International journal of urology : official journal of the Japanese Urological Association
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Traumatic lesions to the penis may extend into the corpus spongiosum, causing laceration or complete transection of the urethra. Blunt penile trauma is usually related to sexual intercourse or manipulation. The aim of this paper was to report the authors experience with the management of urethral injuries in patients with penile blunt trauma. ⋯ The data support the reported incidence of urethral injury associated with blunt penile trauma. No clinically apparent urethral structures were appreciated with primary urethral repair after a follow up of more than 6 months.
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Randomized Controlled Trial Comparative Study
General versus spinal anesthesia with different forms of sedation in patients undergoing radical retropubic prostatectomy: results of a prospective, randomized study.
To assess the impact of spinal anesthesia (SpA) combined with three different forms of conscious sedation on intraoperative and postoperative outcome in patients undergoing radical retropubic prostatectomy (RRP) for organ confined prostate cancer (pCa). ⋯ Conscious sedation coupled with SpA is a safe, reliable and effective procedure for patients undergoing RRP. The use of propofol as sedative agent offers several advantages both over other types of conscious sedation and general anesthesia.
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Multicenter Study Comparative Study
Challenge of percutaneous nephrolithotomy in patients with spinal neuropathy.
To assess the technical difficulties, associated complications and stone clearance rates in patients with spinal neuropathy undergoing percutaneous nephrolithotomy. ⋯ Patients with spinal neuropathy and renal lithiasis pose a significant operative challenge. Technical difficulties and potential complications should be considered carefully before undertaking percutaneous nephrolithotomy in these patients.
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Comparative Study
Virtual reality ureteroscopy simulator as a valid tool for assessing endourological skills.
Virtual reality (VR) simulators are now commercially available for various surgical skills training. The Uro Mentor VR Ureteroscopy Simulator by Symbionix is one system that may revolutionize the way we assess and teach surgical residents. Surgical educators may no longer have to depend on the operating room as the sole venue for teaching residents technical skills. We validated performance on this new system with previously developed assessment tools and compared it to performance on a high fidelity ureteroscopy bench model. ⋯ The Uro Mentor VR Ureteroscopy Simulator is a useful tool in assessing resident endourological skills. Performance on the VR simulator is comparable to a validated high fidelity ureteroscopy bench model. Future studies will assess the utility of VR simulators in surgical skills training.
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Primary adrenal lymphoma (PAL) is an extremely rare neoplasm of T-cell origin. Here we describe a 42-year-old woman who suffered from intermittent fevers and night sweats of 3 months duration. Laboratory results, imaging, pathology, and immunohistological examination led to a final diagnosis of primary adrenal T-cell lymphoma (PATL) with adrenal insufficiency. ⋯ Most reported PAL patients who have received only one therapeutic modality have unsatisfactory survival rates resulting from tumor recurrence and/or postchemotherapy infections. In contrast, one patient who received an adrenectomy followed by low-dose radiotherapy experienced long-term survival. A combination of therapeutic modalities may improve prognosis for patients with PATL, although the case numbers are too small to draw any conclusions.