ObjectiveAlthough medical expulsive therapy (MET) is shown to be effective for ureteric calculi, the optimum duration and the stone size suitable for MET are not well established yet. The objectives of the study were to determine the optimum duration and maximum stone size suitable for MET.ResultsAll patients with radiologically confirmed uncomplicated ureteric calculi treated with MET using tamsulosin over a period of 6 months in the outpatient setting were followed up. There were 213 patients. 165 were men. Mean age was 42 years. At presentation 42 stones were in upper ureter (19.7%), 51 in mid ureter (23.9%), 120 in lower ureter (56.3%). The majority (82.7%) of stones were less than 10 mm. Seven stones (3.3%) were over 15 mm. Ninety-two (43.2%) patients had spontaneous passage of stones within 6-weeks of MET. Another 38.9% passed the stone within the next 6-weeks. Thirty-eight patients (17.8%) required surgery. Uncomplicated ureteric stones up to 10 mm can be given a trial of MET using tamsulosin which can be extended up to 12-weeks with a success rate over 92%. This may have substantial clinical and fiscal benefits by reducing the number of interventional procedures especially in resource-poor settings.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2974-1) contains supplementary material, which is available to authorized users.
Introduction: Haemospermia is an alarming symptom for ordinary members of the public. The worry become greater as it has been described as a warning sign of a prostate cancer in the media. Objectives: The aim of the study was to identify the aetiological factors and outcome of haemospermia in a cohort of patients. Methods: All patients with newly diagnosed haemospermia treated at the urology unit of Colombo South Teaching Hospital over a period of 5 years (2013-2018) constituted the study sample. Data related to demographics, symptomatology, clinical findings, investigations, treatment given and outcome during follow-up were recorded prospectively. Results: There were 94 men with haemospermia who sought treatment during the study period. Mean age was 43.7 years (range: 23-67, median = 41). Twenty-seven (29%) patients had clinical evidence of prostatitis and/or a positive seminal fluid culture. One patient each had prostate carcinoma, prostatic cyst, severe hypertension, sclerotherapy for haemorrhoids, post-chemotherapy and post-epididymectomy. The patient who had high blood pressure (220/150 mmHg) was found to have mesangio-proliferative glomerulonephritis. In 61 (65%) patients, there was no identifiable cause. Conclusion: The majority of patients with haemospermia are aged < 45 years and have a benign aetiology. As haemospermia is self-limiting in the majority of cases, extensive investigations are unnecessary. Advanced and invasive tests should be confined to those with abnormal clinical findings, and to those with persistent or recurrent haemospermia.
IntroductionOne of the core indicators of monitoring universal access to safe, affordable surgical care is access to timely, essential surgery. Analysing the waiting time for elective operations is one way to determine access to surgical services in a country. Aims of this study were to determine the access to surgical services in a urology unit of Sri Lanka by analysing waiting time for elective surgical operations and to determine whether waiting time is related to income categories and social classes.
IntroductionColovesical fistulae (CVF) are the relatively uncommon presentation in colorectal surgical practice. However, the rarity of the disease gives rise to problems in diagnosis and treatment as adequately powered data is lacking in published literature. Furthermore, the aetiology of CVF in Asia differs from the West which plays an important role in patient management.
MethodsThe records of all the patients with CVF managed in the Gastrointestinal and Urological surgical units of a tertiary care centre over a nine-year period were collected and analysed. Follow-up data have been collected prospectively to assess the outcome.
ResultsA total of 11 patients (M: F=9:2) with a median age of 59 years were studied. Faecaluria, pneumaturia and recurrent urinary tract infections were the commonest presenting symptoms. The diagnosis was based on clinical evaluation. Cystoscopy, colonoscopy and CECT were utilized to identify the underlying pathology, complications and for staging. Commonest benign pathology was diverticular disease (n=7), followed by tuberculosis (n=1). Adenocarcinoma of the sigmoid colon and squamous cell Carcinoma of the bladder were reported in three patients. Majority of patients (n=9) were managed successfully by open-left colonic resection with or without temporary ileostomy and bladder repair, while inoperable patients were managed with a stoma.
ConclusionCVF is a relatively uncommon condition in our setup and mostly related to isolated diverticular disease of the sigmoid colon. Diagnosis of CVF can be made with accuracy by proper clinical assessment. Cystoscopy and LGIE are essential components of the diagnostic workup of a patient with suspected CVF. During surgery, segmental resection of the colon is favoured than local repair.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.