"A hard pill to swallow": a case series of chlorpromazine-induced priapism.

Priapism is a rare but potentially serious adverse effect of several medications including chlorpromazine, which is commonly used in the treatment of refractory migraine. We describe three cases of ischaemic priapism occurring in men following intravenous chlorpromazine administration for migraine relief. These cases highlight an important but under-recognised complication that can result in long-term erectile dysfunction if not promptly managed.

Can ChatGPT pass the urology fellowship examination? Artificial intelligence capability in surgical training assessment.

Objectives: To assess the performance of ChatGPT compared to human trainees in the Australian Urology written fellowship examination (essay format).

Materials And Methods: Each examination was marked independently by two blinded examining urologists and assessed for: overall pass/failure; proportion of passing questions; and adjusted aggregate score. Examining urologists also made a blinded judgement as to authorship (artificial intelligence [AI] or trainee).

Evaluation of MV140 in preventing recurrent urinary tract infections: a multicentre double-blind randomized controlled trial protocol.

Objectives: To determine, firstly, whether MV140 reduces rates of recurrent urinary tract infections (rUTIs) in patients older than 65 years, measured as the number of urinary tract infections (UTIs) detected over 12 months following the completion of a 3-month treatment course and, additionally, to assess the number of re-admissions to the emergency department, the rate of antibiotic use for UTIs, the safety profile of MV140, and quality of life.

Materials And Methods: This is a multicentre, double-blind, randomized controlled trial with two arms. Patients will be randomized and allocated to receive either a 3-month course of MV140 or placebo (two sublingual sprays daily).

Urology case report - Emergency penectomy for the transfeminine patient.

Management of gender dysphoria and healthcare for transgender and non-binary patients is a growing field in Australia and abroad. Currently, gender-affirming surgery is not offered under Australia's national public health insurance. We present an unusual case of emergency penectomy required for a 57-year-old woman assigned-male-at-birth from rural Australia after a self-inflicted chemical burn.

Survival benefits with EPIC in addition to HIPEC for low grade appendiceal neoplasms with pseudomyxoma peritonei: a propensity score matched study.

Objectives: Appendiceal cancer is a rare malignancy, occurring in roughly 1.2 per 100,000 per year. Low grade appendiceal neoplasams (LAMN) in particular can lead to pseudomyxoma peritonei (PMP), and respond poorly to systemic chemotherapy.

Differentiation of renal masses with multi-parametric MRI: the de Silva St George classification scheme.

Purpose: To develop a system for multi-parametric MRI to differentiate benign from malignant solid renal masses and assess its accuracy compared to the gold standard of histopathological diagnosis.

Methods: This is a retrospective analysis of patients who underwent 3 Tesla mpMRI for further assessment of small renal tumours with specific scanning and reporting protocol incorporating T2 HASTE signal intensity, contrast enhancement ratios, apparent diffusion coefficient and presence of microscopic/macroscopic fat. All MRIs were reported prior to comparison with histopathologic diagnosis and a reporting scheme was developed.

Does the introduction of pre-operative cardiopulmonary exercise testing in radical cystectomy delay or alter surgical care?

Objectives: To assess if the introduction of routine pre-operative cardiopulmonary exercise testing (CPET) in radical cystectomy has delayed surgical intervention.

Materials And Methods: A prospective database of patients undergoing radical cystectomy in our local health network was maintained. A retrospective analysis of two years (2018-2020) included 38 patients.

Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma.

Objectives: The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is still poorly understood.

Materials And Methods: A retrospective assessment of all poorly differentiated high-grade UC over the last 15 years (2005-2020) in the Hunter New England area was completed.

The diagnostic utility of diffusion weighted MRI imaging and ADC ratio to distinguish benign from malignant renal masses: sorting the kittens from the tigers.

Background: MRI is playing an increasing role in risk stratification and non-invasive diagnosis of the undifferentiated small renal mass. This study was designed to assess the reliability of MRI in diagnostic evaluation of renal masses, specifically characterising lesions with diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) values.

Methods: This is a retrospective analysis of patients undergoing MRI as part of their clinical workup for a renal mass suspicious for renal cell carcinoma (RCC) on CT or ultrasound followed by biopsy and/or surgical excision.

Bladder perforation: A rare complication of retention management.

A healthy 25 year old woman presented with acute urinary retention following alcohol ingestion. A 14 french foley catheter drained over 1 L of haematuria immediately. Due to worsening and persistent abdominal pain, CT and ultrasound imaging was performed, demonstrating only a small amount of free fluid.

Chemical shift imaging in the identification of those renal tumours that contain microscopic fat and the utility of multiparametric MRI in their differentiation.

Introduction: The aim of this study was to assess the qualitative and MRI findings of renal tumours, to determine which lesions contain microscopic fat, one of the potential differentiating factors between tumour types.

Methods: 73 patients who underwent 3 Tesla MRI including chemical shift imaging, with subsequent biopsy or excision for histopathological diagnosis, were included in the study. The images were reviewed for a decrease in signal intensity (SI) on the opposed phase compared with the in-phase gradient echo T1 images, indicating the presence of microscopic fat.

What not to expect when you're expecting - Postpartum proximal ureteric rupture: A case report.

Introduction: Spontaneous ureteric rupture is an extremely rare cause of acute abdominal pain in the intrapartum and postpartum period. We present the case of a right ureteric rupture diagnosed immediately postpartum.

Case: A 23-year-old woman in her second pregnancy (who had had a previous caesarean section) developed acute-onset right-flank pain 12 h after vaginal delivery.

Novel approach to locating a hypoplastic kidney in a unique variant of uterine didelphys syndrome presenting with continuous incontinence.

Mullerian abnormalities such as uterine didelphys have an association with renal abnormalities. Ureteric ectopia must be considered as a differential diagnosis of incontinence. We describe the case of a 21-year-old woman who presented with low volume continuous incontinence with a history of right renal agenesis and uterus didelphys.

Mesh versus non-mesh for inguinal and femoral hernia repair.

Background: This is an update of a Cochrane Review first published in 2001.Hernias are protrusions of all or part of an organ through the body wall that normally contains it. Groin hernias include inguinal (96%) and femoral (4%) hernias, and are often symptomatic with discomfort.

Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease.

Background: Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people.

Full medical program fees and medical student career intention.

Objective: To explore the future career preferences of Commonwealth-supported place (CSP) and full-fee paying (FFP) medical students in Australia.

Design, Setting And Participants: Data from the Medical Schools Outcomes Database and Longitudinal Tracking (MSOD) Project exit questionnaire for CSP and FFP students who graduated between 2008 and 2011 were analysed using logistic regression. The influence of age, sex, marital status, rural background and fee-paying status on future career preference were explored.

Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease.

Background: Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. COPD is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people.