The modified Clavien classification system: a standardized platform for reporting complications in transurethral resection of the prostate

The aim of the study was to evaluate the applicability of the modified Clavien classification system (CCS) in grading perioperative complications of transurethral resection of the prostate (TURP). All patients with benign prostatic hyperplasia submitted to monopolar TURP from January 2006 to February 2008 at a non-academic center were evaluated for complications occurring up to the end of the first postoperative month. All complications were classified according to the modified CCS independently by two urologists, and the final decision was based on consensus. If multiple complications per patient occurred, categorization was done in more than one grade. Results were presented as complication rates per grade. Forty-four complications were recorded in 31 out of 198 patients (overall perioperative morbidity rate: 15.7%), and their grading was generally easy, non-time-consuming and straightforward. Most of them were classified as grade I (59.1%) and II (29.5%). Higher grade complications were scarce (grade III: 2.3% and grade IV: 6.8%, respectively) There was one death (grade V: 2.3%) due to acute myocardial infarction (overall mortality rate: 0.5%). Negative outcomes such as mild dysuria during this early postoperative period or retrograde ejaculation were considered sequelae and were not recorded. Nobody was complicated with severe dysuria. There was one re-operation due to residual adenoma (0.5%). The modified CCS represents a straightforward and easily applicable tool that may help urologists to classify the complications of TURP in a more objective and detailed way. It may serve as a standardized platform of communication among clinicians allowing for sound comparison

Hemangioma of penile urethra—treatment with simple transurethral excision: a case report

Urethral hemangiomas are rare benign vascular tumors with varying size and usually present as urethral bleeding and/ or hematuria. Treatment depends on the size and site of the lesion. We present a 27 year old male with a two year history of intermittent episodes of urethral bleeding. Cystourethroscopy showed a solitary hemangioma in the penile urethra. The patient was treated with simple transurethral excision with the biopsy forceps. The catheter was removed 48 hours later. He remains symptom free four months later. Simple excision of small hemangiomas may be an effective treatment especially for young patients in order to avoid the side effects of diathermy and when facilities such is laser are not available

Spontaneous expulsion from rectum: a rare presentation of intestinal lipomas

Lipomas are rare, subserosal, usually solitary, pedunculated small lesions appearing mainly in the large intestine with a minimal malignancy potential. They usually run asymptomatic and become symptomatic when they become enlarged or complicated causing intestinal obstruction, perforation, intusucception or massive bleeding. In rare cases they can be self-detached and expulsed via the rectum as fleshy masses. This event mainly occurs in large, pendunculated lipomas which detach from their pedicle. The reason for this event remains in most of cases unclear although in some cases a predisposing factor does exist. Abdominal pain and obstructive ileus may be observed while in many cases bleeding occurs. The expulsed mass sets the diagnosis and in most of the cases all symptoms subside. Diagnosis is rarely established before surgery with the use of barium enema, computed tomography and colonoscopy which additionally provides measures of treatment and diagnosis. In atypical cases though, in cases where the malignancy can not be excluded or in complicated cases, surgery is recommended. Usually the resection of the affected intestinal part is adequate. If during surgery a lipoma is encountered simple lipomatectomy seems also to be adequate

Superior Mesenteric Artery Syndrome

A 63-year-old female presented to our department complaining of epigastric pain, nausea and vomiting. Symptoms started after a significant loss of weight and persisted despite treatment, leading to hospitalization for dehydration and renal failure due to protracted vomiting. During hospitalization, no pathology could be identified and the patient was discharged. Symptoms persisted and she was eventually readmitted. Superior mesenteric artery syndrome was diagnosed based upon clinical suspicion and barium studies. She was subjected to duodenojejunostomy after failure of conservative treatment. Her immediate postoperative course was uneventful and the patient was well during her two-year follow-up. Clinicians should be suspicious of superior mesenteric artery syndrome, albeit rare, and be aware of its treatment, which is either conservative or surgical

Penile and scrotal strangulation caused by a steel ring: a case report

Application of constricting devices on the external male genitalia for increasing sexual performance is an unusual practice that can potentially lead to penile strangulation with severe consequences. In this case report we describe a case of a 48 year old male who presented in our hospital with a steel ring on his external genitalia which led to penile strangulation and a short review of the literature. The foreign body was successfully removed by an angle grinder which was not immediately available in the operating theatre. The patient had an uneventful recovery

Measuring Annual Sedimentation through High Accuracy UAV-Photogrammetry Data and Comparison with RUSLE and PESERA Erosion Models

Model-based soil erosion studies have increased in number, given the availability of geodata and the recent technological advances. However, their accuracy remains rather questionable since the scarcity of field records hinders the validation of simulated values. In this context, this study aims to present a method for measuring sediment deposition at a typical Mediterranean catchment (870 ha) in Greece through high spatial resolution field measurements acquired by an Unmanned Aerial Vehicle (UAV) survey. Three-dimensional modeling is considered to be an emerging technique for surface change detection. The UAV-derived point cloud comparison, applying the Structure-from-Motion (SfM) technique at the Platana sediment retention dam test site, quantified annual topsoil change in cm-scale accuracy (0.02–0.03 m), delivering mean sediment yield of 1620 m3 ± 180 m3 or 6.05 t ha−1yr−1 and 3500 m3 ± 194 m3 or 13 t ha−1yr−1 for the 2020–2021 and 2021–2022 estimation. Moreover, the widely applied PESERA and RUSLE models estimated the 2020–2021 mean sediment yield at 1.12 t ha−1yr−1 and 3.51 t ha−1yr−1, respectively, while an increase was evident during the 2021–2022 simulation (2.49 t ha−1yr−1 and 3.56 t ha−1yr−1, respectively). Both applications appear to underestimate the net soil loss rate, with RUSLE being closer to the measured results. The difference is mostly attributed to the model’s limitation to simulate gully erosion or to a C-factor misinterpretation. To the authors’ better knowledge, this study is among the few UAV applications employed to acquire high-accuracy soil loss measurements. The results proved extremely useful in our attempt to measure sediment yield at the cm scale through UAV-SfM and decipher the regional soil erosion and sediment transport pattern, also offering a direct assessment of the retention dams’ life expectancy.Greece and the European UnionPeer Reviewe

A Case Report of Urinary Bladder Carcinosarcoma and Review of the Literature

Carcinosarcoma of the bladder is an unusual tumour characterized by a combination of malignant epithelial and soft tissue elements. Most of the reported cases have been case reports or small series. Optimal treatment is uncertain. We herein report our experience in such a case treated with transurethral resection followed by radiotherapy with adverse final outcome. Treatment of bladder carcinosarcomas should be aggressive and multimodal but optional treatment is still unknown. Radiotherapy alone is insufficient as a treatment option of these aggressive tumors

Urachal carcinoma presenting with chronic mucusuria: a case report

Urachal adenocarcinoma is a rare tumor and represents 0.17–0.34% of all bladder tumors. It has an insidious course and variable clinical presentation. We present a case report of a 58 year old white male with an urachal cyst who suffered irritative voiding symptoms and long term mucusuria, since childhood. After surgical removal of the cyst with a partial cystectomy a mucus adenocarcinoma was diagnosed histologically