RESUMO
Intrauterine devices (IUD) can lead to several complications, including uterine perforation, ectopic pregnancy, spontaneous abortion and pelvic inflammatory disease, but these occur infrequently. The migration of an intrauterine device into the bladder, with the formation of a stone, occurs rarely. We report a case of a 45-year-old multiparous woman, with an egg sized and shaped bladder stone around an intrauterine device.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Aborto Espontâneo , Cálculos , Corpos Estranhos , Dispositivos Intrauterinos , Óvulo , Doença Inflamatória Pélvica , Gravidez Ectópica , Cálculos da Bexiga Urinária , Bexiga Urinária , Perfuração UterinaRESUMO
PURPOSE: Catheter-associated urinary tract infections are inevitable in patients with a long-term indwelling catheter. The antibacterial activity of nitrofurazone-impregnating compounds has recently been employed in urinary catheter, and may be effective in blocking infections. The aims of this study were to evaluate the bacterial isolation, antibiotic sensitivity test and the efficacy of a nitrofurazone-coated urinary catheter. MATERIALS AND METHODS: A total of 41 patients that required an indwelling urinary catheter for longer than 4 weeks were assigned to receive either a silicone (n=24), or nitrofurazone, coated catheter (n=17). Urine and catheter tip samples were cultured for bacteriological assessment. The results of the bacterial culture and antibiotic sensitivity test, rate of infection from urine and proximal tip were compared between the two groups. RESULTS: The bacterial cultures from the tips of the silicone and nitrofurazone catheters were in 95.8 and 82.4%, respectively, but were statistically insignificant (p=0.064). Bacteriuria developed in 79.2 and 64.7% of the silicone-coated and nitrofurazone-coated catheter groups (p=0.476). Gram negative bacteria were found in 65 (69.8%), with the most three frequent species being Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia in 23 (24.7%), 20 (21.5%) and 16 (17.2%), respectively. All the organisms were more susceptible to amikacin, aztreonam and ceftriaxone, but were relatively resistant to ampicillin, gentamycin and ciprofloxacin. CONCLUSIONS: Many of the patients with a long-term indwelling catheter had bacterial infections or colonization in the urine and proximal catheter-tip samples, despite the preventive administration of antibiotics. This study failed to demonstrate any efficacy of a nitrofurazone-coated catheter.
Assuntos
Humanos , Amicacina , Ampicilina , Antibacterianos , Aztreonam , Infecções Bacterianas , Bacteriúria , Cateterismo , Catéteres , Cateteres de Demora , Ceftriaxona , Ciprofloxacina , Colo , Escherichia coli , Gentamicinas , Bactérias Gram-Negativas , Klebsiella , Nitrofurazona , Pneumonia , Pseudomonas aeruginosa , Silicones , Cateteres Urinários , Infecções UrináriasRESUMO
PURPOSE: To investigate the mechanism and type of aspermic ejaculatory dysfunction resulting from high-energy transurethral microwave thermotherapy of benign prostatic hyperplasia. MATERIALS AND METHODS: Eleven patients who complained of dry ejaculation longer than 12 months after transurethral microwave thermotherapy were examined. Transrectal ultrasonography as used to assess seminal vesicle or ejaculatory duct dilatation, urethroscopy to identify any ejaculatory duct orifice obstruction, and urinalysis after ejaculation to detect sperm as an indicator of retrograde ejaculation. RESULTS: Four of eight patients with no sperm on urinalysis after ejaculation showed both seminal vesicle dilation and ejaculatory duct orifice obstruction with or without verumontanal scar formation. Another three patients showed either seminal vesicle dilation or ejaculatory duct orifice obstruction, and the final patient with no sperm on urinalysis showed neither seminal vesicle dilation nor ejaculatory duct orifice obstruction. Five patients with no sperm on urinalysis after ejaculation complained of some combination of perineal, scrotal, and urethral discomfort during or immediately after ejaculation. Three patients had sperm in their urine after ejaculation. CONCLUSIONS: In 7 patients (63.6%), dry ejaculation resulted from ejaculatory duct obstruction. Three patients (27.3%) had retrograde ejaculation, and one patient (0.09%) may have had dry ejaculation as a result of failure of spermatogenesis. The main mechanism of dry ejaculation after transurethral microwave thermotherapy seems to be ejaculatory duct obstruction, not failure of bladder neck closure.
Assuntos
Humanos , Masculino , Cicatriz , Dilatação , Ejaculação , Ductos Ejaculatórios , Hipertermia Induzida , Pescoço , Hiperplasia Prostática , Glândulas Seminais , Espermatogênese , Espermatozoides , Ressecção Transuretral da Próstata , Ultrassonografia , Urinálise , Bexiga UrináriaRESUMO
Although metastatic renal cell carcinoma is not uncommon, metastases to the ureteral stump and bladder are very rare. A 69-year-old woman who had undergone radical nephrectomy because of right renal cell carcinoma about 8 years ago, visited our hospital for evaluation of painless gross hematuria. Histologic examination of the removed ureteral stump and bladder specimen demonstrated metastatic renal cell carcinoma. We report a case of renal cell carcinoma with metastases to the ureteral stump 5 years after radical nephrectomy and bladder 8 years after radical nephrectomy.
Assuntos
Idoso , Feminino , Humanos , Carcinoma de Células Renais , Hematúria , Metástase Neoplásica , Nefrectomia , Ureter , Bexiga UrináriaRESUMO
Castleman's disease is a relatively rate disorder of lymphoid tissue and poorly understood etiology. The disease may occur anywhere along the lymphatic chain, but is most commonly found as a solitary mass in the mediastinum. The hyaline vascular type represents 91% of Castlemen's disease, and these are most often discovered in the asymptomatic patient on routine chest film. Patients with the plasma cell type often exhibit systemic symptoms, including fever, night sweats, anemia, and hypergammaglobulinemia. Surgical excision effects cure, although resection of the hyaline vascular type may be associated with significant hemprrage owing to extreme vascularity. We recently experienced a case of hyaline vascular type Castleman's disease which was treated by surgical resection through the anterior mini-thoracotomy, and report with its review.
Assuntos
Humanos , Anemia , Febre , Hiperplasia do Linfonodo Gigante , Hialina , Hipergamaglobulinemia , Tecido Linfoide , Neoplasias do Mediastino , Mediastino , Plasmócitos , Suor , TóraxRESUMO
Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.