Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

This retrospective study aimed to investigate the clinical characteristics, changes in semen parameters, and outcomes of adult patients with ejaculatory duct obstruction (EDO) who underwent transurethral resection of ejaculatory ducts (TURED). The study included 25 patients diagnosed with EDO who underwent TURED at King Faisal Specialist Hospital & Research Center in Saudi Arabia between January 2015 and December 2021. The results showed that 68% of the patients had complete ED obstruction, while 32% had partial obstruction. Primary infertility was reported in 68% of the patients, with 4% experiencing secondary infertility. The analysis revealed a significant increase in semen volume greater than 0.6 after TURED, while there was a significant decrease in volumes ranging from 0.1 to 0.3 and from 0.4 to 0.6. Patients with partial ED obstruction demonstrated a significant improvement in semen parameters compared to those with complete ED obstruction. The findings suggest that TURED is a safe and effective treatment option for EDO, leading to significant improvements in semen parameters and potentially resulting in spontaneous pregnancy. However, further research is needed to identify specific patient subgroups that may benefit the most from TURED. While magnetic resonance imaging (MRI) with an endorectal coil has been proposed for more detailed evaluation, transrectal ultrasound (TRUS) has been suggested as the standard examination technique

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities

Distributed evolutionary algorithms and their models: A survey of the state-of-the-art

The increasing complexity of real-world optimization problems raises new challenges to evolutionary computation. Responding to these challenges, distributed evolutionary computation has received considerable attention over the past decade. This article provides a comprehensive survey of the state-of-the-art distributed evolutionary algorithms and models, which have been classified into two groups according to their task division mechanism. Population-distributed models are presented with master-slave, island, cellular, hierarchical, and pool architectures, which parallelize an evolution task at population, individual, or operation levels. Dimension-distributed models include coevolution and multi-agent models, which focus on dimension reduction. Insights into the models, such as synchronization, homogeneity, communication, topology, speedup, advantages and disadvantages are also presented and discussed. The study of these models helps guide future development of different and/or improved algorithms. Also highlighted are recent hotspots in this area, including the cloud and MapReduce-based implementations, GPU and CUDA-based implementations, distributed evolutionary multiobjective optimization, and real-world applications. Further, a number of future research directions have been discussed, with a conclusion that the development of distributed evolutionary computation will continue to flourish

Scrotal Abscess Precipitating Late Infection of a Malleable Penile Prosthesis: The Risk Never Evanesces

Although infrequent, infections represent the dreadful complication of penile prosthesis implantation. The incidence substantially decreases after a few infection-free postoperative months. We report herein a case of a very late penile prosthesis infection from a fistualizing scrotal abscess in a 67-year-old man. The patient presented with a one-month history of persistent penile-base discharge from a right hemiscrotal swelling. On examination, mild penile tenderness and a discharging penoscrotal-junction sinus were noted. Microbiological wound culture was positive for Staphylococcus epidermidis. Magnetic resonance imaging revealed this multiloculated fluid collection’s communication with the right corporal body. Removal of the prosthesis was performed. Pathological evaluation of the dissected fistula was suggestive of acute on top of chronic inflammatory reactions. To our knowledge, this is the first report of a scrotal abscess leading to penile prosthesis infection 15 years after an uneventful implantation

Antimicrobial Chitosan-G-poly(AMPS-Co-AA-Co-AM)/Ground Basalt Composite Hydrogel: Synthesis and Characterization

This paper presents for the first time the introduction of ground basalt into the network of a chitosan based hydrogel and the enhancement of the bactericidal activity of the hydrogel.<br /

In utero MRI diagnosis of fetal malformations in oligohydramnios

Objective: To evaluate the role of MRI in assessing Ultrasonographically (US)-suspected fetal malformations associated with oligohydramnios. Methods: We performed MRI in 43 oligohydramnios pregnancies referred with US-suspected fetal malformations at a mean of 25.5 weeks’ gestation. MRI findings were correlated with US data and outcome measures. Results: MRI correctly diagnosed one normal fetus suspected to have posterior cephalocele. In the remaining 42 fetuses who had malformations involving their urinary systems (n = 36), brains (n = 23), bones (n = 4), hearts (n = 3), and hepatobiliary (n = 3), MRI confirmed US diagnosis in 25 fetuses (58.1%), and added US-occult findings in 14 (32.5%) that were mainly related to the brain, urinary and hepatobiliary system. In 2 fetuses (4.7%), MRI added findings but missed data correctly detected by US in another 2 fetuses. MRI missed fetal skeletal and cardiac function abnormalities correctly detected by US. MRI accurately detected multiple body system abnormalities that aided prenatal correct diagnosis of syndromes including Meckel Gruber (n = 15) and Joubert syndrome and related cerebellar disorders (n = 1). Conclusion: MRI is valuable in evaluating suspected fetal malformations especially those related to brain and urinary system when ultrasound is inconclusive owing to oligohydramnios. Fetal MRI can add findings that may modify prenatal diagnosis

Antimicrobial Chitosan-G-poly(AMPS-Co-AA-Co-AM)/Ground Basalt Composite Hydrogel: Synthesis and Characterization

This paper presents for the first time the introduction of ground basalt into the network of a chitosan based hydrogel and the enhancement of the bactericidal activity of<br> the hydrogel.<br