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BackgroundInfection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection.Case presentationWe present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course.ConclusionBrucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

Recurrent testicular torsion after previous orchiopexy is rare and needs high index of suspension to avoid misdiagnosis and delayed management. This case showed that this diagnosis can occur even when the testis is still fixed to the scrotal wall. A 31-year-old male who had previous testicular fixation for testicular torsion with a single stitch to the lower pole before 6 years presented with recurrent testicular torsion and missed diagnosis. This case confirm that recurrent testicular torsion after previous fixation should be included in the differential diagnosis of acute scrotum and emphasis on the testicular fixation with nonabsorbable suture in at least two points to prevent recurrent torsion.

Following publication of the original article [1], the authors identified an error in an author’s name.

Introduction: Telemedicine is using telecommunication tools for education, evaluation, decision-making and treatment Urology is well suited to potentially lead it as a surgical subspecialty 1 Telemedicine has the power to make doctor visits more efficient2 such as outpatient hematuria referrals 3 Aim: early, safe and cost effective Urology outpatient clinic department (OPD) Methods: Urology electronic OPD appointments (patients >14 years) were reviewed one month ahead in AlWakra Hospital during (November 2019 – February 2020) Inclusion: new patients with incomplete workup, follow up patients whom new workup did not show abnormality Exclusion: patients need to attend for physical exam, abnormal labs/imaging, counselling for surgery, suspected malignancy or non compliance (medical record) Patients were called by hospital telephone, assessed, instructed to do labs/imaging (requested electronically), given refill medications and their future clinic appointment was managed accordingly All cases were registered electronically for quality control Patient satisfaction survey was carried out Results: 169 patients, age (16–89) years Eligible patients approached by telephone were 106, out of whom 82 responded (4 new, 78 follow up) Outcome of telecommunication (82): 28 refilled medications and rescheduled, 13 discharged from Urology clinic, 5 cancelled (double appointment), 5 booked into dedicated stone clinic and 31 instructed to complete workup/or refilled medications Gained OPD slots were 51 Patients with exclusion criteria, not responding or asked to attend, had kept original appointment Satisfaction survey: 75 satisfied, 3 not satisfied and 4 not sure Conclusion: Telemedicine in Urology clinic is applicable, offers early, safe, and cost effective management

Penile fracture is not uncommon blunt trauma to the penis. Here, we present a rare case of penile fracture during sexual intercourse. The patient presented with penile swelling, bleeding per urethra, and inability to pass urine. Retrograde urethrogram showed significant extravasation of contrast from anterior penile urethra and no contrast passing to proximal urethra. Surgical exploration showed complete urethral rupture and bilateral cavernosal rupture. This case represents the value of urethrogram to evaluate the urethral injury and the association of complete urethral injury with bilateral ventral cavernosal injury.