scholarly journals A Very Unlikely Finding in a Male Child: Urethral Prolapse

2017 ◽  
Vol 05 (01) ◽  
pp. e36-e38
Author(s):  
Çiğdem Durakbaşa ◽  
Gonca Gercel ◽  
Murat Mutus ◽  
Burhan Aksu ◽  
Seyma Ozkanli

AbstractUrethral prolapse is a disease of prepubertal black girls and postmenopausal women with an unknown cause. It may be congenital in origin or an acquired condition. It has never been reported in males. We report a 10-year-old Caucasian boy who presented because of recurrent right undescended testis. He had been operated on for bilateral undescended testes 7 years ago in another hospital, and circumcision was done during the same operation. The boy complained of a weak urinary stream during voiding. The physical examination was consistent with recurrent right undescended testis. Penile examination showed a circumferential urethral prolapse around the meatus. The urethral meatal appearance was apparent right after the circumcision. An orchiopexy operation as well as circumferential excision of the perimeatal urethral tissue with primary repair was done. The pathological examination of the specimen revealed keratinized stratified squamous epithelium consistent with urethral mucosa. The postoperative course was uneventful, and the patient urinates normally at the 8 postoperative month with a normal uroflowmetry study. This is the first report of urethral prolapse in a male. Because circumcision is a widely employed practice in many cultures, it is unlikely to be a predisposing factor. It is a benign condition that can be cured with simple resection and anastomosis.

2010 ◽  
Vol 4 (6) ◽  
pp. 983-986
Author(s):  
Teerasak Phewplung ◽  
Atchara Mahayosnond ◽  
Panruethai Trinavarat

Abstract Background: The undescended testis represents a common condition affecting male infants with significant clinical implications such as infertility and testicular malignancy. There is controversy as to the diagnosis when a clinical examination fails to identify a testis. Objective: Investigate the value of ultrasound in the diagnosis of undescended testis, and evaluate the correlation between the preoperative ultrasonographic data and operative findings. Material and method: Thirty-nine boys (age: 3months -12 years) with undescended testes were examined between January 2003 and December 2007. All the boys had undergone a sonogram performed for localizing the undescended testes. Only 20 boys were sent for inguinal exploration, or other surgical procedures for localizing the undescended testes. We calculated specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and the accuracy of ultrasonographic diagnosis in boys with undescended testes. Results: Twenty-nine undescended testes were included in this study. Ultrasonography had a sensitivity of 82%, a specificity of 0%, PPV of 96%, NPV of 0%, and accuracy of 79% in the diagnosis of the undescended testis. Conclusions: The sensitivity and specificity including NPV of uetrasound had the unsatisfactory outcomes.


Author(s):  
David F.M Thomas

The testis descends in response to androgen stimulation in the third trimester of pregnancy. Germ cell maturation which normally occurs in early childhood is impaired or absent in undescended testes. The well-documented phenomenon of secondary ascent is now thought to account for a sizeable proportion of boys undergoing orchidopexy in later childhood. Inguinal hernias and communicating hydroceles are caused by persistence of a patent processus vaginalis. Surgery is always indicated for inguinal hernias but the majority of communicating hydroceles resolve spontaneously. Testicular torsion accounts for 90% acute scrotal symptoms in adolescents, in whom urgent surgical exploration is mandatory unless there is compelling evidence of an alternative diagnosis. Treatment is rarely justified for asymptomatic varicoceles in this age group.


Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 440
Author(s):  
Marie Shella De Robles ◽  
Christopher J. Young

Background: Surgical management for traumatic colonic injuries has undergone major changes in the past decades. Despite the increasing confidence in primary repair for both penetrating colonic injury (PCI) and blunt colonic injury (BCI), there are authors still advocating for a colostomy particularly for BCI. This study aims to describe the surgical management of colonic injuries in a level 1 metropolitan trauma center and compare patient outcomes between PCI and BCI. Methods: Twenty-one patients who underwent trauma laparotomy for traumatic colonic injuries between January 2011 and December 2018 were retrospectively reviewed. Results: BCI accounted for 67% and PCI for 33% of traumatic colonic injuries. The transverse colon was the most commonly injured part of the colon (43%), followed by the sigmoid colon (33%). Primary repair (52%) followed by resection-anastomosis (38%) remain the most common procedures performed regardless of the injury mechanism. Only two (10%) patients required a colostomy. There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates (55% vs. 50% vs. 50%, p = 0.979) and length of hospital stay (21 vs. 21 vs. 19 days, p = 0.991). Conclusions: Regardless of the injury mechanism, either primary repair or resection and anastomosis is a safe method in the management of the majority of traumatic colonic injuries.


2005 ◽  
Vol 16 (7) ◽  
pp. 510-511 ◽  
Author(s):  
S Day ◽  
J S Bingham

Mondor's disease of the penis, otherwise known as superficial thrombophlebitis (STP) or thrombosis of the dorsal vein, is an under-reported benign condition, the aetiology of which is poorly understood. It is characterized by a sudden, indurated swelling of the vein, often occurring after vigorous sexual activity. We report a case of Mondor's disease occurring 24h following a 15h flight. This gentleman also reported a history of STP of his left lower limb varicose veins following a similar-length flight three years previously. In the absence of any other clear predisposing factor, we propose long-haul flight as an important factor contributing to the development of dorsal vein thrombosis.


2018 ◽  
Vol 46 ◽  
pp. 4
Author(s):  
Juliana Godoy Santos ◽  
Andressa De Cássia Martini ◽  
Bianca Garay Monteiro ◽  
Deise Cristine Schroder ◽  
Gabrielle Dourado Franco ◽  
...  

Background: The urethral prolapse in dogs is a rare condition known by the protrusion of the urethral mucous membrane and the external orifice of the urethra. It is more frequently seen in young males, especially of brachycephalic breeds, for instance the English bulldog. Despite the pathophysiology of this disorder being little elucidated, it is believed that the cause is related to factors such as genetic susceptibility, excessive sexual behavior, traumas, abnormalities and urinary and prostatic problems. Due to limited reports on the subject, this paper aims to describe the clinical and surgical aspects of a case of urethral prolapse in a dog, surgically corrected.Case: Admitted to the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT) a dog, American Pit Bull, 7 months old, with previous history of bleeding in the penile region and pain while urinating. In the physical exam it presented: intermittent bleeding via external ostium of the urethra, increased volume and protrusion of the distal urethral mucous membrane and the external orifice of the urethra, which was presenting a round shape mass, edematous and little congested of red-purplish coloring, evidenced by the passing of urethral probe. The diagnosis of urethral prolapse was confirmed and, after conducting laboratory tests and obtaining normal results for the species, the animal was sent to surgery. It was opted for the technique of resection and anastomosis of the protruded portion of the mucous membrane. After the anesthetic protocol, it was performed the trichotomy and antisepsis of region, the fenestrated drapes were properly positioned and the urethral catheterization was done, afterwards 3 points of support were produced with nylon thread 3-0, involving the urethra and the external portion of the penis. Subsequently, it was incised 1/3 of the protruded mucous membrane (from a support point to the other) with a pair of iris scissors and the aid of a toothless Adson clamp. Promptly the anastomotic synthesis was manufactured with a simple interrupted suture pattern. By the end of the first one third theremaining ones with go under the same procedure and in the end of the resection and anastomosis of the urethral prolapse the animal was submitted to a bilateral orchiectomy. At the immediate post-surgery it was established antibiotic therapy and the use of anti-inflammatory and painkiller, after 48 h of observation the animal was discharged from the hospital. As a therapeutic measure it was opted to continue with the use of antibiotics and anti-inflammatory, and then recommended the use of Elizabethan collar 24 h a day until the removing of the stitches. It was also recommended that the animal returned for a new evaluation thirteen days after of the procedure.Discussion: That being said, even being an unusual pathology, which the physiopathology is not completely clear, the urethral prolapse is of simple diagnosis, which is based on direct observation of the protruded mucous membrane and by obtaining information of possible factors that cause its appearance, such as genetic susceptibility, in the case of the animalfrom the current report, since it had the English Bulldog as genetic predecessor. Even though there are techniques less traumatic for its diminishing the chosen technique is the resection and anastomose of the protruded portion of the urethral mucous membrane, due to being simple, quick, effective and with lower rates of relapses. Proven by the result of total recovering of the animal and excellent post-surgery healing, not having relapses.Keywords: dog, surgery, urethra.


2015 ◽  
Vol 04 (03) ◽  
pp. 128-133
Author(s):  
Rashmi Rekha Bordoloi ◽  
Roonmoni Deka ◽  
Kunjalal Talukdar

Abstract Background and aims: Undescended testes or Cryptorchidism is a common congenital anomaly of male gonad. In this condition one or both testes fail to descend into the scrotum as the process of descent may get arrested at any point along its normal path. It is a common condition occurring in 1 in 500 individuals. Undescended testis carries a risk of developing seminoma and is prone to injury. Undescended testis also fails to produce mature spermatozoa leading to infertility. Materials and methods: Hundred perinatal human cadavers were collected and meticulously dissected. Results: Undescended testes were found in 30% cases. In 50% cases, left testis descended earlier than the right. Bilateral undescended testes (70%) were more common than unilateral (30%). Unilateral undescended testis was more common on right side (55.5%). Undescended testes were found in the abdomen in 19.61% of cases. In 50.98% of cases, they were located in the ingoina1region and in the remaining 29.41% of cases, they were found in the subinguinal position. Conclusion : The primary management of cryptorchidism is surgery which is called orchipexy and is usually performed in infancy. When the undescended testis is in the inguinal canal, hormone therapy is sometimes attempted and occasionally successful. Therefore through early diagnosis and surgical interventions, the undescended testes can be replaced to the scrotum that will ensure optimal fertility in adulthood and a considerable lessened risk of testicular carcinoma.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Tariq O. Abbas ◽  
Ahmed Hayati ◽  
Adel Ismail ◽  
Mansour Ali

Background. Undescended testis is one of the most common urological problems in children, affecting about 1% of boys at age of 1 year. Of these, about 20% have a nonpalpable testis with a very high probability that the testis is absent. This may have a significant impact on the possibility of malignancy in these testes, as well as on the later fertility of these subjects.Methods. We retrospectively analyzed the demographic and clinical findings, as well as immediate and 6-month outcomes, in 91 patients diagnosed with impalpable undescended testes between January 2006 and December 2010.Results. Of the 91 patients, 9 had bilateral and 82 had unilateral impalpable testes. All 100 testes were managed laparoscopically. The largest group of intra-abdominal testes in this series, 42 testes, was entering the internal ring; in these, laparoscopic exploration and standard open orchiopexy resulted in a 66% success rate. The total success rate was 63.3%.Conclusion. Laparoscopy is extremely useful in both the diagnosis and treatment of impalpable testes. Objectively measured mobility of the testis towards the contralateral internal inguinal ring is an excellent intraoperative indicator for type of orchiopexy. Standardization of management may increase the success rate of orchiopexy.


2008 ◽  
Vol 74 (1) ◽  
pp. 56-58
Author(s):  
Marcelo M. Ghersi ◽  
Sergio A. Carrillo ◽  
Payman Danielpour ◽  
Irvin Willis

Dermoids are mature teratomas lined with a stratified squamous epithelium. They are known to present anywhere in the body, mostly with minimal or no associated symptoms. The authors present the case of a 44-year-old man who presented with an acute abdomen suggestive of appendiceal disease. On surgical exploration, the patient was found to have an inflamed cystic lesion in the mesoappendix that was resected and diagnosed as a dermoid cyst on pathological examination. This is the seventh case in the literature of a periappendiceal dermoid, but the first that presents in such a manner. This report is presented because of its important clinical applications for the general surgeon.


2021 ◽  
Vol 10 (8) ◽  
pp. 1790
Author(s):  
Yun-Suk Choi ◽  
Yoon-Seok Heo ◽  
Jin-Wook Yi

Background: Perforated peptic ulcer (PPU) is a disease whose incidence is decreasing. However, PPU still requires emergency surgery. The aim of this study was to review the clinical characteristics of patients who received primary repair for PPU and identify the predisposing factors associated with severe complications. Method: From January 2011 to December 2020, a total of 75 patients underwent primary repair for PPU in our hospital. We reviewed the patients’ data, including general characteristics and perioperative complications. Surgical complications were evaluated using the Clavien-Dindo Classification (CDC) system, with which we classified patients into the mild complication (CDC 0–III, n = 61) and severe complication (CDC IV–V, n = 14) groups. Result: Fifty patients had gastric perforation, and twenty-five patients had duodenal perforation. Among surgical complications, leakage or fistula were the most common (5/75, 6.7%), followed by wound problems (4/75, 5.3%). Of the medical complications, infection (9/75, 12%) and pulmonary disorder (7/75, 9.3%) were common. Eight patients died within thirty days after surgery (8/75, 10.7%). Liver cirrhosis was the most significant predisposing factor for severe complications (HR = 44.392, p = 0.003). Conclusion: PPU is still a surgically important disease that has significant mortality, above 10%. Liver cirrhosis is the most important underlying disease associated with severe complications.


Author(s):  
Haider Osman Elmisbah ◽  
Fay Melfi Sayer Alenezi ◽  
Raghad Khalid R. Alruwaili ◽  
Sama Abdulfattah M. Almadani

Cryptorchidism (undescended testis, maldescendus testis) is a disorder in which one or together testes miscarry to slope into the bottommost of the scrotum. The study aimed to summarize the updated evidence regards, epidemiology, etiology, classification, diagnosis, and treatments of Cryptorchidism or undescended testis. Several causes can result in developing cryptorchidism. Disruption of any phase of testicular prolapse due to genetic hormonal, structural, ecological, or social issues can lead to cryptorchidism. The diagnosis of undescended testes is clinical. The test should be performed by an experienced person and should always be performed using a two-way technique. In some cases, imaging diagnostics for cryptorchidism may be helpful. The rationale for treating cryptorchidism is to reduce the risk of its long-term consequences. Current treatments for undescended testes include hormone therapy, orchopexy, and surgical correction.


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