Objectives To evaluate early results of the intra-ureteric instillation of capsaicin for the treatment of loin pain haematuria syndrome (LPHS). Patients and methods Ten patients with LPHS were treated using intra-ureteric capsaicin instillation. A solution of capsaicin was infused into the affected ureter through an embolectomy catheter, under anaesthesia. The success of the treatment was assessed using patient questionnaires and the quantitative reduction in the patients' analgesic requirements measured. Results During a mean follow-up of 6 months, six of the 10 patients had short-to medium-term symptomatic relief after one or more treatments; four had no relief from their symptoms. One patient had a mucosal ulceration in the bladder after extravasation of the capsaicin solution. Two patients subsequently underwent simple nephrectomy for symptomatic nonfunctioning kidneys. Conclusion These results are consistent with other preliminary reports of the ef®cacy of capsaicin treatment in LPHS and such treatment therefore has a de®nite therapeutic role in this dif®cult condition. We are uncertain if the treatment contributed to the deterioration of the excised kidneys. This early experience suggests a need for careful consideration when contemplating this treatment, with attention directed to both the initial diagnosis and possibly the technique of capsaicin/instillation. We include a protocol to follow when preparing patients for capsaicin treatment.
Microscopic haematuria is a common finding in young men. Controversy exists as to its significance and how it is best investigated. A prospective study of 100 young men under the age of 40 with microscopic haematuria has been performed. A positive diagnosis was made in 32 patients. Cystourethroscopy was of diagnostic value in only 3 patients and of therapeutic value in a further 3. It was concluded that cystourethroscopy is of minimal diagnostic value in young men with microscopic haematuria. Its routine use is unnecessary and should be reserved for those patients in whom investigation suggests that a treatable cause may be found in the lower urinary tract.
All cases of testicular torsion occurring in the Armed Services between 1972 and 1983 have been reviewed. All cases were post-pubertal. The incidence in older age groups is higher than previously reported. No cases were seen in undescended testes. No seasonal variation in presentation was detected. Recurrent scrotal pain before acute presentation occurred in 29 per cent of cases. The testicular salvage rate was 75 per cent. The salvage rate in patients with pain for greater than 24 h was 46 per cent. Patients with a history of intermittent scrotal pain should be explored as a matter of urgency. Operation should still be considered in patients who have had pain for greater than 24 h.
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