ABSTRACT
Nonparasitic chyluria is rare. Spontaneous remission occurs in 50% of patients. Conservative treatment includes diet with medium-chain triglycerides, lymphangiography, and the instillation of sclerosing solutions of silver nitrate. If conservative management fails, open or retroperitoneoscopic nephrolysis is the treatment of choice. We present a case of spontaneous recumbent nonparasitic chyluria from the left kidney treated twice by endoscopic application of neodymium-YAG laser. This is new to the literature. The chyluria disappeared for several months. The temporary cessation of chyle flow after local laser application should encourage further use of this treatment modality after failure of conservative treatment.
Subject(s)
Chyle , Endoscopy , Fistula/surgery , Kidney Diseases/surgery , Kidney Pelvis/surgery , Laser Coagulation , Lymphatic Diseases/surgery , Urinary Fistula/surgery , Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging , Extravasation of Diagnostic and Therapeutic Materials/surgery , Female , Fistula/diagnostic imaging , Humans , Kidney Diseases/diagnostic imaging , Kidney Pelvis/diagnostic imaging , Lymphatic Diseases/diagnostic imaging , Lymphography , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Recurrence , Reoperation , Tomography, X-Ray Computed , Urinary Fistula/diagnostic imaging , Urine , UrographyABSTRACT
Penile cancer is rare in Western countries. High-risk patients are considered for prophylactic inguinal lymphadenectomy. For advanced disease, a triplet drug regimen consisting of bleomycin, methotrexate, and cisplatin is the most active combination tested so far. A 62-year-old man with penile cancer underwent partial penile amputation but presented 10 months later with inguinal nodal metastasis. He received three cycles of paclitaxel/carboplatin with marked clinical and radiologic (computed tomography and positron emission tomography) tumor regression. Later, complete resection of the inguinal nodal metastasis was performed. The paclitaxel/carboplatin combination has potential activity in penile cancer. Positron emission tomography may be used for screening of nodal metastases.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carboplatin/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Lymphatic Metastasis/diagnostic imaging , Paclitaxel/therapeutic use , Penile Neoplasms/drug therapy , Antineoplastic Agents, Phytogenic/therapeutic use , Carcinoma, Squamous Cell/pathology , Combined Modality Therapy , Fluorodeoxyglucose F18 , Humans , Lymph Node Excision/methods , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymph Nodes/surgery , Lymphatic Metastasis/pathology , Male , Middle Aged , Penile Neoplasms/pathology , Penile Neoplasms/surgery , Penis/surgery , Remission Induction/methods , Survival Analysis , Tomography, Emission-ComputedABSTRACT
We report a case in which a regular prostate massage (chronic prostatitis) turned into a life-threatening event. After the prostate massage, an enormous periprostatic hemorrhage developed. During hospitalization the patient developed an embolic insult to the lungs. To our knowledge no ther cases have been published. This report shows the potentially serious consequences, and we conclude that any pain after prostate massage needs further diagnostic steps (ultrasound, CT scan).
