Cytological examination of urine of patients suffering from cystitis and hematuria

A sample of 390 patients with a mean age of 40.4 years presented with hematuria, cystitis or suspected bladder mass were evaluated clinically and by US and urine cytology [voided and irrigation]. The results were compared with those of cystoscopy and bladder biopsy. Bladder tumors were found in 23.5% of all screened patients [SQ. CC 11.8%, TCC 11% and adenocarcinoma 0.8%]. Urine cytology was positive in 17.7% inconclusive in 17.8% and negative in 64.5%. Sensitivity was 86% and specificity 99%. According to tumor type [SQ. CC, TCC and adenocarcinoma] cytology was positive in 58.7%, 88.3% and 100%, respectively. Low grade tumors, especially SQ. CC and voided urine samples give less positive results than high grade tumors and bladder irrigation urine sampling. It is concluded, that urine cytology is sensitive in detecting bladder tumors. Accuracy increases with high risk and symptomatic patients. Frequent screening of the groups is recommended

Significance of pyuria and bacteria in chronic spinal cord injury Patients

Five hundred patients with chronic spinal cord injury have been studied clinically, radiologically and bacteriologically over a period of one year. Methods of urinary drainage included condom [300], catheter [63], bladder training [107] and intermittent catheterization [30]. 96% of patients had significant pyuria [>5 WBC/HPF]. Low pyuria level [5-30 WBC] was associated with 90% incidence of bacteriuria and 7.5% incidence of symptomatic urinary tract infection. Moderate pyuria [30-100 WBC] was 28%, incidence and high pyuria [>100 WBC] was 19%, incidence and both were similarly associated with 100% incidence of bacteriuria and 25% incidence of symptomatic urinary tract infection. Bacteriuria was presented in 91.2% of all patients. Symptomatic bacteriuria was presented in only 16.4% of bacteriuric patients. The most common isolated organisms were E. coli [65%] and Proteus mirabilis [22%]. In conclusion, low pyuria level [<30 WBC/HPF] has less bacteriuria and lower incidence of symptomatic urinary tract infection. On the other hand, pyuria level [>30 WBC/HPF] has a higher incidence of symptomatic infection. Symptomatic bacteriuria is presented in only 16.4% of bacteriuric patients. Antimicrobial therapy is recommended in pyuria level [>30 WBC/HPF] and symptomatic bacteriuria

Rupture penis: conservative versus surgical repair

Over a period of two years 6 cases of rupture Penis have been reported. Their etiology ranged from masturbation [3 cases], vigorous intercourse [two cases], and penetrating bullet injury [one case] clinically, the site of injury was detected in 75 percent of cases. Cases managed conservatively [2 cases], fallowed by lateral tunical and corpus covernosal fibrosis with bending of penis. While other cases [3] managed by early surgical repair followed by normal erection without pain. We recommend early surgical repair