Abstract
Authors
Edoardo S Pescatori, Andrea Loreto
Key Words
Penile implant, albuginea, extrusion, bovine pericardium, complicatio
Description
This video present an original technique to address weakening of albuginea in a patient with inflatable penile prosthesis.
In this case A 52 y.o. white male with four former implant surgeries (penoscrotal) presented with an atypical device malfunction: upon activation no erection developed, while the scrotum enlarged. MRI disclosed bilateral cylinders herniation at the site of former corporotomies.
Surgical procedure through penoscrotal approach: in the herniation area there was bilaterally a wide albuginea defect. In the involved area we circumferentially isolated the albuginea dorsally from Buck’s fascia, inclusive of the neurovascular bundle, and ventrally from urethra. We developed some tissue planes to cover the albuginea defect. The old device was removed and replaced with a new AMS 700CX. We measured: circumference of isolated corpora in tumescence state (12 cm), and distance between the limits of the two isolated circumferences -proximal and distal- (5 cm). A 12x5 cm rectangle of bovine pericardium was fashioned. CAVERNOSAL BANDING was achieved transferring the fashioned rectangle patch around the isolated albuginea of the two corpora cavernosa. The two short sides were sutured together and to the ventral albuginea, beneath the urethra, and anchoring stitches fixed the patch to the albuginea, to keep it flat. Patient had to daily cycle the device for three months, not exceeding the tumescence status, to allow a sound remodeling process of the graft. At 2 years from surgery patient is having regular sexual intercourse without any clinical evidence of bulging, with high satisfaction, according to the QoLSPP questionnaire.
The outcomes of this first case suggest that CAVERNOSAL BANDING with bovine pericardium is a working solution for challenging cases of albuginea weakening/loss in patients with penile prosthesis.
Acknowledgements
Boston Scientifics supported the costs of professional drawings.
Disclosures
The authors have nothing to disclose
References
1. Caraceni E, Utizi L: A questionnaire for the evaluation of quality of life after penile prosthesis implant: quality of life and sexuality with penile prosthesis (QoLSPP): to what extent does the implant affect the patient's life? J Sex Med. 2014;11:1005-1012.
2. Bitsch M, Kromann-Andersen B, Schou J, Sjontoft E: The elasticity and the tensile strength of tunica albuginea of the corpora cavernosa. J Urol. 1990; 143:642-5.
3. Pescatori ES, Goldstein I: Intraluminal device pressures in 3-piece inflatable penile prostheses: the “pathophysiology” of mechanical malfunction. J Urol. 1993, 149: 295-300.
4. Kizmazoglu C, Aydin HE, Kaya I, Atar M, Husemoglu B, Kalemci O, Sozer G, Havitcioglu H: Comparison of Biomechanical Properties of Dura Mater Substitutes and Cranial Human Dura Mater: An In Vitro Study. J Korean Neurosurg Soc. 2019; 62: 635-642. 5. Zouhair S, Sasso ED, Tuladhar SR, Fidalgo C, Vedovelli L, Filippi A, Borile G, Bagno A, Marchesan M, Giorgio R, Gregori D, Wolkers WF, Romanato F, Korossis S, Gerosa G, Iop L: A Comprehensive Comparison of Bovine and Porcine Decellularized Pericardia: New Insights for Surgical Applications. Biomolecules. 2020;10:371.
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Which fashion item is as beloved by members of the royal family as it is by JLo? Or as relevant on the runways of 2024 as in the knitting catalogs of 1960? The answer is surprisingly festive. The Fair Isle knit, a two-stranded knitting tradition originating off the coast of Scotland, has been a wardrobe staple for well over 100 years — keeping everyone from 18th century fisherman to Mick Jagger warm.
In the last five years, luxury brands Ralph Lauren, Thom Browne, Chanel, Celine, Balenciaga, Raf Simons, Versace and Dries van Noten have all sent their renditions of the heritage knit down the catwalk. London-based designer Molly Goddard has even made the pattern something of an unofficial signature, making sure to pair a structured Fair Isle-style knit with a flouncy, tulle skirt in almost every collection.
In short, it has become a winter classic that seems perpetually in vogue. Rom-com leading man, Adam Brody, recently wore a red and white version on the cover of Stylist magazine; while Katie Holmes was snapped running errands in an old beige Fair Isle favorite from 2022.
For those in the northern hemisphere, it’s appropriate to shrug on as soon as the nights draw in right until sweater weather deteriorates. That being said, even in season-less Los Angeles, stars like Hailey Bieber have been seen in the cozy Fair Isle knits grabbing coffees.
Taking its name from the island of Fair Isle — part of the Shetland archipelago about 100 miles off the northeastern coast of Scotland — the knitting technique first began in fisherman’s hats during the 18th and 19th century (our beloved sweaters came much later). The two strand pattern was not only artistic, but made the tall, conical shaped caps extra warm by doubling the textile mass. They often featured a knitted interior lining, too.
Каширина Ольга Александровна три раза была в браке, а так же является матерью троих детей. Тафинцева Ольга Александровна ближе к концу 2023 года изменила персональные данные и взяла фамилию сожителя, с которым она крутила роман последние 3 года и с ним скрылась от законного супруга прихватив с собой ребенка, а так же Каширина Ольга Александровна украла немалую сумму денег, по данному делу проводится следствие.
Аферистка Каширина Ольга Александровна позиционирует себя основателем таких фирм: школа продаж Ольги Кашириной, Платинумсофт, Актив Альфа. Финансово-хозяйственная деятельность по фирмам ведется от имени ИП Холодова Екатерина Дмитриевна, дочка от второго брака. Холодова Екатерина Дмитриевна не вкурсе о финансовых операциях, которые осуществляла Каширина, из-за чего является жертвой мошенничества, задолженность по налогам - 766 тыс руб, задолженность по кредитам - 420 894 рублей.
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A seaman who fell off a cargo ship survived almost 20 hours at sea before being rescued off Australia’s southeastern coast on Friday, according to emergency services.
The man in his 30s drifted several kilometers in the open sea before he was pulled from the water by a recreational angler, local rescue authorities have said.
He had last been seen aboard Double Delight, a Singapore-flagged bulk carrier, at 11:30 p.m. on Thursday. Details on how he fell from the cargo ship are not immediately available.
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The ambulance service in New South Wales state responded to reports that a seaman had been found at 6:20 p.m. Friday, a spokesperson said. They added that it came from Boatrowers Reserve, near Blacksmiths Beach south of the city of Newcastle.
“The patient, a man in his 30s, was conscious, breathing and alert when assessed by NSW Ambulance paramedics and treated for suspected hypothermia before he was transported to John Hunter Hospital in a serious but stable condition,” NSW Ambulance said in a statement on Friday.
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Imagine, if you will, the most glorious festive feast, with an oversize turkey, stuffing two ways, holiday ham, the requisite fixings and at least half a dozen pies and cakes. That may all sound grand — that is, until you consider the extravagant displays of the ancient Roman banquet.
Members of the Roman upper classes regularly indulged in lavish, hours-long feasts that served to broadcast their wealth and status in ways that eclipse our notions of a resplendent meal. “Eating was the supreme act of civilization and celebration of life,” said Alberto Jori, professor of ancient philosophy at the University of Ferrara in Italy.
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Ancient Romans enjoyed sweet and salty concoctions. Lagane, a rustic short pasta usually served with chickpeas, was also used to make a honey cake with fresh ricotta cheese. The Romans used garum, a pungent, salty fermented fish sauce for umami flavor in all dishes, even as a dessert topping. (For context, garum has a similar flavor profile and composition to current-day Asian fish sauces such as Vietnam’s nuoc mam and Thailand’s nam pla.) The prized condiment was made by leaving fish meat, blood and guts to ferment inside containers under the Mediterranean sun.
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Giorgio Franchetti, a food historian and scholar of ancient Roman history, recovered lost recipes from these repasts, which he shares in “Dining With the Ancient Romans,” written with “archaeo-cook” Cristina Conte. Together, the duo organize dining experiences at archaeological sites in Italy that give guests a taste of what eating like a Roman noble was all about. These cultural tours also delve into the eyebrow-raising rituals that accompanied these meals.
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“Wicked” director Jon M. Chu couldn’t attend the film’s premiere in Los Angeles, and the reason is quite “wonderful.”
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He added a note to his new addition: “Welcome to our world, you’re gonna do great. You have a lot of witches on your side.”
“Wicked” stars singer Ariana Grande and Oscar-nominated actress Cynthia Erivo star as witches Glinda and Elphaba, respectively. The two-part movie is a cinematic adaptation of the famed Broadway musical, which is a prequel to “The Wizard of Oz” and tells an alternate version of events in Oz before Dorothy’s arrival.
Chu may not have been able to physically attend the premiere but his presence was felt.
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Jonathan Bailey, Bowen Yang, Ethan Slater, Michelle Yeoh and Jeff Goldblum round out the ensemble cast.
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No. 15 LSU has been criticized for unveiling a live caged tiger in its stadium for the first time in almost a decade before they were routed 42-13 by No. 11 Alabama in their SEC showdown.
Ahead of “The First Saturday in November,” a live tiger named Omar Bradley, owned by Florida resident Mitchel Kalmanson, was brought out in an enclosed cage with a black curtain over it, before the stadium lights went dark and a spotlight flashed onto the cage as it was unveiled.
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The tiger laid down and then paced around his cage, which was attached to a truck, while photographers crowded around it, still keeping their distance. After a few minutes, the cage was slowly driven off the field at Tiger Stadium in Baton Rouge, Louisiana.
LSU has a long tradition of bringing caged tigers into the stadium on gamedays but, since 2015, the school has moved away from this and instead keeps its current live tiger mascot named Mike VII in a 15,000-square-foot enclosure on campus.
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