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Canadian Urological Association Journal... 2013Difficult urinary catheterization (DUC) is a frequent reason for urologic consultation. Literature regarding DUC is limited. The objective of the study is to examine the...
BACKGROUND
Difficult urinary catheterization (DUC) is a frequent reason for urologic consultation. Literature regarding DUC is limited. The objective of the study is to examine the current practice pattern of DUC and identify strategies to reduce its incidence and related adverse events.
METHODS
This is a prospective observational study of consultation for DUC at tertiary care centres in Edmonton, Alberta between October 2010 and February 2011. All urologic consultations for DUC in adults at the 2 tertiary hospitals were enrolled. Patients were managed according to the current regional standard of care established prior to the study. A clinical encounter questionnaire (CEQ) was completed by the urology service regarding details of the consultation and patient factors. CEQ results were tabulated and analyzed for trends, areas of strengths and weakness in the consultation process.
RESULTS
In total, 89 patients were accrued to the study. Mean age was 67 years and 91% were male. Seventeen percent of patients had history of previous DUC and 65% had urologic history. Forty-two percent of patients had catheter placement without any auxiliary tools. Adverse events, including urosepsis, bladder perforation, hydrouterus, paraphimosis and urethral trauma, were experienced by 37% of patients. Significant urethral injury as a result of catheterization attempts occurred in 32%. Forty-one percent of consultations were classified as inappropriate and 53% occurred between 5 pm and 6:30 am.
CONCLUSION
DUC is associated with significant patient morbidity and may often be preventable. This study highlights the need for implementation of preventive strategies, widespread education and increased awareness regarding catheter care.
PubMed: 24319514
DOI: 10.5489/cuaj.574 -
Archives of Disease in Childhood Jul 2006
Topics: Anti-Inflammatory Agents; Child, Preschool; Diagnostic Errors; Humans; IgA Vasculitis; Male; Paraphimosis; Penile Diseases; Prednisone
PubMed: 16790720
DOI: 10.1136/adc.2005.072652 -
The Medical Journal of Malaysia Aug 2011
Topics: Aged, 80 and over; Hair Diseases; Humans; Male; Paraphimosis
PubMed: 22111458
DOI: No ID Found -
BMJ Case Reports 2009
PubMed: 21687264
DOI: 10.1136/bcr.2007.054601 -
American Family Physician Feb 2004
Topics: Adult; Coitus; Humans; Male; Paraphimosis
PubMed: 14989568
DOI: No ID Found -
Journal of the American Veterinary... Oct 2011CASE DESCRIPTION-A 22-year-old American Paint Horse gelding from the Gulf Coast region of Texas was evaluated for regrowth of a perirectal squamous cell carcinoma that...
CASE DESCRIPTION-A 22-year-old American Paint Horse gelding from the Gulf Coast region of Texas was evaluated for regrowth of a perirectal squamous cell carcinoma that had been surgically removed 11 months previously. CLINICAL FINDINGS-A necrotic and ulcerated mass was present below the anus. The horse had paraphimosis and was having difficulty with urination. Histologic examination of the mass revealed that it was squamous cell carcinoma, and the horse was euthanized because of the unlikelihood that the mass could be adequately resected and its close proximity to the urethra. OUTCOME-At necropsy, in addition to the squamous cell carcinoma, hundreds of round, white to pale yellow nodules were disseminated throughout the liver, resulting in a so-called starry-sky appearance. Similar granulomas were seen in the right caudal lung lobe and small intestinal serosa. A single granuloma in the liver, which differed from the others by its larger size, contained a pair of adult schistosomes. Several hepatic granuloma specimens were used for PCR amplification and sequencing. Use of primers specific for a portion of the Heterobilharzia americana small subunit rRNA gene resulted in amplification of a 487-base pair product that had 100% sequence identity with H americana. CLINICAL RELEVANCE-Severe cases of disseminated granulomas in the liver of horses may result in a liver with a grossly abnormal starry-sky pattern. To our knowledge, this is the first report documenting the association of granulomas with H americana infection along with adult schistosomes in the liver of a horse.
Topics: Animals; Granuloma; Horse Diseases; Horses; Liver Diseases; Male; Schistosomatidae; Trematode Infections
PubMed: 21985355
DOI: 10.2460/javma.239.8.1117 -
Reproductive Biology and Endocrinology... Jul 2014C-type natriuretic peptide (CNP) signaling through its receptor natriuretic peptide receptor B (NPR-B) is a key molecule for mammalian reproduction, and known to play...
BACKGROUND
C-type natriuretic peptide (CNP) signaling through its receptor natriuretic peptide receptor B (NPR-B) is a key molecule for mammalian reproduction, and known to play important roles in female fertility. However, the function of these peptides in mouse male reproduction remains largely unknown. To determine the role of CNP/NPR-B signaling in male reproduction we investigated phenotype of Npr2-deficient short-limbed-dwarfism (Npr2(slw/slw)) mice, which have been shown to have gastrointestinal (GI) abnormalities.
FINDINGS
In homozygous Npr2(slw/slw) mice, spermatogenesis is developmentally delayed at both 2 and 4 weeks of age, with vacuolation and degenerating apoptotic germ cells being observed at 3 weeks age. However, the adult Npr2(slw/slw) mice exhibited apparently normal spermatogenesis, albeit with some aberrant spermatids, suggesting that developmental delay was overcome. In addition, the adult Npr2(slw/slw) mice showed abnormal penile morphology (paraphimosis).
CONCLUSIONS
The potential role of CNP signaling via the NPR-B receptor in male fertility appears to be mediated not through germ-cell development, but may be through maintenance of normal penile function.
Topics: Animals; Apoptosis; Crosses, Genetic; Erectile Dysfunction; Homozygote; Infertility, Male; Male; Mice, Inbred Strains; Mice, Mutant Strains; Mutation; Paraphimosis; Penile Erection; Penis; Receptors, Atrial Natriuretic Factor; Spermatids; Spermatogenesis; Spermatozoa; Testicular Diseases; Vacuoles
PubMed: 25012822
DOI: 10.1186/1477-7827-12-64 -
Medical Journal, Armed Forces India Oct 2004Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized,...
BACKGROUND
Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized, non-operative methods have been tried and operations preserving the skin of prepuce have been recommended. The presence of physiological phimosis, which is self-correcting by the age of 15 years in children, needs to be differentiated from the pathological variety.
METHOD
The child population reporting to Surgery OPD was taken as sectional representative of the Indian communities and socioeconomic strata. A simple protocol was adapted to differentiate true phimosis from the physiological one and data collected. An observational study was done and data collected for last six years.
RESULT
566 children were referred to the hospital and only 212 were subjected to circumcision. Of these, 169 were cases of true phimosis, 7 had paraphimosis and the rest included 9 ritual circumcisions.
CONCLUSION
The incidence in this study is much less as compared to the series from the west. Though rare, this simple surgery is often fraught with complications. A refined approach has been planned for referring cases and selection for surgery thereby reducing unnecessary referrals and circumcisions.
PubMed: 27407673
DOI: 10.1016/S0377-1237(04)80008-X -
British Medical Journal Nov 1979
Topics: Adolescent; Adult; Child Abuse; Child, Preschool; Circumcision, Male; Humans; Infant; Male; Paraphimosis; Penile Diseases; Penile Neoplasms
PubMed: 519371
DOI: 10.1136/bmj.2.6199.1220-e -
Journal of the American Veterinary... Feb 2007A 6-year-old castrated male Shih Tzu was evaluated because of intermittent bleeding during urination.
CASE DESCRIPTION
A 6-year-old castrated male Shih Tzu was evaluated because of intermittent bleeding during urination.
CLINICAL FINDINGS
Necrosis of the cranial portion of the penile shaft extended distally from the preputial fornix. Penile necrosis secondary to strangulation from paraphimosis was diagnosed.
TREATMENT AND OUTCOME
A midline preputiotomy incision was used to expose the penile shaft; amputation was performed caudal to the preputial fornix. The terminal portion of the urethra was anastomosed to the preputial mucosa, which allowed the dog to urinate through the preputial orifice.
CLINICAL RELEVANCE
Unlike the more conventional urethrostomy procedures performed in dogs, preputial urethrostomy eliminates the potential for local skin irritation during urination. Preputial urethrostomy is also easier to perform in those dogs in which penile amputation is required adjacent to the preputial fornix. A release incision cranial to the prepuce can be used to facilitate caudal displacement of the preputial mucosa, which facilitates urethral anastomosis to this structure. A midline preputiotomy incision provided excellent exposure of the penile shaft for this surgical procedure.
Topics: Amputation, Surgical; Animals; Dog Diseases; Dogs; Male; Penile Diseases; Penis; Treatment Outcome; Urination
PubMed: 17269869
DOI: 10.2460/javma.230.3.375