Bladder stone formation on iatrogenic foreign bodies following radical prostatectomy is an uncommon postoperative complication. We present the case of a bladder lithiasis that developed around a metallic clip five years after radical retropubic prostatectomy.
Aim: Trueperella pyogenes is known to affect cattle, but was never isolated as a cause of human urinary tract infections. Clinical case: A 69-year-old male presented for recurring low urinary tract symptoms after a 20-day ciprofloxacin regimen for prostatitis. He previously underwent open right nephrolithotomy and left ureterovesical junction reimplantation for an iatrogenic distal ureteral stricture. Computed tomography showed spontaneous cortical calcifications; renoscopy was performed and deep cultures from the pelvis were taken; culture on chocolate agar revealed T. pyogenes. Intravenous teicoplanin for 3 weeks resulted in resolution of low urinary tract symptoms with regression of bladder and ureteral thickening. Conclusion: T. pyogenes can cause encrusted pyelitis in humans especially evoked in a context of persisting or recurring urinary tract infections.
Phytotherapy for lower urinary tract symptoms (LUTSs) due to benign prostate hyperplasia (BPH) is progressively demanded by patients and trusted by physicians. The aim was to assess the efficacy of a mix of pumpkin seed extract, soy germ isoflavonoids, and cranberry (Novex®) in the management of mild to moderate LUTS in BPH patients. Male patients aged ≥40 years, who had had mild to moderate LUTS for >6 months at screening, with no previous therapy or who are still symptomatic despite current use of alpha-blockers, were recruited. Exclusion criteria were an IPSS >19 and an age >80 years. The mixed compound was administered orally, daily, for 3 months. Patients were evaluated by means of IPSS, urological quality of life (uQoL) index, and International Index of Erectile Function (IIEF-5) at 3 visits: baseline (visit 1), 30 days (visit 2), and 90 days after treatment (visit 3). Among 163 screened patients, 128 patients (61.8 ± 9.9 years) were recruited. IPSS improved from 15 (Q1 : 12–Q3 : 17) in visit 1, to 11 (Q1 : 8–Q3 : 14) in visit 2, and to 9 (Q1 : 6–Q3 : 12) in visit 3 (p<0.001). uQoL improved from 4 (3–4) in visit 1, to 3 (2–3) in visit 2, and to 2 (1–2) in visit 3 (p<0.001). The patients had an IIEF-5 score of 15 (12–18.7) in visit 1, 15 (12–18) in visit 2, and 17 (13–19) in visit 3 (p=0.99 visits 1 vs. 2, p=0.004 visits 2 vs. 3, and p=0.001 visits 1 vs. 3). Treating mild to moderate LUTS/BPH patients with Novex® might therefore relieve symptoms, improve the quality of life, and have a mild beneficial effect on erectile function.
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