scholarly journals Penile fracture; three years’ experience from a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 553
Author(s):  
Hanief Mohamed Dar ◽  
Tariq Ahmed Mala ◽  
Yaqoob Hassan ◽  
Shahid Amin Malla ◽  
Mir Mujtaba Ahmad ◽  
...  
Keyword(s):  
Sexual Intercourse ◽  
General Surgery ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Urethral Injury ◽  
Time Interval ◽  
Tertiary Care Centre ◽  
Penile Fracture ◽  
Early Management ◽  
Surgery Department

Background: To study cause, presentation, diagnosis and early management of penile fracture and to prevent the complications.Methods: In this study 48 patients of penile fracture were included in the study who were admitted in general surgery department at Government Medical College Srinagar from May 2007 to May 2010. All patients were evaluated with detailed history, clinical examination and baseline investigations followed by immediate surgical repair.Results: Age range of patients was 21-75 years. Youngest being 21 years and eldest being 75 years (median-30 years). 38(79.1%) patients were married while as 10(20.9%) patients were unmarried. Sexual intercourse was main cause, seen in 41(85.4%) of patients, aggressive masturbation in 5(10.4%) patients and rolling over in bed during erection was seen in 3(6.2%) patients. All patients presented in general surgery department with complaints of pain and swelling in penile region. Time interval between injury and presentation to the department ranged from 4-24 hours (mean 11 hours). Isolated cavernosa injury was seen in 43 (89.6%) patients, while as 5 (10.4%) patients were having associated urethral injury (3 were having partial injury and 2 complete urethral disruption). There was a ventral rent in 31(64.6%) patients and lateral rent in17 (35.4%). Size of tear in tunica albuginea was less than 1cms in 19(39.6%) patients, 1-2cm in 17(35.4) patients and more than 2cms in 12 (25%) patients. Patients were discharged on 2-5 days (mean 3.1 days). There were no immediate postoperative complications. 2 (4.1%) patients had pricking sensation at repair site, 1(2.05%) patient had pain during erection and 2 (4.01%) patients had mild deviation during erection on follow up.Conclusions: Penile fracture is a relatively rare urological emergency which mostly occurs during sexual intercourse or aggressive masturbation and is usually a clinical diagnosis. Early surgical repair avoids complications and preserves both sexual and voiding functions.

scholarly journals Approach to management of penile fracture- Our Three-year experience at a Teaching Hospital

2021 ◽  
Vol 24 (1) ◽  
pp. 10-13
Author(s):  
Sunil Basukala ◽  
Narayan Thapa ◽  
Bikash Bahadur Rayamajhi ◽  
Bikram Basukala ◽  
Saurav Karki
Keyword(s):  
Teaching Hospital ◽  
Clinical Presentation ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Time Interval ◽  
Penile Fracture ◽  
Presenting Symptoms ◽  
Presentation Time ◽  
Manual Manipulation ◽  
Penile Hematoma

Introduction: Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a rupture of both masses is an uncommon finding. We conducted this study to determine the etiology, clinical presentation and to review the causes and management of penile fracture. Methods: The retrospective study was carried out on 17 patients, admitted in the department of Urosurgery from January 2017 to December 2020 with penile fracture in a tertiary care teaching hospital in Kathmandu. Patient demographic profile, etiology, clinical presentation, time interval from injury to presentation, investigation done, treatment given and intraoperative findings were analyzed. Results: The main cause of penile fractures was sexual intercourse (82.35%) followed by manual manipulation (17.65%). Crackling sound (100%) followed by penile hematoma and pain were the most common presenting symptoms among the patients.  Surgical exploration and repair of injury was done in all patients. Conclusion: Most of the time diagnosis of penile fracture can be made reliably by history and physical examination. Early surgical intervention is associated with a good outcome, regardless of the timing of presentation.

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

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Ibrahim Alnadhari ◽  
Osama Abdelhaleem Abdeljaleel ◽  
Venkata Ramana Pai Sampige ◽  
Ausama Abdulmuhsin ◽  
Ahmad Shamsodini
Keyword(s):  
Blunt Trauma ◽  
Sexual Intercourse ◽  
Rare Case ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
Corpora Cavernosa ◽  
Retrograde Urethrogram ◽  
Proximal Urethra ◽  
Urethral 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.

scholarly journals Case Report: Double penile fracture

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1828
Author(s):  
Felipe Mercado-Olivares ◽  
J. Antonio Grandez-Urbina ◽  
Giomar Farfan-Daza ◽  
Juan Pacheco-Sauñe ◽  
Luciano Nuñez-Bragayrac
Keyword(s):  
Tunica Albuginea ◽  
Young Male ◽  
Successful Outcome ◽  
Urethral Injury ◽  
Penile Shaft ◽  
Post Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
The Third ◽  
Corpora Cavernosa

Penile fracture is an underreported surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture of both masses is an uncommon finding. We report a case of a young male who presented to the emergency department two hours after sustaining penile trauma. Prompt surgical exploration was performed four hours post-injury. He was found to have one fracture on each corpora cavernosa, without urethral injury, which were repaired successfully. The patient had a favorable recovery and was discharged on the third postoperative day without complications. The aim of this report is to highlight the importance of complete degloving of the penile shaft for a meticulous search during surgery to avoid missed injuries. This approach will ensure a successful outcome avoiding physical and psychological disabilities.

Endoscopic Retrograde Cholangiopancreatography in General Surgery: How Much are We Outsourcing?

2009 ◽  
Vol 75 (11) ◽  
pp. 1050-1053
Author(s):  
Wesley B. Jones ◽  
Richard H. Roettger ◽  
William S. Cobb ◽  
Alfredo M. Carbonell
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Surgical Patients ◽  
Time Interval ◽  
Endoscopic Retrograde ◽  
Care Surgery ◽  
Surgery Department ◽  
Nonsurgical Patients

Although surgeons can safely perform endoscopic retrograde cholangiopancreatography (ERCP), it has fallen within the domain of gastroenterologists. We sought to quantify the role of ERCP in a tertiary-care surgery department. The hospital discharge database was queried for all ERCPs performed from January 2007 to December 2007. Gastroenterologists performed all ERCPs in our query. Surgical patients were admitted and/or under the care of a surgeon; whereas nonsurgical patients had no surgeon involvement. Patient characteristics and diagnoses were compared between groups. ERCP procedural details were recorded. Surgical patients comprised 48 per cent (n = 151) of the total 311 ERCPs performed. The mean time interval from a surgeon's request for ERCP to actual procedure was 2.43 days (standard deviation [SD] 2.55; range, 0-13 days). The surgical group had significantly different diagnoses and underwent less diagnostic (22% vs 56%) and more therapeutic ERCPs (72% vs 38%). Surgical patients were more likely inpatients (82.1% vs 16.8%) with a longer length of stay (6.7 vs 3.9 days; P = 0.0029) compared with nonsurgical patients. We found surgical patients requiring ERCP differ significantly from nonsurgical patients, with a significant number of technical interventions being outsourced. Given the benefits of a surgical ERCP program and the potential volume of these unique patients, this procedure should be performed by appropriately trained surgeons.

scholarly journals Changing patterns of first medical contact management profile of corneal ulcers in a developing country: a hospital-based study

2020 ◽  
Vol 9 (1) ◽  
pp. 216
Author(s):  
Santosh Kumar ◽  
Vijay K. Sharma
Keyword(s):  
Tertiary Care ◽  
Statistical Correlation ◽  
North India ◽  
Time Interval ◽  
Eye Drops ◽  
Fungal Culture ◽  
Infectious Keratitis ◽  
Tertiary Care Centre ◽  
Changing Patterns ◽  
First Contact

Background: Infectious keratitis is a major cause of corneal blindness throughout the world. There are guidelines and protocols for management of infectious keratitis, but these are rarely practiced by the treating physician. The aim of this study is to find the first medical contact management profile in a tertiary care Centre in north India and compare it to the previous studies to see the changing patterns of first contact management in our country.Methods: The data for the study was collected by retrospective data review of 100 consecutive patients with infectious keratitis. Various parameters were studied and statistical correlation established, where it was felt necessary. The parameters were age and sex distribution, first medical contact, initial treatment prescribed, time interval for first medical contact, inciting factors for corneal ulcer, bacterial and fungal culture spectrum, visual recovery after medical and surgical treatment.Results: Data review of 100 consecutive patients with infectious keratitis was done. More than 70% of patients were above 40 years of age. In 54% of patients, no inciting agent could be identified. The first medical contact for majority of patients was ophthalmologists in independent practice (48%). Time interval for first contact to any health professional varied from one day to 75 days with mean 4.63 days. Moxifloxacin hydrochloride   eye drops was the most commonly used drug.   Staphylococcus epidermidis was the commonest isolate grown in the culture (38.9%).Conclusions: Early diagnosis and appropriate management of infectious keratitis is important and role of first medical contact of patient is most crucial in final outcome.

scholarly journals Prevalence of surgical site infection in general surgery in a tertiary care centre in India

2017 ◽  
Vol 4 (9) ◽  
pp. 3101 ◽  
Author(s):  
Ansul Kumar ◽  
Arpita Rai
Keyword(s):  
Surgical Site Infection ◽  
General Surgery ◽  
Surgical Procedure ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Exploratory Laparotomy ◽  
Site Infection ◽  
Tertiary Care Centre ◽  
One Year

Background: Surgical site infection (SSI) can be defined as an infection that is present up to 30 days after a surgical procedure if no implants are placed and up to one year if an implantable device was placed in the patient. SSI is a significant problem associated with major surgeries and is the 3rd most frequently reported nosocomial infection. This study aims to study the prevalence of SSI in the Department of Surgery, Rajendra Institute of Medical Sciences (RIMS), Ranchi.Methods: A retrospective study was undertaken at the Department of General Surgery for a period of one year. Retrospective chart review was conducted from the hospital database. The rate of SSI was studied in relation to its type, the type of surgical procedure and elective vs emergency surgeries.Results: The present study revealed 12.5% prevalence of SSI in Department of General Surgery, RIMS. Among the 3 types, superficial incision SSI was most prevalent followed by deep incisional SSI and finally by organ/space SSI. The surgical procedure most commonly associated with SSI was exploratory laparotomy. An alarming 17.7% of SSI was associated with emergency surgeries as compared to 12.5% of elective surgeries.Conclusions: The consequences of SSIs greatly impact patients and the healthcare systems. Prevention of SSI requires a multifaceted approach targeting pre-, intra-, and postoperative factors. It is imperative that facilities have open-minded management teams, regulatory agencies and medical associations that want to provide the foundation required to generate a culture of patient safety in our health care systems.

scholarly journals Non sex-related subtotal rupture of the corpus cavernosum without urethral injury: A case report and literature review

2016 ◽  
Vol 88 (3) ◽  
pp. 233 ◽  
Author(s):  
Zeki Bayraktar ◽  
Selami Albayrak
Keyword(s):  
Surgical Repair ◽  
Tunica Albuginea ◽  
Correct Diagnosis ◽  
Corpus Cavernosum ◽  
Early Surgery ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Minimal Rate ◽  
The Right

Although penile fracture is a rare case, it is a well-described urologic emergency. It results from the rupture of the tunica albuginea of corpora cavernosa by blunt strain that commonly mandates immediate surgical exploration. Urethral injury may also accompany penile fracture. An ideal anamnesis and a special physical examination were determinant to achieve a correct diagnosis. It is usually diagnosed based on clinical examination, but ultrasonography can be very helpful in diagnosis. The treatment is based on the presence of associated urethral injury. Early surgery is preferable to conservative management, because it is associated with better outcomes and fewer long-term complications. The surgical repair of cavernous body can produce good results, with a favorable prognosis and minimal rate of complications. We present a penile fracture case of 34-year-old with subtotal rupture of the right corpus cavernosum without urethral injury who treated by early surgery and good results.

scholarly journals Lens-Induced Glaucoma: The Need to Spread Awareness about Early Management of Cataract among Rural Population

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Raghunandan Kothari ◽  
Sandeep Tathe ◽  
Pratik Gogri ◽  
Akshay Bhandari
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Tertiary Care ◽  
Late Presentation ◽  
Rural India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Current Management ◽  
Early Management ◽  
Phacolytic Glaucoma

Purpose. To determine the clinical profile of lens-induced glaucoma (LIG), reasons for late presentation, and outcome of current management. Methods. Retrospective analysis of 50 eyes with LIG over a 6-year period between 2005 and 2011 at a tertiary care centre in rural India. Visual acuity and intraocular pressure (IOP) were assessed preoperatively and postoperatively along with postoperative complications. Results. Fifty (2.4%) of 12,004 senile cataracts operated at Pravara Rural Hospital, Loni, presented with LIG. There were 39 (78%) phacomorphic cases and 11 (22%) phacolytic glaucoma. Following cataract surgery, 21 of 50 operated eyes (42%) had visual acuity 6/60 or worse. Conclusion. The results highlight the importance of early diagnosis and treatment of visually disabling cataract. There is a need to educate both the patient and the cataract surgeon about the dangers of lens-induced glaucoma and of about poor outcome if treatment is delayed.

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