Leiomyoma of tunica albuginea

Leiomyoma of the tunica albuginea is an extremely rare benign tumor of the genitourinary tract. A thorough and proper examination and investigation are necessary for proper management and testis salvage surgery should be considered if feasible in such cases. We present a fifty-six-year-old male who had benign smooth muscle tumor [leiomyoma] arising from tunica albuginea which was successfully treated with testis sparing excision of the tumor. This is the first case of leiomyoma of tunica albuginea which has been reported in the Kingdom of Bahrain

Percutaneous nephrolithotomy

To study the outcome of Percutaneous Nephrolithotomy [PCNL] procedures for renal stone management. Urology Unit, Salmaniya Medical Complex, Bahrain. Retrospective Study. Twenty-five patients who had PCNL from January 2011 to April 2013 were reviewed. Twenty-five patients were reviewed. Only one case had failed access. The majority of our patients were of young age group, a mean age of 39 years. Fifteen [60%] patients were diagnosed to have renal stone by the combination of KUB and IVP; most of the stone sizes were >2 cm, 21[87.5%]. The overall stone clearance rate was 19 [76%] and the overall complications rate reported was 5 [20%]. This revealed good success rate and minimal acceptable complications. Based on our early experience, it is believed that the general experience of PCNL in SMC is adequate and should be considered as the first line of treatment for indicated renal stones

Penile prosthesis implantation for the treatment of erectile dysfunction

To evaluate the outcome of penile prosthesis implantation Salmaniya Medical Complex, urology unit Retrospective study. The data of Patients who underwent penile prosthesis implantation for the treatment of erectile dysfunction from 10/01/2003 to 01/01/2008 were reviewed. The patients were operated by a single surgeon using the same technique. Fifty-three patients underwent penile prosthesis implantation surgery for ED. The mean age was 56 [ranged between 27-81 years]. The implanted prosthesis is manufactured by the American Medical Systems. Thirty-three patients had AMS 650 Malleable penile prosthesis and 20 patients had AMS Ambicor inflatable penile prosthesis. The most common complication was superficial wound infection in 3 patients, erosion in 2 patients and urinary retention in one patient. Forty-seven patients [88%] were satisfied with the outcome, more with inflatable devises. The dissatisfaction was mainly due to cosmetic factors, high expectations and glans penis flaccidity. Penile prosthesis surgery is a safe and effective treatment for patients with erectile dysfunction in whom medical treatment had failed. It has a high patient satisfaction rate. In our study, the satisfaction rate was 88% and we encountered few minor complications

Penile prosthesis implantation for treatment of postpriapism erectile dysfunction

Our aim to evaluate the procedure and outcome of penile prosthesis surgery in the treatment of men with postpriapism erectile dysfunction. During the period between 1997 and 2004, a total of 17 patients with postpriapism erectile dysfunction underwent penile prosthesis implantation at our institution. Prosthesis implantation was done electively 6 to 18 months after priapism, when the patients presented with erectile dysfunction. Of the prosthesis implanted, 11 were malleable, 4 were 2-piece, and 2 were 3-piece prostheses [AMS, Minnetonka, Minnesota, USA]. All the 17 patients were successfully implanted with penile prosthesis, which led to urethral injury in 2 patients. There were no major postoperative complications. The median hospital stay was 5 days. The follow-up period ranged from 2 to 9 years [median, 6 years]. All the patients were satisfied with the prosthesis. Penile prosthesis implantation is the modality of treatment for patients with postpriapism erectile dysfunction at our institution. It has a high patient satisfaction rate. Although procedure-related complications are common due to corporeal fibrosis, they wre mostly minor ones and did not affect the outcome of the procedure

Breast cancer risk factors and stage at presentation

Breast cancer is the most common cancer in females all over the world. In American females, it is accounting for 32% of all cancers. It is well-known that there are major risk factors for cancer of the breast, such as, advanced age, positive family history and history of cancer in the same or other breast. Minor factors have been associated with breast cancer, such as, mammogram abnormalities, biopsy confirmed a typical hyperplasia, early menarche and late menopause etc' etc. Not enough studies have concentrated on reviewing the risk factors in Bahrain; therefore, we have embarked on this study 1,2. To review and assess the staging and risk factors of breast cancer. Surgery Department, Salmaniya Medical Complex. Retrospective/Prospective study. It is a retrospective/prospective clinical review involving 52 breast cancer patients operated upon by the senior author over five years period [1999-2005]. Presentation, diagnostic approach, and management were evaluated. Age at presentation, age of menarche and menopause were recorded. The risk factors, such as age at first delivery if any, lactation, hormonal therapy and if there were any past history or family history of breast or other related cancers. The stage of the disease at presentation was reviewed. Mortality and morbidity were recorded. All patients were females. Age at diagnosis was below 30 years in 2 patients [3.8%], between 30-39 years in 12 patients [23.1%], between 40-49 years in 21 patients [40.4%], 50 years or more in 17 patients [32.7%]. The mean age at menarche was 12 years of age. Sixteen patients [30.8%] were at menopause. The mean age at menopause was 48 years. Thirty-seven patients had child birth [71.2%], unmarried or nuliparous were 10 patients [19.2%]. Age at first delivery was ranging between 16 and 40 years of age. Number before percentage 59.6% of the patients breast fed their infants. Only 11 patients [22%] were using oral contraceptive pills [OCP]. One patient was on hormonal replacement therapy. Family history of breast cancer was positive in 18 patients [34.6%]. Two patients had history of breast cancer of the other breast. Thirty-seven patients [71.2%] had early breast cancer [T1, T2, N0, N1, M0] and 15 patients [28.8%] had advanced breast cancer [T3, T4, N1, N2, M0 -1]. There was no local recurrence, and three mortalities to date. More than half of our patients [67.3%] were below 50 years at presentation whereas internationally it is prevalent above fifty years [85%]. There was a significant high incidence of positive family history [35.3%] in comparison to international studies [5-15%]. In this study, breast cancer was still diagnosed late. In this study, locally-advanced breast cancer was 28.8%, which may improve as breast screening program is being implemented