Bladder calculus presenting as excessive masturbation.

Masturbation in childhood is a normal behaviour which most commonly begins at 2 months of age, and peaks at 4 years and in adolescence. However excessive masturbation causes anxiety in parents. We describe a boy with a bladder calculus presenting as excessive masturbation.

A preliminary study of the impact of long-term psychotic disorder on patients' families.

OBJECTIVE: To assess impact of long term psychotic disorders on caregivers. DESIGN: A questionnaire based, interviewer administered, cross-sectional survey using the translated version of a Burden Assessment scale (BAS). SETTING: Outpatient clinic of the University Psychiatry Unit, National Hospital, Sri Lanka. SAMPLE: 50 caregivers of patients suffering from psychotic disorders for more than 2 years. MEASUREMENTS: The BAS was administered to 50 caregivers to assess degree of distress and domains of concerns. RESULTS: 60% of caregivers felt very anxious and depressed. 54% experienced a financial decline, and 82% felt responsible for meeting the entire financial needs of the patient. 54% felt that their workload increased due to the illness. 58% of the caregivers were parents. CONCLUSIONS: Caregivers of patients with long term psychotic disorders are distressed, and have several concerns. Interventions focused on these will relieve the distress of caregivers and help patients. A majority of caregivers are parents. This has future implications, as many patients are not capable of independent living.

Management of men with a first episode of acute urinary retention due to benign prostatic enlargement.

OBJECTIVE: To determine the effect of the existing management protocol of patients presenting with acute urinary retention due to benign prostatic enlargement on clinical efficacy and surgical practice. DESIGN: Prospective study. SETTING: The Urology Unit at the Teaching Hospital, Karapitiya, Galle. PATIENTS: 100 consecutive patients with a first episode of acute urinary retention due to a clinically benign enlarged prostate. MEASUREMENTS: Success of voiding urine after one week of treatment with an alpha adrenoceptor blocker (prazosin). Incidence of subsequent urinary retention during the follow up period of 6 months despite continuing treatment with the drug. RESULTS: Of the 94 patients who completed the follow up period of 6 months, 56 voided successfully after the initial trial without catheter at one week. However, 12 of them developed urinary retention during the follow up and required surgery. CONCLUSION: Treatment with an alpha adrenoceptor blocker followed by a single trial without catheter can avoid prostatic surgery in 40% of patients with acute urinary retention due to benign prostatic enlargement.

Tuberculous ureteric stricture.

The management of a young woman with a ureteric stricture is a challenge to the urologist. Genitourinary tuberculosis can cause ureteric strictures, with minimal symptoms. Untreated, it can lead to impairment of renal function. Diagnosis of genitourinary tuberculosis may be delayed until histopathological assessment. Drug treatment and reconstructive surgery produce good results.