Flexible cystoscope: a useful aid to difficult male catheterization

To assess usefulness of flexible cystoscope in difficult male urethral catheterization. Fauji Foundation Hospital and Maryam Memorial Hospital, Rawalpindi during a period of four years. In a consecutive series of thirty patients with acute urinary retention and initial difficulty in urethral catheterization, a flexible cystoscope and a guide wire was used to insert the Foley's catheter. Ten patients [33.3%] presented with acute urinary retention due to benign enlargement of prostate. Five patients [16.6%] required re-catheterization following unsuccessful trial after transurethral resection of prostate. Four patients [13.3%] had carcinoma of prostate. This technique was used five times [16%] to catheterize prior to intravesical instillation of cytotoxic drugs. Two patients [6.6%] had bladder neck distortion due to transitional cell carcinoma of bladder, one [3.3%] had an extravesical haematoma and another one [3.3%] had massive post traumatic clot retention. The procedure was successful in 86.7% of the cases. Difficulty to negotiate the urethra was faced in cases of urethral strictures [6.6%]. Flexible cystoscope is a safe, quick and effective method for difficult urethral catheterization in male patients

Rupture splenic artery aneurysm

We present a case of ruptured splenic artery aneurysm in 18 years old unmarried girl who presented with severe upper abdominal pain and sudden collapse. Ultrasound abdomen showed free fluid and ultrasound guided needle aspiration confirmed haemoperitoneum. On laparotomy, a 3cm saccular aneurysm of the middle of the splenic artery was noted. With prompt and urgent management the patient survived