No abstract

Erectile dysfunction (ED) resulting from direct damage of pudendal nerve injury during orthopedic surgery is common and closely associated to the use of traction tables. Prolonged countertraction on the fracture table and the inappropriate placement of the perineal post are the two main contributing factors. Clinical signs are essentially sensitive, such as hypoesthesia of the perineum. Urinary incontinence, ED and hypoesthesia or complete anesthesia of scrotum and glans penis are the main clinical manifestations. Electrophysiological examinations should be considered when symptoms are not regressive and in cases of vesico-sphincter dysfunction and immediate severe ED. No medical treatment has demonstrated its effectiveness. Pudendal nerve decompression was reported to be useful in some cases. Preventive measures should be considered by surgeons to avoid perineal traction injuries. Patients must be clearly informed about this possible neurological complication before an operation on the orthopedic table.

Highlights The urogenital tuberculosis is characterized by a non-specific and highly misleading clinical symptomatology. The clinical polymorphism of urogenital tuberculosis leads to a delayed diagnosis and severe complications. The diagnosis is a mixture of clinical, biological, radiological and especially histological arguments. The urogenital tuberculosis can mimic a renal or a bladder cancer requiring often a useless surgical treatment.

Comparatively to scrotal gangrene, isolated penile gangrene is very rare due to the rich blood supply of the organ. It is thought to be initiated by a traumatic or vascular insult to the penis. This condition requires parenteral antibiotic therapy and serial debridement of necrotic tissue. Split thickness skin graft is thought to be the best approach to cover penile skin loss. We share our experience on the presentation of an isolated penile gangrene in a 35-year-old male. In the light of this case, we review the predisposing factors and the management of this entity.

Vesicouterine fistula (VUF) is the rarest form of genitourinary fistulas. Despite the advantages of laparoscopy, there are few case reports showing its feasibility in the management of this rare entity. A 40-year-old woman presented to our department with urinary incontinence associated to cyclic hematuria and amenorrhea. After diagnosis of cervicovesical fistula, the laparoscopic approach was chosen. Catheterization of the fistula tract during cystoscopy at the time of laparoscopy was beneficial to localize the fistula tract and allowed meticulous dissection in the retrovesical space between the bladder and the uterus. Operating time was approximately 165 min. The woman had no signs of recurrence after 12 months of follow-up. Laparoscopic VUF repair is an effective and safe technique with successful outcome.