Unusual clinical presentation of Klebsiella pneumoniae induced endogenous endophthalmitis and xanthogranulomatous pyelonephritis in a non-nephrolithiasis and non-obstructive urinary tract.

The genitourinary tract is well recognized as a route through which bacteria could gain access to the blood circulation. Under some circumstances, metastatic infections may occur in distant organs, including endogenous endophthalmitis. Xanthogranulomatous pyelonephritis (XGP) is an unusual variant of chronic pyelonephritis. It most often occurs in middle-aged women who frequently have a history of recurrent urinary tract infections combined with obstruction and a kidney of poor function. We reported an unusual case of urinary tract infection in a non-nephrolithiasis and non-obstructive urinary tract complicated by Klebsiella pneumoniae endogenous endophthalmitis and developed XGP in two months.

Microsurgical vasectomy reversal: ten-years' experience in a single institute.

BACKGROUND: A retrospective review was made of patients who received vasectomy reversal from 1989 to 1998 at Chang Gung Memorial Hospital (CGMH) in Linkou, Taiwan. The patency rate and partner pregnancy rates were also analyzed. METHODS: Seventy patients underwent a vasovasostomy at CGMH from 1989 to 1998. Postoperative semen analysis and achievement of pregnancy in a partner were examined. Various preoperative factors were also examined and analyzed. RESULTS: Patients ranged from 30 to 58 (average, 40.8 +/- 6.5) years old. The most common reason for requesting a vasovasostomy was divorce (42.3%). The patency rate was 85.7% (36/42), and the pregnancy rate was 40.6% (13/32). However, if patients receiving a vasovasostomy for reasons other than to achieve pregnancy (i.e., pain, erectile dysfunction, or infertility of the wife) were excluded, the pregnancy rate reached 50.0% (13/26). Three patients received a second vasovasostomy; patency was noted in 2, and pregnancy was achieved in the partner of 1. Of the 5 patients receiving a vasovasostomy due to post-vasectomy pain syndrome, 3 felt that their condition had improved. CONCLUSION: The patency and pregnancy rates of vasovasostomies in CGMH were 85.7% and 50.0%, respectively. Repeat surgery could be considered an effective means of restoring fertility if an initial vasovasostomy failed. Moreover, a vasovasostomy appeared to be an effective means of treating post-vasectomy pain syndrome.