Isolated bladder rupture has an insidious presentation which results in delayed diagnosis and management. Forty-four patients, of mean age 33.3 years, were seen over a period of 7 years. There was a history of trauma in 33 patients, although this was minor in 20. Alcohol intoxication, head injury or paraplegia could have led to lack of sensation of the distending and subsequently injured bladder in 18 patients. The mean delay between an identifiable incident or presentation and diagnosis was 5.4 days. The mean admission or preoperative levels of blood urea and creatinine were raised to 19.6 mmol/l and 362 mumol/l respectively in those with a delayed diagnosis. The diagnosis was made by voiding cystourethrography in 36 patients and by laparotomy in eight. When blood urea and creatinine concentrations are increased in a patient with an ill-defined abdominal ailment and a history of trauma or drunkenness, ruptured bladder should be considered.

This paper identified important clinical predictors of arterial extravasation, rebleed and 30-day mortality in GI bleedings, which will assist in patient selection and help to improve the overall angiographic management of GI bleeding.

Background: RHBDD2 is distantly related to rhomboids, membrane-bound proteases. Results: In retina, RHBDD2 exists as a monomer in all cells throughout life and a homotrimer only in cone outer segments; a mutation in RHBDD2 possibly leads to retinitis pigmentosa. Conclusion: RHBDD2 plays important roles in development and normal retinal function. Significance: This is the first characterization of RHBDD2 and its association with retinal disease.

Purpose: To determine a single-center experience of sexual functionality, symptomatology, benefits and complications after coil embolization of arterial collaterals supplying blood to the penile plexus as an adjunct during prostatic artery embolization (PAE). Materials: A retrospective analysis of patients who underwent PAE with coil embolization (cPAE) of arterial communications to the penile vascular plexus to prevent nontarget embolization between September 2014 and September 2017. Clinical symptomatology data (IIEF/SHIM, QOL, Qmax, PVR, and nocturia) and medication usage was collected pre-procedure and at follow-up clinic visits (1 month, 3 months, 6 months, and 1 year). Adverse events, identified in accordance with the SIR guidelines, were collected during follow-up. Results: 29 patients underwent cPAE with coils placed in a capsular artery to penile plexus communication (n ¼ 16), prostatic artery to penile plexus communication (n ¼ 6), accessory pudendal artery (APA) to penile plexus communication (n ¼ 5), obturator artery to distal prostatic artery branch (n ¼ 1), and prostatic artery communication to contralateral APA (n ¼ 1) to prevent nontarget distal embolization to the penis. The average IIEF/SHIM score increased by 1.23 points (14.18 to 15.41, p ¼ 0.51), reported episodes of nocturia decreased by 1.375 events per night (3.5 to 2.125, p ¼ 0.007), and average QOL improved by 4.25 points (5 to 0.75, p ¼ 0.00008) at the most recent clinic visits, while the average Qmax improved by 4.67cc/s (8.77cc/s to 13.4cc/s, p ¼ 0.018), and PVR decreased by 11.72cc (108.12cc to 96.4cc, p ¼ 0.73) over a 1 year interval. Two major complications occurred: urosepsis (3.4%) resolved after a week of intravenous antibiotics, and glans penis ischemia (3.4%) after an arterial collateral became visualized post injection of embolic material. The most common minor complication, dysuria, occurred in 12/29 patients (41%). Conclusions: Coil embolization of arterial communications with the penile plexus during prostatic artery embolization appears to be a safe adjunctive technique in preventing nontarget embolization and sexual side effects do not appear to be a major concern.