The Knotted Urethral Catheter-Description of a Novel Technique and Steps for Removal.

ABSTRACT: The spontaneous intravesicular knotting of a feeding tube used for urethral catheterization is a rare but documented complication. The reported incidence in the world literature is 0.2 per 100,000, with only 40 cases reported. Removal of these intravesicular knots has been attempted in a number of ways, such as the use of a guide wire to untangle the knot, use of excess lubrication and traction with or without anesthetic, and percutaneous or open cystostomy. This cystoscopic technique for removal has not been previously described.Based on our experience and published recommendations, we formulate an algorithm for removal. We outline steps for prevention and techniques from simple to complex, which can be used to remove knotted catheters.Although a rare complication of catheterization in children, catheter knotting can be troublesome. Following the steps suggested in this algorithm may avoid the use of more invasive techniques for removal.

Penile hair tourniquet to base of penis resulting in circumferential separation of shaft skin without vascular compromise: An unusual case report.

Hair tourniquet syndrome occurs when a strand of hair or thread becomes wrapped around an appendage, causing injury which can progress to ischemia, necrosis or autoamputation. A 2 year old uncircumcised male presented with 1 day of erythema to base of penis followed by a bleeding wound of 5 hours duration. On examination, there was circumferential separation of shaft skin at the base of the penis. Examination of diaper revealed a coiled strand of maternal hair. Debridement and primary repair were done, with an uneventful recovery. This represents an unusual presentation, as both the site and pattern of injury were atypical.

Pyourachus in spina bifida: case report and review.

Failure of the urachus to close results in a multitude of clinical anomalies. Such anomalies have been documented as occurring in association with mechanical bladder outlet obstruction. However, no urachal anomalies have been linked specifically to spina bifida. Two cases of urachal abscesses were identified in adolescent male patients with spina bifida at our institution, both with neuropathic bladders and using self-catheterization. The clinical presentations differed, with classic involvement of the umbilicus in 1 case. Because of its varied presentations, the diagnosis of a urachal anomaly is potentially difficult. Urachal anomalies should be considered in the evaluation of pelvic masses in this demographic.

Common myths and misconceptions about the foreskin

A recent national study in Trinidad and Tobago done by the author revealed that there are many misconceptions and lack of knowledge amongst parents about the foreskin and circumcisions. As clinicians it is our duty to educate parents and hence reduce the need for unnecessary referrals and circumcisions. These are some facts concerning the foreskin and circumcision.

Mature cystic teratoma arising at the porta hepatis: a diagnostic dilemma.

Mature cystic teratoma (MCT) is a tumor of embryological origin, which contains tissue derived from any or all germ cell lines found in an abnormal location. We present 2 cases of MCT both arising from the porta hepatis that were incorrectly thought perioperatively to be a choledochal cyst, which subsequently were demonstrated on histology to be a MCT.