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4 results

  • Visualising the proximal urethra by MRI voiding scan: results of a prospective clinical trial evaluating a novel approach to radiotherapy simulation for prostate cancer

  • Grace C. Blitzer, Poonam Yadav, Huaising C. Ko, Aleksandra Kuczmarska-Haas, Adam M. Burr, Michael F. Bassetti, Daniel J. Steinhoff, Kailee N. Borchert, Jason J. Meudt, Dustin J. Hebel, Stephanie K. Bailey, Zachary S. Morris
  • Journal:
    Journal of Radiotherapy in Practice / Volume 21 / Issue 4 / December 2022
    Published online by Cambridge University Press:
    05 April 2021, pp. 472-475
    • Article
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  • Background:

    Delineating the proximal urethra can be critical for radiotherapy planning but is challenging on computerised tomography (CT) imaging.

    Materials and methods:

    We trialed a novel non-invasive technique to allow visualisation of the proximal urethra using a rapid sequence magnetic resonance imaging (MRI) protocol to visualise the urinary flow in patients voiding during the simulation scan.

    Results:

    Of the seven patients enrolled, four were able to void during the MRI scan. For these four patients, direct visualisation of urinary flow through the proximal urethra was achieved. The average volume of the proximal urethra contoured on voiding MRI was significantly higher than the proximal urethra contoured on CT, 4·07 and 1·60 cc, respectively (p = 0·02). The proximal urethra location also differed; the Dice coefficient average was 0·28 (range 0–0·62).

    Findings:

    In this small, proof-of-concept prospective clinical trial, the volume and location of the proximal urethra differed significantly when contoured on a voiding MRI scan compared to that determined by a conventional CT simulation. The shape of the proximal urethra on voiding MRI may be more anatomically correct compared to the proximal urethra shape determined with a semi-rigid catheter in place.

  • Disseminated rhinosporidiosis

  • S N Bandyopadhyay, S Das, T K Majhi, G Bandyopadhyay, D Roy
  • Journal:
    The Journal of Laryngology & Otology / Volume 127 / Issue 10 / October 2013
    Published online by Cambridge University Press:
    14 October 2013, pp. 1020-1024
    Print publication:
    October 2013
  • Introduction:

    Rhinosporidiosis primarily affects the mucous membranes of the nose and nasopharynx. The disseminated form of this chronic fungal disease is extremely rare.

    Case report:

    The authors present a case of disseminated rhinosporidiosis in an immunocompetent patient with involvement of the skin, subcutaneous tissue, muscle, bone, penis and urethra, and with a long-standing primary lesion in the nose.

    Discussion:

    A late or atypical presentation of rhinosporidiosis may cause diagnostic dilemma. Fine needle aspiration cytology of the tumoural lesions may establish the diagnosis. Histopathology is confirmatory. The subcutaneous masses may be solid or cystic. Ulceroproliferative lesions need to be differentiated from malignancies.

    Conclusion:

    This is the first reported case of truly disseminated rhinosporidiosis with simultaneous involvement of multiple anatomically unrelated sites in a single patient. This is also the first reported case of cystic rhinosporidiosis. The possibility and sequelae of spontaneous regression of rhinosporidiosis are also discussed.

  • Chapter 33 - Semen analysis

  • Edited by Larry I. Lipshultz, Stuart S. Howards, University of Virginia, Craig S. Niederberger, University of Illinois, Chicago
  • Book:
    Infertility in the Male
    Published online:
    19 May 2010
    Print publication:
    24 September 2009, pp 550-573

  • Summary

    Ejaculatory dysfunction obviously becomes important in the younger male when fatherhood is of concern but, even then, its role in fertility is often looked at only as a problem in transport of sperm. The organs involved in the process of ejaculation are the epididymides, vasa deferentia, prostate, seminal vesicles, bladder neck, and bulbourethral glands. Neural control of ejaculation consists of the ejaculatory reflex, which is mediated at the thoracolumbar level and involves a coordinated interaction of the sympathetic and parasympathetic autonomic nervous systems. Premature ejaculation and delayed ejaculation are the two conditions of importance. Men with a nerve-sparing retroperitoneal lymph node dissection (RPLND) will have innervation of the ejaculatory organs, and the stimulation afforded by drug therapy may be enough to allow seminal emission or bladder neck closure. Penile vibratory stimulation (PVS) is usually recommended as the first line of treatment for anejaculation in men with spinal cord injury (SCI).