Background: Prostate cancer awareness is increasing day by day, especially in the USA and western world. Before PSA period, up to 27% of prostate cancers were detected incidentally in the TURP chips done for BPH. The Incidental diagnosis of prostate cancer in patients treated for BPH by a transurethral prostate resection is seen in 1.4-16.7% of patients, but it’s incidence is decreasing due to the use of Serum PSA testing. Nevertheless, some patients are still diagnosed with incidental prostate cancer. However, incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this study, we concentrated on rates of incidentally detected prostate cancer in TURP chips done for BPH in our hospital. Materials and methods: This retrospective study of histopathological findings of TURP chips was conducted for patients undergoing TURP from 2010. The inclusion criteria were patients diagnosed with BPH, DRE showing no abnormal hard areas and age adjusted PSA value is normal. Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved Adenocarcinoma Prostate (CaP) were excluded from the study. The age of the patients, clinical diagnosis, occurrence of carcinoma of prostate in the TURP chips and Gleason’s scores were recorded. Results: A total of 263 patients who fulfilled the inclusion criteria were studied. The incidence of CaP in the study group was 5.3 % (14/263). 10 (71.4 %) patients were aged ³65 years or older had maximum incidence of CaP. Conclusions: The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.3 % in our study, which is low when compared with similar studies done elsewhere in the world. JCMCTA 2017 ; 28 (2) : 16-20
Spontaneous nephrocutaneous fistula is a very rare entity. The majority of causes are:post operative, calculus pyonephrosis, chronic pyelonephritis, renal infection, perinephric abscess, trauma. Renal tumor, xanthogranulomatous pyelonephritis (XGP) and renal tuberculosis. A case of spontaneous nephrocutaneous fistula in a 32 years young lady complaining of seropurulent discharge from the fistula over the right lumber flank for last 8 months is presented and discussed here. Brief history, physical examination. Ultrasonography. CT fistulogramwere performed which revealed an active fistula tract from skin to pelvicalyceal system of right kidney with a large impacted stone at right pelviureteric junction (PUJ). Patient was nondiabetic and negative for renal tuberculosis whereas renogram showed 32% relative renal function of the affected side. We performed exploration along with excision of the fistula tract, partial nephrectomy, pylolithotomy with DJ stenting and percutaneous nephrostomy (PCN). Follow up period was grossly uneventful. Currently, the occurrence of these types of spontaneous fistula is extremely rare except in patient with uncontrolled DM, neoplasia or immunosuppression in general. Bangladesh J. Urol. 2021; 24(2): 235-238
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