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FRII-04 SIR PERCIVALL POTT AND SOOT WART: THE EFFECTS OF SCROTAL CANCER ON CHILD LABOR LAWS IN THE BRITISH EMPIRE
THE JOURNAL OF UROLOGYâ
Vol. 193, No. 4S, Supplement, Sunday, May 17, 2015
Case reports of the implantation of penile nodules indicate that this uncommon phenomenon should be recognized despite having few reported complications. Although the diagnosis of an artificial penile nodule is straightforward, it must be differentiated from other conditions such as subcutaneous angiitis, cysts, or calcification of the penis. Often, there are no serious side effects but there are reports of infection and hematoma. Long-term complications may include scar tissue formation, pain, and erectile dysfunction. CONCLUSIONS: The practice of genital modification by genital pearling is an uncommon phenomenon generally practiced to produce enhanced sexual pleasure. Source of Funding: None
FRII-03 CASTRATION OF SEXUAL OFFENDERS IN THE UNITED STATES. Ariel Schulman*, Ruben Pinkhasov, Ciril Godec, David Silver, Brooklyn, NY INTRODUCTION AND OBJECTIVES: Urologists manipulate the male androgen axis with stimulation for hypogonadism and blockade for prostate cancer. Less common but more controversial is the castration of sex offenders, a practice that is currently legal in many states. We review the history and associated controversies of punitive castration in the United States. METHODS: Journals and news publications were examined for relevant historical information. RESULTS: Castration can be traced throughout human history and is documented as early as the 1700’s as punishment for sexual deviance in the United States. Surgical castration was used until the 1960’s when reversible forms of chemical castration were developed. Medroxyprogesterone (MPA,) a synthetic form of progesterone, is the drug of choice for long-acting, chemical castration. Formal legislation exists in nine states, including Louisiana, for castration of those convicted of a range of sexual crimes. There is variation among states regarding type of offense, method of castration and consequences of non-compliance. The goal is to reduce deviant sexual impulses to allow convicted sex offenders to return to the community. But the practice presents important ethical questions including the validity of informed consent given by a prisoner as a condition for release from incarceration and the justifiability of the detrimental consequences of iatrogenic hypogonadism. Further difficulties arise finding appropriately trained medical professionals to administer injections, perform surgery and monitor hormone levels. CONCLUSIONS: The practice of punitive castration in the United States is designed to reintegrate sexual offenders into the community while protecting the public from victimization. While seemingly well intentioned, critical issues including incentivized consent, the sequelae of iatrogenic hypogonadism and appropriate medical supervision remain unresolved. As Urologists, we may face the decision to participate in this procedure and should know its history. Source of Funding: “none”
FRII-04 SIR PERCIVALL POTT AND SOOT WART: THE EFFECTS OF SCROTAL CANCER ON CHILD LABOR LAWS IN THE BRITISH EMPIRE Drew Palmer*, Kari Bailey, Shiv Patel, Burlington, MA INTRODUCTION AND OBJECTIVES: In Britain during the 18th century, young boys were being used as chimney sweeps under brutal and appalling conditions. Sir Percivall Pott (1714-1788), a prominent English surgeon, was the first to describe the association between the contact with soot in these young chimney sweeps and scrotal cancer.
e589
METHODS: A comprehensive literature review was performed (JSTOR, PubMed) using the search terms Percivall Pott, soot wart, scrotal cancer, and the Chimney Sweeper’s Act of 1788. RESULTS: In 1765, Sir Percivall Pott was elected Master of the Company of Surgeons (the precursor to the Royal College of Surgeons). In his landmark paper Chirurgical Observations: Cancer Scroti, published in 1775, he identified the causation between “the lodgement of soot in the ruggae of the scrotum” in chimney sweeps and scrotal cancer (known as soot wart to those afflicted). The young boys often worked in the nude, leading to prolonged contact with the environmental carcinogen. By identifying this cause, Pott was the first to demonstrate an occupational link to cancer. During his research, he was moved by the plight of these young boys which he described as: “singularly hard. in their early infancy they are most frequently treated with great brutality and almost starved with cold and hunger. and when they get to puberty, become liable to a most noisome, painful, and fatal disease.” He described scrotal cancer as “a disease of the abdomen, most frequently indurating and spoiling the inguinal glands, when arrived within the abdomen, it affects the viscera and then becomes painfully destructive.” His work was opposed by master chimney sweeps and wealthy home owners but eventually it had influence on public opinion and helped lead to the reformation of child labor laws. The Chimney Sweeper’s Act of 1788 decreed that apprentices have a minimum age of eight years, parental consent, and acceptable living conditions. Unfortunately, these Acts were not enforced until 1875, when Parliament implemented an Act that required chimney sweeps to be licensed and that any violation of the previous Acts would result in loss of licensure. CONCLUSIONS: Sir Percival Pott was the first to identify the cause of the increased incidence of scrotal cancer in chimney sweeps, and his landmark work influenced public opinion which helped lead to a change in child labor laws in Britain. Source of Funding: none
FRII-05 THE OLDEST RETAINED URETERAL STENT: A HISTORY OF THE URETERAL STENT Rishi Modh*, James Mason, Akira Yamamoto, Thomas Stringer, Vincent Bird, Gainesville, FL INTRODUCTION AND OBJECTIVES: An 81 year old male presented for the evaluation of urinary tract infections. History and work up revealed that the patient had a ureteral stent placed about 35 years ago at the University of Florida by Dr. Birdwell Finlayson. We will review the origins of the ureteral stent as well as the outcome of our interesting case. METHODS: Literature review was performed to understand the history of ureteral stents. We searched pubmed as well as text books. We will also review the clinical course and treatment of our patient. RESULTS: For our case, first a nephrostomy tube was placed due to hydronephrosis, obstruction, and a positive urine culture. First the distal curl was removed and then remainder of the stent and stone burden was removed percutaneously. Urinary catheters and stents are documented as early as ancient Egypt. In the nineteenth century, Dr. Gustav Simon is credited as being the first person to “stent” a ureter. He described inserting a tube into a ureter during open bladder surgery. Dr. Joaquin Albarrano was the first to create a catheter for the ureter. In 1967 Paul Zimskind reported inserting a straight, open ended, silicone tube into a ureter to relieve obstruction. However this was a straight tube that easily became dislodged. The term “stent” was coined by Dr Montie is 1973.
Vol. 193, No. 4S, Supplement, Sunday, May 17, 2015
Case reports of the implantation of penile nodules indicate that this uncommon phenomenon should be recognized despite having few reported complications. Although the diagnosis of an artificial penile nodule is straightforward, it must be differentiated from other conditions such as subcutaneous angiitis, cysts, or calcification of the penis. Often, there are no serious side effects but there are reports of infection and hematoma. Long-term complications may include scar tissue formation, pain, and erectile dysfunction. CONCLUSIONS: The practice of genital modification by genital pearling is an uncommon phenomenon generally practiced to produce enhanced sexual pleasure. Source of Funding: None
FRII-03 CASTRATION OF SEXUAL OFFENDERS IN THE UNITED STATES. Ariel Schulman*, Ruben Pinkhasov, Ciril Godec, David Silver, Brooklyn, NY INTRODUCTION AND OBJECTIVES: Urologists manipulate the male androgen axis with stimulation for hypogonadism and blockade for prostate cancer. Less common but more controversial is the castration of sex offenders, a practice that is currently legal in many states. We review the history and associated controversies of punitive castration in the United States. METHODS: Journals and news publications were examined for relevant historical information. RESULTS: Castration can be traced throughout human history and is documented as early as the 1700’s as punishment for sexual deviance in the United States. Surgical castration was used until the 1960’s when reversible forms of chemical castration were developed. Medroxyprogesterone (MPA,) a synthetic form of progesterone, is the drug of choice for long-acting, chemical castration. Formal legislation exists in nine states, including Louisiana, for castration of those convicted of a range of sexual crimes. There is variation among states regarding type of offense, method of castration and consequences of non-compliance. The goal is to reduce deviant sexual impulses to allow convicted sex offenders to return to the community. But the practice presents important ethical questions including the validity of informed consent given by a prisoner as a condition for release from incarceration and the justifiability of the detrimental consequences of iatrogenic hypogonadism. Further difficulties arise finding appropriately trained medical professionals to administer injections, perform surgery and monitor hormone levels. CONCLUSIONS: The practice of punitive castration in the United States is designed to reintegrate sexual offenders into the community while protecting the public from victimization. While seemingly well intentioned, critical issues including incentivized consent, the sequelae of iatrogenic hypogonadism and appropriate medical supervision remain unresolved. As Urologists, we may face the decision to participate in this procedure and should know its history. Source of Funding: “none”
FRII-04 SIR PERCIVALL POTT AND SOOT WART: THE EFFECTS OF SCROTAL CANCER ON CHILD LABOR LAWS IN THE BRITISH EMPIRE Drew Palmer*, Kari Bailey, Shiv Patel, Burlington, MA INTRODUCTION AND OBJECTIVES: In Britain during the 18th century, young boys were being used as chimney sweeps under brutal and appalling conditions. Sir Percivall Pott (1714-1788), a prominent English surgeon, was the first to describe the association between the contact with soot in these young chimney sweeps and scrotal cancer.
e589
METHODS: A comprehensive literature review was performed (JSTOR, PubMed) using the search terms Percivall Pott, soot wart, scrotal cancer, and the Chimney Sweeper’s Act of 1788. RESULTS: In 1765, Sir Percivall Pott was elected Master of the Company of Surgeons (the precursor to the Royal College of Surgeons). In his landmark paper Chirurgical Observations: Cancer Scroti, published in 1775, he identified the causation between “the lodgement of soot in the ruggae of the scrotum” in chimney sweeps and scrotal cancer (known as soot wart to those afflicted). The young boys often worked in the nude, leading to prolonged contact with the environmental carcinogen. By identifying this cause, Pott was the first to demonstrate an occupational link to cancer. During his research, he was moved by the plight of these young boys which he described as: “singularly hard. in their early infancy they are most frequently treated with great brutality and almost starved with cold and hunger. and when they get to puberty, become liable to a most noisome, painful, and fatal disease.” He described scrotal cancer as “a disease of the abdomen, most frequently indurating and spoiling the inguinal glands, when arrived within the abdomen, it affects the viscera and then becomes painfully destructive.” His work was opposed by master chimney sweeps and wealthy home owners but eventually it had influence on public opinion and helped lead to the reformation of child labor laws. The Chimney Sweeper’s Act of 1788 decreed that apprentices have a minimum age of eight years, parental consent, and acceptable living conditions. Unfortunately, these Acts were not enforced until 1875, when Parliament implemented an Act that required chimney sweeps to be licensed and that any violation of the previous Acts would result in loss of licensure. CONCLUSIONS: Sir Percival Pott was the first to identify the cause of the increased incidence of scrotal cancer in chimney sweeps, and his landmark work influenced public opinion which helped lead to a change in child labor laws in Britain. Source of Funding: none
FRII-05 THE OLDEST RETAINED URETERAL STENT: A HISTORY OF THE URETERAL STENT Rishi Modh*, James Mason, Akira Yamamoto, Thomas Stringer, Vincent Bird, Gainesville, FL INTRODUCTION AND OBJECTIVES: An 81 year old male presented for the evaluation of urinary tract infections. History and work up revealed that the patient had a ureteral stent placed about 35 years ago at the University of Florida by Dr. Birdwell Finlayson. We will review the origins of the ureteral stent as well as the outcome of our interesting case. METHODS: Literature review was performed to understand the history of ureteral stents. We searched pubmed as well as text books. We will also review the clinical course and treatment of our patient. RESULTS: For our case, first a nephrostomy tube was placed due to hydronephrosis, obstruction, and a positive urine culture. First the distal curl was removed and then remainder of the stent and stone burden was removed percutaneously. Urinary catheters and stents are documented as early as ancient Egypt. In the nineteenth century, Dr. Gustav Simon is credited as being the first person to “stent” a ureter. He described inserting a tube into a ureter during open bladder surgery. Dr. Joaquin Albarrano was the first to create a catheter for the ureter. In 1967 Paul Zimskind reported inserting a straight, open ended, silicone tube into a ureter to relieve obstruction. However this was a straight tube that easily became dislodged. The term “stent” was coined by Dr Montie is 1973.