We present a case of a male patient with a history of renal allograft transplant four years prior to admission who presented with acute kidney injury. There were initial concerns for acute transplant rejection due to elevated creatinine. Urine cultures were positive for Gardnerella vaginalis. Renal biopsy results were concerning for chronic pyelonephritis. The patient developed hypertension, fever, and hematuria during the hospital course. He was initially treated with metronidazole, vancomycin, and cefepime. Broad-spectrum antibiotics were quickly discontinued, and the patient improved with metronidazole monotherapy. Patients with a history of renal transplants are often immunocompromised and at risk of infection. The few reported cases primarily involve urinary tract infections. There are scarce reports in the literature of G. vaginalis infection in patients with renal allograft transplants, such as in the present case. This case highlights the importance of considering and treating G. vaginalis in patients with renal transplants who present with symptoms of urinary tract infection.

Translation: The University of Toledo Journal of Medical Sciences is the online journal launched by the University of Toledo. Manuscripts will be considered on the understanding that they report original work and are not under consideration for publication by any other journal. The journal publishes original articles reporting experimental results of basic or clinical research, case reports, and reviews. The journal uses a single blind peer review system and each manuscript, based on the results presented in its original submission, will be evaluated by two student reviewers and one faculty reviewer. This process will provide an opportunity for medical students, graduate students, residents, fellows and faculty to publish research observation in a timely manner.

In this case report, we present two clinical cases of penile strangulation caused by a bottleneck at the base of the penis. In the first case, corporal aspiration was used to decrease the blood that is trapped in the corpora due to the constriction. A rotating saw was used to incise the bottleneck in a full-thickness manner. The plastic bottleneck was successfully incised and extricated with the rotating saw while the penile shaft was protected. This technique is novel and unique, as there are no prior instances in the literature where both corporal aspiration and a rotating saw were used simultaneously. In the second case, penile strangulation was resolved with a ring cutter, which allowed the bottleneck to be extricated without causing further laceration. Both the combined use of corporal aspiration and a rotating saw, as well as the utilization of a ring cutter, were efficacious approaches that led to immediate improvement in the patients.

Introduction: We examined three patient characteristics: body mass index (BMI), the American Society of Anesthesiologists (ASA) status, and pre-admission testing (PAT), and their effect on total operating room (OR) time for six urologic procedures, including ureteroscopy, transurethral resection of the prostate (TURP), transurethral resection of bladder tumor (TURBT), prostatectomy, nephrectomy, and kidney transplants. Methods: We investigated the effect of these patient factors on OR time using linear regression for urologic procedures from The University of Toledo Medical Center from 2015 to 2020. Results: An increase in BMI was found to correlate with a statistically significant increase in total OR time for ureteroscopy, prostatectomy, and kidney transplant. The PAT showed a decrease in OR time for TURBT cases and an increase for kidney transplant cases. We found no correlation between the ASA status and changes in the total OR time. Conclusions: A higher BMI significantly increases the total OR time for robotic-assisted prostatectomy and kidney transplant but has a minimal effect on endoscopic procedures. Our results do not support ASA status as a predictor of total OR time. Due to the lack of consistency in results for PAT for the different procedures analyzed, further exploration of the effect of this patient factor on OR efficiency is needed.

Translation: The University of Toledo Journal of Medical Sciences is the online journal launched by the University of Toledo. Manuscripts will be considered on the understanding that they report original work and are not under consideration for publication by any other journal. The journal publishes original articles reporting experimental results of basic or clinical research, case reports, and reviews. The journal uses a single blind peer review system and each manuscript, based on the results presented in its original submission, will be evaluated by two student reviewers and one faculty reviewer. This process will provide an opportunity for medical students, graduate students, residents, fellows and faculty to publish research observation in a timely manner.