Beware of the Dog Traumatic Extrusion of an Artificial Urinary Sphincter Following Blunt Trauma to the Scrotum by a Domestic Animal英文文献资料.docVIP

Open Journal of Urology, 2011, 1, 91-93 doi:10.4236/oju.2011.14020 Published Online November 2011 (http://www.SciRP.org/journal/oju) Beware of the Dog: Traumatic Extrusion of an Artificial Urinary Sphincter Following Blunt Trauma to the Scrotum by a Domestic Animal Michael S. Floyd Jr. , Karen Chan, Andrew D. Baird * Department of Urology, Aintree University Hospital, Liverpool, United Kingdom E-mail: Received September 14, 2011; revised October 28, 2011; accepted November 10, 2011 * nilbury@ Abstract Artificial urinary sphincters are commonly used in males with intrinsic sphincter deficiency to improve con- tinence and quality of life. Complications include erosion, mechanical failure and infection. Frequently, a staged approach involving removal of the device, followed by a period of healing and subsequent reinsertion of a new sphincter is required to restore continence. We describe the first case ever reported of traumatic sphincter extrusion following blunt scrotal trauma by a dog and review its clinical features and management. Keywords: Sphincter, Erosion, Trauma, Artificial, Urinary 1. Case Report allow satisfactory urethral voiding. Initial surgical management involved examination under anaesthesia, cystoscopic evaluation and removal of the eroded, infected sphincter. Physical examination re- vealed a cutaneous fistula at the left side of his perineum near the scrotal junction. (Figure 1) Rigid cystoscopy revealed a urethral erosion at the junction of the mid and distal bulbar urethra with the sphincter cuff visible on the left side of the urethral defect. A 14 french silicone catheter was inserted with the assistance of a guidewire to allow urethral healing. Using a perineal incision the A 59 year old man presented to out patients with a three month history of a discharging wound in his perineum adjacent to the bulbar urethra. He also complained of urinary loss through this sinus when voiding. Ther