Publications by authors named "Hossam S El-Tholoth"

13 Publications

  • Page 1 of 1

Management of polyorchidism in a prepubertal boy: A case report and literature review.

Urol Ann 2020 Oct-Dec;12(4):385-387. Epub 2020 Oct 15.

Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Polyorchidism is a very rare embryological anomaly characterized by the presence of extra number of testes with the usual presentation of two homolateral and one contralateral testis and no clear guidelines for management. Herein, we present a 14yearold case with left supernumerary testes presented with discomfort and painless mass, diagnosed by US and confirmed by magnetic resonance imaging. Conservative treatment was implemented, in the form of ultrasound followup imaging (every 6-12 months) with selfscrotal examination every month.
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http://dx.doi.org/10.4103/UA.UA_154_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992534PMC
October 2020

Varicocele indicated scrotoplasty with varicocelectomy: A case report.

Urol Case Rep 2021 May 27;36:101577. Epub 2021 Jan 27.

Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

A 72 -year- old male patient presented to the clinic complaining of mild dragging scrotal pain and hanging scrotum interfering with his daily activity. Clinical examination revealed grade three left varicocele, enlarged hanging scrotum for more than 15 cm from the scrotal neck. The scrotum was explored and left varicocelectomy was done then scrotoplasty. Fifteen months post-operatively patient has an excellent outcome.
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http://dx.doi.org/10.1016/j.eucr.2021.101577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856312PMC
May 2021

Microscopic subinguinal varicocelectomy for testicular pain: a retrospective study on outcomes and predictors of pain relief.

Basic Clin Androl 2021 Jan 7;31(1). Epub 2021 Jan 7.

Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Background: Approximately 2-10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele.

Results: Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief.

Conclusions: Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.
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http://dx.doi.org/10.1186/s12610-020-00119-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788765PMC
January 2021

Scrotal calcinosis effect - Case report and review of literature.

Urol Case Rep 2020 Nov 18;33:101347. Epub 2020 Jul 18.

Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Idiopathic scrotal calcinosis is a benign rare diseases that is characterized by single or multiple scrotal skin calcified nodules without evidence of systemic disease. We report the first case in Saudi Arabia of Idiopathic scrotal calcinosis in a patient whose a 42 years old male, medically and surgically free who presented to our clinic with multiple scrotal nodular lesions in which excision was done and histology showed calcium deposition in basophilic globules which is consistent with Idiopathic scrotal calcinosis. Although pathogenesis and etiology of Idiopathic scrotal calcinosis is controversial, surgical excision is the treatment of choice.
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http://dx.doi.org/10.1016/j.eucr.2020.101347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573946PMC
November 2020

Giant hydronephrosis management in the Era of minimally invasive surgery: A case series.

Int J Surg Case Rep 2020 23;75:513-516. Epub 2020 Sep 23.

Prince Sultan Military Medical City, Urology Department, Riyadh, Saudi Arabia. Electronic address:

Introduction: Giant hydronephrosis (GH) is a rare urological entity, described as more than 1 L of fluid contained in the renal collecting system. Ureteropelvic junction obstruction (UPJO) is the most common cause. GH if not discovered and managed early can result in long term complications. We present our experience in the late presentation of adult Giant hydornephrosis.

Presentation Of Cases: We reviewed all the cases of patients with giant hydronephrosis who presented to our institute from December 2017-December 2019 at our institute. Pre-operative renal ultrasound, computed tomography with contrast and MAG-3 were performed on all patients to establish their diagnoses. The patients' demographic data, clinical presentation, preparatory investigations, indications for intervention, type of intervention, pre- and post-operative complications and durations of hospital stay were reported. Laparoscopic transperitoneal nephrectomy was completed in three cases without open conversion. One case proceeded to open conversion owing to a lack of space and severe adhesions. The mean operating time was 79.7 min (range: 65-95 min), estimated blood loss was 75 mL and the mean hospital stay was 4 days (range: 2-6 days).

Discussion: The first case of GH was described in 1746. Since then, few cases have been described in the literature. A radiological definition, is the occupation of the hemi-abdomen by the kidney with a midline cross which is the height of five vertebral bodies. GH may be congenital or acquired. The most common presentation of GH is abdominal distention followed by fever and flank pain.

Conclusion: When nephrectomy is indicated in giant hydronephrosis, the laparoscopic trans-peritoneal approach is feasible. Pre-operative decompression using a nephrostomy tube and suspension stitch use facilitate the surgery.
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http://dx.doi.org/10.1016/j.ijscr.2020.09.144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530226PMC
September 2020

Intraprostatic Abscess: An Acute Complication of Prostatic Artery Embolization.

J Vasc Interv Radiol 2019 02;30(2):267-269

Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia 4777714 ext #42969/25458.

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http://dx.doi.org/10.1016/j.jvir.2018.11.024DOI Listing
February 2019

Different managements of horseshoe kidney stones, any difference in the outcome?

Urol Ann 2018 Jul-Sep;10(3):287-290

Division of Pediatric Urology, Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Purpose: The aim is to assess the outcomes of different approaches for the management of renal stones associated with horseshoe kidneys (HSKs) in our institution over a 12-year period.

Methods: A retrospective review of 144 patients with HSKs who presented from 2000 to 2012 was performed. Twenty-eight patients (19.4%) were found to have renal stones. Demographic data were collected; the method of treatment and the outcomes of stone management were reviewed. We excluded patients with non-functioning moieties and associated genitourinary anomalies, and those with incomplete data.

Results: We included 25 patients, of which 16 males (64%) and 9 females (36%), with a mean age of 37 years. Mean serum creatinine level was 66 mmol/L. Eleven patients with a stone size <8 mm were treated expectantly with medical treatment, with only one patient requiring endoscopic intervention. Six patients (24%) with a stone size between 1 cm and ≤2 cm were treated with extracorporeal shock wave lithotripsy (ESWL) with the placement of double J stents, and seven patients (28%) with a stone size of >2 cm were treated with percutaneous nephrolithotomy. One patient with a 10 mm stone was treated using flexible ureteroscopy. No significant perioperative complications were encountered.

Conclusions: Indications, methods of treatment, and outcomes of management of stones associated with HSKs were comparable to those for stones associated with normal kidneys. Tailored approach based on stone size is highly recommended. ESWL accompanied with ureteric stenting is a promising strategy for the management of stones associated with HSKs in selected patients requiring intervention.
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http://dx.doi.org/10.4103/UA.UA_116_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060601PMC
August 2018

Knowledge and attitude about sexually transmitted diseases among youth in Saudi Arabia.

Urol Ann 2018 Apr-Jun;10(2):198-202

Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Background: Sexually transmitted diseases (STDs) are one of the most serious diseases in the world. Our aim was to explore the knowledge and attitude about STDs among the youth.

Patients And Methods: This cross-sectional survey was conducted from August 1 to August 13, 2016. Male and female youth between 18 and 25 years were invited to participate in the survey using social media open to all Internet users consisting of questions and statements about STDs, and then the data were analyzed.

Results: We received 5040 responses to the survey; out of these participants 76.6% were females and 23.4% were males with a mean age 21.5 and most of them were single (85.1%). We noticed that most of the respondents selected the Internet (71.7%) as the main source of their knowledge about STDs followed by school, television, and others, respectively. In spite of, 94.08% knew that human immunodeficiency virus/AIDS is an STD, only 43.61% knew that herpes simplex virus is an STD, and only 31.03% knew that Chlamydia is an STD. A high percent (93.1%) agreed that sexual intercourse transmits STDs. Only 59.6% agreed that condom does not provide complete protection from STDs. To our surprise, only 55% considered themselves capable of protecting themselves against STDs. About 95.8% of the participants agreed that STDs should be taught in schools, while 4.2% disagreed.

Conclusion: We noticed a lack of participant's knowledge regarding the types, mode of transmission, and the ways of protections from STDs and their desire to find out information about STDs. Hence, awareness programs about STDs should be started that aim at encouraging youth to follow our religion and culture.
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http://dx.doi.org/10.4103/UA.UA_14_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5907331PMC
May 2018

Paraganglioma of Urinary Bladder Managed by Laparoscopic Partial Cystectomy in Conjunction with Flexible Cystoscopy: A Case Report.

J Endourol Case Rep 2018 1;4(1):15-17. Epub 2018 Feb 1.

Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Paraganglioma of the urinary bladder (PUB) is exceedingly rare, accounting for <0.1% of all urinary bladder tumors. Various challenging treatment options are available. A 67-year-old female presented with malignant hypertension on four medications for which investigation was done. An observation of having functioning PUB was noted. She was admitted and laparoscopic partial cystectomy was done with the guidance of flexible cystoscopy. She had a smooth postoperative course and was discharged home, then catheter was removed after cystogram. Histopathology confirmed the diagnosis of a bladder paraganglioma. Finally, during the last follow-up, the patient was asymptomatic with controlled blood pressure and normalized catecholamine levels with no evidence of recurrence. PUB is an exceedingly rare tumor that can be managed with minimally invasive techniques such as laparoscopic partial cystectomy with cystoscopy guidance.
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http://dx.doi.org/10.1089/cren.2017.0132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820683PMC
February 2018

Does timing of presentation of penile fracture affect outcome of surgical intervention?

Urology 2011 Jun 25;77(6):1388-91. Epub 2011 Mar 25.

Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Objective: To assess the effect of timing of presentation of cases with penile fracture on the outcome of surgical intervention.

Patients And Methods: Between January 1986 and May 2010, 180 patients with penile fracture were treated surgically in our center. To assess the effect of timing of presentation, patients were classified into 2 groups: group I with early presentation (≤24 hours) and group II with delayed presentation (>24 hours). All patients were contacted by mail or phone and were re-evaluated. All patients were reevaluated by questionnaire and local examination. Patients with erectile dysfunction were evaluated by color Doppler ultrasonography.

Results: Group I included 149 patients (82.8%) and group II included 31 (17.2%). In group I, patients presented to the emergency department from 1-24 hours (mean, 11.8) after occurrence of the penile trauma. Although patients in group II presented from 30 hours to 7 days (mean, 44.7 hours). Both groups were similar regarding etiology of injury, clinical presentation, surgical findings, and incidence of associated urethral injury. Mean follow-up period for group I was 105 months, and for group II it was 113 months. After such long-term follow up, 35 (19.4%) patients had complications; however, there was no statistically significant difference between both groups.

Conclusions: Cases of penile fracture with early or delayed presentation up to 7 days should be managed surgically. Both groups have comparable excellent outcome with no serious long-term complications.
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http://dx.doi.org/10.1016/j.urology.2010.12.070DOI Listing
June 2011

False penile fracture: value of different diagnostic approaches and long-term outcome of conservative and surgical management.

Urology 2010 Jun 29;75(6):1353-6. Epub 2010 Mar 29.

Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Objectives: We determined the value of clinical and radiological findings in diagnosis of false penile fracture. Also, the long-term outcome of conservative and surgical treatment of such patients was evaluated.

Methods: Seventeen patients with false penile fracture were treated conservatively (3 patients) and surgically (14 patients) at our center. Medical records were retrospectively reviewed for etiology, symptoms, signs of physical examination, and information on findings of surgical exploration. Data on erectile function and penile sequelae were obtained during follow-up using the Sexual Health Inventory for Men (SHIM) questionnaire and local examination.

Results: The most common cause of false penile fracture is sexual intercourse (76.5%). False fracture was suspected in 3 patients who presented with small hematoma and slow post-trauma detumescence; intact tunicas were diagnosed by magnetic resonance imaging (MRI) in all of them and were managed conservatively. Surgical penile exploration was performed in 14 cases, in whom preoperative ultrasound was done in 6, and it was false positive for presence of tunical tear in 50%. Exploration revealed nonspecific dartos bleeding in 9 cases and avulsed superficial dorsal vein in 5. Long-term follow-up (mean=93 months) was available for 16 patients, among whom there was no complications.

Conclusions: In most cases, false penile fracture is indistinguishable from true penile fracture either clinically or radiologically. In atypical cases, MRI seems to be a promising modality for diagnosis of such patients. The long-term outcome of conservative and surgical treatment is excellent.
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http://dx.doi.org/10.1016/j.urology.2009.11.086DOI Listing
June 2010

Long-term outcome of surgical treatment of penile fracture complicated by urethral rupture.

J Sex Med 2010 Nov;7(11):3784-8

Mansoura Urology and Nephrology Center-Urology, Mansoura, Egypt.

Introduction: The combination of lesions of the penile urethra and the corpus cavernosum is rare and is likely to worsen the immediate and long-term prognosis.

Aim: To assess the late effects of penile fractures complicated by urethral rupture treated by immediate surgical intervention.

Methods: Fourteen patients with concomitant urethral rupture were treated surgically at our center. Those patients were seen in the outpatient follow-up clinic and were re-evaluated.

Main Outcome Measures: Sexual Health Inventory for Men questionnaire, local examination, uroflowmetry and penile color Doppler ultrasound.

Results: The most common cause of penile fracture is sexual intercourse (50%). The site of tunical tear was in the proximal shaft of the penis in 3 patients (21%) and in the mid of the shaft in 11 patients (79%). Urethral injury was localized at the same level as the corpus cavernosum tear in all cases; and it was partial in 11 cases and complete in 3. Long-term follow-up (mean=90 months) was available for 12 patients; among whom there was no complications in 4 (33%), painful erection in 1 (8%), erectile dysfunction in 2 (17%), and palpable fibrous nodule in 5 (47%). All patients had a normal urinary flow except one who developed relative urethral narrowing that required regular dilatation for 1 month.

Conclusions: The urethral injury complicating penile fracture is often partial and localized at the level of the corpora cavenosa tear. Standard treatment consists of immediate surgical repair of both urethral and corporal ruptures with no harmful long-term sequelae on urethral and erectile function in most of patients.
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http://dx.doi.org/10.1111/j.1743-6109.2009.01653.xDOI Listing
November 2010

Penile fracture: long-term outcome of immediate surgical intervention.

Urology 2010 Jan 6;75(1):108-11. Epub 2009 Nov 6.

Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Objectives: To assess the etiology and the late effects of penile fractures treated by immediate surgical intervention.

Methods: Between 1986 and 2008, a total of 155 patients with penile fracture were treated surgically in our center. The interval from injury to presentation was between 1 and 96 hours. Those patients were contacted by mail or phone and were re-evaluated. All patients were re-evaluated by questionnaire and local examination. Patients with erectile dysfunction were evaluated by color Doppler ultrasonography.

Results: The most common cause of fracture of penis is sexual intercourse (51.5%). Unilateral and bilateral corporeal ruptures were present in 139 (89.7%) and 3 (1.9%) cases, respectively, whereas no tunical tear was found in 13 (8.4%) cases. Concomitant urethral injury was present in 14 (9%) cases. Long-term follow-up (>12 months) was available for 141 patients; among whom there was no complications in 108 (77%), painful erection in 2 (1.3%), penile deviation in 5 (3.2%), both in 1 (0.7%), erectile dysfunction in 11 (7.8%), and palpable scarring in 14 (10%). Scar formation was highly associated using nonabsorbable sutures (P <.001).

Conclusions: Vigorous sexual intercourse was found to be the most common cause of penile fracture. Immediate surgical intervention has low morbidity, short hospital stay, rapid functional recovery, and no serious long-term sequelae. Nonabsorbable sutures should be avoided as it has a higher incidence of scar formation.
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http://dx.doi.org/10.1016/j.urology.2009.08.057DOI Listing
January 2010