The Prevalence of Penile Pearly Papules among Young Men.

The aim of this study was to determine the prevalence of pearly penile papules (PPP) among young men in Eskisehir, Turkey. This was a prospective, non-randomized, cross-sectional study. From December 2014 to September 2015, 2613 consecutive male patients who were referred to the dermatology outpatient clinic were included in the study. Patients were inspected for the presence of PPP, localization, and association with human papilloma virus (HPV). A total of 2613 patients were included in the study. The average age of the patients was 21.33±2.08 (mean ± Standard Deviation (SD); ranging from 18 to 24) years. All of the patients were white and circumcised men. Of the 2613 patients, 449 (17.18%) PPP were observed. PPP were localized on the corona of the glans penis (100%), coronal sulcus (18.9%), frenulum (15.1%), ventral shaft (5.3%), and dorsal shaft of the penis (2.4%). Of the 449 patients with PPP, 23 (5.3%) underwent treatment; 73 (16.2%) would consider removal, 7 (1.5%) had a previous treatment for HPV, and 5 (1.1%) had HPV. PPP are encountered very commonly in the pubertal age in boys and young men. All medical practitioners should be familiar with PPP. Their similarity to genital warts may generate a false apprehension of venereal disease and may lead to unwanted and hazardous treatments. Therefore, better health education is needed.

Severe lower urinary tract symptoms due to anteriorly located midline prostatic cyst arising from the bladder neck in a young male: case report / Sintomas graves do trato urinário inferior em decorrência de cisto anteriormente localizado na linha mediana da próstata proveniente do colo vesical em um jovem do sexo masculino: relato de caso

ABSTRACT CONTEXT: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. CASE REPORT: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS), computed tomography (CT) and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o'clock position. It was acting as a ball-valve, such that it obstructed the bladder outlet. Transurethral unroofing of the cyst was performed and the patient's obstructive symptoms were successfully resolved. Histopathological examination indicated a retention cyst. CONCLUSIONS: It should be borne in mind that midline prostate cysts can be a reason for bladder outlet obstruction in a young male. Such patients may have tremendous improvement in symptoms through transurethral unroofing of the cyst wall.

RESUMO CONTEXTO: Cistos prostáticos são incomuns. Esses cistos são geralmente assintomáticos e são diagnosticados incidentalmente durante o exame ultrassonográfico. Raramente podem causar sintomas importantes. RELATO DE CASO: Relatamos um caso sintomático de grave cisto prostático de localização anterior, originário do colo da bexiga de um homem de 30 anos de idade, que apresentou sintomas do trato urinário inferior, sem evidência clínica de hiperplasia prostática benigna. Ultrassonografia transretal (TRUS), tomografia computadorizada (CT) e cistouretroscopia demonstraram um cisto prostático saliente que ocupou o colo da bexiga na posição exata de 12 horas. O cisto estava agindo como uma válvula de esfera, obstruindo a saída da bexiga. Retirada da cobertura do cisto foi realizada por via transuretral e os sintomas obstrutivos do paciente foram resolvidos com sucesso. O exame histopatológico indicou um cisto de retenção. CONCLUSÕES: Deve ser lembrado que a linha média do cisto de próstata pode ser motivo de obstrução da saída da bexiga em um jovem do sexo masculino. Esses pacientes podem ter notável melhoria nos sintomas com retirada da cobertura por via transuretral da parede do cisto.

Severe lower urinary tract symptoms due to anteriorly located midline prostatic cyst arising from the bladder neck in a young male: case report.

CONTEXT:: Prostatic cysts are uncommon. These cysts are usually asymptomatic and are diagnosed incidentally during ultrasonographic examination. On rare occasions, they may cause drastic symptoms. CASE REPORT:: We report on a case of severely symptomatic anteriorly located prostatic cyst arising from the bladder neck in a 30-year-old man presenting with lower urinary tract symptoms, without clinical evidence of benign prostatic hyperplasia. Transrectal ultrasonography (TRUS), computed tomography (CT) and cystourethroscopy demonstrated a projecting prostatic cyst that occupied the bladder neck at the precise twelve o'clock position. It was acting as a ball-valve, such that it obstructed the bladder outlet. Transurethral unroofing of the cyst was performed and the patient's obstructive symptoms were successfully resolved. Histopathological examination indicated a retention cyst. CONCLUSIONS:: It should be borne in mind that midline prostate cysts can be a reason for bladder outlet obstruction in a young male. Such patients may have tremendous improvement in symptoms through transurethral unroofing of the cyst wall.

Congenital anterior urethral diverticulum presenting as a scrotal mass in a two-year-old child.

Here, we describe a case of congenital anterior urethral diverticulum (CAUD) in a two-year-old boy, who presented with right inguinoscrotal swelling that mimicked a spermatic cord cyst or hydrocele. Accurate diagnosis was made intraoperatively by retrograde urethrography. Open diverticulectomy and primary urethroplasty were performed for its management. The clinical presentation, diagnosis, and the management of this rare condition is discussed.

Testis-Sparing Surgery in Small Testicular Masses Not Suspected to Be Malignant.

UNLABELLED: Fifteen patients with small testicular masses not suspected to be malignant were included in the study, and permanent and frozen section analyses were evaluated. As a result frozen analysis, preoperative externalization of the suspected malignancy with a physical examination, ultrasonographic evaluation, and serum tumor marker analysis were concluded as key points for accurate decision making between TSS and radical orchiectomy. BACKGROUND: We aimed to determine the safety, efficacy, and the concordance of permanent and frozen section analysis (FSA) of testis-sparing surgery (TSS) in patients who had small testicular masses that were not suspected to be malignant. PATIENTS AND METHODS: Fifteen patients who underwent TSS were included in the study. TSS was performed for the patients who had testicular lesions <25 mm and testicular lesion volume <30% of the whole testis. All patients had normal serum tumor marker levels and ultrasonographic evaluation did not indicate malignancy. Surgery was performed via an inguinal approach with temporary cord occlusion and FSA of the lesions. Benign findings allowed for TSS, and cancer prompted total orchiectomy. RESULTS: The mean patient age was 25.33 (range, 20-36) years. The predominant complaint was swelling (9 patients). The mean lesion diameter was 16 mm (range, 5-26 mm). Fourteen of all cases (93%) had benign pathology and underwent TSS. Only 1 patient, whose FSA revealed malignant formation, underwent radical orchiectomy. Final pathology of this patient was seminoma. Complete histopathologic concordance was observed between the results of frozen and permanent sections. TSS was performed with no intra- or postoperative complications. After a mean follow-up of 23 months (range, 6-44 months) all patients, except 3 who were lost to follow-up, were free of disease. CONCLUSION: The main key points for accurate decision-making between TSS and radical orchiectomy are intraoperative FSA and preoperative externalization of possible suspected malignancy with physical examination, ultrasonographic evaluation, and serum tumor marker analysis.

A rare case of penis agenesis (Aphallia) with associated multiple urogenital anomalies.

The penis as a component of external genitalia, takes part in fertility, urinary and psychosexual structure of males with its complex character. We report a case of penis agenesis with associated left renal agenesis, left superior segment ureteral agenesis, prostate agenesis, left ureterocele, right vesicoureteral reflux and high urethrorectal communication above the rectal sphincter. The patient refused any surgical intervention because of his religious beliefs.

Efficacy of poly(adenosine diphosphate-ribose) polymerase inhibition in extracorporeal shock wave-induced renal injury.

OBJECTIVES: Extracorporeal shock wave lithotripsy (ESW) induces renal damage by excessive production of free oxygen radicals. Free Oxygen radicals cause cellular injury by inducing nicks in DNA. The enzyme poly(adenosine diphosphate-ribose) polymerase (PARP) involved in the process of repair of DNA in damaged cells. However, its activation in damaged cells can lead to adenosine triphosphate depletion and death. Thus, we designed a study to evaluate the efficacy of 3-aminobenzamide (3-AB), a PARP inhibitor, against extracorporeal shock wave induced renal injury. METHODS: Twenty-four Sprague-Dawley rats were divided into three groups: control, ESW, ESW + 3-AB groups. All groups except control group were subjected to ESW procedure. ESW + 3-AB group received 20 mg/kg/day 3-aminobenzamide intraperitoneally at 2 h before ESW and continued once a day for consecutive 3 days. The surviving animals were sacrificed at the 4th day and their kidneys were harvested for biochemical and histopathologic analysis. Blood samples from animals were also obtained. RESULTS: Serum ALT and AST levels, serum neopterin and tissue oxidative stress parameters were increased in the ESW group and almost came to control values in the treatment group (p < 0.05, ESW vs. ESW + 3-AB). Histopathological injury score were significantly lower in treatment group than the ESW group (p < 0.05, ESW vs. ESW + 3-AB). CONCLUSION: Our data showed that PARP inhibition protected renal tissue against ESW induced renal injury. These findings suggest that it would be possible to improve the outcome of ESW induced renal injury by using PARP inhibitors as a preventive therapy.

Persistent Mullerian duct syndrome with transverse testicular ectopia and seminoma.

Persistent Mullerian duct syndrome (PMDS) is a rare form of the 46 XY disorders of sexual differentiation, characterized by the presence of a uterus and fallopian tubes due to the failure of Mullerian duct regression in genotypically normal males. More than 150 cases have been recorded, most of them in adults. In most cases, the PMDS is discovered during surgery for inguinal hernia or cryptorchidism, or by the presence of transverse testicular ectopia (TTE). The presence of PMDS with TTE is even more uncommon. In TTE, both testes descend through the same inguinal canal into the same scrotal sac. Patients with TTE present with symptoms of unilateral cryptorchidism and a contralateral inguinal hernia. For patients with inguinal hernia and cryptorchidism associated with TTE, PMDS should be kept in mind, and radiologic evaluation such as ultrasonography or magnetic resonance imaging of the genitourinary system and karyotyping are recommended. Whereas radiologic evaluation could be helpful in the diagnosis of TTE, it cannot diagnose the malignancy itself. The case explained in this report will offer urologists additional useful treatment strategies for patients with inguinal hernia and cryptorchidism.

Bilateral renal metastasis of an inguinal malignant solitary fibrous tumor, 9 years after primary surgical treatment.

OBJECTIVE: To report the first case of a bilateral renal solitary fibrous tumor (SFT) as a metastasis of an inguinal malignant SFT. CLINICAL PRESENTATION AND INTERVENTION: A 60-year-old male patient with a history of a right inguinal 7 × 8 cm soft tissue mass excision 9 years ago was referred to our clinic with abdominal pain. Both physical examination and chest X-ray were normal. Computed tomography revealed bilateral renal tumor. He was successfully treated with left partial and right radical nephrectomy. Histopathological examination showed a metastasis of the previous inguinal SFT. CONCLUSION: This case showed that although malignant SFT is extremely rare in the urogenital tract, this tumor should be included in the differential diagnosis when identified in the kidneys.