Unusual presentation of a periurethral abscess following infection with .

We describe an unusual case of a male patient presenting with penile and testicular swelling following an unprotected and traumatic sexual encounter. It was suspected that an isolated penile injury occurred during intercourse; however, ultrasound imaging identified an intact tunical layer and right-sided epididymo-orchitis. Following screening for sexually transmitted infections (STIs), he was discharged with antibiotics and advice to attend the Sexual Health Centre for contact tracing.

Multidisciplinary Approach for the Management of Penoscrotal Extramammary Paget's disease -An eUROGEN study.

Introduction: We reviewed the medical and surgical management and long-term outcomes for patients diagnosed with penoscrotal extramammary Pagets disease (EMPD) within an eUROGEN centre.

Patients And Methods: Retrospective review of cases from an institutional database with biopsy proven penoscrotal EMPD.

Results: A total of 10 patients were identified with penoscrotal EMPD over a 10-year period.

Long-term outcomes for penile cancer patients presenting with advanced N3 disease requiring a myocutaneous flap reconstruction or primary closure-a retrospective single centre study.

Background: Penile cancer patients with advanced metastatic disease in the inguinal region present a therapeutic challenge. We compared the outcomes for patients with advanced inguinal node disease requiring myocutaneous flap reconstruction (MFR) against primary closure for N3 disease.

Methods: A retrospective comparative study of a consecutive cohort of advanced penile cancer patients with N3 disease was performed.

Primary Squamous Cell Carcinoma of the Male Proximal Urethra: Outcomes from a Single Centre.

Background: Primary squamous cell carcinoma (SCC) of the male proximal urethra is an aggressive and rare urogenital malignancy.

Objective: To review the surgical management and outcomes for male proximal urethral SCCs within a single centre and to suggest an algorithm for the surgical management of these rare tumours.

Design, Setting, And Participants: This was a retrospective study of patients undergoing surgery for male proximal urethral SCC within a single tertiary academic centre managing rare genital tumours.

Predictive factors for local recurrence after glansectomy and neoglans reconstruction for penile squamous cell carcinoma.

Objectives: To investigate predictive pathological factors for local recurrence (LR) after glansectomy for penile squamous cell carcinoma (SCC) and to develop a risk score for prediction of LR after glansectomy.

Patients And Methods: In this retrospective study, we analyzed 117 patients operated between February 2005 and January 2016 in a supraregional penile cancer center in the UK for LR after glansectomy and glans reconstruction. Univariate and multivariate Cox proportional hazards regression was used to identify 4 prognostic indicators for LR.

Large bilateral seminal vesicle calculi presenting with spermolithiasis.

A 34-year-old male presented with an 8-month history of passing increasingly painful 'grit' in his ejaculate. Semen analysis was normal as were urinary and blood tests. T1-weighted MRI revealed several bilateral high-signal areas measuring up to 1 cm in diameter, located in the seminal vesicles.

Diagnosis and management of symptomatic seminal vesicle calculi.

Objective: The aim of this study was to review the management of patients with symptomatic seminal vesicle calculi, from presentation and diagnosis to postoperative outcomes.

Materials And Methods: A systematic review of the English literature in MEDLINE and Embase was performed, based on the following model: patients with a diagnosis of seminal vesicle calculi; all interventions considered with or without control groups with single and comparator interventions; outcomes considered were incidence, presentation, diagnostic methods and treatment. A narrative synthesis of the data was performed according to PRISMA 2009 guidelines.

Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain.

We describe the case of a man aged 43 years who presented with a 2-week history of a palpable lump in the right proximal penile shaft. This was preceded by a 6-month history of perineal pain, accompanied by erectile dysfunction. An urgent MRI scan of his penis identified a thrombus within the right crus and corpus of the penis.

Glansectomy and Split-thickness Skin Graft for Penile Cancer.

Background: Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series.

Objective: To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction.

Management of non-visualization following dynamic sentinel lymph node biopsy for squamous cell carcinoma of the penis.

Objectives: To review the management and clinical outcomes of uni- or bilateral non-visualization of inguinal lymph nodes during dynamic sentinel lymph node biopsy (DSNB) in patients diagnosed with penile cancer and clinically impalpable inguinal lymph nodes (cN0), and to develop an algorithm for the management of patients in which non-visualization occurs.

Patients And Methods: This is a retrospective observational study over a period of 4 years, comprising 166 patients with penile squamous cell carcinoma undergoing DSNB and followed up for a minimum of 6 months. All cases diagnosed with uni- or bilateral non-visualization of sentinel nodes in this cohort were identified from a penile cancer database.

Necrotizing granulomatous inflammation of the glans penis.

We describe the case of a 73-year-old man who presented with a 10-month history of an ulcerating lesion on the glans penis. Initially this was thought to be an invasive squamous cell carcinoma but a biopsy showed histological features consistent with necrotizing granulomatous inflammation. Extensive serological, immunological and microbiological tests only showed a positive antinuclear and perinuclear antineutrophil cytoplasmic antibodies indicating a possible autoimmune aetiology but an underlying systemic cause was not identified.

A rare case of metachronous penile and urethral metastases from a rectal mucinous adenocarcinoma.

Metastatic lesions in the penis are uncommon in patients with prostate or bladder cancer but penile metastatic lesions from rectal tumours are rare with only 65 cases reported in the literature. We describe the case of a 70-year-old man who developed metastatic lesions within his corpus cavernosum 2 years after being diagnosed and treated for a mucinous adenocarcinoma of the rectum and a year after a wedge resection of an isolated lung metastasis. He proceeded with total penectomy and intraoperatively two skip lesions were also found within the wall of his urethra; histological analysis proved that these were also metastatic lesions.

Paratesticular liposarcoma and contralateral angiolipoma in a 60-year-old patient.

We present the case of a 60-year-old man who was referred with a 1-year history of a slow-growing right scrotal lump. Following surgical excision together with a radical orchidectomy, the histological diagnosis was of a paratesticular dedifferentiated liposarcoma. Radiological staging showed no metastatic disease.

Infection of Penile Prostheses in Patients with Diabetes Mellitus.

Background: Controversy still exists in some centers on whether diabetes mellitus is a risk factor for penile prosthesis infection. The aim of this review is to examine the evidence correlating penile implant infections to the presence of diabetes mellitus in patients with organic erectile dysfunction.

Methods: We performed a systematic review searching through Medline database from 1960 to 2014, using keywords; penile prosthesis(es), penile implant(s), and diabetes mellitus.

A case of metastatic adenocarcinoma on a background of penoscrotal extramammary Paget's disease.

A 77-year-old man presented with a chronic lesion located in the left penoscrotal area. Apart from pruritus, bleeding and an occasional discharge from this area, he also reported reduced appetite and weight loss. Examination revealed an ulcerated skin lesion attached to a firm subcutaneous mass.

Infected urinoma secondary to a ruptured renal calyx from a partial staghorn stone.

A urinoma is a collection of urine outside the urinary tract as a result of disruption of the collecting system. Obstructive causes of urine extravasation secondary to stones are not unseen but display a delayed diagnosis due to the gradual onset of symptoms, which can mimic pyelonephritis. We present the case of a 70-year-old female patient who was admitted to hospital with symptoms of right loin pain and sepsis.

Acute urinary retention in an adolescent girl and important learning points.

We presented a case of a 13-year-old girl who attended the emergency department with acute urinary retention and 1400 mL residual urine after catheterisation. She had no significant medical history, neurological examination was normal and she had not reached menarche. She was found to have a haematocolpos on ultrasound scan which was compressing the urinary bladder.

A complication of Artificial Urinary Sphincter: migration of pump onto the rectus sheath in a patient with cauda equina syndrome.

We describe a very rare complication of migration of Artificial Urinary Sphincter pump device, following an elective implantation in a male patient with significant stress incontinence secondary to cauda equina syndrome. Looking through existing literature there has not been a similar complication reported. Usual complications reported include erosion, infection and mechanical failure.

Incidental paraganglioma of the urinary bladder in a 66-year-old woman.

A 66-year-old female patient was referred to drology department when a bladder mass was incidentally found on a transvaginal ultrasound scan. Cystoscopy revealed a small, smooth mass just above the trigone which appeared to be covered with normal urothelium. The histology from this growth after transurethral resection revealed a paraganglioma of the bladder.

Severe diabetic ketoacidosis leading to cardiac failure, pulmonary oedema and spinal cord oedema resulting in tetraplegia.

A 23-year-old man with poorly controlled insulin-dependent diabetes mellitus presented to casualty with community-acquired pneumonia and diabetic ketoacidosis. Shortly after admission he deteriorated and developed cardiac failure, pulmonary oedema and further decreased level of consciousness. He was sedated and ventilated for 3 weeks in the intensive care unit.

Hydronephrosis and loin pain as a presentation of tubo-ovarian abscess developing after Mirena coil removal.

We present an unusual and complicated case of a 39-year-old woman who was admitted three times in hospital over a period of 4 weeks, with abdominal pain initially and then right loin pain, fever and feeling generally unwell. She was investigated on each admission with different diagnoses set each time, but only on her last admission due to persisting symptoms, an MRI scan revealed a tubo-ovarian abscess associated with pelvic inflammatory disease (PID). We believe that the PID had developed secondary to the intrauterine device and a few weeks after the removal of the Mirena coil she was diagnosed with a tubo-ovarian abscess.

Perioperative use of antibiotics in intra-abdominal surgical infections.

Background: We created a questionnaire with the aim of evaluating surgeon compliance with the guidelines for antibiotic use in the perioperative period in intra-abdominal surgical infections. We discuss the problems emerging from non-adherence to these guidelines.

Methods: In the questionnaire, we tried to correlate the type of intra-abdominal infection with: (1) Time of antibiotic administration commencement; (2) type of antibiotic(s) administered; (c) duration of antibiotic administration; and (4) modification of antibiotic type/duration of administration in the presence of factors increasing the risk of treatment failure.