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Loeb CA, Hammad MAM, Barham DW, Miller J, Young K, Horwitz R, Amini E, Nguyen MX, Nag N, Jenkins LC, Pearlman AM, Yafi FA. Trends, safety, and efficacy of wearable male sexual devices. Sex Med Rev 2024:qead053. [PMID: 38686687 DOI: 10.1093/sxmrev/qead053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/05/2023] [Accepted: 11/19/2023] [Indexed: 05/02/2024]
Abstract
INTRODUCTION The prevalence of male sexual dysfunction (MSD) increases with age, with >50% of men aged >40 years reporting erectile dysfunction (ED). In recent years, wearable male sex devices (WMSDs) have been increasingly utilized by patients and recommended by sexual medicine clinicians. OBJECTIVES This study seeks to investigate the safety and efficacy of products currently marketed for the treatment of MSD. METHODS Available products for WMSDs were reviewed by analyzing product websites, forums, advertisements, and clinical recommendations. Qualitative comparisons were based on patient reviews, cost, and specific features. Investigatory evidence and Food and Drug Administration status were also reviewed. Additionally, Google Trends was used to determine the popularity of devices over time. RESULTS Eight WMSDs for the treatment of MSD and enhancement of sexual pleasure were reviewed. Constriction bands, such as the Maintain Ring Loop, Eddie by Giddy, and Xialla, have shown significant benefits in clinical trials and were the most popular devices among patients. Smart devices can provide real-time feedback on erectile quality and/or sexual performance. Similar to the RigiScan, the Adam sensor provides feedback on erectile quality while monitoring changes in penile tumescence during sleep with additional analysis available through a mobile application. Neuromodulation devices such as the Morari Patch and vPatch/in2 Patch use electrical stimulation to delay ejaculation and improve sexual function. The FirmTech Performance Ring uses sensors to track the vital signs of erectile fitness with clinical trials ongoing. CONCLUSIONS Overall, this review describes the available investigatory evidence for a range of WMSDs and highlights the potential benefits and limitations of these devices in treating MSD and enhancing sexual pleasure. Further research is needed to evaluate the effectiveness of these devices and to determine which ones may be the most suitable for individual patients.
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Affiliation(s)
- Charles A Loeb
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - Muhammad A M Hammad
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - David W Barham
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - Jake Miller
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - Kirsten Young
- School of Medicine, University of California Irvine, Orange, CA, 92617, United States
| | - Rainey Horwitz
- Department of Urology, Emory University, Atlanta, GA, 30322, United States
| | - Eliad Amini
- School of Medicine, University of California Irvine, Orange, CA, 92617, United States
| | - Mai Xuan Nguyen
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - Nitish Nag
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
| | - Lawrence C Jenkins
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
- Department of Urology, Tulane University, New Orleans, LA, 70112, United States
| | - Amy M Pearlman
- Prime Institute, Fort Lauderdale, FL, 33301, United States
| | - Faysal A Yafi
- Department of Urology, University of California Irvine, Orange, CA, 92868, United States
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Skalak M, Jirjis R, Anderson BG, Miller BD. Robot-Assisted Repair of Bladder Rupture following Penile Ring Entrapment. Case Rep Urol 2023; 2023:5523569. [PMID: 37719234 PMCID: PMC10501845 DOI: 10.1155/2023/5523569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/06/2023] [Accepted: 08/11/2023] [Indexed: 09/19/2023] Open
Abstract
Penile rings have been used to help sustain erection and enhance sexual pleasure for centuries. Constriction of the penis reduces the outflow of blood from the cavernosal tissue. However, if left for an extended time period, a condition called penile ring entrapment can occur. This may result in severe edema, gangrene, necrosis, and even penile amputation. Penile ring entrapment is a very rare condition; complete urinary obstruction with concomitant bladder rupture as a result renders this case even more extraordinary. We discuss our experience in the management of a 64-year-old man, who presented with altered mental status and inability to urinate, found to have penile ring entrapment and intraperitoneal bladder rupture. Removal of the constricting ring was performed in the ED, and bladder injury and penile necrosis were subsequently repaired with robot-assisted laparoscopic cystorrhaphy, penectomy, and perineal urethrostomy.
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Affiliation(s)
- Matthew Skalak
- Detroit Medical Center Urology Residency, Harper Professional Building, 4160 John R St., Suite 1017, Detroit, MI 48201, USA
| | - Rami Jirjis
- Detroit Medical Center Urology Residency, Harper Professional Building, 4160 John R St., Suite 1017, Detroit, MI 48201, USA
| | - Barrett G. Anderson
- Detroit Medical Center Urology Residency, Harper Professional Building, 4160 John R St., Suite 1017, Detroit, MI 48201, USA
| | - Brandi D. Miller
- Detroit Medical Center Urology Residency, Harper Professional Building, 4160 John R St., Suite 1017, Detroit, MI 48201, USA
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3
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Wang KG, Zhang J, Chen YH, Xia JZ, Li LG, Gu XE. Removal of a Hard Plastic Bottleneck Causing Penile Strangulation With Holmium Laser. Urology 2023; 176:e1-e2. [PMID: 36858320 DOI: 10.1016/j.urology.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 02/05/2023] [Indexed: 03/03/2023]
Affiliation(s)
- Kai-Ge Wang
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China
| | - Jun Zhang
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China
| | - Yong-Hua Chen
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China
| | - Jun-Zhe Xia
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China
| | - Lin-Ge Li
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China
| | - Xian-En Gu
- Department of Urology, Beijing Chuiyangliu Hospital, Beijing, China.
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Mugialan P, Fahmey O, Lee C, Arvind J, Saiful Azli MZ, Khairul Asri MG. A case of penoscrotal ring incarceration: lesson from experience. ANDROLOGY AND GENITAL SURGERY 2023. [DOI: 10.17650/2070-9781-2022-23-4-110-112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Penoscrotal incarceration is a rare complication commonly caused by penile ring application for sexual enhancement. Due to rarity of this condition, managing this condition is still a challenge for many urologists. Here, we present a 31 years old man who presented to our centre with two days history of penile and scrotal swelling after fitting penile ring. We will present method used by our team in managing this rare condition.
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Pandher M, Oparanozie A, Song A, Mahajan J, Berg C, Fernandez G, Chang C, Alwaal A, Weiss R. Characterization of genital injuries secondary to foreign bodies from 2011 to 2020. Investig Clin Urol 2023; 64:66-73. [PMID: 36629067 PMCID: PMC9834569 DOI: 10.4111/icu.20220316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To identify demographic trends of foreign object genital injuries presenting to emergency departments from 2011 to 2020. MATERIALS AND METHODS The National Electronic Injury Surveillance System database reports consumer product-related injuries in United States ED visits. The database was queried to identify 375 cases of genital injuries from 2011 to 2020. Inclusion criteria consisted of cases reporting injuries involving the urethra, penis, or scrotum. Data was reported and analyzed using linear regression. RESULTS Based on 375 cases, an estimated 13,170 (95% confidence interval, 10,817-15,522) patients in the US suffered genital injuries due to foreign bodies between 2011 and 2020. These injuries involved the penis (65.9%), urethra (30.7%) and scrotum (3.5%). Of all patients, 11.8% required hospital admission after treatment of which injuries to the urethra were most common (44.0%). Most of these patients were ages 19 to 64 (66.1%). Consumer products most implicated included rings (50.7%), zippers (17.1%), and pens and pencils (10.3%). Injuries due to zippers and swimming apparel occurred significantly more frequently in patients ages 0-18 (p<0.05). Injuries due to kitchen gadgets occurred significantly more in patients ages ≥65 (p<0.05). Pens, pencils, and massage devices were items that routinely resulted in urethral injuries, often requiring hospitalization. Linear regression showed genital injuries related to foreign objects significantly increased from 2011 to 2020 (p<0.001). CONCLUSIONS Due to the nature of injury caused to genitalia by intentional and unintentional exposure to foreign bodies, educating individuals on this topic in sexual education classes is necessary for preventing future injuries.
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Affiliation(s)
- Meher Pandher
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Arnold Oparanozie
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Amy Song
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Jasmine Mahajan
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Courtney Berg
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Gabriel Fernandez
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Chrystal Chang
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Amjad Alwaal
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
| | - Robert Weiss
- Division of Urology, New Jersey Medical School to Newark, Newark, NJ, USA
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Puspaningrat AAP, Kloping YP, Renaldo J. Management of prolonged penile ring entrapment in an Indonesian tertiary hospital: A case report and literature review. Urol Case Rep 2022; 45:102202. [PMID: 36185756 PMCID: PMC9523068 DOI: 10.1016/j.eucr.2022.102202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/15/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022] Open
Abstract
Penile ring entrapment is a rare urological emergency with severe functional consequences if not treated in time. It may be challenging for physicians in limited-resource settings without a standardized intervention method. An lectrical grinder is the most commonly used tool for ring removal. However, in prolonged cases, additional post-removal interventions may be necessary. We report a prolonged penile ring entrapment case in an Indonesian tertiary hospital. Penile ring entrapment is a rare urological emergency. Prolonged ring entrapment could lead to irreversible damage. Electric grinder and continuous saline injection are used for penile ring removal.
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7
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Nguyen TT, Ngo XT, Chau QT, Hoang KC, Dinh LQV, Ly HT, Hoang TD, Dobbs RW, Thai MS. Use of dental drill handpiece to remove steel nut causing penile strangulation: a case report and review of the literature. J Med Case Rep 2022; 16:158. [PMID: 35440026 PMCID: PMC9020065 DOI: 10.1186/s13256-022-03342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Penile strangulation is an uncommon urological emergency that requires prompt intervention to avoid potentially serious sequelae including loss of the distal penis secondary to ischemia and subsequent gangrene. We present a case report of a patient who presented to the hospital with penile strangulation injury of 10-hour duration secondary to the presence of a thick hexagonal steel nut. This case is presented in accordance with Consensus Surgical Case Report guidelines. CASE PRESENTATION A 24-year-old Vietnamese man presented to the emergency room with urinary retention and decreased penile sensation following a 10-hour history of penile strangulation due to the presence of a thick hexagonal steel nut that he had placed around the shaft of the penis for the purpose of sexual enhancement during masturbation. The hexagonal nut was tightly entrapping the penile shaft, resulting in edema, congestion, and swelling of the distal 5 cm of the phallus. Given the thickness of the foreign body as well as the degree of penile swelling, we were unable to remove the hexagonal nut using traditional methods of alleviating penile strangulation injuries. Following consultation with a dental colleague, a dental diamond drill handpiece was utilized to cut the foreign body without injury to the underlying penile skin. Subsequent follow-up in clinic demonstrated no significant urinary or sexual sequalae from this episode. CONCLUSION We report a case of penile strangulation requiring novel instrumentation and collaboration for successful treatment.
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Affiliation(s)
- Tuan Thanh Nguyen
- Cho Ray Hospital, Ho Chi Minh City, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Xuan Thai Ngo
- Cho Ray Hospital, Ho Chi Minh City, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | - Ryan W Dobbs
- Cook County Health and Hospitals System, Chicago, IL, USA
| | - Minh Sam Thai
- Cho Ray Hospital, Ho Chi Minh City, Vietnam. .,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Zeid M, Sayedin H, Nabi N, Abdelrahman M, Jacob PT. Penile Entrapment With Thick Penile Ring: A Case Report and Literature Review. Cureus 2022; 14:e21034. [PMID: 35155002 PMCID: PMC8820492 DOI: 10.7759/cureus.21034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 12/03/2022] Open
Abstract
The penis is one of the end-artery organs in the human body. The blood supply of the penis depends on the internal pudendal artery, which arises from the anterior division of the internal iliac artery. Subsequently, the penis is one of the organs that are highly affected by peripheral vascular disease. Furthermore, erectile dysfunction is a clinical sign that might precede coronary heart disease. Artificial entrapment of the blood into the cavernous bodies is one of the treatment options for erectile dysfunction. In addition, the same concept might be utilized in some sex aids to increase self-pleasure; hence, penile rings are widely used in some cultures. We present here a case of metal penile ring entrapment, which was managed successfully with the help of the hospital maintenance team. Therefore, it is of tremendous importance in unusual cases to seek advice from all possible resources. Such complications should be highlighted to increase the awareness of the users and the medical professionals as well.
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9
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Forrester MB. Penis Ring Injuries Treated at Emergency Departments. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:103-111. [PMID: 33734034 DOI: 10.1080/0092623x.2021.1900003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to determine the pattern of penis ring-related injuries in the US. During 2000-2019, 162 penis ring-related injuries (for a national estimate of 6,344 such injuries) were treated at US emergency departments (EDs). Of the estimated injuries, 32.3% occurred during 2000-2011 and 67.7% during 2012-2015. The patients were 49.8% age 30-49 years. The most common types of injuries were ring stuck on the penis or scrotum (75.3%), edema (29.9%), pain (18.7%), and contusion or abrasion (7.6%). In 81.9% of the estimated injuries, the patient was treated or examined at the ED and then released.
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10
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Walters U, Gresty H, El-Husseiny T. Engagement of Other Emergency Services in the Management of Penile Ring Entrapment. Urology 2021; 152:10-11. [PMID: 33621586 DOI: 10.1016/j.urology.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
Penile ring entrapment is a rare urological emergency, which may risk tissue loss if not managed appropriately. We present the case of a 59-year-old man with penile ring entrapment secondary to the placement of 14 metallic rings for sexual pleasure. We recommend involvement of the fire emergency service if local equipment is inadequate for urgent penile ring removal.
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Affiliation(s)
- Uma Walters
- Department of Urology, Imperial College Healthcare NHS Foundation Trust, London, United Kingdom.
| | - Helena Gresty
- Department of Urology, University College London, Hospital NHS Foundation Trust, London, United Kingdom
| | - Tamer El-Husseiny
- Department of Urology, Imperial College Healthcare NHS Foundation Trust, London, United Kingdom
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11
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Harris E, Llompart D, Izquierdo G, Aziz MA. Patient With Penile and Scrotal Strangulation Due to Prolonged Use of a Metal Ring Device. Cureus 2020; 12:e11928. [PMID: 33425509 PMCID: PMC7785473 DOI: 10.7759/cureus.11928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Penile and scrotal incarceration by a metal ring is a rare urological emergency that requires immediate removal of the strangulating object to avoid severe clinical consequences. Metal rings are used to enhance sexual activity. Here we present a case of penile and scrotal entrapment in a young patient who presented three hours after removal with fever and pain. Before removal, the ring had remained in place for over 48 hours. This case highlights the importance of prompt treatment of these patients as complications such as gangrene can occur if not treated expediently.
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Affiliation(s)
- Emily Harris
- Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Diana Llompart
- Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Guillermo Izquierdo
- Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.,Internal Medicine, Jackson Memorial Hospital, Miami, USA
| | - Muhammad A Aziz
- Internal Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.,Internal Medicine, Jackson Memorial Hospital, Miami, USA
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12
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Kyomukama LA, Ssebuufu R, Wani SA, Waziri MA, Lule H. Penile ring entrapment and strangulation: A case report at Kampala International University Teaching Hospital in Western Uganda. Int J Surg Case Rep 2020; 80:104982. [PMID: 33607367 PMCID: PMC7900217 DOI: 10.1016/j.ijscr.2020.09.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 11/04/2022] Open
Abstract
Penile ring entrapment is when a ring previously inserted onto penis is left for extended period of recommended time. Delayed removal of the ring lead to strangulation that presents challenges to general surgeons and institution to manage it. Pilot bearing ball ring was removed by cutting with electrically powered angled grinder
Introduction Penile ring entrapment during self-sexual satisfaction is one of the rare cases in general and urologic surgery. When the penile shaft is entrapped in a metal ring, one risks possible complete loss of distal penis to strangulation and gangrene. We present management of a case of entrapped penile ring with penile strangulation in resource limited set up amidst absence of management guidelines. The case has been reported in line with SCARE criteria (1). Presentation of case A 43-year-old male presented after 72 h of pilot ball bearing ring penile insertion for sustainability of an erection, with 24 -h history of painful penile swelling and acute urine retention. The patient had history of using recreational drugs and erectile dysfunction with evidence of high-grade penile injuries at presentation. The ring was cut using electrically powered angled grinder, with full penile recovery on conservative management in eight months of follow up. Discussion Entrapped penile ring is clinically diagnosed but establishing incentive of insertion is difficult just like identifying a correct technique to remove it. Entrapped ring obstructs blood and lymphatic flow leading to oedema and ischaemia with associated penile tissue injuries. High grade penile injuries or penile amputation are sequels of delayed ring removal and good outcomes are tangible through timely multidisciplinary approach. Conclusion Eroticism and erectile dysfunctions are known incentive to using penile rings to sustain erection. Delayed ring removal results in its entrapment and penile strangulation and related complications. Timely removal of ring requires multidisciplinary approach and local management protocols.
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Affiliation(s)
- Lauben Amagara Kyomukama
- Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda.
| | - Robinson Ssebuufu
- Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda.
| | - Shaban Abdullah Wani
- Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda.
| | - Musa Abbas Waziri
- Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda; Department of Surgery, Muhammad Shuwa Memorial Hospital, Maiduguri, Nigeria.
| | - Herman Lule
- Department of Surgery, Kampala International University Teaching Hospital, P.O. Box 71, Bushenyi, Uganda.
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