DOCSLIB.ORG

What Can Wrong with Your Willy?

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
What Can Wrong with Your Willy? WHAT CAN WRONG WITH YOUR WILLY? ANDREW LIENERT UROLOGIST ONESIXONE UROLOGY 161 GILLIES AVE, AUCKLAND IT CAN BEND IT CAN BREAK IT CAN GROW IT CAN SHRINK YOU CAN DECORATE IT PENILE CONDITIONS Foreskin + glans Shaft + corpora - phimosis - SCC - paraphimosis - balanitis - fordyce spots - frenular tear - fracture - skin bridges - peyronie’s - SCC - priapism - BXO - pearly papules - trauma - veruca - smegma PENILE ANATOMY PHIMOSIS PHIMOSIS: CHILDREN PHYSIOLOGICAL PATHOLOGICAL PHIMOSIS: CHILDREN TREATMENT PHYSIOLOGICAL PATHOLOGICAL - 95% newborns have - Infection phimosis - 10% 4 yr olds - Pain - ‘Ballooning’ common - Tight white band - Steroid cream - Less likely to - 0.05% betamethasone resolve with cream - 1% hydrocortisone - Apply BD 4-6 weeks - 60-90% success - ‘Stretching’ - circumcision PHIMOSIS: ADULT - Usually due to balitiis xerotica obliterans (BXO) or chronic infection / inflammation from poor hygiene or incontinence - BXO Beware of a - Male equivalent of lichen sclerosis tumour beneath - Chronic inflammation leading to fibrosis - White bands or patches a phimosis in - Thickening of skin older men - phimosis - Unlikely to resolve with steroids - Can trial if only minor scarring - Circumcision usually necessary BXO BALANITIS / POSTHITIS BALANITIS: INFECTIVE BALANITIS: INFECTIVE Organisms: - streptococcus most common - fungal - STI’s: Herpes, syphilis, gonorrhoea Treatment: - swab; especially if there is pus - antifungal or antibiotic; ?both - may be difficult to distinguish from non-infective causes so can consider steroid as well - should respond within 1-2 weeks BALANITIS: NONINFECTIVE Zoon’s Balanitis Drug reaction Allergic reaction (tetracycline) BALANITIS: KEY POINTS 1. It is hard to determine cause and treatment may have to be ‘best guess’ 2. Consider biopsy if: a. No response to treatment b. Raised, ulcerated lesions TIGHT FRENULUM May tear and bleed or cause pain during intercourse Frenuloplasty is treatment of choice SKIN BRIDGES PEARLY PENILE PAPULES These are not STDs Found in 30% uncircumcised men Can be treated although generally this is not necessary SMEGMA PARAPHIMOSIS PARAPHIMOSIS WHAT WORKS WHAT DOESN’T Manual reduction Ice - requires quite a bit Salt of force! Aspirating - Painful ‘popping the cyst’ Leaving it alone! Dorsal slit PARAPHIMOSIS PARAPHIMOSIS: DORSAL SLIT GENITAL WARTS GENITAL WARTS - Caused by Human Papiloma virus - Virtually all sexually active adults have been exposed - Lifetime risk >80% - Most infections transient and asymptomatic - Most visible warts will resolve spontaneously - HPV 16 + 18 linked to penile cancer but rarely cause visible warts - But history of warts increases risk of penile cancer - Treatment: - Imiquimod (aldara) or podophylotoxin (condyline) - Cryotherapy / trichloroacetic acid - Laser therapy / Surgical excision - Assess / treat partner WARTS: WHICH TREATMENT? Observe Topical cream Cryo / TCA WARTS: WHICH TREATMENT? Surgical excision + / - Cream Likely to need multiple treatments PIERCINGS Prince Albert Ampalling Apadravya SCC PENIS SCC PENIS - LETHAL DISEASE - 50% 5 yr survival across all stages - If your worried refer for a biopsy - Risk factors: - Uncircumcised - Older age; rare below age 50 - Smoker - HPV and genital warts: RR 3.7 - HIV - Phimosis / poor hygeine / smegma build up SCC IN-SITU - Erythroplasia of queyrat - Bowenoid papulosis - Diagnose via biopsy - Treatment: - Effudix cream - Imiquimod cream Biopsy if: - Cryotherapy - MOHS microsurgery - No response to treatment - Raised / ulcerated - Significant risk factors SCC TREATMENT Should be completely excised to ensure accurate staging SCC: KEYPOINT If your suspicious that a lesion may be an SCC either biopsy or refer for a biopsy because SCC is a lethal disease which is usually curable if found early enough. FORDYCE SPOTS PENILE FRACTURE UROLOGICAL EMERGENCY Repair within 24 hours improves outcomes Classic history: Sudden pain during intercourse Immediate detumescence Early, rapid swelling and bruising of penile shaft PRIAPISM Sustained erection for >6hrs Urological emergency: leads to ischemia of corpora PRIAPISM - Risk factors: - Intra-cavernosal injections: alprostadil, papaverine - PDE-5 inhibitors: rarely cause this - Medication: antidepressants, antipsychotics - Recreational drugs: heroin / cocaine, ?alcohol - Sickle cell anemia - Hematological: Leukemia / thallasemia Prompt specialist management essential: permanent erectile dysfunction results if left for >24 hours PRIAPISM: INITIAL MANAGEMENT - Place 16g or 18g butterfly needle into corpora cavernosa near base of penis, approaching from lateral - Aspirate 10-20ml of blood - Leave butterfly needle in - If erection still present a few minutes later then aspirate again but this time inject alpha-agonist - Phenylephrine 1000mcg:1ml dilute to 10ml and inject 0.5- 1.0ml; i.e 50-100mcg dose - Need to monitor BP / pulse / ECG if possible - Repeat every 10-15mins for 1 hour - If unsuccessful then surgery required PEYRONIE’S DISEASE PEYRONIE’S PEYRONIE’S • Fibrosis of the corpora cavernosum leading to deformity of the erect penis • Penile trauma, especially during intercourse thought to be cause • Some weak data showing genetic association • Prevalence estimated at 1-3% • 30% of men with Peyronie’s also have erectile dysfunction • Associatted with other connective tissue disorders • Dupuytren’s PEYRONIE’S: NATURAL HISTORY ACTIVE PHASE CHRONIC PHASE • Lasts 6-12 months • No longer painful • Painful, tender • Bend stable plaque • Plaque may still be • Active inflammation palpable • Deformity may change with time • 20% improve • 40% worsen • 40% stay same PEYRONIE’S: TREATMENT IN ACTIVE PHASE PEYRONIE’S: TREATMENT IN ACTIVE PHASE ORAL INTRA-LESIONAL Vitamin E Verapamil Colchicine Interferons Collagenase Potassium aminobenzoate L-Arginine Pentoxifylline Steroids ESWL Tamoxifen Penile traction device PEYRONIE’S: TREATMENT IN ACTIVE PHASE ORAL INTRA-LESIONAL Vitamin E Verapamil Colchicine Interferons Collagenase Potassium aminobenzoate L-Arginine Pentoxifylline Steroids ESWL Tamoxifen Penile traction device PEYRONIE’S PEYRONIE’S: TREATMENT IN ACTIVE PHASE ORAL INTRA-LESIONAL Vitamin E Verapamil Colchicine Interferons Collagenase Potassium aminobenzoate L-Arginine Pentoxifylline Steroids ESWL Tamoxifen Penile traction device PEYRONIE’S: TREATMENT IN CHRONIC PHASE GOOD ERECTIONS POOR ERECTIONS • Plication • Penile prosthesis • Excision and grafting PENILE TRAUMA PENILE TRAUMA ZIPPER INJURY Zipper injury is the commonest cause of penile trauma AMPUTATION hjghghg bvgvb.
Load more

Recommended publications
  • The Male Reproductive System
    Management of Men’s Reproductive 3 Health Problems Men’s Reproductive Health Curriculum Management of Men’s Reproductive 3 Health Problems © 2003 EngenderHealth. All rights reserved. 440 Ninth Avenue New York, NY 10001 U.S.A. Telephone: 212-561-8000 Fax: 212-561-8067 e-mail: [email protected] www.engenderhealth.org This publication was made possible, in part, through support provided by the Office of Population, U.S. Agency for International Development (USAID), under the terms of cooperative agreement HRN-A-00-98-00042-00. The opinions expressed herein are those of the publisher and do not necessarily reflect the views of USAID. Cover design: Virginia Taddoni ISBN 1-885063-45-8 Printed in the United States of America. Printed on recycled paper. Library of Congress Cataloging-in-Publication Data Men’s reproductive health curriculum : management of men’s reproductive health problems. p. ; cm. Companion v. to: Introduction to men’s reproductive health services, and: Counseling and communicating with men. Includes bibliographical references. ISBN 1-885063-45-8 1. Andrology. 2. Human reproduction. 3. Generative organs, Male--Diseases--Treatment. I. EngenderHealth (Firm) II. Counseling and communicating with men. III. Title: Introduction to men’s reproductive health services. [DNLM: 1. Genital Diseases, Male. 2. Physical Examination--methods. 3. Reproductive Health Services. WJ 700 M5483 2003] QP253.M465 2003 616.6’5--dc22 2003063056 Contents Acknowledgments v Introduction vii 1 Disorders of the Male Reproductive System 1.1 The Male
    [Show full text]
  • Ultrasonography and Elastography Imaging
    Jemds.com Case Report Post Traumatic Hematocele - Ultrasonography and Elastography Imaging Shivesh Pandey1, Suresh Vasant Phatak2, Gopidi Sai Nidhi Reddy3, Apoorvi Bharat Shah4 1, 2, 3, 4 Department of Radio diagnosis, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra India. INTRODUCTION Hematocele with blunt scrotal trauma is an uncommon cause of the testicular pain. Corresponding Author: Elastography is the new recent advance in the field of ultrasound. USG and Dr. Suresh Vasant Phatak, elastography findings of the acute hematocele is described in this aricle. Department of Radiodiagnosis, Jawaharlal Testicular trauma is the third most common cause of acute scrotal pain,1 and Nehru Medical College, Sawangi (Meghe), high-frequency ultrasonography (USG) with a linear array transducer is the first Wardha, Maharashtra – 442001, India. E-mail: [email protected] preferred modality for testicular trauma evaluation. Extra testicular haematoceles or blood collections inside the tunica vaginalis are the most common findings in the DOI: 10.14260/jemds/2021/340 scrotum after blunt injury.2 On clinical assessment, haematocele appears as a hard mass like swelling and causes pain in the scrotum. In the majority of cases, How to Cite This Article: spontaneous resolution occurs with the support of conservative therapy,3 even if Pandey S, Phatak SV, Reddy GSN, et al. Post treated conservatively, may result in infection, discomfort, or atrophy in undiagnosed traumatic hematocele - usg and broad hematoceles and testicular hematomas over time.4 elastography imaging. J Evolution Med A testis with its coverings, epididymis, and spermatic cord are all contained in Dent Sci 2021;10(21):1636-1638, DOI: 10.14260/jemds/2021/340 each hemiscrotum.
    [Show full text]
  • AMERICAN ACADEMY of PEDIATRICS Circumcision Policy
    AMERICAN ACADEMY OF PEDIATRICS Task Force on Circumcision Circumcision Policy Statement ABSTRACT. Existing scientific evidence demonstrates the Australian College of Paediatrics emphasized potential medical benefits of newborn male circumci- that in all cases, the medical attendant should avoid sion; however, these data are not sufficient to recom- exaggeration of either risks or benefits of this proce- mend routine neonatal circumcision. In circumstances in dure.5 which there are potential benefits and risks, yet the pro- Because of the ongoing debate, as well as the pub- cedure is not essential to the child’s current well-being, lication of new research, it was appropriate to reeval- parents should determine what is in the best interest of the child. To make an informed choice, parents of all uate the issue of routine neonatal circumcision. This male infants should be given accurate and unbiased in- Task Force adopted an evidence-based approach to formation and be provided the opportunity to discuss analyzing the medical literature concerning circum- this decision. If a decision for circumcision is made, cision. The studies reviewed were obtained through procedural analgesia should be provided. a search of the English language medical literature from 1960 to the present and, additionally, through a ABBREVIATIONS. UTI, urinary tract infection; STD, sexually search of the bibliographies of the published studies. transmitted disease; NCHS, National Center for Health Statistics; DPNB, dorsal penile nerve block; SCCP, squamous cell carcinoma EPIDEMIOLOGY of the penis; HPV, human papilloma virus; HIV, human immu- nodeficiency virus. The percentage of male infants circumcised varies by geographic location, by religious affiliation, and, to some extent, by socioeconomic classification.
    [Show full text]
  • GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M Anual
    13 Male Reproductive System Disorders Vaunette Fay, PhD, RN, FNP-BC, GNP-BC GERIATRIC APPRoACH Normal Changes of Aging Male Reproductive System • Decreased testosterone level leads to increased estrogen-to-androgen ratio • Testicular atrophy • Decreased sperm motility; fertility reduced but extant • Increased incidence of gynecomastia Sexual function • Slowed arousal—increased time to achieve erection • Erection less firm, shorter lasting • Delayed ejaculation and decreased forcefulness at ejaculation • Longer interval to achieving subsequent erection Prostate • By fourth decade of life, stromal fibrous elements and glandular tissue hypertrophy, stimulated by dihydrotestosterone (DHT, the active androgen within the prostate); hyperplastic nodules enlarge in size, ultimately leading to urethral obstruction 398 GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M anual Clinical Implications History • Many men are overly sensitive about complaints of the male genitourinary system; men are often not inclined to initiate discussion, seek help; important to take active role in screening with an approach that is open, trustworthy, and nonjudgmental • Sexual function remains important to many men, even at ages over 80 • Lack of an available partner, poor health, erectile dysfunction, medication adverse effects, and lack of desire are the main reasons men do not continue to have sex • Acute and chronic alcohol use can lead to impotence in men • Nocturia is reported in 66% of patients over 65 – Due to impaired ability to concentrate urine, reduced
    [Show full text]
  • Assessment of Lower Urinary Tract Symptoms in Younger Men
    MEN’S HEALTH ASSESSMENT OF LOWER URINARY TRACT SYMPTOMS IN YOUNGER MEN Lower urinary tract symptoms (LUTS) are common in the ageing male and represent a significant burden on both the patient and the healthcare system worldwide. 1,2 Accordingly, the majority of clinical trials and guidelines focus on the older patient, despite the fact that men below these ages will also present with many of the same symptoms. In this review, the authors explore the challenges of assessing and managing men below 50 years with LUTS. Dr Odunayo The aetiology of LUTS is multifactorial with causes How common are LUTS Kalejaiye attributed to dysfunction of the bladder and its in younger men? Urology SpR outlet – including the prostate, urethra and sphincter; The EPIC study, 3 a population-based survey which the neurological innervation of the lower urinary recruited men aged over 18 years, found that the Professor tract, and medical co-morbidities.1,2 It is important prevalence of LUTS increased with age, from 51.3% Raj Persad to consider all these aspects when assessing patients. in men aged 18-39 years to 62% in those aged 40-59 While in older men, benign prostatic enlargement years. This is compared with a prevalence of 80.7% Consultant is the commonest cause of male LUTS, in younger in men aged 60 years or older. Storage symptoms Urologist; men this is unusual, and other diagnoses should be were commonest in men 39 years or younger, with a Honorary considered more likely. prevalence of 37.5%, compared with a prevalence of Professor of 19.9% for voiding symptoms in this age group.
    [Show full text]
  • Penile Fracture Anurag Chahal,1 Sahil Gupta,2 Chandan Das1
    Images in… BMJ Case Reports: first published as 10.1136/bcr-2016-215385 on 13 May 2016. Downloaded from Penile fracture Anurag Chahal,1 Sahil Gupta,2 Chandan Das1 1Department of DESCRIPTION Radiodiagnosis, All India A 32-year-old man presented to our emergency Institute of Medical Sciences, New Delhi, India department, with pain, swelling and a dorsal curva- 2Department of Surgical ture in his penis. He had severe pain and lost Disciplines, All India Institute tumescence with a snapping sound during vigorous of Medical Sciences, New sexual intercourse. On examination, he had a swel- Delhi, India ling with ecchymosis on the ventral aspect of his fi Correspondence to penis causing an acute dorsal angulation ( gure 1). Dr Sahil Gupta, There was no blood at the meatus/haematuria. [email protected] Taking the typical history and examination findings Figure 3 Ultrasound images showing ventral into account, the diagnosis of penile fracture was Accepted 1 May 2016 haematoma (H) displacing the corpus spongiosum (CS), made. Ultrasound showed a focal tear in the medial and central urethra (U) displaced towards the left with wall of the right corpora cavernosa with haema- the corpora cavernosa (CC) seen dorsally. toma tracking ventrally and displacing the corpora spongiosa to the other side (figures 2 and 3). The patient was taken for emergent haematoma diagnosis is usually clinical and requires prompt evacuation and corporal repair. surgical intervention.3 Sometimes, the presentation Penile fracture occurs when an erect penis under- may be occult and the patient may present with goes a blunt trauma during sexual intercourse or pain with or without swelling.
    [Show full text]
  • Bilateral Fracture of Corpora Cavernosa with Complete
    Rev. Fac. Med. 2018 Vol. 66 No. 4: 635-8 635 CASE REPORT DOI: http://dx.doi.org/10.15446/revfacmed.v66n4.65917 Bilateral fracture of corpora cavernosa with complete rupture of the anterior urethra: Case report and review of recent findings for surgical management Fractura bilateral de cuerpos cavernosos con sección completa de uretra anterior. Reporte de caso y revisión de conceptos actuales sobre el manejo quirúrgico Received: 25/06/2017. Accepted: 17/11/2017. David Andrés Castañeda-Millán1 • Otto Manrique-Mejía2 • César Capera-López1 • Wilfredo Donoso-Donoso1,2 1 Universidad Nacional de Colombia - Bogotá Campus- Faculty of Medicine - Department of Surgery - Urology Unit - Bogotá D.C. - Colombia. 2 Hospital Universitario Mayor Méderi - Urology Service - Bogotá D.C. - Colombia. Corresponding author: David Andrés Castañeda-Millán. Urology Unit, Departament of Surgery, Faculty of Medicine, Universidad Nacional de Colombia. Carrera 30 No. 45-03, building 471, office: 107.Telephone number: +57 1 3165000, ext.: 15106-15107. Bogotá D.C. Colombia. Email: [email protected]. | Abstract | | Resumen | Introduction: Penile fracture is a rare urological emergency associated Introducción. La fractura de cuerpos cavernosos es una urgencia urológica in up to 30% of cases with injury to the anterior urethra. Recent data que se asocia hasta en 30% de los casos a lesión de la uretra anterior. Datos suggest that early surgical intervention is the best treatment strategy. recientes postulan la intervención quirúrgica temprana como la mejor This investigation describes a case of bilateral corpora cavernosa estrategia de tratamiento. La presente investigación describe un caso de injury associated with complete rupture of the anterior urethra and lesión bilateral de cuerpos cavernosos asociada a sección completa de presents current concepts about its management.
    [Show full text]
  • Management of Male Lower Urinary Tract Symptoms (LUTS), Incl
    Guidelines on the Management of Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) M. Oelke (chair), A. Bachmann, A. Descazeaud, M. Emberton, S. Gravas, M.C. Michel, J. N’Dow, J. Nordling, J.J. de la Rosette © European Association of Urology 2013 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 References 7 2. ASSESSMENT 8 3. CONSERVATIVE TREATMENT 9 3.1 Watchful waiting - behavioural treatment 9 3.2 Patient selection 9 3.3 Education, reassurance, and periodic monitoring 9 3.4 Lifestyle advice 10 3.5 Practical considerations 10 3.6 Recommendations 10 3.7 References 10 4. DRUG TREATMENT 11 4.1 a1-adrenoceptor antagonists (a1-blockers) 11 4.1.1 Mechanism of action 11 4.1.2 Available drugs 11 4.1.3 Efficacy 12 4.1.4 Tolerability and safety 13 4.1.5 Practical considerations 14 4.1.6 Recommendation 14 4.1.7 References 14 4.2 5a-reductase inhibitors 15 4.2.1 Mechanism of action 15 4.2.2 Available drugs 16 4.2.3 Efficacy 16 4.2.4 Tolerability and safety 17 4.2.5 Practical considerations 17 4.2.6 Recommendations 18 4.2.7 References 18 4.3 Muscarinic receptor antagonists 19 4.3.1 Mechanism of action 19 4.3.2 Available drugs 20 4.3.3 Efficacy 20 4.3.4 Tolerability and safety 21 4.3.5 Practical considerations 22 4.3.6 Recommendations 22 4.3.7 References 22 4.4 Plant extracts - Phytotherapy 23 4.4.1 Mechanism of action 23 4.4.2 Available drugs 23 4.4.3 Efficacy 24 4.4.4 Tolerability and safety 26 4.4.5 Practical considerations 26 4.4.6 Recommendations 26 4.4.7 References 26 4.5 Vasopressin analogue - desmopressin 27 4.5.1
    [Show full text]
  • A Comparison of Pain Scores with Or Without Local Anaesthesia in Neonatal Circmcision Using Plastibell Technique at Plateau Stat
    A COMPARISON OF PAIN SCORES WITH OR WITHOUT LOCAL ANAESTHESIA IN NEONATAL CIRCMCISION USING PLASTIBELL TECHNIQUE AT PLATEAU STATE SPECIALIST HOSPITAL, JOS, NIGERIA A DISSERTATION SUBMITTED TO THE NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE FELLOWSHIP OF THE COLLEGE IN FAMILY MEDICINE (FMCFM) PART II FINAL EXAMINATION MAY 2010 BY DR.AMINU GANGO FIKIN DEPARTMENT OF FAMILY MEDICINE PLATEAU STATE SPECIALIST HOSPITAL, JOS, NIGERIA i ACKNOWLEDGEMENT My heartfelt gratitude goes to DR STEPHEN YOHANNA for his ingenuity, thorough supervision, guidance and encouragement throughout the entire period of my training and this work. I’m also grateful to DR PITMANG, DR LAR, DR LAABES, and DR INYANG for their contribution and criticism. My gratitude goes to all the consultants of Plateau State Specialist Hospital, Jos for contributing in one way or the other during my period of training. My sincere thanks goes to DR ABUBAKAR BALLA who provided me with shelter throughout the period of my training. ii DEDICATION To my children, AHMED, YUSUF, HADIJA, ALHAJI GONI, BA MAINA, AWULU and ABDULMUMINI, my wife, MOGOROM FATI MAINA GORIA, and my Mother and Father. Thank you for everything you are to me. iii CERTIFICATION This is to certify that Dr. Aminu G. FIKIN performed the study reported in this Dissertation at Plateau State Specialist Hospital under our supervision. We also supervised the writing of the dissertation. SUPERVISOR Dr. STEPHEN YOHANNA (BM, BCH; MPH; FMCGP; FWACP) CONSULTANT FAMILY PHYSICIAN EVANGEL HOSPITAL, JOS, NIGERIA SIGNATURE: ………………………………………………….. DATE: …………………………………………………………. HEAD OF DEPARTMENT Dr. INYANG OLUBUKUNOLA (MB, BS; FMCGP) CONSULTANT FAMILY PHYSICIAN PLATEAU STATE SPECIALIST HOSPITAL, JOS, NIGERIA SIGNATURE: ………………………………………….
    [Show full text]
  • Fearful Symmetries: Essays and Testimonies Around Excision and Circumcision. Rodopi
    Fearful Symmetries Matatu Journal for African Culture and Society ————————————]^——————————— EDITORIAL BOARD Gordon Collier Christine Matzke Frank Schulze–Engler Geoffrey V. Davis Aderemi Raji–Oyelade Chantal Zabus †Ezenwa–Ohaeto TECHNICAL AND CARIBBEAN EDITOR Gordon Collier ———————————— ]^ ——————————— BOARD OF ADVISORS Anne V. Adams (Ithaca NY) Jürgen Martini (Magdeburg, Germany) Eckhard Breitinger (Bayreuth, Germany) Henning Melber (Windhoek, Namibia) Margaret J. Daymond (Durban, South Africa) Amadou Booker Sadji (Dakar, Senegal) Anne Fuchs (Nice, France) Reinhard Sander (San Juan, Puerto Rico) James Gibbs (Bristol, England) John A. Stotesbury (Joensuu, Finland) Johan U. Jacobs (Durban, South Africa) Peter O. Stummer (Munich, Germany) Jürgen Jansen (Aachen, Germany) Ahmed Yerma (Lagos, Nigeria)i — Founding Editor: Holger G. Ehling — ]^ Matatu is a journal on African and African diaspora literatures and societies dedicated to interdisciplinary dialogue between literary and cultural studies, historiography, the social sciences and cultural anthropology. ]^ Matatu is animated by a lively interest in African culture and literature (including the Afro- Caribbean) that moves beyond worn-out clichés of ‘cultural authenticity’ and ‘national liberation’ towards critical exploration of African modernities. The East African public transport vehicle from which Matatu takes its name is both a component and a symbol of these modernities: based on ‘Western’ (these days usually Japanese) technology, it is a vigorously African institution; it is usually
    [Show full text]
  • Penile Fracture
    FEATURE Penile fracture BY PRASHANT K SINGH, CHRISTOPHER M MCLEAVY AND MARGARET LYTTLE Traumatic rupture of the tunica albuginea with either one or both corpora cavernosa of the penis is known as penile fracture. This may be associated with corpus spongiosum or urethral injury. Incidence ventrolaterally. During sexual intercourse, limbs are associated with higher incidence. Penile fracture was reported for the first the intracorporeal pressure can reach Other reported causes include vigorous time by Abul Kasem, an Arab physician, in 180mmHg, and the tunica albuginea intercourse, masturbation, falling off a bed, Cordoba, Spain more than 1000 years ago can withstand values up to 1500mmHg. placing an erect penis in underwear and [1]. It is not an uncommon condition but However, sudden flexion-based trauma spontaneously fracturing the penis while is often underreported [2]. It occurs more to an already thinned tunica albuginea urinating. In the Islamic world, instances frequently in Middle Eastern and North can result in rupture. Not unexpectedly, of penile fracture may be accidentally African countries (almost 55% of the total the most common site of rupture is self-inflicted by bending the erect penis number reported) than in the United States ventrolateral at the thinnest aspect, often in to achieve rapid detumescence, known as or Europe (almost 30% of those reported). the midshaft. taghaandan. Annual incidence in the USA is estimated The urethra passes through the corpus Injury can involve one or both of at 500–600 cases, responsible for one spongiosum. This is very elastic relative the corporal bodies and associated in every 175,000 emergency admissions to tunica albuginea, allowing expansion simultaneous urethral injuries may also [3].
    [Show full text]
  • Evaluation and Treatment of Acute Urinary Retention
    The Journal of Emergency Medicine, Vol. 35, No. 2, pp. 193–198, 2008 Copyright © 2008 Elsevier Inc. Printed in the USA. All rights reserved 0736-4679/08 $–see front matter doi:10.1016/j.jemermed.2007.06.039 Technical Tips EVALUATION AND TREATMENT OF ACUTE URINARY RETENTION Gary M. Vilke, MD,* Jacob W. Ufberg, MD,† Richard A. Harrigan, MD,† and Theodore C. Chan, MD* *Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California and †Department of Emergency Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania Reprint Address: Gary M. Vilke, MD, Department of Emergency Medicine, UC San Diego Medical Center, 200 West Arbor Drive Mailcode #8676, San Diego, CA 92103 e Abstract—Acute urinary retention is a common presen- ETIOLOGY OF ACUTE URINARY RETENTION tation to the Emergency Department and is often simply treated with placement of a Foley catheter. However, var- Acute obstruction of urinary outflow is most often the ious cases will arise when this will not remedy the retention result of physical blockages or by urinary retention and more aggressive measures will be needed, particularly caused by medications. The most common cause of acute if emergent urological consultation is not available. This urinary obstruction continues to be benign prostatic hy- article will review the causes of urinary obstruction and pertrophy, with other obstructive causes listed in Table 1 systematically review emergent techniques and procedures (4). Common medications that can result in acute
    [Show full text]