The organ Injury Severity Scale for the kidney classifies renal injuries into five grades in order of increasing severity. It is widely used and is a powerful predictor of clinical outcome. The grade directly correlates with the need for intervention, nephrectomy, dialysis, and mortality. The majority of renal injuries are associated with injury of other abdominal organs. In the event of suspected blunt renal injury, the indications for imaging are visible hematuria, microscopic hematuria with systolic blood pressure < 90 mm Hg, the presence of major associated injuries, or a high index

of suspicion based on mechanism of injury, such as a rapid deceleration injury. Indications Inhibitors,research,lifescience,medical for exploration in renal trauma are life-threatening hemorrhage, renal pedicle avulsion, or pulsatile/expanding retroperitoneal hematoma at the time of laparotomy. In cases of active extravasation of intravenous contrast, surgical exploration or angioembolization must be based on the presence of concomitant injuries Inhibitors,research,lifescience,medical and the surgical team’s experience. ​ Figure 2 Grade 2 injury. Figure 3 Grade 3 injury. Figure 4 (A) Grade 4 injury with segmental renal injury. (B) Grade 4 injury with urine extravasation. Footnotes aEstimated population of 5.2 million as of 31 December 2007 (Australian Bureau of Statistics).
Malignant priapism is a term first used by Peacock in 1938 to Inhibitors,research,lifescience,medical describe persistent, nonsexual erections caused by invasion of malignant cells into the cavernosal

sinuses and their associated venous systems.1 Several more mechanisms of priapism secondary Inhibitors,research,lifescience,medical to malignancy have been postulated and described. Metastatic penile disease has historically been a rare event, mostly found to be originating from pelvic primary sites.

Clinical manifestations of penile metastases vary widely, and include penile nodules, cutaneous findings, and priapism.2 We describe an interesting case of malignant priapism secondary to penile metastasis following radiation treatment Inhibitors,research,lifescience,medical for prostate carcinoma, review current literature on penile metastases and malignant priapism, and discuss the frequency, pathophysiology, mechanism, and BMN 673 manufacturer prognosis of the disease process. Case Report An 84-year-old man with diabetes and a known diagnosis of prostate cancer presented with a 3-month history of persistent erection that began when he finished about radiation treatment. The patient was first diagnosed approximately 3 months prior to current presentation with locally advanced, high-grade prostate cancer with a Gleason 4 + 5 component. He had undergone radiation treatment, after which he noticed the onset of persistent erection that was constant and painful. The patient reported sharp and burning pain that was only mildly relieved by topical lidocaine gel. A Winter shunt for detumescence had been attempted at an outside facility 6 weeks earlier, but the procedure provided no significant improvement in symptoms. Similarly, phenylephrine treatment was attempted to no avail.