Complete regression of renal tumour following ligation of an accessory renal artery during repair of an abdominal aortic aneurysm.

The existence of concomitant intra-abdominal pathology with abdominal aortic aneurysms is not uncommon. The optimal management is often controversial. We describe the successful treatment of a case of an abdominal aortic aneurysm (AAA) associated with a renal tumour without performing a nephrectomy. An accessory lower pole renal artery supplying the tumour was ligated at the time of open AAA repair. The lower pole renal tumour (suspected renal cell carcinoma) reduced in size dramatically and progressively on follow-up computed tomography and the patient remains well at over two years after surgery. The successful treatment of the two conditions in such a manner represents an alternative management strategy and adds to the options available in selected patients who present with challenging and unusual pathology.

Haematuria and clot retention after transurethral resection of the prostate: a pilot study.

OBJECTIVE: To determine, prospectively, the effect of clinical factors on the duration of frank haematuria and the incidence of clot retention after transurethral resection of the prostate (TURP). PATIENTS AND METHODS: Seventy-nine men who underwent TURP in a 3-month period were entered into this study, during which the time to cessation of bleeding and the occurrence of clot retention(s) were recorded over a 4-week period. The effect of other clinical factors (histology, weight of tissue resected. operative duration, grade of surgeon and resection rate) was also assessed. RESULTS: Gross haematuria ceased in 47%, 73%, 96%, and 97% of patients at the end of the first, second, third and fourth weeks, respectively. The duration of postoperative bleeding was significantly associated with the weight of tissue resected and the operation time (P<0.001 and <0.05, respectively). Furthermore, five patients were re-admitted with clot retention, but there was no significant correlation between the occurrence of this morbidity and any of the other indices. CONCLUSION: Postoperative bleeding usually stops within 3 weeks of TURP. This period, which is about half the time hitherto assumed, is directly related to the size of the gland resected and the duration of the procedure. However, the occurrence of clot retention is not significantly associated with the duration of haematuria or any of the other clinical factors evaluated. Thus, a high fluid intake is mandatory for 3 weeks after TURP, but men who continue to bleed should be advised to continue with a high-fluid regimen until their urine is clear.