Does decentralisation of surgical management improve outcomes for paediatric testicular torsion?

Introduction: In testicular torsion (TT), delayed emergency scrotal exploration (ESE) increases the risk of orchidectomy. Transfer of a patient with suspected TT from a district general hospital (DGH) to a paediatric surgical centre (PSC) delays ESE and potentially puts them at increased risk of testicular loss. Prior to 1st January 2017, all boys under aged <16 years presenting to a DGH within the East Midlands Clinical Network (EMCN) would be referred to the PSC.

Acute testicular ischemia following manual reduction of inguinoscrotal hernia.

Testicular ischemia caused by inguinal hernia repair, and even the presence of the hernia itself, has been recognized in the medical literature, with the latter more commonly in children, but such an event after manual reduction has never been reported before. We present the case of a 67-year-old man who presented to the emergency department with a painful left groin lump. A left inguinoscrotal hernia was diagnosed and reduced "" with manual pressure at the bedside.

Long-term follow-up and outcomes of percutaneous nephron-sparing surgery for upper tract urothelial carcinoma.

Introduction: Upper tract urothelial carcinoma (UTUC) is uncommon, accounting for 5%-10% of all urothelial carcinomas. Current standard of care for localized disease consists of radical nephroureterectomy (RNU) which leads to loss of half the patient's functioning nephrons. Percutaneous nephron-sparing surgery (PCNSS) is an alternative minimally-invasive approach in selected cases where nephron preservation is desired.

Clinical Safety and Cost-Effectiveness of Follow-up Virtual Clinic for Bladder Outflow Obstruction Surgery.

Bladder outflow obstruction (BOO) surgery is among the most commonly performed urologic procedures. Postoperative assessment consists of physical measurement of uroflowmetry and post-void residual volume, but health systems worldwide have experienced pressures in demand, leading to exploration of greater efficiency in organizing clinic protocols. International Prostate Symptom Score (IPSS) questionnaire measurement has been identified as a tool to predict change in postoperative management.

Ureteroscopy for stone disease: expanding roles in the modern era.

Introduction: The prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era.

Material And Methods: Ureteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities.

Low vs. high fidelity: the importance of 'realism' in the simulation of a stone treatment procedure.

Purpose Of Review: Simulation training for stone surgery is now increasingly used as part of training curricula worldwide. A combination of low and high fidelity simulators has been used with varying degrees of 'realism' provided by them. In this review, we discuss low and high fidelity simulators used for ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) stone procedures with their advantages, disadvantages and future direction for endourological simulation surgery.

Making models to simulate testicular swellings.

Background: Testicular examination and the recognition of common scrotal swellings is a key clinical skill that is difficult to teach undergraduates because of its intimate nature. A novel approach for this topic was prompted by the description of handmade models in the medical literature to teach anatomical knowledge and clinical skills.

Methods: Affordable low-cost materials were purchased and assembled to form six models replicating key scrotal pathologies: epididymal cyst, epididymitis, hydrocoele, inguinoscrotal hernia, testicular tumour and varicocoele.

Ureteric Suture Urolithiasis Following Open Emergency Ureteric Repair.

Suture urolithiasis is an unusual but recognised phenomenon following surgery on the urinary tract. We report a case in a 30-year-old man who sustained a gunshot injury to the left ureter in Burundi and underwent open ureteric repair in a regional hospital. He migrated to the UK and presented one year later with left loin pain.

Asymptomatic ureteral rupture secondary to chronic urinary retention from massive prostatic enlargement.

Non-traumatic ureteral rupture has been reported more frequently, resulting from increased intraluminal pressures from distal urinary tract obstruction. We report the case of a 77-year-old man presenting with chronic urinary retention secondary to massive prostatic enlargement through acute kidney injury. Ultrasound scan detected a shallow left perinephric fluid collection with a possible bladder mass, demonstrated on flexible cystoscopy to be a massive median lobe of prostate.

Fournier's gangrene secondary to an acutely inflamed appendix herniating into the deep inguinal ring.

Fournier's gangrene (FG) requires prompt recognition and management. We report the case of a 68-year-old man who presented with extensive pain and purple discolouration from the right iliac fossa to perineum. Computed tomography demonstrated gas within the right hemiscrotum extending into the inguinal canal and right buttock, with a right pelvic fluid and air collection.

Enterobius vermicularis infection of the ovary.

Enterobius vermicularis is an intestinal parasite, which may occasionally involve extraintestinal sites including the female genital tract. We report a rare case of ovarian involvement, which presented with chronic right iliac fossa pain in a 31-year-old woman. A transvaginal ultrasound scan was suggestive of a right adnexal dermoid cyst; however, histological examination of the subsequent salpingo-oophorectomy specimen showed an abscess containing viable E.