| Emphysematous pyelonephritis is a rare, often severe infection of one or both kidneys that is most often caused by bacterial infection. Surgical intervention is often necessary. We describe a case of a diabetic patient with bilateral emphysematous pyelonephritis caused by candida infection that was treated conservatively. Renal function recovered almost completely in spite of giving a potential nephrotoxic drug for 6 weeks. ( info) |
2/218. Waxing and waning gynecomastia: an indication of noncompliant use of prescribed medication. We present two cases of recurrent gynecomastia in men enrolled in a placebo-controlled trial evaluating the efficacy of finasteride in treating benign prostatic hyperplasia. When the pharmacologic records were examined, it was apparent that the breast tissue hyperplasia diminished when the patients become noncompliant with their study medication and then resumed therapy. Because of the difficulty in obtaining accurate data on an individual's ability to maintain a consistent pharmacologic regimen, we believe that observing such "waxing and waning gynecomastia" may provide the physician with a clue regarding a patient's actual compliance with certain medications. ( info) |
| Transurethral incision (TUI) is a simple and safe procedure. We, herein, present a case undergoing transurethral incision procedure during which he developed transurethral resection of prostate syndrome (TURP syndrome) and hypothermia precipitating an acute perioperative myocardial infarction attack. The potential risk of development of TURP syndrome in settings other than TURP surgery as well as its prevention are reviewed and discussed. ( info) |
4/218. Concomitant renal and prostatic aspergillosis. aspergillosis limited to the urinary tract is a rare disease seen most often in patients with altered immune status. Only 19 cases of renal aspergillosis including 3 with AIDS and 4 cases of isolated prostatic aspergillosis have been reported. We report the first case of concomitant renal and prostatic aspergillosis in a non-immunocompromised patient who presented with pyrexia of unknown origin and with dysuria. The diagnosis was based on the demonstration of characteristic hyphal elements on direct microscopy and isolation of the fungus in the culture of pus from the kidney. In view of obstructive prostatic enlargement and left non-functioning renal mass, transurethral resection of the prostate and left nephrectomy were performed in a single session with successful outcome. The aetiopathogenesis and brief review of the literature are discussed. ( info) |
5/218. Penile necrosis: an unexpected complication following transurethral resection of the prostate. A 69-year-old man who had undergone a transurethral resection of the prostate for benign prostatic hyperplasia developed necrosis of the glans penis following traction of the urethral catheter ( info) |
6/218. A monthly period of symptoms associated with benign prostatic hyperplasia. The number of times that a man with benign prostatic hyperplasia awoke each night with the urge to urinate (nocturia) was analyzed for randomness by Bartlett's Kolmogorov-Smirnov white noise test and for a periodic component by fourier analysis. The data series (n = 1549) was not white noise; it had a peak periodic component of 25 days, with a range of 21 to 37 days. The possibility that the monthly period of nocturia is a general phenomenon and is coupled to a monthly menstrual period, and the implications for more accurate diagnosis and new modes of therapy, are discussed. ( info) |
7/218. Transperineal magnetic resonance image guided prostate biopsy. PURPOSE: We report the findings of a transperineal magnetic resonance image (MRI) guided biopsy of the prostate in a man with increasing prostate specific antigen who was not a candidate for a transrectal ultrasound guided biopsy. MATERIALS AND methods: Using an open configuration 0.5 Tesla MRI scanner and pelvic coil, a random sextant sample was obtained under real time MRI guidance from the peripheral zone of the prostate gland as well as a single core from each MRI defined lesion. The patient had previously undergone proctocolectomy for ulcerative colitis and, therefore, was not a candidate for transrectal ultrasound guided biopsy. Prior attempts to make the diagnosis of prostate cancer using a transurethral approach were unsuccessful. RESULTS: The random sextant samples contained benign prostatic hyperplasia, whereas Gleason grade 3 3 = 6 adenocarcinoma was confirmed in 15% and 25% of the 2 cores obtained from the MRI targeted specimens of 2 defined lesions. The procedure was well tolerated by the patient. CONCLUSIONS: Transperineal MRI guided biopsy is a new technique that may be useful in detecting prostate cancer in men with increasing prostate specific antigen who are not candidates for transrectal ultrasound guided biopsy. ( info) |
8/218. Inferior vena cava compression due to massive hydronephrosis from bladder outlet obstruction. A 71-year-old man presented with acute urinary retention due to benign prostatic hyperplasia and was found to have computed tomography-documented mechanical obstruction of the inferior vena cava (IVC) due to massive hydronephrosis. Obstruction of IVC flow promptly resolved after bladder decompression. ( info) |
9/218. Unusual retrovesical masses in men. Retrovesical masses in men not related to prostatic carcinoma or hyperplasia is an uncommon pathology. Rare masses or unusual manifestations of those common diseases are a diagnostic dilemma. We review our experience in three unusual retrovesical masses in men: carcinosarcoma filling a giant bladder diverticulum; cystic prostatic carcinoma; and acquired cystic dilatation of the seminal vesicle associated with a prostatic carcinoma that obstructed and invaded the vesicle. We report the imaging findings and review the literature. In our experience, the imaging findings are usually not specific for doing a precise diagnosis and biopsy procedures are necessary. ( info) |
10/218. Calcified seminal vesicles and vasa deferentia: "beware or be aware". Calcification of the seminal vesicles and vasa deferentia is rare. Only the second idiopathic case recorded is presented herein. This case highlights the need to exclude serious, but treatable diseases associated with this condition, which are not generally considered on initial presentation. ( info) |