Management of acute urinary retention secoundry to bening prostatic hyperplasia

To analyze patients' status and current practice in the management of acute urinary retention [AUR] secondary to benign prostatic hyperplasia [BPH]. Salmaniya Medical Complex [SMC], Kingdom of Bahrain. Records of 478 patients with AUR were reviewed. The patients were managed by five consultant urologists during period of eight years [1995-2003]. We have documented: in patients and methods. Urethral catheterization was the initial management of choice in 459 [96%] and suprapubic catheters in 19 [4%]. Digital rectal examination [DRE] and abdominal ultrasonography were done in the majority, of patients. Prostate specific antigen [PSA] was done in 229 [48%]; transrectal ultrasonography in 14 [3%] and intravenous pyelography [IVP] in 129 [27%]. Fifty-three patients [11%] were managed successfully with trial without catheter [TWOC], 2-3 days after starting alpha blocker. Four hundred twenty-five patients [89%] underwent endoscopic examination, of these 10 patients had prostatic stenting only, one had open prostatectomy and the remainder had transurethral resection of the prostate [TURP]. This study revealed a reasonable uniformity in the management of AUR secondary to BPH in SMC without or with guidelines, which needs to depend on evidence-based studies

Supernumerary kidney: a case report

Herpetic infection of the digit is although not common but is being increasingly diagnosed by hand surgeons or the personnel involved in taking care of the hand. A case of herpetic infection of a digit in a four year old child is described. Running title: Herpetic Infection of a Digit

Routine ultrasound in acute retention of urine

To evaluate the frequency of urological abnormalities in routine urinary tract ultrasonography [renal and pelvic] in patients with urinary retention secondary to benign prostatic hyperplasia. All patients presented to Salmaniya Medical Complex, Bahrain with acute retention of urine secondary to benign prostatic hyperplasia [BPH] in the period between January 2001 and December 2001 were included. The frequency of urological abnormalities, other than BPH, was obtained. One hundred patients were enrolled with a mean age of 67 years. Forty-one patients [41%] had other urological abnormalities. Among these, 3 cases of malignancy were discovered incidentally. A case of renal cell carcinoma, which was completely excised, and 4 cases of bladder tumor, 2 were new cases and 2 were previously known cases of cancer bladder. Other urological abnormalities were renal stones [9 cases], renal cysts [9 cases], hydronephrosis [14 cases] and bladder stones [5 cases]. Asymptomatic non-urological abnormalities were gallstones [3 cases], liver cirrhosis [one case] and hepatic hemangioma [one case]. Renal impairment was found in 18% of all patients and 80% with hydronephrosis. Four patients had hypoechoic nodules, and all had cancer prostate. Significant fraction of patients with acute urinary retention due to BPH have another pathology; although the majority are trivial and it did not influence the immediate management, some are life threatening such as renal cell carcinoma and bladder tumor. Hydronephrosis can be missed if one depends solely on renal biochemistry. Thus, routine evaluation of such patients with pelvic and renal ultrasonography is justified