ABSTRACT
Pyeloduodenal fistula is a rare condition and its association with malignancy is even rarer. Herein we report the case of a 66-year-old man who was admitted to the hospital with a three-month history of intermittent melena and a more than 20-year history of right-side renal stones. Computed tomography showed a heterogeneous right renal mass with a staghorn stone that had invaded the duodenum and caused an internal fistula. An upper gastrointestinal series showed pyeloduodenal fistula. The patient underwent an exploratory operation and a biopsy was taken at the peripelvic region. Pathological examination verified the existence of squamous cell carcinoma. To our knowledge, this is the first case of pyeloduodenal fistula associated with renal stones, squamous cell carcinoma and upper urinary tract calculus presenting on melena. We report on the features of this rare entity but also review and summarize the etiology, diagnosis and treatment options that can be extrapolated from the existing literature
ABSTRACT
Bladder stones in elderly men are commonly associated with bladder outlet obstruction, and many different treatment modalities have been presented for both these conditions. To evaluate the effectiveness and safety of a novel method concerning spontaneous usage of both monopoplar transurethral resection of the prostate and Holmium Laser cystolithotripsy, we compared the transurethral use of resectoscope and cystoscope lithotripsy approaches retrospectively. Patients data of one hundred and nine male patients with benign prostatic hyperplasia [BPH] and bladder stone[s] were analyzed retrospectively. Two groups of patients were compared: Group I was treated with combination of transurethral holmium laser cystolithotripsy [HLC] and transurethral resection of the prostate [TURP] using the 24F resectoscope, and group II used 22F cystoscope and 24F resectoscope for treating both these conditions. We reviewed the records of 109 patients undergoing transurethral cystolithotripsy with holmium laser and simultaneous TURP. The mean bladder stone size were 3.6 +/- 1.5 cm in Group-I and 3.7 +/- 1.1 cm [mean 3.8] in Group-II [p > 0.05]. The mean operation time of Group-I and Group-II was 49.0 +/- 22.5 minutes and 79.0 +/- 28.5 minutes, respectively [p < 0.05]. Stone fragments were removed completely and TURP procedures were done successfully in all of the patients. Mild hematuria was found more frequently in Group-II [22.2%], and four [7.4%] patients had urethral stricture in the same group during the late follow-up. Combination of transurethral laser cystolithotripsy and TURP using the same 24F resectooscope is an effective, safe and economical treatment for bladder stones in BPH patients. It is minimally invasive and involves and has lower complication rates and shorter hospital stay. However, this combined approach should be taken in the treatment of calculus within 4 or 5 centimeters
ABSTRACT
<p><b>OBJECTIVE</b>To explore the possible correlation between the driver's occupation and male semen quality.</p><p><b>METHODS</b>Semen samples were collected from 1,223 infertile men (78 drivers and 1,145 non-drivers) and 100 normal men, and their liquefaction, sperm density, sperm vitality, sperm motility and sperm shape were analysed.</p><p><b>RESULTS</b>The abnormal rates of semen quality in sterile male drivers were significantly higher than in non-drivers(P < 0.05) and in normal men(P < 0.01). The semen abnormal rates in drivers with more than 8 years' driving experience were higher than in those with less than 8 years' driving experience(P < 0.05).</p><p><b>CONCLUSION</b>Driving occupation can result in abnormal semen quality.</p>