Genitourinary Lesions Due to Monkeypox.

BACKGROUND: Since May 2022, 31 000 cases of monkeypox infection have been reported in nonendemic areas. OBJECTIVE: To describe a series of cases of monkeypox with genitourinary involvement. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective observational study of men diagnosed with monkeypox disease with genitourinary involvement. RESULTS AND LIMITATIONS: A total of 14 patients were recruited. The median age was 42 yr. Of these patients, 43% sought a consultation for genitourinary symptomatology, and 71% had engaged in sex with other men. Eight patients (57%) were positive for human immunodeficiency virus, one diagnosed synchronously; the remainder had a median CD4 count of 663/µl. Six patients (43%) had a different sexually transmitted disease. Penile oedema was present in 43% of patients and two patients required surgical exploration. CONCLUSIONS: Genitourinary involvement is frequent in monkeypox disease and is often the reason for the consultation visit. PATIENTS SUMMARY: In this report we looked at how monkeypox disease can affect the genitourinary area, causing swelling of the penis or skin lesions.

Efficacy, tolerance and predictors of response to the treatment with hyperbaric oxygen therapy for patients with hemorrhagic radiation cystitis.

OBJECTIVES: The aim was to study the efficacy and tolerance in patients with haemorrhagic radiation-induced cystitis (HRC) treated with hyperbaric oxygen therapy (HOT) and analyze which factors were related to the response to the treatment. MATERIAL AND METHODS: We performed a retrospective cohort study of patients treated with HOT for HRC symptoms in a provincial referral centre from 2010 to 2020. We evaluated clinical response to treatment, number of hospitalizations due to HRC and subjective response using the PGI-I questionnaire. RESULTS: We treated 52 patients, with a median of 30 sessions, during 6 months and 40 months (6-68 months) of follow-up. 69.2%of patients responded completely and 21,2% partially. The 53.2% of patients improved before the first 10 sessions. Reduction of hospitalizations/per year due to haematuria from 2.8 to 1.1 (p=0,001). The 73,5% of patients stated that they were "very much better" or "much better" after treatment. During the follow-up, 15.4% of patients had recurrence of HRC. 9.6% of the patients required salvage cystectomy. The patients with a highest RTOG-EORTC scale had more risk to still with symptoms (OR 3.01 (IC95 1.48 - 6.16). All patients were able to complete the proposed treatment plan with good tolerance to HOT. CONCLUSIONS: These results show the clinical benefit of HOT in the treatment of HRC, with a reduction of the number of hospitalizations and a subjective improvement.

[Metabolic alterations and stones in patients with orthotopic ileal diversions. Case description.] / Alteraciones metabólicas y litiasis en pacientes con derivación ileal ortotópica. A propósito de un caso.

OBJECTIVE: Bacterial presence, anatomic anomalies and metabolic alterations increase the risk of stone formation in patients with neobladders. These patients sometimes require medical or surgical procedures. The aim of the current work is to analyze those alterations and medical treatment associated to it. METHODS: A case of a 66 yo male who had undergone a cystectomy with neobladder 3 years ago. Currently present with a staghorn stone on the right kidney. Past medical history of stone formation as well as double J calcification. RESULTS: The combination of medical and surgical treatment for stone was performed. Medical therapy will allow prevention of new stones. CONCLUSIONS: Metabolic and chronic infections in patients with neobladders treated should decreased the new stone formation in patients with neobladders.

OBJETIVO: La colonización bacteriana, las alteraciones anatómicas y las anomalías metabólicas aumentan el riesgo de litiasis en los pacientes con neovejiga, precisando en muchas ocasiones de un abordaje médico y quirúrgico complejo. El objetivo del trabajo es analizar dichas alteraciones y el tratamiento médico de las mismas. MÉTODOS: Se presenta el caso de un varón de 66 años con antecedente de cistectomía más derivación ortotópica desde hace tres años, el cual presenta litiasis coraliforme en riñón derecho. Antecedentes de varias litiasis, así como calcificación de doble J. RESULTADO: Mediante la combinación de tratamientos médicos y quirúrgicos se tratan las litiasis del paciente, siendo especialmente importante el manejo médico en la prevención de futuros eventos litiásicos. CONCLUSIONES: Diagnosticar y tratar las alteraciones metabólicas y las infecciones crónicas en pacientes con neovejiga puede reducir la aparición de litiasis en los pacientes con neovejiga.

Transurethral Drainage of Prostatic Abscess Using 120 W Holmium Laser Technology.

Introduction: Prostatic abscess is an infrequent but serious pathology that could be treated by ultrasound-guided puncture, transurethral resection, or open surgery. Case Report: We present a case of a 72-year-old male with a 3x5 cm prostatic abscess in the right lobe showed in abdominal computed tomography (CT). In the blood test, he presented coagulopathy. Urgent transurethral drainage by holmium laser was decided to be performed. It started with incision and opening of the right prostatic lobe with an energy of 1.2 J and a frequency of 20 Hz with a total power of 24 W. A 550-micron fiber was used for this technique. Coagulation of the area was performed with a power of 20 W. The postoperative course was uneventful. Conclusion: The holmium laser appears to be an effective alternative in the treatment of this pathology in patients with coagulation disorders by providing adequate hemostatic control.