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.
In the second part of a review of leg ulcer studies, the significance of microbial colonisation is explored and suggestions are offered for the direction of future research
Aspects of the bacteriological and immunological status of patients with leg ulcers who also need podiatric treatment have been examined. Qualitative and quantitative bacteriological analyses of 52 patients have provided values for the numbers and types of bacteria present. A simple survey of the immunological status of 11 of the patients was also undertaken. The results of the bacteriological survey are consistent with those of other workers, while the results of the immunological studies are sufficiently heterogeneous to warrant a further dedicated study of a longitudinal nature. Because of the numbers of bacteria isolated, the range of bacterial species identified and uncertainties about the immunological status of the patients and others attending multi-clinic sites, it is suggested that in order to safeguard all patients, personnel and the immediate environment, clearly defined special procedures for infection control should be in place
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