Hypospadias associated undescended testis in a Spigelian hernia.

BACKGROUND: First described in 1764, Spigelian hernias are rare. The patient profile is of an overweight, 50-year-old with associated respiratory disease. However we report the case of a four-month-old, with an associated hypospadias and cryptorchidism, where the testis was lying in a spigelian hernia. AIMS: To highlight this unusual presentation of cryptorchidism. CONCLUSION: Embryological development is a complex event that relies on the sequencing of hormonal surges for anatomical development. In this case report we postulate that the findings are secondary to hormonal disruption.

Encrusted cystitis--an unusual cause of recurrent frank haematuria.

BACKGROUND: Encrusted cystitis associated with malakoplakia is described in the literature as a rare condition characterized by the formation of calcified plaques adherent to or embedded in the bladder mucosa. AIMS: We present the case of a 51-year-old male, presenting with recurrent haematuria associated with minimal exercise. Despite normal ultrasound, IVP, two calcified lesions on his bladder were found on cystoscopy. Conservative management was ineffective thereby necessitating a curative partial cystectomy. CONCLUSION: We would like to illustrate/discuss this rare but problematic condition with gross and microscopic pictures.

Pubovaginal sling for urodynamic stress incontinence: effect on patient quality of life.

To report the medium term effects of the pubovaginal sling (PVS) on patient quality of life (QOL). Patients and Methods Over a two year period, 72 females aged between 17 and 63 years (mean 46.1 years) underwent PVS for urodynamic stress incontinence (USI). All data were accrued prospectively. Preoperative assessment consisted of a full history (including King's Health and SF-36 questionnaires), physical examination, urinalysis and urodynamics. Postoperatively all patients were assessed at 6 weeks and 6 months. At these intervals each patient was questioned regarding persistence or recurrence of USI, presence of urge/urge incontinence (UI) and QOL. Preoperatively, 60 patients (83.3%) demonstrated type II USI and 12 (16.7%) had type III USI. Detrusor overactivity (DO) was also present in 3 patients. At 6 weeks 100% of patients remained completely dry, 8 (11%) patients complained of urgency but none complained of UI. At 6 months 95% of the subjects remained dry, 3 complained of recurrent USI, 7 complained of urgency and 1 of UI. The incidence of de novo urgency was 5.5%. There were significant improvements in 4 of the 8 domains of the SF-36, and in 8 of the 9 domains of the King's Health questionnaire, at both 6 weeks and 6 months follow-up. PVS is effective in the treatment of all types of USI, with early success rates of up to 95%. The procedure is associated with minimal morbidity and has a positive impact on patient QOL.