Penile strangulation secondary to a plastic bottle neck

Penile strangulation from a foreign body is a rare presentation to the emergency department. It must be treated as soon as possible as any delay in management can lead to complications such as gangrene and amputation of the penis. There is no superior standard of care as each case needs to be managed individually depending on clinical findings. We present a 40 year old male with a plastic bottle neck strangulating his penis requiring a medical cast saw to successfully free it

Does histological prostatic inflammation during transurethral resection of the prostate for bladder outlet obstruction affect post-operative urinary outcomes?

Objective: Benign prostate hyperplasia (BPH) is a common cause for bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS) in men. The pathophysiology of BPH is multifactorial and inflammation has been linked with progression of BPH and LUTS. The association between histological prostatitis found at transurethral resection of the prostate (TURP) and adverse post-operative urinary outcomes is not clearly defined. Our aim was to evaluate the association between histological prostatitis and adverse post-operative urinary outcomes following TURP procedure. Methods: Patients who had undergone TURP for BPH at a single institution between 2014 and 2018 were included. The study population was divided into three cohorts: those with no histological inflammation, those with any form of inflammation and those specifically with prostatic stromal inflammation. Functional outcomes were assessed by defining a series of measurable post-operative “LUTS events” and comparing these to time-to-event profile using a Kaplan–Meier estimator. Results: A total 198 patients were included (no inflammation n = 101; any inflammation n = 97, prostatic stromal inflammation n = 81). All three groups were comparable in terms of baseline characteristics. The any inflammation group had significantly more adverse post-operative outcomes after TURP compared to the no inflammation group, P = 0.0065. The stromal inflammation group had more LUTS events after surgery compared to the no inflammation groups in the first year of follow-up n = 0.011; over a 5-year follow-up period the results were not statistically significant, P = 0.244. Conclusion: Histological prostatitis is associated with worse urinary outcomes after TURP compared to no inflammation. These results are useful in improving prognostic discussions with patients after TURP

Metastatic urothelial carcinoma of the bladder with sarcomatoid differentiation showing large cell neuroendocrine transformation in the liver; an unusual behaviour of a rare disease

Metastatic urothelial carcinoma of the bladder is generally considered to be an aggressive disease with many recognised variants, however what is unique about our patient is the metastatic transformation from a urothelial primary malignancy with sarcomatoid variation to a neuroendocrine deposit within the liver. From what we have identified, this pattern of pathological transformation has not been reported for a urothelial malignancy in the literature. We present a 64 year old male who we believe is the first reported case of a primary urothelial malignancy presenting de-novo with metastatic liver deposits showing neuro-endocrine transformation

Plasmacytoma of the testis in a patient with relapsed and refractory multiple myeloma: Case report and review of the literature

Testicular plasmacytoma, whether occurring as a primary lesion or as a reflection of underlying multiple myeloma (MM), is a rare disease. We report the case of a 38-year-old male with multiply relapsed MM, who was found to have a testicular plasmacytoma. He presented with a gradually enlarging scrotal mass. Following orchidectomy, pathologic examination of the specimen demonstrated a plasmacytoma. In the context of active MM, the specimen was also sent for cytogenetic analysis but this was unhelpful in guiding a chemotherapy regime, which still continues at time of reporting. Although a rare lesion, there remains no definitive treatment protocol for the management of testicular plasmacytoma representing an extramedullary manifestation of MM

Comparing outcomes of transurethral resection of the prostate in men with greater than or less than 100 cc prostate volume: a single-centre study

Objective: This study describes the pen-operative results, safety, and functional outcomes of transurethral resection of the prostate (TURP) performed in men with benign prostatic hyperplasia [or hypertrophy; (BPH)] and a prostate gland volume >= 100 cc. Materials and Methods: A retrospective analysis of a cohort of patients undergoing TURP at a single institution over four years was undertaken. Patients with known prostate cancer were excluded. Clinical outcomes were between men with a prostate volume of >= 100 cc and men with a prostate volume <100 cc. Functional outcomes were assessed by defining a series of measurable post-operative lower urinary tract symptoms (LOTS) events" and comparing the time-to-event profile using a Kaplan-Meier estimator. Results: Out of a total of 238 men who underwent TURP for BPH during the study period, 72 had a prostate volume >= 100 cc (30%). Baseline demographics were similar to the group of patients with a prostate volume <100 cc. Patients with large prostates had a significantly longer mean operating time (56 vs 98 minutes, p<0.0001). The pen-operative complication profile and post-operative complication rate were similar between the two groups. During a median follow-up period of 27 months (range, 2-54 months), no difference in LUTS events-free survival was observed (p=0.93). Conclusion: Our results show that TURP can be safely performed in patients with large prostate glands (>= 100 cc). Although operating times were longer in the large prostate group, this did not significantly affect the complication rate nor compromise a good functional outcome