Biomedical subjects
Publications and source records attributed to M K Ankem.
Priapism is well documented as a potential side effect of psychotropic medications. To date, there have been no reports of risperidone-induced priapism in the urologic literature. We report a case of risperidone-induced priapism requiring surgical treatment.
High-flow priapism is a rare entity, which is typically diagnosed with the help of either color flow Doppler ultrasound or arteriogram. In the case presented, both of these diagnostic modalities were unsuccessful in uncovering a vascular lesion. The patient underwent an empiric selective embolization of the left pudendal artery followed by a repeat angiogram of the right because of persistent tumescence. This procedure uncovered a previously unseen arteriolacunar fistula, which was treated successfully with a second selective embolization.
OBJECTIVES: To evaluate in a preliminary study the utility of biofeedback for the treatment of the daytime syndrome of urinary frequency and urgency of childhood, a benign, self-limited condition with symptoms that can last for months or years. Observation is a commonly recommended approach to this syndrome because medications and other forms of therapy are often not effective. METHODS: During a 2-year period, 89 children (34 boys and 55 girls) presented with this syndrome. Patient age ranged from 4 to 11 years, and duration of symptoms ranged from 1 to 38 months. All children were evaluated with a history, physical examination, urinalysis and culture, and renal and bladder ultrasound scanning. After the evaluation, the parents were offered either observation or surface patch electromyography biofeedback for the problem. RESULTS: Overall, 84 parents (94.3%) selected biofeedback for their child. After 1 month of biofeedback, 34.5% of children were able to achieve a 2 to 4-hour voiding interval. After 2 to 4 months of biofeedback, another 51.2% of patients experienced the same improvement. Overall, 85.7% of children who underwent biofeedback had symptom improvement. In 14.3% of children, no symptom improvement was noted after 4 months of biofeedback and these children were considered nonresponders. CONCLUSIONS: The results of this study suggest that biofeedback may be a treatment option for this disorder and warrants further investigation.
OBJECTIVE: To examine the utility of cyanoacrylate tissue adhesive (Dermabond, Ethicon, Somerville, NJ, USA; an effective means of epithelial skin closure) under a diaper (i.e. constantly exposed to bodily fluids) in 25 children (not toilet-trained) undergoing inguinal surgery. PATIENTS AND METHODS: A retrospective review of charts between July 1998 and July 2000 was used to identify children who were not toilet-trained and who had undergone inguinal surgery (e.g. orchidopexy, hernia and hydrocele repair). In addition to the type of surgery, the method of closure was also assessed; in all cases reported the subcutaneous tissues were approximated with 4/0 polyglactin suture. From July 1998 to October 1999 all epithelial skin was closed with 5/0 poliglecaprone, benzoin, sterile strips and collodion; from October 1999 to July 2000 all skin was closed with cyanoacrylate tissue adhesive. RESULTS: The chart review identified 45 boys (mean age 15.3 months, range 1-26) of whom 26 (57%) had undergone either inguinal hernia or hydrocele repair, and 19 (42%) who had undergone orchidopexy. These procedures resulted in a total of 52 incisions in the 45 children. Of the 52 incisions, 27 were closed with suture and 25 with cyanoacrylate adhesive. All patients were followed up at 2 weeks; there were no instances of infection or wound dehiscence in either group. The incisions were cosmetically identical at 3 months of follow-up. CONCLUSION: Cyanoacrylate adhesive is a safe and effective method of skin closure that can be used under a diaper.
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Blunt trauma to the penis is an uncommon injury in young children. We present two cases of blunt penile trauma secondary to mechanical compression from a toilet seat.
Metastatic cancer presenting as an oral lesion is exceedingly uncommon. To the best of our knowledge this is the first reported instance of renal cell carcinoma presenting initially as an oral lesion.