Congenital pelvic arteriovenous malformation presenting with urinary retention: a case report

To report a case of congenital pelvic arteriovenous malformation [pAVM] with urinary retention. A 39-year-old male patient presented with inability to void urine for 8 h. He did not have a history of dysuria or fever, but had increasing urinary frequency and difficulty in voiding over 2 years. Examination revealed a suprapubic mass without external signs of vascular anomaly. A huge, soft, irregular, non-pulsating mass was felt rectally. This mass did not disappear on urinary bladder decompression. Subsequent ultrasound and CT scan revealed pAVMs filling most of the pelvic cavity. To our knowledge, this is the first report of a male patient with congenital pAVM presenting with urinary retention, emphasizing the need for a high index of suspicion for pAVM to avoid potential severe bleeding during suprapubic catheterization for urinary drainage

Experience with the ureteroscope

In a retrospective analysis, the results of using the ureteroscope in 62 consecutive patients at the Dubai Hospital are analysed. 53 patients with 56 ureteric stones had 78 procedures, 15 patients being attempted more than once. Complications in this group included 6 patients with loin pain, 5 perforation, 3 urinary infection and 1 ureteric stricture. Time analysis showed a 93% success rate in the last quarter of the study. 2 children had bladder calculi disintegrated using the scope. In addition, the ureteroscope aided the passage of a ureteric catheter in 6 patients, and was used diagnostically in 2 patients with unexplained loin pain and one with painless haematuria, suspicious cytology and negative cystoscopy

outcome of antenatally diagnosed hydronephrosis

15 patients with an antenatal diagnosis of hydronephrosis were evaluated with a false positive rate of 4%. 8 patients had bilateral and 7 unilateral hydronephrosis. The commonest final diagnosis in patients with bilateral dilatation was posterior urethral valve [43%] and when unilateral, pelviureteric junction obstruction [57%]. 4 patients [27% of total] had normal physical examination at birth, abnormalities only being detected on investigations. All patients had eventual normal renal function

Congenital vesicovaginal fistula- a double urethra?

A 9 year old girl presenting with a congenital vesicovaginal fistula underwent excision of the tract via a vaginal approach. The surgical technique is detailed and an embryological explanation for the fistula suggested

nuclear nephrostogram and enema

A method of performing a nephrostogram and enema [to detect sigmoidoureteric reflux using nuclear imaging techniques is described. The advantage of performing these procedures over conventional ones includes a lower radiation dosage exposure

spectrum of genitourinary disease seen in Abu Dhabi

A retrospective survey of all patients admitted over a period of 12 months to the Department of Urology, Abu Dhabi Central Hospital, showed that over one-third [36%] presented with urinary tract lithiasis. The majority of these were located in the upper urinary tract and important aetiological factors appear to be an inadequate fluid intake and dietary excesses of purine and oxalate foods. Genitourinary infections accounted for pathology in approximately 28% of the 1555 patients seen, almost half of whom showed bacterial infection of the lower genitourinary tract. Urinary.bilharziasis is imported by workers from endemic areas outside the UAE and was seen in 8% of the total number of patients. The incidence of upper urinary tract infection in this series was not more than 5%. 3% of patients presented with urethral stricture and in only a quarter of these, the aetiology was definitely related to previous gonococcal infection. An increasing number of patients present with infertility but both, benign prostatic hypertrophy [2.5%] and genitourinary malignancies [1%] are uncommon as compared to pathology seen in Western countries