No abstract

Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms in aging men, worsening their quality of life. Primary care physicians are uniquely positioned to screen for BPH, conduct a timely diagnostic workup, and if indicated, initiate medical therapy. A number of safe and effective medical treatments are available to alleviate symptoms, delay disease progression, and lessen the chance of needing surgery for BPH.

No abstract

Schwannomas, not uncommon in the head and neck, rarely occur in the pelvis. Here we describe a seminal vesicle schwannoma, the first of its kind successfully excised via robotic surgery. An otherwise well 62 year−old male presented with a complaint of rectal pain. Colonoscopy identified a mass effect on the rectum, suggesting an external lesion. A computed tomography scan revealed a right seminal vesicle mass. Transrectal ultrasound guided biopsy returned a tissue diagnosis of schwannoma. To aid in operative planning, magnetic resonance imaging of the prostate and pelvis was obtained with and without contrast. This defined a 5 × 4 × 4 cm3 mass abutting the right seminal vesicle without evidence of invasion into adjacent structures. The patient underwent an elective robotic−assisted laparoscopic resection of the mass. Final pathology demonstrated a completely excised schwannoma arising from the soft tissue adherent to the right seminal vesicle.

Spontaneous perforation of the esophagus is an uncommon event; when it does occur, it usually aff ects the thoracic esophagus. We present a rare and fatal case of spontaneous perforation of the cervical esophagus in a 68-year-old woman. We believe this rupture was related to a proximal outlet obstruction secondary to cricopharyngeal muscle dysfunction.