Traumatic rupture of the corpus cavernosum: surgical management and clinical outcomes. A 30 years review.

INTRODUCTION: Penile trauma (PT) with associated rupture of the corpus cavernosum, also called penile fracture, is a urological emergency and surgical treatment is usually the choice of management. Our objective is to report our experience after 30 years in the diagnosis and therapeutic options of PT and evaluate the clinical outcomes after the treatment. MATERIAL AND METHODS: From January 1983 to January 2013, 27 patients were identified. Data was analyzed and is presented in absolute numbers, range, percentage and mean. RESULTS: Mean age of patients was 30.7 years, range from 19 to 37. All the patients came complaining of penile swelling and hematoma, and more than half of them (60.7%) reported hearing a snap sound. Some rare causes were identified in our series such as self-mutilation, avulsion, firearm and electrocution. Clinical presentation was diagnostic in all the patients, and the diagnosis was verified by penile ultrasonography in most cases (60.7%). Mean surgery time: 94 minutes. Urethral repair was required in 2 patients. Mean hospital stay was 2 days. Good functional results are shown during follow up. CONCLUSIONS: Rupture of the corpus cavernosum is a rare condition and is generally diagnosed by clinical findings. Emergency surgical exploration and treatment is the best guarantee of good functional and cosmetic results.

First experience with the ATOMS(®) implant, a new treatment option for male urinary incontinence.

INTRODUCTION: Urinary incontinence (UI) is defined as any complaint of involuntary urine leakage. A description is provided of our experience with the ATOMS(®) (Adjustable Transobturator Male System. Agency for Medical Innovations. A.M.I.) adjustable implant in patients with mild to moderate UI. MATERIAL AND METHODS: A retrospective study was made of the data referring to 13 patients treated with this adjustable system. Demographic and personal data were collected along with information on the etiology, severity, characteristics, duration of UI, complementary tests, surgery times, complications and results obtained. RESULTS: The full continence (no use of pad) recovery rate at the close of the study was 12/13 (92.3%). Three cases required a single filling during the mean 16 months of follow-up (range 4-32; median 14 months). A complication in the form of perineal hematoma was resolved with conservative treatment and a case of urinary retention was resolved by placing a bladder catheter for the duration of one week. Three patients experienced perineal-scrotal dysesthesias that disappeared spontaneously in the first three months. CONCLUSIONS: The described adjustable continence system has been found to be very effective in males with mild to moderate UI. In our experience, the ATOMS(®) implant offers excellent results over the middle term with a very low rate of complications that were easily resolved in all cases.