RUINAS DE LA IGLESIA DE SAN PEDRO [Material gráfico]

EN LA ACTUALIDAD ESTÁ RESTAURADA. ADQUIRIDA POR EL COLECCIONISTA EN LAS PALMAS G.C.FOTO DE ARCO DE PIEDRA EN PATIO INTERIOR ABANDONADO. RUINAS DE LA IGLESIA DE SAN PEDRO EN TELDE.Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte. Subdirección General de Coordinación Bibliotecaria, 201

Treatment of penile strangulation by the rotating saw and 4-needle aspiration method: Two case reports

Introduction: The aim of this article was to describe our experience in using rotating saw and also combination of the instrument with 4-needle aspiration. Methods: A comprehensive review of the literature was performed using PubMed. “Penile strangulation, -constriction, -incarceration, -entrapment” were used as search terms, and a manual bibliographic review of cross referenced items was performed. Results: Search results yielded nearly 70 cases of penile strangulation caused by a variety of objects. Various instruments have been described in the literature for their safe removal, each with its own pros and cons. Conclusions: Penile strangulation should be accepted as a self-induced priapism and managed as an emergency in order to preserve erectile function and to prevent penile necrosis. Surgical creativity and patience are necessary in order to have a successful outcome

Axial penile rigidity influences patient and partner satisfaction after penile prosthesis implantation

Introduction: Penile prosthesis implantation is one of the treatment choices that is kept for patients who were not satisfied with other treatments. Although penile prosthesis satisfaction rates are higher, there are some dissatisfied patients. The patients’ reasons are mostly shortness and softness of implanted prosthesis. It was previously demonstrated that penile axial rigidity of more than 500 grams is enough for successful vaginal intromission. To our knowledge, there is no study comparing axial rigidity of penile prosthesis and satisfaction. Objectives: The aim of this study was to examine whether axial rigidity of penile prosthesis had impact on patient and partner satisfaction. Materials and Methods: We enrolled one hundred patients who were implanted penile prosthesis before to evaluate their penile axial rigidity. We used Rigidometry (by using the digital inflection rigidometer) to assess the minimal axial pressure to bend the implanted penis. Results: We demonstrated that mean axial pressure to bend the implanted penis was 984.8 ± 268.7 grams. Overall satisfaction score with the penile prosthesis implant was 4.55 and 4.49 (out of 5) in patients and partners, respectively. In total, seven men were unsatisfied with their implant and reported a mean satisfaction score of 0.6 ± 0.48 (out of 5). All prostheses types showed good and more than 500 grams axial rigidity. The patients with Ambicor type, which were buckled at about 710.5 grams, showed worse satisfaction rates in comparison to other prostheses in two patients. Digital inflection rigidometer results of other penile prosthesis types in unsatisfied patient were 842.0, 872.0, 887.0 and 920 g. in CX700, Titan, Genesis and Titan OTR, respectively. Conclusion: We demonstrated that dissatisfaction rate was highest in Ambicor prosthesis implanted patients. Additionally, patients with 3-piece penile prosthesis were more satisfied than 2-piece or malleable ones, interestingly, although some cases had lower axial rigidity results

Isolated pump erosion of an inflatable penile prosthesis through the scrotum in a diabetic patient

Isolated pump erosion is a rare complication in patients with inflatable penile prosthesis. We describe a case of a diabetic patient who underwent inflatable penile prosthesis implantation with subsequent isolated pump erosion. Repeated attempts of conservative repair of the erosion failed. Finally, the inflatable penile prosthesis was replaced with a malleable one to avoid new pump erosion. In case of isolated pump erosion, replacement of the inflatable penile prosthesis with a malleable one looks to be a good alternative salvage treatment for the patient

Penile Fracture: Simultaneous Complete Urethral Rupture with Bilateral Corpora Cavernosa Rupture

Penile fracture is not uncommon blunt trauma to the penis. Here, we present a rare case of penile fracture during sexual intercourse. The patient presented with penile swelling, bleeding per urethra, and inability to pass urine. Retrograde urethrogram showed significant extravasation of contrast from anterior penile urethra and no contrast passing to proximal urethra. Surgical exploration showed complete urethral rupture and bilateral cavernosal rupture. This case represents the value of urethrogram to evaluate the urethral injury and the association of complete urethral injury with bilateral ventral cavernosal injury

Presentation, diagnosis, management, and outcomes of prostatic abscess : comparison of three treatment modalities

Purpose: The lack of available guidelines for the management of prostatic abscess (PA) results in inconsistencies in its management. The most commonly used management modalities were conservative treatment with parenteral antibiotics alone, transrectal ultrasound-guided (TRUS) needle aspiration, or transurethral deroofing (TUD). The current study is a retrospective study and examines prostatic abscess cases treated by either one or more of the different modalities. We assess and compare presentation, diagnosis, management, and outcomes of prostatic abscess and we compare the outcomes of the three management modalities. Methods: We retrieved the records of all patients (n = 23) admitted to the Urology department at Al Wakra hospital with the computed tomography (CT) diagnosis of prostatic abscess from January 2013 to March 2018. Data collected included demographic, clinical, laboratory, and imaging findings, as well as management modality, duration of hospital stay, duration of follow up, outcome, and recurrence. Results: A total of nine (39.1%) patients had conservative treatment only; eight (34.8%) had TUD, and six (26.1%) had TRUS needle aspiration. The mean age was 52.7 years. Lower urinary tract symptoms and fever were the most common presentations (95.7% and 82.6%, respectively). CT scan of the abdomen and pelvis with contrast was undertaken for all patients and it showed that multiple abscesses were observed in 14 (60.9%) cases. The overall mean hospital stay was 8.45 days (range 2–21 days). We observed no recurrences for patients treated conservatively or those who undertook TUD, but three patient (50%) recurrences were noted in TRUS aspiration patients. There was no mortality across the sample. Conclusion: Early diagnosis of prostatic abscess and prompt management may have decreased the morbidity and mortality. Conservative management can succeed in subcentimeter abscesses but TUD is the definite therapy for large and multiloculated abscess. TRUS aspiration does have a role in treatment, but it has higher recurrence and longer hospital stay