Background: The aim of this study was to review our experience with iliopsoas abscesses (IPAs) and evaluate the various drainage procedures.Methods: All consecutive patients with an IPA admitted to three university hospitals between September 2008 and June 2017 were retrospectively included.Results: Of the 26 patients, 17 (65.4%) were male and nine (34.6%) were female, with an average age of 30.7 (17-58) years. Fifteen (57.7%) cases had primary IPAs and Staphylococcus spp. was the most common isolate. Eleven (42.3%) cases had secondary IPAs, and spinal tuberculosis was the most common underlying condition. Lower-back or flank pain was the most common presentation (69.2%). Computed tomography (CT) scans confirmed all clinical diagnoses. All patients were managed via drainage and antibiotic therapy; seven (26.9%) were subjected to open surgical drainage and 19 (73.1%) received percutaneous drainage (PCD) under ultrasound (US) guidance. The average hospital stay was 9.5 days (range 5-18 days). The hospital stay was significantly shorter in patients treated via PCD compared to those who received open drainage: 8.5 days (range 5-14 days) vs. 12.1 days (range 6-18 days), respectively (p = 0.031). The overall recurrence rate was 11.5% (3/26). Recurrence developed in three patients treated via US-guided PCD and all were successfully treated via a second round of PCD. No mortality was recorded.Conclusions: US-guided PCD combined with appropriate antibiotic therapy is safe and effective with shorter hospital stay when used to treat IPAs. Open surgical drainage may be warranted if the IPA is multiloculated or if there is an underlying pathology.

ObjectiveTo report on our initial experience in the management of war-related penile injuries; proper diagnosis and immediate treatment of penile injuries is essential to gain satisfactory results. Besides treating primary wounds and restoring penile function, the cosmetic result is also an important issue for the surgeon.Patients and methodsThe study was conducted in the Department of Urology at Benghazi Medical Center and comprised all patients who presented with a shotgun, gunshot or explosive penile injury between February 2011 and August 2017. The patient’s age, cause of injury, site and severity of injuries, management, postoperative complications, and hospital stay, were recorded.ResultsIn all, 29 males with war-related penile injuries were enrolled in the study. The mean (SD) age of these patients was 31.3 (10.5) years. The glans, urethra, and corporal bodies were involved in four (13.7%), 10 (34.4%), and 20 (68.9%) of the patients, respectively. According to the American Association for the Surgery of Trauma Penis Injury Scale, Grade III penile injuries were the most common (11 patients, 37.9%). The most common post-intervention complications were urethral stricture with or without proximal urethrocutaneous fistula (eight patients, 27.5%), followed by permanent erectile dysfunction (five patients, 17.2%).ConclusionIn patients who sustain war-related penile injuries the surgeon’s efforts should not only be directed to restoring normal voiding and erectile function but also on the cosmetic appearance of the penis.

Background: Ureteropelvic junction obstruction (UPJO) is an obstruction of urine flow from the renal pelvis to the ureter. This condition can be caused by congenital and acquired due to intrinsic or extrinsic factors. UPJO due to acquired conditions such as secondary to inflammation, passage stones, or ureteric folds is less common. In case of suspected UPJO, the critical decision to be made depends on the correlation between the radiologic findings and the physiologic picture. There have been recent and serious trials to perform the surgical repair of UPJO without intubation, with reservation of double J (DJ) stents and nephrostomy tubes for complex cases. The Aim of Study: The aim of the study was a comparison of the time of drain removal, hospital stay, complications, and the end result of surgery in intubated and nonintubated UPJO repair. Patients and Methods: A retrospective case serious study performed in Urological Departments at Benghazi Medical Center and Al-Hawari Urology Center by reviewing 51 files of consecutive patients of UPJO admitted to the department of urology from May 2010 to 2015. All patients were diagnosed using different diagnostic tools. Forty-three cases underwent reconstructive surgeries as follows: 41 (95.3%) patients underwent Anderson-Hynes-dismembered (A-H-D) pyeloplasties and 2 (4.7%) patients underwent VY Foley pyeloplasties. Out of 41 cases underwent A-H-D pyeloplasties, there were six cases underwent concomitant pyelolithotomy. Results: The time of removal percutaneous perinephric tube drain was 7 th to 9 th postoperative days and 7.9 ± 0.5 days. The postoperative hospital stay for all cases range from 7 days to 10 days and the mean was 8.0 ± 0.8 days. Conclusions: Despite both intubated and nonintubated techniques of UPJO repair are comparable regarding the hospital stay postoperative complication, the tubeless surgical repair of UPJO is more suitable for children and superior to the intubated technique regarding the cost of DJ stent and nephrectomy tube.

Gunshot injuries (GSIs) are considered an emergency as life threatening. The gunshots injuries in the urinary tract are uncommon. The high-velocity of bullet can cause both a penetrating injury to the target organs as well as a blast injury to nearby structures, in addition to thermal injuries. In most cases, laparotomy is required to remove the bullet and to repair the injuries. The phenomenon of spontaneous migration of retained bullet to different parts of the body has been described in medical literature. Here, we present a patient who sustained penetrating GSI to the pelvis, without organ injuries, including the bladder. The bullet initially was retained within peri-vesical fat and the bladder wall while the mucosa remained intact, then it migrated into the bladder and came out through the urethra during voiding on the sixth day of the injury.

Background: Undescended testis (UDT) is the failure of testes to descend into the scrotum. It is classified according to the site of arrest into; Intra-abdominal, deep inguinal ring, canalicular, or emergent from the superficial inguinal ring. The diagnosis of UDT is mainly clinical and its treatment is usually surgical. The aim of our study is to analyze age distribution at the time of diagnosis and treatment to determine if the international guideline recommendations are followed in our institution or not. PATIENTS & METHODS: A retrospective study was carried at Urological Center by reviewing the files of 75 consecutive patients admitted to the hospital in the period from July 2011 to April 2014. A data flow sheet was used to record and analyze the patients' personal data, age at diagnosis, physical findings, type of surgical procedure, and the age of the patients at the time of surgery, as well as surgical findings. Results: Total number of patients enrolled in the study was 75 patients. Fifty-two cases were diagnosed at birth, 14 cases discovered incidentally, and 9 cases were presented with reducible inguinal swelling with or without pain. The 75 patients had 93 UDTs, 49 UDTs on right side and 44 UDTs on left side. Sixty-nine UDTs were clinically palpable while the other 24 UDTs were not palpable (74.2% and 25.8% respectively). The mean age at the time of diagnosis was 3.7 ± 8.3 years. However, the mean age at the time of surgery was 10.8 ± 10 years. The surgical procedures performed were: orchiopexy (n=58, 62.3 %,), orchiopexy combined with ipsilateral hernial repair (n=16, 17.2%) and orchiectomy (n=19, 20.4%). Conclusion: In our institution, the mean age at orchiopexy was significantly delayed beyond the recommended time of surgery because of delayed diagnosis or referral.