethra. Non-surgical removal was limited over concern for accidental discharge of the round, and the patient was taken to the operating room where open removal was performed.

Lymphatic Mapping in the Repair of Adult-acquired Buried Penis: Proof of Concept.

Adult-acquired buried penis (AABP) is an acquired clinical entity where a normal sized phallus is concealed by prepubic skin, fat, or subcutaneous tissue, often caused by obesity, lymphedema, or trauma. Surgical repair is the standard of care in management of AABP; however, up to 60% of patients have developed bothersome genital lymphedema postoperatively. Despite the rates of postoperative scrotal lymphedema, and lymphedema itself representing a risk for AABP, very little data exist on the role of lymphatic evaluation in this patient population.

Erectile Dysfunction in Pelvic Cancer Survivors and Current Management Options.

Pelvic malignancies, including prostate, rectal, and bladder cancers, are among the most frequent malignancies found in the male population. These issues are most effectively and commonly treated with radiotherapy and/or surgery. However, these treatments can cause collateral damage, resulting in significant impacts on quality of life, with erectile dysfunction being one of the most frequent postoperative complications.

FTIR spectroscopy as a convenient tool for detection and identification of airborne Cr(VI) compounds arising from arc welding fumes.

Given the significant presence of the carcinogenic Cr(VI) in arc welding fumes from stainless steels, it is also important, in addition to estimating the Cr(VI) levels, to identify Cr(VI) compounds, as it throws light on the mechanistic pathways towards fume formation. FTIR data is presented in this paper for arc welding fumes collected from Manual Metal Arc Welding (MMA), Flux Cored Arc Welding (FCAW) and Solid Wire Welding (Metal Inert/ Active Gas Welding [MIG/ MAG]). For MMA and FCAW samples, clear spectra corresponding to Na, K, dichromates was observed at wave number of around 725-740 cm and at 890-900 cm.

Do no harm: the role of perioperative heparin in urethroplasty.

Objective: To examine the safety of single modality mechanical venous thromboembolism (VTE) prophylaxis in patients undergoing urethroplasty. VTE is a perioperative complication with significant morbidity. Routine use of peri-operative VTE prophylaxis is common guideline-driven practice across multiple surgical specialties.

Recurrent vesicourethral anastomotic stenosis following treatment for prostate cancer: an effective endoscopic treatment using bipolar plasma button and triamcinolone.

Purpose: To evaluate the efficacy of deep bladder neck incision plus adjuvant Triamcinolone in the treatment of recurrent vesicourethral anastomotic stenosis following surgical treatment for prostate cancer.

Materials And Methods: A retrospective review of patients undergoing bladder neck incision from 2013 to 2019 was conducted. Patients who had previously undergone surgical treatment for prostate cancer and had failed treatment for bladder neck contracture were included.

Multi-institutional review of non-hypospadiac penile urethral stricture management and outcomes.

Objectives: Penile urethral stricture disease not associated with hypospadias is rare, and there is a wide range of commonly used surgical repair techniques for this disease. We sought to compile a multi-institutional database of patients who had surgical correction of strictures in the penile urethra not limited to the meatus, and who had no history of hypospadias, for analysis using the Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology classification system.

Methods: A retrospective database from 13 institutions was compiled of patients who had undergone surgical correction of Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology urethral stricture segments S2b/S2c and excluding E5, with a minimum follow-up time of 4 months.

Multi-Institutional Study of Dorsal Onlay Urethroplasty of the Membranous Urethra after Endoscopic Prostate Procedures: Operative Results, Continence, Erectile Function and Patient Reported Outcomes.

(1) Background: To critically evaluate dorsal onlay buccal mucosal graft urethroplasty (DOBMGU) for posterior urethral stenosis repair following transurethral resection and other endoscopic prostate procedures. (2) Methods: A retrospective multi-institutional review of patients with membranous or bulbomembranous urethral stenosis for whom treatment with DOBMGU was conducted after receipt of prostate endoscopic procedures. Baseline data, peri-operative care, post-operative care and patient-reported outcomes were analyzed.

Gunshot wounds to the penis and scrotum: a narrative review of management in civilian and military settings.

Gunshot wounds (GSW) to the penis and scrotum are present in two thirds of all genitourinary (GU) trauma, with a growing proportion of blast injuries in the military setting. Depending on the energy of the projectile, the injury patterns present differently for military and civilian GSWs. In this review, we sought to provide a detailed overview of GSWs to the external genitalia, from mechanisms to management.

Novel use of Asopa technique for penile urethrocutaneous fistula repair.

Purpose: To evaluate the feasibility of ventral urethrotomy, dorsal inlay (Asopa) technique in management of urethrocutaneous fistula. The Asopa technique has been employed for management of urethral stricture repair but has not been described in adult penile urethrocutaneous fistula.

Methods: This is a retrospective review of IRB-approved databases of patients undergoing urethral reconstruction from two urologic reconstruction units.

A case of acute vasitis mimicking an incarcerated inguinal hernia with subtle imaging findings.

Acute vasitis, or inflammation of the vas deferens, is a rare condition that classically presents with unilateral groin pain radiating into the scrotum and a bulge or induration along the inguinal canal. As a result, it mimics and is often mistaken for more common pathologies such as inguinal hernia, epididymo-orchitis or testicular torsion. A misdiagnosis may lead to unnecessary surgery and morbidity.

A multi-institutional critical assessment of dorsal onlay urethroplasty for post-radiation urethral stenosis.

Purpose: To critically evaluate a multi-institutional patient cohort undergoing Dorsal-Onlay Buccal Mucosal Graft Urethroplasty (D-BMGU) for recurrent post-radiation posterior urethral stenosis.

Methods: Retrospective multi-institutional review of patients with posterior urethral stenosis from 10 institutions between 2010-2019 was performed. Patients with at least 1-year follow-up were assessed.

Larger patients shouldn't have fewer options: urethroplasty is safe in the obese.

Objective: To examine the impact of obesity on perioperative outcomes and urethral stricture recurrence after anterior urethroplasty.

Material And Methods: We reviewed our prospectively maintained single-surgeon database to identify men with anterior urethral strictures who had undergone anastomotic or augmentation urethroplasty between October 2012 and March 2018. In all, 210 patients were included for primary analysis of perioperative outcomes, while 193 patients with at least 12 months follow-up were included for secondary analysis of stricture recurrence.

Fournier's gangrene: a modern analysis of predictors of outcomes.

Background: Fournier's gangrene (FG) is a rapidly progressing necrotizing fasciitis that carries a significant morbidity and mortality. The present study sought to identify the predisposing factors related to FG and validate the Fournier's Gangrene Severity Index (FGSI) score as a prognostic tool in the care of the Fournier's patient.

Methods: Medstar Washington Hospital Center records were searched from January 2003 to February 2015 for all patients with a diagnosis code of FG, n=42.

Urethroplasty After Urethral Urolume Stent: An International Multicenter Experience.

Objective: To evaluate the outcomes and factors affecting success of urethroplasty in patients with stricture recurrence after Urolume urethral stent.

Material And Methods: This is a retrospective international multicenter study on patients treated with urethral reconstruction after Urolume stent. Stricture and stent length, time between urethral stent insertion and urethroplasty, age, mode of stent retrieval, type of urethroplasty, complications and baseline, and posturethroplasty voiding parameters were analyzed.

Comparison of Correlated Comorbidities in Male and Female Sexual Dysfunction: Findings From the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

Background: Many of the same mechanisms involved in the sexual arousal-response system in men exist in women and can be affected by underlying general medical conditions.

Aim: To assess whether sexual function in men and women is correlated with similar comorbidities.

Methods: This study was a secondary analysis of the 3rd National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a prospective stratified probability sample of British individuals 16 to 74 years old interviewed from 2010 to 2012.

Endoscopic Management of Urethral Stricture: Review and Practice Algorithm for Management of Male Urethral Stricture Disease.

Purpose Of Review: Male urethral stricture disease is characterized by the formation of scar tissue within the urethra resulting in lower urinary tract symptoms, infection, and potentially kidney dysfunction. There is significant variability in clinical practice for the treatment of urethral stricture. We sought to summarize the known data on endoscopic management of urethral stricture disease as part of this larger edition on urethral stricture management.

Novel pericatheter retrograde urethrogram technique is a viable method for postoperative urethroplasty imaging.

Purpose: The purpose of this study is to describe our technique for pericatheter retrograde urethrogram (pcRUG) and to evaluate the utility of a pcRUG to detect a clinically significant leak after urethral reconstruction.

Methods: We retrospectively reviewed our prospective IRB-approved database of patients undergoing urethral reconstruction. pcRUG was performed at 3-4 weeks after surgery, in standardized fashion.

Clinical and Patient-reported Outcomes of 1-sided Anterior Urethroplasty for Long-segment or Panurethral Strictures.

Objective: To evaluate clinical and patient-reported urinary and sexual outcomes after a long-segment stricture repair using the 1-sided urethral dissection, penile invagination, and dorsal buccal mucosa graft onlay technique described by Kulkarni et al.

Methods: Patients from 4 institutions after single-stage repairs for long-segment urethral strictures (>8 cm) from January 2002 to April 2016 were reviewed. Technique described by Kulkarni et al was used in all cases.

Bladder Injury From Penetrating Trauma of the Inner Thigh.

This is a unique case of bladder injury from a penetrating upper leg wound. The patient's initial presentation did not suggest genitourinary injury, however the patient had a relatively late episode of gross hematuria that prompted further investigation. Based on findings of bladder laceration, the patient was managed conservatively and did well.

A Rare Consequence of Chronic Graft Versus Host Disease - Peyronie's Disease.

Chronic graft versus host disease (GvHD) after allogeneic stem cell transplantation (SCT) may involve any organ system, but male genital involvement is rare. Peyronie's Disease (PD) is an acquired, localized fibrotic disorder of the tunica albuginea, which leads to penile deformity, pain, and eventually to erectile dysfunction. We report the case of a 52 year old African American male with Acute Myeloid Leukemia who underwent human leucocyte antigen (HLA) matched sibling allogeneic peripheral blood SCT.