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A 23-year-old Falabella gelding kept in Tochigi, Japan, for more than 20 years presented with a recurrent mass of the glans penis that was first noticed about a year earlier. Partial phallectomy was performed with no adjunctive therapy for local regrowth of the mass. The horse was euthanized 3 months after surgery for urinary retention due to suspected regrowth. The resected mass affected the genital and urethral mucosa of the glans penis, and was diagnosed as equine sarcoid by histopathology and identification of bovine papillomavirus (BPV) DNA. Phylogenetic analysis of the BPV genome of the sarcoid showed high sequence homology to BPV type 1 (BPV-1) from Hokkaido, Japan, suggesting a geographical relationship for BPV-1 in Japan.

Objective: To report the clinical outcome of urethral reconstruction by cultured urothelial or oral mucosa cells for tissue-engineered urethroplasty. Methods: We systematically searched for studies reporting the use of tissue-engineered techniques for hypospadias and urethral stricture repair in humans in PubMed and Embase (OvidSP) through January, 1990 to June, 2018. We excluded studies based on titles that clearly were not related to the subject, studies in which tissue-engineered biomaterial were used only in laboratory or experimental animals, and in the absence of autologous cultured epithelial cells. Studies were also excluded if they were not published in English, had no disease background and adequate follow-up. Finally, we search all relevant abstract presented at two of the main urological meetings in the last 10 years: European Association of Urology (EAU) and American Urological Association (AUA). Results: A total of six articles, reporting the clinical use of tissue-engineered techniques in humans, were fully reviewed in our review. The epithelial cells were harvested from the urethra (10 patients), the bladder (11 patients) and the mouth (104 patients). The tissue-engineered grafts were used in children for primary hypospadias repair in 16 cases, and in adults for posterior and anterior urethral strictures repair in 109 cases. Tissue-engineered grafts were showed working better in children for primary hypospadias repair than in adults for urethral strictures repair. Conclusion: One hundred and twenty-five patients received tissue-engineered urethroplasty using cultured epithelial cells for primary hypospadias or urethral strictures repair. The studies demonstrate a high degree of heterogeneity respect to epithelial cells (from urethra, bladder, and mouth), type of scaffold, etiology, site of urethral stricture, number of patients, follow-up and outcomes. Keywords: Urethra, Urethroplasty, Tissue engineering, Urethral mucosa, Oral mucosa, Surgical technique

Objective A urethral diverticulum (UD) is a localised evagination of the urethral mucosa that forms a herniation that is continuous with the lumen of the urethra. We report of a patient who presented with a persistent UD during consecutive pregnancies and present a review of the current literature of other cases of UD during pregnancy. Methods A literature search was undertaken to identify previous research and case reports on the clinical presentation and management of UD in pregnancy using the search terms “pregnancy” and “urethral diverticulum”. Medline, PubMed and Cinahl were used as search engines. Results Six publications that described UD in pregnancy were identified with a total of nine cases documented within the literature. The articles reviewed showed that UD during pregnancy can be managed conservatively with expectant management, antibiotics and incision and drainage if required. Conclusion Overall, it is important for clinicians treating women in pregnancy to be aware of the rare diagnosis of UD, especially in those women who present with vague urinary symptoms refractory to other treatments. Brief Summary A case presentation of UD and literature review of UD in pregnancy., Highlights • A urethral diverticulum is an evagination of the urethral mucosa that forms a herniation that is continuous with the lumen of the urethra. • We report the case of a patient who presented with a persistent urethral diverticulum during consecutive pregnancies. • A literature search identified six publications that described urethral diverticulum in pregnancy, with a total of nine cases. • It is important for clinicians treating women in pregnancy to be aware of the rare diagnosis of urethral diverticulum.

Background: The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis. Methods: The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings. Results: The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ≥5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%-75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%-40.93%) for the conventional method. At a threshold of ≥2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%-90.5%) and 50% (95% CI, 33.15%-66.85%) in all patients, and 66.67% (95% CI, 41.71%-84.82%) and 20% (95% CI, 7.047%-45.19%) in cases without visible urethral discharge, respectively. Conclusion: The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings. WOS:000574642100014 32649578 Q3

A 23 year old Ugandan, Black, Mukiga, mother of two presented to us one year after delivery with severe lower abdominal pain, failure to pass urine, slight vaginal bleeding and a mass protruding from her vagina. Vaginal examination revealed she had a prolapsed urethral mucosa which was undergoing ischemic necrosis. Her condition was successfully treated by surgical excision of the prolapsed mucosa. The patient had no urinary, genital or other symptoms at 6 weeks, 6 months and at one and half years follow up. Keywords: Urethral, Mucosa, Prolapse, Post-partum patient

Urethral prolapse (UP) is a circular complete eversion of the distal urethral mucosa through the external meatus. It is a rare condition seen mostly in African-American premenarcheal girls. Both a medical and a surgical approach to this condition have been described. We present a case of a spontaneous urethral prolapse in a 60-year-old postmenopausal Caucasian woman, who failed medical management and underwent successful surgical management. The patient is asymptomatic 18 months following the procedure.

Urethral mucosa with intestinal metaplasia and dysplasia is a rare occurrence. To date only a single case has been reported in a male with long-standing urethral stricture. We present a 33-year-old female with polypoid intestinal metaplasia and dysplasia of the external urethral meatus in the absence of an inciting factor. Intestinal metaplasia of the urethral mucosa may undergo dysplasia, emphasizing the necessity of a high degree of clinical suspicion and vigilant pathological examination of these lesions.

Urethral prolapse is a rare cause of vaginal bleeding in prepubertal females and occurs most commonly in black people. It is characterized by a sliding outward of the urethral mucosa around the entire urethral meatus. Because it can present with vaginal bleeding in a child, it can be mistaken for sexual abuse. We report a five-year-old girl with urethral prolapse that was mistaken for complications of sexual abuse. She was treated by complete excision of the urethral prolapse with satisfactory result. Key words: Urethral prolapse, Vaginal bleeding, Female, Prepubertal. Nigerian Journal of Paediatrics Vol.31(1) 2004: 29-31

For the reconstruction of urethra-vesical anastamosis after radical prostatectomy and for neobladder reconstruction, taking adequate sutures to include the urethral mucosa is vital. Due to the retraction of the urethra and unfriendly pelvis, the process of taking satisfactory urethral sutures may be laborious. Here, we describe a simple method by which we could overcome similar technical problems during surgery using Foley catheter as the guide for the suture.