Traumatic Metachronous Penile Fracture to the Contralateral Corpora.

Penile fracture is an uncommon condition in day-to-day urological practice. Though most cases of penile fracture are traumatic in nature, these are typically unilateral. Synchronous bilateral cases have been rarely reported.

Zonal mapping of sentinel lymph nodes in penile cancer patients using fused SPECT/CT imaging and lymphoscintigraphy.

Purpose: To define the anatomical location of sentinel lymph nodes (SLN) in penile cancer patients based on Daseler's original zonal description using a combination of single photon emission computed tomography-computed tomography (SPECT-CT), cross sectional imaging and lymphoscintigraphy and characterise the limits of Zone V.

Materials And Methods: Patients with primary penile cancer ≥T1G2 were included in the study. A total of 113 groins with impalpable inguinal lymph nodes (cN0) underwent planar lymphoscintigraphy and SPECT-CT.

Investigating the role of SPECT/CT in dynamic sentinel lymph node biopsy for penile cancers.

Purpose: Currently, most centres use 2-D planar lymphoscintigraphy when performing dynamic sentinel lymph node biopsy in penile cancer patients with clinically impalpable inguinal nodes. This study aimed to investigate the role of SPECT/CT following 2-D planar lymphoscintigraphy (dynamic and static) in the detection and localization of sentinel lymph nodes in the groin.

Methods: A qualitative (visual) review was performed on planar followed by SPECT/CT lymphoscintigraphy in 115 consecutive patients (age 28-86 years) who underwent injection of Tc-nanocolloid followed by immediate acquisition of dynamic (20 min) and early static scans (5 min) initially and further delayed static (5 min) images at 120 min followed by SPECT/CT imaging.

Feasibility of performing dynamic sentinel lymph node biopsy as a delayed procedure in penile cancer.

Introduction: Patients diagnosed with penile cancer and clinically impalpable inguinal lymph nodes (cN0), normally undergo dynamic sentinel lymph node biopsy (DSNB) at the same time as the primary penile surgery. The aim of this study is to investigate the diagnostic accuracy and clinical outcomes of performing DSNB in patients who have already undergone surgery for the primary penile cancer.

Methods: Ninety-two patients with unilateral or bilateral impalpable inguinal lymph nodes (LNs) who had already undergone primary resection of the penile tumour (stage ≥ T1G2) were included in this study.

Seminoma presented as testicular rupture: Case report and literature review.

Rupture of the testis as a result of blunt trauma is rarely seen in daily urological practice. We report an unusual case of incidental seminoma diagnosed after surgical exploration and subsequent orchidectomy of a severed testis following testicular injury as a result of trivial blunt trauma. This case highlights the inability of investigative tools, such as a scrotal ultrasound, in distinguishing an underlying tumour in the presence of testicular parenchymal damage.

Searching for the G spot in the urinary bladder: autoerotism and potential complications.

Self-insertion of foreign bodies into the urethra and urinary bladder for autoerotic stimulation is a rather rare urological emergency condition. We present a case of 41-year-old lady who self-inserted a crochet needle into the urethra for sexual pleasure, which was successfully retrieved during examination under general anaesthetic and endoscopic bladder evaluation. Foreign bodies in the urinary bladder are rarely encountered yet represent a urological challenge that requires prompt management in view of possible sequellae if left untreated.

Mitral valve repair: beyond the French correction.

Introduction: We analysed retrospectively patients who underwent mitral valve repair using techniques beyond the "French correction", as popularised by Carpentier.

Methods: From June 1997 to June 2006, 153 patients underwent mitral valve repair. Their mean age was 63.

Delayed repair of esophageal perforation due to transoesophageal echocardiography.

Since its introduction into clinical practice in the 1980s, transesophageal echocardiography has become an invaluable tool in cardiac surgery having only a few cases of serious complications reported in the literature. We report a novel case of delayed surgical repair of esophageal perforation due to transesophageal echocardiography in cardiac surgery and reviewed the anecdotal literature.

In patients undergoing cardiac surgery does asymptomatic significant carotid artery stenosis warrant carotid endarterectomy?

A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether asymptomatic significant carotid artery stenosis (ASCAS) warrants carotid endarterectomy (CEA) in patients undergoing cardiac surgery. 128 Papers were found using the reported search, of these 10 presented represent the best evidence to answer the clinical question.

Are prophylactic beta-blockers of benefit in reducing the incidence of AF following coronary bypass surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether prophylactic beta-blockers effectively reduces the incidence of atrial fibrillation post-cardiac surgery. Altogether 113 papers were found using the reported search, of which 8 represented the best evidence on this topic.

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Need for cervical spine imaging for alert children after trauma.

A short cut review was carried out to establish whether clinical examination can be used to exclude cervical spine injury in alert children. Altogether 298 papers were found using the reported search, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated.

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Cervical spine imaging in children under 9 after trauma.

A short cut review was carried out to establish whether the odontoid peg view is useful to radiologically exclude cervical spine injury in children under 9 years of age. Altogether 156 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. In addition recent guidelines are noted.