Mycobacterial infection, mainly by M. tuberculosis, has an important impact on kidney transplant recipients, particularly during the first year after surgery. Diagnosis often presents some difficulties, and a delay in treatment represents a determinant factor for the evolution, with a risk of death or permanent damage in renal function. Therefore, early diagnosis is mandatory. When the Mantoux reaction is positive, antituberculous prophylaxis seems advisable.
We report 8 cases of self-inserted unusual foreign bodies in the lower urinary tract, all being treated from 1976 to 1990. Three of them were located in the urethra and 5 in the bladder. Several objects were found (electric cable, tweezers, hairpin, drawing pin, pebbles, paper clip). In 4 cases the objects were inserted for masturbatory purposes. Five of the patients were psychologically ill or handicapped. The most common reason for consultation was dysuria, and the treatment procedures were endoscopy in 5 patients and cystotomy in the other 3.
Purpose: Report and review the literature on ureteral avulsion as a rare complication of ureteroscopy.Materials and Methods: We analyzed 3 cases of ureteral avulsion in a series of 4,645 ureteroscopic procedures performed from January 1990 to December 2001. We especially report the different managements for this complication.Results: Due to the different extent of the injury, each patient was treated in a particular way, including a patient managed by means of an endourological approach.Conclusions: When performing ureteroscopy or using Dormia baskets, one should always bear in mind the possibility of serious complications, including ureteral avulsion or perforation. The use of an extremely careful technique of ureteral insertion, the mandatory placement of a safety guidewire, and a working guidewire, all minimize the risk of untoward events.
A semen sample has higher sensitivity than an EPS for the diagnosis of bacterial chronic prostatitis. In our clinical work-up, first-void urine and a semen culture are considered the only tests necessary to diagnose chronic prostatitis.
Bilateral testicular torsion is a very uncommon emergency, with a challenging differential diagnosis. We describe the case of a 15-year-old patient with a left testicular torsion of 48 hours of duration and a sudden onset of right scrotum pain during his stay at the emergency area. Bilateral testicular torsion was diagnosed after repeat physical examination and doppler ultrasound, which had been normal for right testis in a first evaluation. Surgical exploration was performed with orchiectomy in left testis and fixation in right testis. In previous literature, there are reported bilateral torsion only in four adolescents and five adults. With this case, we demonstrate that bilateral spermatic cord torsion may be easily overlooked in a patient with acute scrotum and we emphasize the importance of bilateral exploration in testicular torsion.
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