Suction tube uterine tamponade versus uterine balloon tamponade for treatment of refractory postpartum hemorrhage: A randomized clinical feasibility trial.

Objective: To compare low-cost "Suction Tube Uterine Tamponade" (STUT) treatment for refractory postpartum hemorrhage (PPH) with uterine balloon tamponade (UBT) using a randomized feasibility study.

Methods: After verbal assent, we allocated participants with refractory PPH by randomly ordered envelopes to STUT or routine UBT at 10 hospitals in South Africa and one tertiary referral center in Colombia between January 10, 2020, and May 3, 2024. In the STUT group, we inserted a 24 FG Levin stomach tube into the uterine cavity and applied suction.

Solitary fibrous tumor of the bladder: A rare cause of bladder outlet obstruction in an adult male.

Introduction: Solitary fibrous bladder tumors are extremely uncommon, with only a few cases reported. These fibroblastic mesenchymal neoplasms are typically benign, indolent, and slow growing.

Case Presentation: A 44-year-old male patient with obstructive uropathy was referred to our unit for workup.

Intrarenal Pressure in Retrograde Intrarenal Surgery: A Narrative Review.

Objective: To review the latest evidence on the complications of elevated intrarenal pressures (IRPs) in retrograde intrarenal surgery (RIRS) and the strategies to mitigate the increase of IRP during surgery.

Methods: A comprehensive literature search of PubMed, Web of Science and EBSCO research databases was conducted from inception to July 31, 2024. The analysis involved a narrative review.

Pharmacological Modulation of Intrarenal Pressure in a Porcine Model Using a Novel Isoprenaline-Eluting Guidewire.

Several complications of retrograde intrarenal surgery have been attributed to inadvertent increases in intrarenal pressure. We recently described the development of an innovative isoprenaline-eluting guidewire (IsoWire). The objective of this study was to investigate the impact of this IsoWire on the intrarenal pressure and evaluate its safety.

Design and Validation of a Novel 3D-Printed Retrograde Intrarenal Surgery Trainer.

Objective: To report on the design of a novel 3D-printed retrograde intrarenal surgery (RIRS) benchtop trainer and detail its validation against real-life experiences.

Methods: Digital Imaging and Communications in Medicine (DICOM) files of 2 patients with normal computed tomography of the kidney and bladder were converted into stereolithography files to create 3D triangular mesh models. These images were further refined using Autodesk Meshmixer.

Introducing an lsoprenaline Eluting Guidewire: Report on its Design and the Results of the Dose-Determining Pilot Study.

Retrograde intrarenal surgery (RIRS) is associated with complications, many of which are related to the intrarenal pressure (IRP). We aim to describe the design of a novel isoprenaline-eluting guidewire ("IsoWire") and present the results from the first release studies and the first animal studies showing its effect on IRP. The IsoWire comprises a Nitinol core surrounded by a stainless-steel wire wound into a tight coil.

Hydrogen peroxide bladder irrigation: A simple, safe and effective management option for clot retention.

While the historical benefits of hydrogen peroxide on wounds and wound healing have recently been questioned, physicians have started to explore its other potential medicinal benefits. We present a case of a 14-year-old girl who presented to our urology unit with macroscopic haematuria and clot retention. Ultrasonography confirmed a large organised intravesical blood clot.

Liver cystic echinococcosis: a parasitic review.

Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm . Humans are accidental hosts in this zoonotic disease process, and hepatic infection accounts for over two-thirds of all cases. Since signs and symptoms are mainly non-specific, especially in early disease, clinicians should have a low threshold to include CE as a differential diagnosis in patients with positive serology and suggestive radiological findings, especially in endemic regions.

Small bowel intussusception caused by a metastatic testicular germ cell tumour.

Intussusception from a testicular germ cell tumour is extremely rare. Metastatic gastrointestinal implants outgrow their blood supply leading to central necrosis. This results in erosions and ulcerations, which can be visualised as submucosal polypoid masses.

Inflammatory myofibroblastic tumour of the bladder: a case report and review of the literature.

Inflammatory myofibroblastic tumours (IMTs) are rare neoplasms of uncertain malignant potential that closely resemble other more aggressive spindle cell tumours. The distinction of IMT from the latter is of importance. We report a case of IMT in a 27-year-old man who presented with intermittent painless, macroscopic haematuria and was found to have a large bladder mass arising from the dome of the bladder.

Metastatic prostate carcinoma presenting as a gluteal soft tissue mass.

Metastatic lesions from prostate adenocarcinoma to the bone and lymph nodes and less frequently to the lungs, pleura, liver and adrenal glands are well documented. The presence of soft tissue metastases from a prostate adenocarcinoma is extremely rare. We report a case of a 56-year-old male who presented with a 2-year history of a painless buttock mass.

-rearranged renal cell carcinoma with osseous metaplasia and indolent behaviour.

TFE3-rearranged renal cell carcinoma (RCC) is a rare but well characterised histological subtype of RCC with an aggressive clinical course and propensity for late metastases. Osseous metaplasia is an uncommon but well documented finding in clear cell, papillary and chromophobe RCC. We present the first case of a -rearranged RCC to be found harbouring metaplastic bone in a 47-year-old woman who presented with a slowly enlarging left flank mass over a 10 year period.

Wilms' tumour with spinal cord involvement.

Spinal cord involvement of Wilms' tumour is rare. A 14-year-old girl presented with an abdominal mass, paraplegia and loss of bladder and bowel control. Radiological investigations confirmed the presence of a large intraabdominal mass with infiltration into the spinal canal with impingement of nerve roots and the spinal cord.

Pulmonary lymphangioleiomyomatosis with an associated giant renal angiomyolipoma.

Pulmonary lymphangioleiomyomatosis (LAM), a rare, progressive disease predominantly affecting the lungs of women of reproductive age, is often associated with renal angiomyolipoma (AML). We report the case of a 29-year-old female patient who presented to our obstetrics department at 37 weeks' gestation, complaining of abdominal pain, and constipation. Ultrasound noted a viable singleton with a large left-sided abdominal mass.

Lytic parasitic: a case of bone destructing echinococcosis.

Pelvic hydatid bone disease is a rare and debilitating condition. Patients often present with symptoms and signs when the disease process is advanced and curative resection is not possible. We present a case of destructive bone hydatid disease affecting the left iliac bone.

"Suction Tube Uterine Tamponade" for treatment of refractory postpartum hemorrhage: Internal feasibility and acceptability pilot of a randomized clinical trial.

Objective: To assess feasibility and acceptability of a novel, low-cost "Suction Tube Uterine Tamponade" (STUT) treatment for refractory postpartum hemorrhage (PPH).

Methods: We allocated patients with refractory PPH by randomly ordered envelopes to STUT or routine uterine balloon tamponade (UBT, Ellavi free-flow system) in 10 hospitals in South Africa. In the STUT group, a 24FG Levin stomach tube was inserted into the uterine cavity and vacuum created with a vacuum pump or manual vacuum aspiration syringe.

Priapism after spinal cord injury - a case report and review of the literature.

Involuntary unwanted erections are extremely rare after spinal cord injury (SCI). A sudden loss of sympathetic tone to the pelvic vasculature following SCI causes an increase in the parasympathetic tone and uncontrolled arterial blood flow into the penile sinusoidal spaces. When occurring immediately after an acute SCI, it is generally self-limiting and settles within a few hours.

Urethral polyembolokoilamania: not a bread-and-butter issue.

Urethral polyembolokoilamania, the self-insertion of a foreign body into the male urethra for sexual gratification and autoerotism, is an uncommon urological emergency with potentially severe consequences. We present the case of a 27-year-old male who presented to our emergency unit after apparently sustaining a penile injury during sexual intercourse. Clinically, a foreign body was thought to be palpable, extending from the mid-shaft of the penis to the penoscrotal junction.

Florid cystitis cystica et glandularis causing irreversible renal injury.

Cystitis cystica et glandularis (CCEG) is widely believed to be innocuous and self-limiting. We report a case of a 32-year-old male patient who was found to have gross bilateral hydroureter and hydronephrosis and an estimated glomerular filtration rate of 3 ml/min/1.73 m.

Clear Cell Renal Cell Carcinoma with a Ureteral Thrombus.

Cancers of the kidney, arising from either the renal parenchymal tissue or the renal pelvis, is among the 13 commonest types of malignancy globally, accounting for between 3% and 4% of all newly diagnosed cancers. Renal cell carcinoma (RCC) accounts for 85% of all malignant renal neoplasms. We present a rare case of an RCC directly extending into the renal pelvicalyceal system and with a thrombus within the ureter.

Are Prophylactic and Therapeutic Target Concentrations Different?: the Case of Lopinavir-Ritonavir or Lamivudine Administered to Infants for Prevention of Mother-to-Child HIV-1 Transmission during Breastfeeding.

The ANRS 12174 trial assessed the efficacy and tolerance of lopinavir (LPV)-ritonavir (LPV/r) prophylaxis versus those of lamivudine (3TC) prophylaxis administered to breastfed infants whose HIV-infected mothers were not on antiretroviral therapy. In this substudy, we assessed LPV/r and 3TC pharmacokinetics to evaluate the percentage of infants with therapeutic plasma concentrations and to discuss these data in the context of a prophylactic treatment. Infants from the South African trial site underwent blood sampling for pharmacokinetic study at weeks 6, 26, and 38 of life.

Malignancies in South African children with HIV.

Objectives: In 2008 the South African Children's Cancer Study Group decided to review the epidemiology, management, and chemotherapy response of HIV-positive children with malignancy.

Methods: This is a retrospective analysis of data collected from the records of HIV-positive children diagnosed with malignancy at 7 university-based pediatric oncology units serving 8 of the 9 provinces in South Africa.

Results: Two hundred eighty-eight HIV-positive children were diagnosed with 289 malignancies between 1995 and 2009.