The autologous pubovaginal cystocele sling seems to be a safe, effective technique to correct cystocele with or without stress urinary incontinence.

The study reports a single center experience with surgical management of female pelvic organ prolapse (POP) with and without urinary incontinence.Between January 2006 and July 2016, 93 consecutive patients with anterior and/or apical symptomatic POP underwent abdominal sacrocolpopexy (ASC) or laparoscopic sacrocolpopexy (LSC) or pubovaginal cystocele sling (PCS); 25 patients had concomitant stress urinary incontinence (SUI). Subjective outcome was assessed by the Pelvic Floor Impact Questionnaire (short form) (PFIQ-7) investigating bladder, bowel and vaginal functions, sexual activity, and daily life. Objective outcomes included the POP anatomic correction by Baden Walker HWS classification, urinary tract infection (UTI) rates, urge urinary incontinence (UUI), and SUI rates. Data were prospectively collected.Forty-three patients underwent PCS, 29 ASC, and 21 LSC. Mean follow-up was 54.88 ± 33.1, 28.89 ± 23.5, and 16.8 ± 11.3 months for PCS, ASC, and LSC, respectively. POP recurrence occurred in 10.5%, 7.5%, and 0% while de novo (ie, in untreated compartment/s) POP occurred in 15.8%, 7.4%, and 4.8% of patients who have undergone PCS, ASC, and LSC, respectively. Kaplan–Meier estimates of POP-free survival showed no difference among the 3 procedures. All procedures significantly reduced PFIQ-7 scores improving quality of life and the rates of recurrent UTIs and concomitant UUI. PCS cured all cases with concomitant SUI; de novo SUI occurred only in 7.4% and 4.8% of patients who have undergone ASC and LSC, respectively. Mean surgical time was significantly shorter for PCS compared to ASC and LSC (P = .0001), and for ASC compared to LSC (P = .004); there was no difference in postoperative pain and hospital stay. Compared to ASC/LSC, PCS involved a higher rate (27.9% vs 6%; P = .01) of minor complications, mainly transient urinary retention, and a lower rate (0% vs 8%; P = .06) of complications requiring surgery.In this single center experience, PCS was not only provided similar subjective and objective results than ASC and LSC but also able to correct concomitant SUI without causing de novo SUI and was safer than other 2 techniques, in female POP repair.

BackgroundPenile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier’s gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention.Case presentationA 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck’s fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.ConclusionsThe present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

Introduction. Breast cancer is the most common nondermatologic cancer in women. Common metastatic sites include lymph nodes, lung, liver, and bone. Metastases to the bladder are extremely rare, with all reported cases presenting with urinary symptoms. Case Report. Herein, we report the first case of completely asymptomatic bladder metastasis from breast cancer, occasionally revealed, 98 months after the initial diagnosis of lobular breast carcinoma, by a follow-up computed tomography scanning showing thickening of left bladder wall and grade II left hydronephrosis. A positive staining for estrogen and progesterone receptors was confirmed by immunohistochemistry. Discussion. The reported case confirms that bladder metastases from breast cancer tend to occur late after the diagnosis of the primary tumor and, for the first time, points out they can be asymptomatic. Conclusion. Such data support the need for careful follow-up and early intervention whenever such clinical situation is suspected.

BackgroundBladder metastases from lung adenocarcinoma are extremely rare; in the seven previously reported cases, the finding of an intact epithelium overlying the bladder tumour was considered suggestive of a secondary lesion. We describe the first case of bladder metastasis from lung adenocarcinoma whereby endoscopic appearance was strongly consistent with primary bladder cancer, thus complicating the differential diagnosis with primary bladder adenocarcinoma.Case reportA 65-year-old woman with a 13-year history of clean intermittent catheterization was diagnosed with a right lung adenocarcinoma metastatic to mediastinal and right supraclavicular nodes, as well as to the left lung, and treated with six cycles of cisplatin/pemetrexed, followed by six cycles of pemetrexed only. The 18-month follow-up computed tomography revealed several solid lesions of the bladder wall and she was scheduled for transurethral resection of bladder tumours. Endoscopic appearance was strongly consistent with primary bladder cancer but a thorough pathologic evaluation allowed the diagnosis of bladder metastasis from lung adenocarcinoma.ConclusionsDifferentiating primary bladder adenocarcinoma from metastatic adenocarcinoma lesions can be difficult. An endoscopic appearance consistent with primary bladder cancer further complicates the differential diagnosis, which heavily relies on pathologic evaluation and specific immunohistochemical staining.