Risk Factors for Penile Fracture After Intralesional Collagenase Clostridium histolyticum in Peyronie's Disease.

OBJECTIVE: To evaluate risk factors leading to corporal rupture after Collagenase Clostridium histolyticum (CCh). Peyronie's disease (PD) is a fibrotic condition of the penis characterized by abnormal plaque formation. Intralesional CCh is the only FDA-approved medication for PD, however, it can lead to corporal rupture, a potential surgical emergency. METHODS: We retrospectively reviewed medical records from Veterans diagnosed with PD who were under treatment with CCh using the Veterans Administration Informatics and Computing Infrastructure (VINCI). Using International Classification of Diseases and Current Procedural Terminology codes, we identified men who suffered a corporal rupture after CCh. Individual charts were reviewed to determine potential risk factors and events leading to corporal rupture. RESULTS: We identified 17,647 veterans who were diagnosed with PD, of which 8.7% (1541) received at least one injection of CCh for PD. Of them, 0.7% (11/1541) veterans suffered corporal rupture. Within these 11 patients, the median number of CCH injections was 6 with a median initial curvature of 35°. Fracture occurred at a median of 8days after CCH injection. The majority of fractures were secondary to spontaneous erections or sexual intercourse. Finally, six patients had their fracture repaired surgically while the remaining were managed conservatively. CONCLUSION: Most fractures occurred within 2weeks of CCh injections and were associated with sexual intercourse and spontaneous morning erections.

Evaluating PubMed-Indexed Publications of Applicants Successfully Matching into the Top 50 Urology Residency Programs in the 2021-2023 Cycles.

Background and objective Urology residency match occurs through the American Urological Association (AUA), and hence information about the success of applicants in finding a match is not readily available. The average number of publications a successful urology applicant has when applying for residency is unknown. In light of this, we conducted this study to examine the number of PubMed-indexed research projects involving US senior medical students who successfully matched into the top 50 urology residency programs in the 2021, 2022, and 2023 match cycles. We also assessed these applicants based on their medical schools and gender. Methods Doximity Residency Navigator was used to generate the top 50 residency programs as sorted by reputation. Newly matched residents were found using program Twitter accounts and residency program websites. PubMed was queried for peer-reviewed publications of incoming interns. Results The average number of publications across all incoming interns in the three years was 3.65. The average number of urology-specific publications was 1.86 and that of first-author urology publications was 1.11. The median number of total publications for matched applicants was 2, and applicants with a total of five publications were in the 75th percentile for research productivity. Conclusion A successful applicant had two PubMed-indexed urology papers on average and also had a urology-specific first-author paper in the cycles we surveyed. There has been an increase in publications per applicant when comparing the results to previous application cycles, which can be attributed to post-pandemic changes.

When Shortness of Breath Gets Misdiagnosed: Atrial Myxoma Case Report.

The vague presentation of an atrial myxoma makes accurate diagnosis difficult. This case report reviews the case of a 54-year-old female who presented to the Emergency Department complaining of shortness of breath and back pain. Prior to her Emergency Department evaluation, she had been given a diagnosis with pneumonia. Upon further evaluation, she was diagnosed with a large left atrial myxoma that was surgically removed via median sternotomy. After recovering from her surgery, the patient had a full resolution of her symptoms. Although the treatment for myxomas has a high success rate of full recovery, the difficulty in diagnosis poses problems for patients and can prolong symptoms due to potential misdiagnosis.