A Literature Review and Two Case Reports: Is Traumatic Dislocation of the Testes a Surgical Emergency?

Traumatic dislocation of the testes (TDT) is a rare sequela of blunt scrotal and perineal trauma. TDT can easily be overlooked during concomitant trauma due to other injuries, The damage to the testis appears to be not severe in dislocation and may be corrected by repositioning even if it is delayed. However, delayed intervention might be associated with pain and discomfort and may lead to abnormal sperm parameters and possible infertility. The urgency of surgical intervention increases whenever there is associated testicular torsion, rupture, or bilateral testicular TDT. We report two cases of unilateral traumatic testicular dislocation following motorcycle crashes with different presentations and approaches to treatment. We also engage in a review of the relevant literature.

Clinical Phenotyping and Multimodal Treatment of Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome From the Middle East and North Africa: Determining Treatment Outcomes and Predictors of Clinical Improvement.

OBJECTIVE: To evaluate the effectiveness of UPOINT based multimodal treatment on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and determine factors that could be associated with clinical improvement. METHODS: A retrospective study was conducted in Doha, Qatar including patients with CP/CPPS from the Middle East and North Africa. The UPOINT phenotyping system was used to classify patients and guide their multimodal therapy. NIH-CPSI scores were computed initially and after 3 months of treatment, and predictors of clinical improvement were assessed. RESULTS: The total NIH-CPSI improved significantly with a mean reduction of 8.21 after 3 months of treatment (P < .001). 66.2% of patients had a clinical improvement demonstrated as a total NIH-CPSI score reduction by at least 6 points after 3 months of treatment. No significant association was found between clinical improvement, and extent of pain (ORa = 1.198, 95% CI 0.392-3.662, P = .751), initial total NIH-CPSI (ORa = 0.983, 95% CI 0.886-1.089, P = .738), number of positive UPOINT domains (ORa = 0.871, 95% CI 0.451-1.681, P = .681), and number of prescribed therapies (ORa = 1.118, 95% CI 0.699-1.789, P = .641). CONCLUSION: UPOINT phenotyping and directed therapy is associated with an important improvement in the CP/CPPS. Therapeutic response does not appear to related to age or ethnicity. Clinical improvement is also not predicted by initial extent and severity of the disease, whether relating to NIH-CPSI or the number of positive UPOINT phenotypes, neither to the number of therapies involved in the multimodal treatment strategy.

Venatorbacter cucullus gen. nov sp. nov a novel bacterial predator.

A novel Gram-stain negative, aerobic, halotolerant, motile, rod-shaped, predatory bacterium ASxL5T, was isolated from a bovine slurry tank in Nottinghamshire, UK using Campylobacter hyointestinalis as prey. Other Campylobacter species and members of the Enterobacteriaceae were subsequently found to serve as prey. Weak axenic growth on Brain Heart Infusion agar was achieved upon subculture without host cells. The optimal growth conditions were 37 °C, at pH 7. Transmission electron microscopy revealed some highly unusual morphological characteristics related to prey availability. Phylogenetic analyses using 16S rRNA gene sequences showed that the isolate was related to members of the Oceanospirillaceae family but could not be classified clearly as a member of any known genus. Whole genome sequencing of ASxL5T confirmed the relationship to members the Oceanospirillaceae. Database searches revealed that several ASxL5T share 16S rRNA gene sequences with several uncultured bacteria from marine, and terrestrial surface and subsurface water. We propose that strain ASxL5T represents a novel species in a new genus. We propose the name Venatorbacter cucullus gen. nov., sp. nov. with ASxL5T as the type strain.

Life-threatening abdominal compartment syndrome as a complication of supine super mini percutaneous nephrolithotomy, the first case report and literature review.

Abdominal compartment syndrome is a life-threatening complication of conventional percutaneous nephrolithotomy (PCNL), with few cases reported in different positions. We present the first case of abdominal compartment syndrome as a complication of supermini percutaneous nephrolithotomy (SMP) in The Galdakao-modified supine Valdivia position, possibly predisposing factors, diagnosis, and management. Although it is a challenging diagnosis and life-threatening condition, morbidity and mortality can be decreased with early detection and drainage of the intra-peritoneal fluid, causing increased abdominal pressure, which is the most important prognostic factor.

Is RIRS emerging as the preferred option for the management of 2 cm-4 cm renal stones: our experience.

INTRODUCTION: The European Association of Urology (EAU) and the American Urological Association (AUA) guidelines recommend percutaneous nephrolithotomy (PCNL) as the first-line treatment of renal stones greater than 20 mm, however multistage retrograde intrarenal stone surgery (RIRS) is reported to have high stone-free rates (SFR), fewer complications and a rapid learning curve. This study presents our experience of RIRS in the management of 2 cm-4 cm renal stones. MATERIALS AND METHODS: A retrospective study was performed of all patients who underwent RIRS for 2 cm-4 cm renal stones over a period of 22 months. The demographics of 71 patients as well as the stone and procedural demographics were recorded. Pre and postoperative radiological assessment was performed by NCCT scanning in 83% of the patients and ureteral access sheaths were used in only 12% of the patients. The severity of surgical complications was determined according to the Clavien-Dindo system. RESULTS: RIRS was performed on 71 patients for renal stones with a mean size of 26 mm. The mean number of procedures per patient was 2.1 and the overall SFR was 81%. Few complications were encountered and only 1 patient had III-b Clavien complication. CONCLUSION: The study further supports RIRS as a safe and efficacious treatment option for renal stones of 2 cm-4 cm in size. Although both the EAU and AUA do not currently recommend RIRS as the first-line treatment of such stones, it appears to be emerging as a commonly utilized primary modality.