James B. McGeady

The effect of the new 2010 World Health Organization criteria for semen analyses on male infertility.

OBJECTIVE To quantify the effect of the new 2010 World Health Organization (WHO) semen analysis reference values on reclassifying previous semen analysis parameters and definition of patients with male factor infertility. DESIGN A multi-institutional retrospective chart review. SETTING University and private male infertility clinics. PATIENT(S) Men referred for infertility evaluation. INTERVENTION(S) Comparison of semen analysis values based on 2010 versus 1999 reference criteria. MAIN OUTCOME MEASURE(S) Quantification of the change based on individual sperm parameters and as a whole. RESULT(S) A total of 184 men had at least two semen analyses; 13 (7%), 17 (9.2%), 34 (18.4%), and 29 (15.7%) patients changed classification to being at or above the reference values by the 2010 criteria for semen volume, sperm concentration, motility, and morphology, respectively. A total of 501 men had one semen analysis on file; 40 (7.9%), 31 (6.2%), 50 (9.9%), and 74 (19.3%) would change classification for volume, concentration, motility, and morphology, respectively. Overall, 103 patients (15.1%) who had one or more parameter below the reference value on the original analysis were converted to having all parameters at or above the 2010 reference values. CONCLUSION(S) The 2010 reference values result in some infertile men being reclassified as fertile if status is based on semen analysis alone. This may lead to fewer men being referred for proper infertility evaluation or treatment.

Current epidemiology of genitourinary trauma.

This article reviews recent publications evaluating the current epidemiology of urologic trauma. The authors briefly explain databases that have been recently used to study this patient population and then discuss each genitourinary organ individually, utilizing the most relevant and up-to-date information published for each one. The conclusion of the article briefly discusses possible future research and development areas pertaining to the topic.

Subcutaneous Penile Insertion of Domino Fragments by Incarcerated Males in Southwest United States Prisons: A Report of Three Cases

INTRODUCTION Self-insertion of penile foreign bodies is performed worldwide, largely due to a perception that it will enhance sexual performance and virility. There are relatively few cases reported in the United States. AIM We report three cases of Hispanic men incarcerated in separate southwest United States prisons who utilized a similar technique to insert foreign bodies fabricated out of dominos into the subcutaneous tissues of the penis. METHODS Details of the three cases were retrospectively reviewed. MAIN OUTCOME MEASURE Resolution of the case. RESULTS In each case, an incarcerated Hispanic male or fellow inmate filed a domino into a unique shape for placement under the penile skin. Utilizing the tip of a ballpoint pen or a sharpened shard of plastic to create a puncture wound, each man inserted the domino fragment into the subcutaneous tissue of the penis. All three men presented with infection requiring operative removal. CONCLUSIONS Incarcerated males put themselves at risk for injury and infection when attempting penile enhancement with improvised equipment.

No small slam: increasing incidents of genitourinary injury from toilets and toilet seats

To describe the epidemiology of genitourinary (GU) injury from toilets that present to USA Emergency rooms (ERs).

Zip‐related genital injury

To describe the epidemiology of genital injuries caused by trouser zips and to educate both consumers and the caregivers of patients who sustain such injuries.

Electronic Preconsultation as a Method of Quality Improvement for Urological Referrals

Introduction: Preconsultation exchange is a method to promote expedited care among health care providers through communication between primary care providers and specialists before a clinic visit. We evaluated the efficacy of a preconsultation exchange in streamlining patient visits to the urology clinic with an emphasis on resource efficiency in a safety net hospital. Methods: Between April 1, 2011 and March 31, 2012 there were 1,705 electronic referrals to our urology department. A random sample of 500 referrals was selected for evaluation, of whom 487 patients met study inclusion criteria. Scheduling outcome and preconsultation exchange were evaluated for each chief complaint. Results: Patients with operative or procedural chief complaints, or potential oncologic diagnoses were most likely to be scheduled directly to the urology clinic. Of the 487 patients 36 (7.4%) were treated for benign urological conditions by primary care providers and did not need to be seen in the urology clinic. For 13.5% of patients recommended laboratory and radiological tests were obtained before the initial urology clinic visit as a result of preconsultation exchange. Conclusions: Electronic preconsultation exchange served as a method of quality improvement by promoting urology clinic efficiency. Unnecessary appointments were limited and the completeness of appropriate laboratory and imaging studies at the initial visit was increased. Health care was streamlined by increased access to urological care and by management of benign urological conditions without a formal clinic visit in appropriate cases.