The use of intravesical BCG has improved the survival and outcomes in the treatment of bladder cancer. However, the worldwide shortage of OncoTice BCG has caused disruption and changes in treatment regimes, leading to use of alternative strains. We describe a severe complication as the result of using intravesical SII Onco BCG for the treatment bladder cancer, in an 82 year old man presenting with granulomatous epididymo-orchitis.
Objective
To evaluate the efficacy of aspiration and sclerotherapy with 100% alcohol for the primary treatment of benign scrotal cysts.
Methods
From March 2014 to March 2018, 114 patients were identified who underwent their first aspiration and sclerotherapy procedure (80 hydroceles and 34 spermatoceles/epididymal cysts). The procedure was carried out in the outpatient clinic with local anaesthesia. A 16‐gauge IV catheter is used to puncture the sac under aseptic conditions. The volume of alcohol instilled was 10% of the aspirated volume (maximum of 50 mL). Patients were then observed in the waiting room and completed a questionnaire. Urology clinic follow up was scheduled at 6 weeks.
Results
At follow up, 54 patients (67.5%) with hydroceles and 25 patients (73.5%) with spermatoceles/epididymal cysts had resolution after a single procedure. A second procedure was offered if fluid collection persisted, of which 71% of patients with hydroceles and 100% of patients with spermatoceles/epididymal cysts had a successful outcome. At a median of 31 months post‐initial procedure, the overall success rate, after at most two procedures, was 80% for hydroceles and 85% for spermatoceles/epididymal cysts. The complication rate was low (6%). Almost all patients were happy to undergo the procedure again, if needed. Persistence following aspiration and sclerotherapy were more likely to occur in younger patients (45.4 versus 61.2 years, P = 0.001). Persistence was not related to the volume of fluid aspirated.
Conclusion
Aspiration and sclerotherapy with alcohol is a reliable, safe and effective technique for treatment of benign scrotal cysts.
Background: The incidence rate of testicular cancer in New Zealand (NZ) is one of the highest in the world. Compared to other ethnic groups in NZ, Maori have been reported as having the highest incidence and cancer specific mortality. We aim to investigate whether disparities in presentation and management of the disease exist between European and Maori males within a large tertiary referral centre in NZ. Methods: A retrospective cohort study was performed from January 2009 to July 2019. Ethnicity was self-defined. Tumour characteristics and mortality data were recorded. Time from onset of symptoms to surgical treatment was measured. Exclusion criteria were paratesticular tumour and non-Maori and non-European ethnicity.Results: 113 patients underwent radical orchidectomy within the time period. Maori had a significantly higher risk of developing testicular cancer compared to Europeans (RR 2.19, 95% CI 1.47 – 3.24, p =0.01). There were no significant differences in cancer specific or overall survival. The mean time duration between symptom onset and first specialist assessment (FSA) was 189 days for Maori and 128 days for European (p=0.12). Once FSA is done, there was no difference in time to operating theatre. However, Maori were less likely to attend follow up appointments (87% vs 98%, p =0.02). Conclusion: Maori males are more likely to develop testicular cancer in this study. Although no difference in cancer specific survival was seen, there was a large difference in time from symptom onset to referral to specialist review and the probability of attending follow up appointments.
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