Retrograde Ejaculation: A Rare Presenting Symptom of Type 1 Diabetes Mellitus

A 19 year old presented with a progressive decline in ejaculate volume over 2 weeks, followed by a complete absence of ejaculate emission. A post-ejaculatory urine specimen demonstrated spermatozoa confirming a diagnosis of retrograde ejaculation. Investigations revealed a raised blood glucose level of 24.5 mmol/L and HbA1c >15%, with positive tests for anti-GAD antibodies and anti-IA2 antibodies consistent with a diagnosis of Type 1 diabetes mellitus. Retrograde ejaculation in diabetes is associated with autonomic neuropathy and is a late feature of the disease. This case is unique with retrograde ejaculation being the primary presenting symptom of Type 1 diabetes mellitus

Bladder Contracture – A Rare and Serious Side Effect of Intravesical Bacillus Calmette-Guérin Therapy

Instillation of intravesical bacillus Calmette-Guérin (BCG) is an effective treatment for non-muscle invasive bladder cancer (NMIBC). The high incidence of side effects may limit its tolerability in patients. Local side effects including cystitis and hematuria are common but generally self-limiting. Bladder contractures are a rare but serious consequence of BCG treatment. In this case, an 82 year-old male developed BCG reactivation and subsequent bladder contractures following transurethral resection of the prostate (TURP) three years post-BCG. To our knowledge, this is the first reported case of BCG reactivation post-TURP leading to the rare but serious effect of bladder contractures

Penile Abscess: A Case Report and Review of Literature

A case of penile abscess after amphetamine injection into the penis is reported. A 45-year-old male patient was successfully treated with surgical drainage and antibiotics. There were no 3-month consequences of treatment at follow-up, and the patient maintained potency, without any penile deformity. The aetiology, diagnosis, and management of penile abscesses are discussed

A rare case of an enormous sacral meningocele causing ureteric obstruction

Sacral Meningoceles, ductal ectasia and pseudomeningoceles are all rare spinal defects that occur due to errors in collagen biosynthesis in the setting of Marfan’s Syndrome. Meningoceles, which are extradural collections of cerebrospinal fluid, can form large pelvic collections which can compress local structures. In rare cases, this can lead to extrinsic ureteric obstruction, which can result in acute renal failure and urosepsis. We present a case of a 35-year old female with Marfan’s syndrome, with one of the largest sacral meningoceles reported in the literature, causing acute ureteric obstruction, requiring urgent surgical intervention

Photoselective vaporisation of the prostate using 80-W and 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis from 2002 to 2012

Context: Photoselective vaporisation (PVP) of the prostate is being used increasingly to treat symptomatic benign prostatic hyperplasia, due to the associated lower morbidity. Holmium laser enucleation of the prostate was considered to be the treatment with the highest evidence; however, evidence for PVP has dramatically increased recently. Objective: To conduct a systematic review and meta-analysis of level 1 evidence studies to determine the effectiveness of PVP versus transurethral resection of the prostate (TURP) for surgical treatment of benign prostatic hyperplasia. Outcomes reviewed included perioperative data, complications, and functional outcomes. Evidence acquisition: Biomedical databases from 2002 to 2012 and American Urological Association and European Association of Urology conference proceedings from 2007 to 2011 were searched. Trials were included if they were randomised controlled trials, had PVP as the intervention, and TURP as control. Meta-analysis was performed using a random effects model. Evidence synthesis: Nine trials were identified with 448 patients undergoing PVP (80 W in five trials and 120 W in four trials) and 441 undergoing TURP. Catheterisation time and length of stay were shorter in the PVP group by 1.91 d (95% confidence interval [CI], 1.47-2.35; p < 0.00001) and 2.13 d (95% CI, 1.78-2.48; p < 0.00001), respectively. Operation time was shorter in the TURP group by 19.64 min (95% CI, 9.05-30.23; p = 0.0003). Blood transfusion was significantly less likely in the PVP group (risk ratio: 0.16; 95% CI, 0.05-0.53; p = 0.003). There were no significant differences between PVP and TURP when comparing other complications. Regarding functional outcomes, six studies found no difference between PVP and TURP, two favoured TURP, and one favoured PVP. Conclusions: Perioperative outcomes of catheterisation time and length of hospital stay were shorter with PVP, whereas operative time was longer with PVP. Postoperative complications of blood transfusion and clot retention were significantly less likely with PVP; no difference was noted in other complications. Overall, no difference was noted in intermediate-term functional outcomes

Malakoplakia Causing Poor Bladder Compliance and Bilateral Hydroureteronephrosis

None

Fibrous Pseudotumor of the Penis – An Unusual Finding During Repair of Fractured Penis

Fibrous pseudotumors of the testis and penis are a rare phenomenon, forming a spectrum of heterogeneous lesions. To the best of our knowledge, there has been only 1 previous report arising from the penis. We present a case of fibrous pseudotumor of the penis, incidentally found during the surgical repair of a fractured penis. These benign lesions have been described in the literature and are most commonly referred to as pseudotumors. They should be distinguished from potentially malignant lesions, including fibrosarcomas, squamous cell carcinoma, and polypoid urothelial carcinoma. Being aware of this pathology is important to prevent unnecessary radical surgery