Tiaprofenic acid-induced cystitis--three cases and a literature review.

Tiaprofenic acid is a non-steroidal anti-inflammatory drug that may cause severe non-bacterial cystitis. Three cases are described and the literature is reviewed.

[Disease classification--how are bladder tumors registered? A questionnaire]. / Sygdomsklassifikation--hvordan registreres blaeretumorer? Et rundspørge.

Sixty-one surgical departments in Denmark were asked how they used the three possible diagnoses: carcinoma in situ vesicae urinariae (D09.0), neoplasma benignum vesicae urinariae (D30.3) and neoplasma malignum vesicae urinariae (C67.9) for bladder tumours with specific reference to different stages and grades of the tumour. The answers from 59 departments demonstrated great variation in the classification of the same bladder tumour. This variation results in a registration of data which is not valid for a statistical outcome of the real incidence of benign and malignant bladder tumours in Denmark. A consensus from the Danish Bladder Cancer Committee, which will be published in 1996, concerning the criteria for the use of the different diagnoses for bladder tumours, should however in the future make it possible for all departments to make a uniform classification.

[Extracorporeal shockwave lithotripsy in the treatment of common bile duct calculi]. / Ekstrakorporal schockbølgelitotripsi ved behandling af sten i ductus choledochus.

Fifteen patients with stones in the common bile duct, in whom treatment with endoscopic papillotomy and stone-extraction had been unsuccessful were treated with extracorporeal shockwave lithotripsy. Nine patients were stone-free after one or two sessions, and two patients after further endoscopic treatment. One patient achieved partial clearance and palliation. One patient had a choledochoduodenostomy performed due to ineffectiveness of the shockwave lithotripsy. Two patients, who were thought to have a stone, turned out to have neoplasma in the common bile duct. Complications were frequent but temporary and needed no treatment. We conclude that extracorporeal shockwave lithotripsy is a valuable and safe alternative in those cases where conventional endoscopic treatment has failed, and should be considered before operation, especially to old for high-risk patients.

[Inguinal funicular block in vasectomy]. / Ingvinalt funikelblok ved vasektomi.

The analgesic efficacy of inguinal funicular block with 10 ml carbocaine 1% as a supplement to local infiltration analgesia of the vas deferens was investigated in patients undergoing vasectomy. Pain/discomfort during vasectomy and on the first and third day postoperatively were investigated using a questionnaire. Fifty-seven male patients scheduled for legal sterilization were randomized and allocated in a double-blinded manner to receive the 10 ml carbocaine 1% in the right or left side and 10 ml isotonic NaCl in the contralateral side, the patient then being his own control. There was significantly less intraoperative pain on the side of the active inguinal funicular block (p < 0.0001), but no significant differences were found at the first and third postoperative day (p = 1.16-1.19). Inguinal funicular block can be recommended as a supplement to the usual use of local infiltration analgesia of the vas deferens.

PIP: Vasectomy is performed routinely under local anesthesia without major complications. The most frequently used method is local infiltration analgesia (LIA) of the vas deferens at the site of the resection. During the period of August 1992 - February 1993, all men who were referred for vasectomy at the Frederikssund Hospital were solicited to participate in the study. The analgesic efficacy of inguinal funicular block (FB) with 10 ml carbocaine 1% as a supplement to LIA of the vas deferens was investigated. Pain and discomfort during vasectomy and on the first and third day postoperatively were investigated using a questionnaire. 57 healthy male patients scheduled for legal sterilization were randomized in a double blind manner to receive 10 ml carbocaine 1% in the right or left side and 10 ml isotonic NaCl in the contralateral side, the patient thereby serving as his own control. Six patients were excluded for inadequate answers to the questionnaire (5) or reoperation for bleeding (1) which could not be related to administration of analgesia. 42 (82%) of 51 patients had pain during the operation; 39 (76%) on the first day after the operation; and 29 (57%) on the third day postoperatively. The therapeutic effect with active FB as a supplement to LIA in the scrotal skin was 73% (p 0.0001). There was significantly less intraoperative pain on the side of the active inguinal funicular block (p 0.0001), but no significant differences were found at the first and third postoperative day (p=1.16-1.19). With active FB on the left side, the localization of pain was exclusively scrotal in 14% (3/12) and both abdominal and scrotal in 86% (18/21). With active FB on the right side, pain distribution was scrotal in 52% (11/21) and abdominal/scrotal in 48% (10/21). Inguinal funicular block can be recommended as a supplement to the routine use of local infiltration analgesia of the vas deferens.

The personality patterns in patients with duodenal ulcer and ulcer-like dyspepsia and their relationship to the course of the diseases. Hvidovre Ulcer Project Group.

OBJECTIVES: To compare personality characteristics in duodenal ulcer patients and patients with ulcer-like dyspepsia from the primary health sector with duodenal ulcer patients from a hospital and to evaluate the relationship of the personality characteristics to the course of the diseases. DESIGN: A prospective study using the Minnesota Multiphasic Personality Inventory (MMPI) with retesting of a subgroup of patients after a median observation period of 14 months. SETTING: Departments of Medical and Surgical Gastroenterology, Hvidovre University Hospital, and the primary health sector in Roskilde County, Denmark. SUBJECTS: Sixty hospital patients with duodenal ulceration and 17 patients with duodenal ulceration plus 25 patients with ulcer-like dyspepsia from the primary health sector. MAIN OUTCOME MEASURES: MMPI scores. RESULTS: The hospital patients differed from the two other groups of patients by having higher scores of depression and anxiety (P < 0.05). Twenty-eight of the patients were retested with MMPI. Contrary to the patients with persisting complaints, abnormal personality characteristics disappeared in patients without complaints (P < 0.05-0.001). CONCLUSIONS: The results indicate that abnormal personality characteristics in patients with functional and organic upper dyspepsia are consequential rather than causal factors.

Comparison of patients undergoing transurethral resection of the prostate in 1935-36 and 1991-92.

This retrospective study compares two patient groups undergoing transurethral prostatectomy in the same department nearly 60 years apart. The first 100 patients (group A) were operated in 1935-36, the last 100 (group B) in 1991-92. In group A the main indication was residual urine of more than 5o ml, and in 33% total retention. In group B the main indications were elevated symptom score and low flow, supplemented with pressure flow measurements in some patients. To our surprise, total acute retention was the indication in 23% of group B, only a minor reduction from 26% of group A. Median age was increased from 66 years (49-83) in group A to 75 years (57-92) in group B. Of the first 100 patients 7% (3-14%) died within one month after the operation, in group B 0% (0-4%). Preoperative infection rate fell from 29% to 11%, and the number of patients with impaired kidney function fell from 30% to 8%. Postoperative results were satisfactory in 54% and 85%, respectively.

[Inguinal hernias with bladder herniation]. / Ingvinalhernier med blaereindhold.

Two cases of inguinal scrotal bladder herniation are reported. Both patients were operated upon with repositioning of the bladder and fascial repair. Herniation of the urinary bladder should be suspected in men aged over 50 years with scrotal herniation and symptoms of bladder outlet obstruction.

[Incidence and treatment of urinary calculi in patients in Frederiksborg County]. / Forekomst og behandling af sten i urinveje hos patienter i Frederiksborg Amt.

The case records of all patients admitted to one of the hospitals in the County of Frederiksborg with radiologically demonstrated first episodes of urinary calculi during a period of one year in 1983/1984 and 1988/1989 respectively were reviewed retrospectively. Uniform frequencies of calculus incidence and sex distribution were encountered mutually and as compared with the remainder of Denmark during the two periods. In 30% of the cases the calculi were localized to the kidneys and in 58% to the ureter. In approximately 65% of the patients, the greatest diameter of the stones was 100 mm or less. Spontaneous passage of the stones occurred in approximately 40%. Development in the treatment of urinary tract stones has followed the development in the county as a whole. The number of operative interventions during the five year period was reduced by 30% and extracorporeal shock wave treatment was employed in 22% during the second period.

Prostatic-type polyp in the bladder. A case report.

A case of prostatic-type polyp in the wall of the urinary bladder in a 73-year-old male is presented. The literature concerning ectopic prostatic tissue in the urinary tract is reviewed and it is concluded that the lesion is benign. However, recurrence has been reported in two cases. The etiology and pathogenesis is unknown.

[Erective dysfunction. Therapeutic consequences of a basal program of investigation]. / Erektiv dysfunktion. Terapeutiske konsekvenser af et basalt undersøgelsesprogram.

During a period of nine months, 50 men aged 21-75 years were investigated on account of erective dysfunction by means of a simple outpatient programme of investigation. Five patients could be discharged after the primary contact with history-taking and information about further investigation and treatment. Forty-five patients were submitted to the programme of investigation which consisted of measurement of penile blood pressure, Doppler investigation of the penile arteries and the papaverine test. After this, ten patients (20%) could be referred for sexological advice while five were discharged as they did not desire further treatment. Sixteen patients (32%) were taught self injection. Out of the six patients (12%) in whom arterial insufficiency was demonstrated, penile prostheses were introduced operatively in four. Venous leakage from the corpus cavernosum was demonstrated in seven patients (14%) by means of cavernosometry and cavernosography. Venous ligature was performed in five with good effect in two. Thus, specific treatment could be offered to 35 men (70%) with satisfactory therapeutic results in 22 (44%).

Spontaneous rupture of the urinary bladder--a late complication to radiotherapy. Case report.

Spontaneous rupture of the urinary bladder is extremely rare. A case of spontaneous intraperitoneal rupture of the urinary bladder 18 years after radiation therapy for testis cancer is reported.

Ureteroscopy: results and complications.

The results and complications of 100 consecutive ureteroscopy studies are reported. Introduction through the orifice or the intramural ureter failed in 11 per cent of the patients and in 14 per cent the ureteroscope could not be advanced up to the level of the lesion. Ureteroscopy was successful in 75 per cent of the patients and stone extraction was successful in 69 per cent. Complications occurred in 9 patients: 4 had an uncomplicated urinary tract infection, 4 had a ureteral perforation and 1 presented with ureteral stenosis at the site of the extracted stone a few weeks later. At followup 1 to 3 months after ureteroscopy clinical examination, excretory urography and/or renography revealed no further late sequelae.

A prospective study of antisperm antibody development in acute epididymitis.

The association between acute epididymitis and development of antisperm antibodies was investigated by the gelatin agglutination technique in prospectively collected serum samples from 27 patients. Agglutinating antisperm antibodies, mainly of the IgG class, were detected in seven men (27 per cent), a significantly increased frequency compared to prevalences previously found among blood donors and men from infertile couples. The antibodies developed de novo in four patients (15 per cent). The increased incidence of positive sera and the kinetics of the antibody responses strongly indicate a causal link between acute epididymitis and autoimmunization against spermatozoa. In the majority of the patients the antibody titers were low, being of only theoretical importance in respect to later fertility.

Distribution of xenon-133 in mice from the urinary bladder.

The distribution of 133Xe from the bladder was investigated in sliced mice at autoradiography and quantitatively by counting tissue samples from the abdomen and thoracic cavity. Xenon is a highly diffusible inert gas that passes the bladder urothelium. In living mice activity could be seen in the intra-abdominal fat, liver and kidneys; the activity in the kidneys depended on reflux through the ureters. The xenon gas was found in the highest concentration in the lungs where it is expired. The study confirms the assumption that instillation of xenon in the bladder can be used as an indicator for permeability and flow in the wall of the urinary bladder.