scholarly journals OUTCOMES OF SURGICAL MANAGEMENT OF FRACTURE PENIS: EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN BANGLADESH

2019 ◽  
Vol 5 (4) ◽  
pp. 122-130
Author(s):  
Md. Selim Morshed ◽  
AKM Musa Bhuyian ◽  
Mohammad Saruar Alam ◽  
Md. Towhid Belal ◽  
Sayem Hossain ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Surgical Repair ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Self Report ◽  
Care Hospital ◽  
Penile Fracture ◽  
Uncommon Presentation

Background: Penile fracture is an emergency and uncommon presentation to the urology department. Immediate surgical repair can be a standard of care for patients with penile fracture. Objective: The study was conducted to evaluate the outcome of surgical repair of the fractured penis.Methods: This quasi-experimental study was conducted from Jan 2017 to Dec 2018 in the urology department of Dhaka Medical College Hospital, Bangladesh. Thirty-five patients with fractures of the penis were included in this study. After proper evaluation, surgery was performed under spinal anesthesia. Follow up was scheduled at 6th week, 3rd month, and 6th month. We used validated questionnaires of the ‘International index of erectile function (IIEF-5)’ for married and ‘Single question self-report (SQSR)’ for unmarried patients to evaluate postoperative erectile function.Results: Total 35 patients completed three follow up. The mean age of patients was 36.4 years, and 88% of them were married. The most common triggers were for vigorous sexual intercourse (68.5%) followed by history of rolling over in bed with erect penis (20.0%). Per-operative findings were: rupture of tunica albuginea (100%); rupture of corpora cavernosa on the right (65.7%). After 6th month, 28 patients (80%) were able to maintain their normal erectile function. However, seven patients developed erectile dysfunction, of which 4 had a mild form, and 3 had mild to moderate form erectile dysfunction. All patients complained of pain during or after intercourse, but the pain has gradually subsided with time.Conclusion: Immediate surgical exploration and repair of fracture penis can offer complete recovery of sexual and voiding functions.

Penile fracture and investigation of early surgical repair effects on erectile dysfunction

2019 ◽  
Vol 86 (4) ◽  
pp. 207-210
Author(s):  
Bulent Kati ◽  
Yigit Akin ◽  
Mehmet Demir ◽  
Omer Faruk Boran ◽  
Kemal Gumus ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Surgical Repair ◽  
Urethral Injury ◽  
Penile Curvature ◽  
Penile Fracture ◽  
Direct Trauma ◽  
Significant Difference ◽  
The Mean ◽  
Erect Penis

Objectives: Penile fracture is one of the urological emergencies caused by direct trauma to an erect penis during sexual intercourse, which results in a tear in the tunica albuginea within the corpus cavernosum. Serious complications such as penile curvature and erectile dysfunction may develop due to inappropriate and/or late surgical repair. This study aims to evaluate patients with penile fracture and to describe their demographics, surgical repairs, and long-term outcomes. Materials and Methods: A total of 56 patients who were diagnosed with penile fracture between January 2012 and June 2017 were reviewed. Clinical features, pre-operative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Early surgical management was performed. Outcomes, including International Index of Erectile Function 5 pre-operation and after 6 months, were evaluated. Results: The mean age was 30.2 (18–57) years. In etiological questionnaires, 32 (57.2%) patients reported direct trauma to an erect penis during intercourse. The mean size of tunica defects was 1.61 ± 0.42 (0.3–3.6) cm of the nine (16%) patients, and penile fracture was associated with urethral injury. There was no significant difference in International Index of Erectile Function 5 scores before the surgery and 6 months after surgery. Penile skin necrosis developed in one patient 10 days post-operation. Conclusion: Early surgical repair could be an effective method of achieving post-operative erection success in patients with penile fracture due to direct trauma during intercourse.

scholarly journals Penile fracture with urethral injury: Our experience in a tertiary care hospital

2019 ◽  
Vol 90 (4) ◽  
pp. 283-287
Author(s):  
Priyatham Kasaraneni ◽  
Prasad Mylarappa ◽  
Ramesh Desi Gowda ◽  
Sandeep Puvvada ◽  
Dheeraj Kasaraneni
Keyword(s):  
Tertiary Care ◽  
Urethral Injury ◽  
Common Mechanism ◽  
Care Hospital ◽  
Penile Fracture ◽  
Urethral Trauma ◽  
Effective Option ◽  
Urological Emergency ◽  
Local Examination

Penile fracture is a rare urological emergency that always requires immediate attention. It may be associated with urethral trauma in 9% to 20% of cases. We present our experience in treating 12 such cases. This is a prospective observational study extending from January 2000 to December 2016. Each patient with penile fracture underwent a thorough clinical evaluation and received proper treatment. Seventy-five patients with penile fracture, aged 25 to 36 years (mean, 31.5 years) were evaluated in this study. Sexual intercourse was the common mechanism of injury in most of the patients. 12 of the patients had associated urethral injury. All the patients were diagnosed on taking proper history and after clinical examination. All patients were subjected emergency surgical exploration. All the patients underwent minimum of 1 year of follow-up, and were evaluated with local examination, uroflowmetry and Colour Doppler ultrasonography. Penile fracture is associated with urethral injury especially in the presence of suggestive history and physical examination like acute urinary retention, bleeding per urethra. Immediate primary surgical management of both the penile fracture and urethral injury is a safe and effective option with minimal complications.

scholarly journals Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review

2013 ◽  
Vol 5 (2) ◽  
pp. 23
Author(s):  
Nathan A. Hoag ◽  
Kiara Hennessey ◽  
Alan So
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Erectile Function ◽  
Surgical Repair ◽  
Review Of The Literature ◽  
Penile Fracture ◽  
Rare Injury ◽  
Surgical Exploration ◽  
Corpora Cavernosa

Penile fracture is a rare injury most commonly sustained duringsexual intercourse. We report the case of a 35-year-old man whopresented with bilateral rupture of the corpora cavernosa andcomplete disruption of the urethra. A review of the literature onpenile fracture is also presented. Urgent surgical exploration wasperformed and the injuries repaired primarily. In follow-up, thepatient reported satisfactory erectile function. This case highlightsthe importance of early surgical repair and evaluation for concomitanturethral injuries in cases of penile fracture.

scholarly journals Penile fracture and associated urethral injury: Experience at a tertiary care hospital

2013 ◽  
Vol 7 (3-4) ◽  
pp. E168-170 ◽  
Author(s):  
Amit Attam ◽  
Arun Kerketta ◽  
Bharat Behera ◽  
Navin Ram ◽  
Sameer Trivedi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Urethral Injury ◽  
Care Hospital ◽  
Penile Fracture ◽  
Urethral Trauma ◽  
Typical History ◽  
The Mean ◽  
High Level ◽  
Good Flow

Introduction: Penile fracture may be associated with urethral trauma in 1% to 38% of cases. We present our experience in treating 8 such cases.Methods: Data were collected retrospectively from hospital records and from out-patient department follow-up visits.Results: The mean age of the patients was 30.4 years; trauma during coitus was the most common cause of the penile fracture. One patient presented after 7 days. Two patients had normal examination of their penis despite typical history. All fractures were repaired on an emergency basis via subcoronal incision. In 2 patients with normal findings, the urethra had to be mobilized to locate the site of the injury. In 1 patient, the site of the urethral trauma was 1 cm away from the site of the corporal injury, which was localized by injecting sterile methylene blue per urethra. Postoperatively, all patients voided with good flow and had erections with adequate rigidity.Conclusion: A high level of suspicion for urethral injury during surgical exploration is warranted, especially in the presence of suggestive history and examination.

scholarly journals Penile Fracture : Experience from a Tertiary Care Hospital

2019 ◽  
Vol 6 ◽  
Author(s):  
Malik Suhail Ahmad ◽  
Irfan Nazir Mir ◽  
Malik Faizan Abbass
Keyword(s):  
Tunica Albuginea ◽  
Tertiary Care ◽  
Corpus Cavernosum ◽  
Care Hospital ◽  
Postoperative Complication Rate ◽  
Penile Fracture ◽  
Jammu And Kashmir ◽  
History Of ◽  
The Mean ◽  
Erect Penis

Introduction: Penile fracture is a misnomer,penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination.standard mode of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital srinagar ,(Jammu and Kashmir), extending over a period of about three and a half years from june 2013 to January 2017 . All patients with diagnosed penile fracture were included in this study. All except one patient were operated one the same day of admission.Results: out of a total of 50 patients studied ,the mean age of presentation was 26.7 years.Majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as cause of trauma,followed by vaginal intercourse in38% and rolling on erect penis in 20%.About 80% patients gave history of audible click/crackling sound.All patients had swelling and discolouration on examination,90% patients had penile deformity,only 36 % had palpable defect.Dopler USG was correct in 93% patients.Majority (44%) patients had defect less than 1cm.defect was mostly seen on right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of penile fracture.

scholarly journals Penile Fracture: Experience from a Third World Country

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Rajandeep Singh Bali ◽  
Arshad Rashid ◽  
Majid Mushtaque ◽  
Shakeeb Nabi ◽  
Sajad Ahmad Thakur ◽  
...  
Keyword(s):  
Third World ◽  
Clinical Presentation ◽  
Surgical Repair ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Findings ◽  
Urethral Injury ◽  
Care Hospital ◽  
Penile Fracture ◽  
Third World Country

Aim. To ascertain the clinical presentation, commonest age group affected, and treatment of patients diagnosed to have penis fracture.Materials and Methods. We performed a retrospective study carried at a tertiary care hospital from January 2005 to January 2011. All the 36 patients diagnosed to have penile fracture were enrolled in the study group. The diagnosis was made based on the clinical findings in the patients. All, except two patients, were managed by a standard surgical procedure, same for all the patients, on the day of presentation to the hospital. All the data pertaining to the presentation, management, and followup of these patients were studied and scrutinized thoroughly.Results. Thirty-four patients were operated while 2 refused surgery. Most of our patients were between 16 and 30 years (55.6%) of age. The commonest presenting complaints were penile swelling and detumescence during sexual intercourse or an erection. All except two of our patients were managed with immediate surgical repair which had excellent results even in the presence of associated urethral injury.Conclusion. Fracture of the penis is a surgical emergency which can be best managed by immediate surgical repair with excellent results even in the presence of urethral injury.

Chemo-prophylaxis of COVID-19 with hydroxychloroquine: a study of health care workers attitude, adherence to regime and toxicities/side effects (Preprint)

2020 ◽  
Author(s):  
Debajyoti Bhattacharyya ◽  
Neeraj Raizada ◽  
Bharathnag Nagappa ◽  
Arvind Tomar ◽  
Prateek Maurya ◽  
...  
Keyword(s):  
Side Effects ◽  
Health Care Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perceived Threat ◽  
Care Hospital ◽  
Care Workers ◽  
Perceived Danger ◽  
Structured Questionnaire

BACKGROUND There are apprehensions among healthcare worker (HCWs) about COVID-19. The HCWs have been given hydroxychloroquine (HCQ) chemo-prophylaxis for seven weeks as per Government of India guidelines. OBJECTIVE To assess the apprehensions among HCWs about COVID-19 and to document accessibility, adherence and side effects related to HCQ prophylaxis in HCWs. METHODS A longitudinal follow up study was conducted in a tertiary care hospital. HCQ was given in the dose of 400 mg twice on day one, and then 400 mg weekly for seven weeks. 391 HCWs were interviewed using semi structured questionnaire. RESULTS 62.2% HCWs expressed perceived danger posted by COVID-19 infection. Doctors (54%) showed least acceptance and paramedics (88%) showed highest acceptance to chemo-prophylaxis. 17.5% participants developed at least one of the side effects to HCQ. Females and nursing profession were significantly associated with adverse effects. Common side effects were gastro-intestinal symptoms, headache and abnormal mood change. Most of these were mild, not requiring any intervention. Gender, professions and perceived threat of COVID-19 were significantly associated with acceptance and adherence to HCQ prophylaxis. CONCLUSIONS Two third of HCWs had perceived danger due to COVID-19. Three fourth of the HCWs accepted chemo-prophylaxis and four out of five who accepted had complete adherence to prophylaxis schedule. One out of five had developed at least one of side effects; however, most of these were mild not requiring any intervention.

scholarly journals Incidence of valvular regurgitation and leaflet perforation by using automated titanium fasteners (CORKNOT®) in heart valve repair or replacement: less usual than reported

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Faizus Sazzad ◽  
Ong Zhi Xian ◽  
Ashlynn Ler ◽  
Chang Guohao ◽  
Kang Giap Swee ◽  
...  
Keyword(s):  
Heart Valve ◽  
Operative Time ◽  
Tertiary Care ◽  
Paravalvular Leak ◽  
Valvular Regurgitation ◽  
Care Hospital ◽  
Valve Repair ◽  
Replacement Surgery ◽  
Triple Valve

Abstract Background CORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries. Methods Patients who underwent heart valve repair or replacement surgery via the use of automated titanium suture fasteners (CORKNOT®) in a tertiary care hospital were included in the study. This single-centre retrospective study was conducted on 132 patients between January 2016 and June 2018. Results In our study, the overall mean operative time was 320.0 ± 97.0 min, mean CPB time was 171.4 ± 76.0 min and the calculated mean ACC time was 105.9 ± 54.0 min. Fifty-eight patients (43.9%) underwent minimally invasive valve replacement or repair surgery and 66 patients (50.0%) underwent concomitant procedures. A total of 157 valves were operated on, with 112 (84.8%) single valve surgeries, 15 (11.4%) double valve surgeries and 5 (3.8%) triple valve surgeries. After reviewed by the cardiologist blinded towards the study, we report trivial and/or mild paravalvular leak (PVL) in immediate post-operative echocardiography was found in 1 (1.01%) patients. There were no reported cases of valvular thrombosis, leaflet perforation, device dislodgement or embolization, moderate and/or severe PVL during hospitalization and follow-up echocardiography within 1 year. Single mitral valve and aortic surgeries had comparable incidences of post surgical complications. Conclusion We conclude the feasibility of CORKNOT® utilisation in mitral and aortic valve surgeries. Additionally, incidence of CORKNOT® related complications in heart valve repair or replacement surgery is less usual in our setting than previously reported. These results motivate the use of CORKNOT® as a valid alternative with complete commitment.

scholarly journals 99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S180
Author(s):  
Thana Khawcharoenporn ◽  
Pimjira Kanoktipakorn
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Extended Spectrum Beta Lactamase ◽  
Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

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