RESUMO
AIM OF STUDY: Clean intermittent self catheterisation (CISC) is commonly used by patients with impaired bladder emptying. But how to manage acute false passages in patients on CISC? METHODS: Six patients experienced difficulty when performing intermittent catheterisation. Urethrocystoscopy demonstrated a new false passage in all of them. Treatment consisted of urethral stenting with an 14-16F indwelling catheter during 3-6 weeks and antibiotic therapy for 5 days. RESULTS: The false passage disappeared on cystoscopy. During a mean follow up of 10 months (1-28 months), none of these patients developed another false passage. All are practising CISC without any further difficulty. CONCLUSIONS: Analysis of our data suggests that temporary urethral stenting and antibiotic therapy are an excellent management in patients on CISC who develop an acute false passage.
Assuntos
Cateterismo/efeitos adversos , Cateterismo/métodos , Autocuidado/efeitos adversos , Stents , Uretra/lesões , Doenças Uretrais/terapia , Bexiga Urinaria Neurogênica/reabilitação , Ferimentos Penetrantes/terapia , Adulto , Antibacterianos/uso terapêutico , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado/métodos , Traumatismos da Medula Espinal/complicações , Resultado do Tratamento , Doenças Uretrais/etiologia , Bexiga Urinaria Neurogênica/etiologia , Procedimentos Cirúrgicos Urológicos/métodos , Ferimentos Penetrantes/etiologiaRESUMO
In a retrospective study four questions concerning urodynamics and lower urinary tract symptoms (LUTS) were answered: Do obstructive symptoms correlate with bladder outlet obstruction? Does the symptom urgency correlate with bladder instability? What is the value of a free uroflow study in men with LUTS? Should all men with LUTS have pressure-flow studies before surgery? The authors state that urodynamic investigation is very important before surgery in patients with LUTS.
Assuntos
Transtornos Urinários/diagnóstico , Urodinâmica/fisiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Pressão , Antígeno Prostático Específico/sangue , Estudos Retrospectivos , Bexiga Urinária/fisiopatologia , Doenças da Bexiga Urinária/diagnóstico , Doenças da Bexiga Urinária/fisiopatologia , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Incontinência Urinária/diagnóstico , Incontinência Urinária/fisiopatologia , Micção/fisiologia , Transtornos Urinários/fisiopatologia , Transtornos Urinários/urinaRESUMO
A vesico-uterine fistula with vaginal urinary incontinence secondary to cesarean section is reported. Diagnosis was made clinically, radiologically and endoscopically. Conservative management failed. Surgical repair was successful. The literature is reviewed, and the treatment options (conservative management--surgical intervention) are discussed.
Assuntos
Cesárea/efeitos adversos , Fístula/etiologia , Fístula da Bexiga Urinária/etiologia , Doenças Uterinas/etiologia , Adulto , Cistoscopia , Feminino , Fístula/diagnóstico , Fístula/cirurgia , Hematúria/etiologia , Humanos , Fístula da Bexiga Urinária/diagnóstico , Fístula da Bexiga Urinária/cirurgia , Cateterismo Urinário , Incontinência Urinária/etiologia , Doenças Uterinas/diagnóstico , Doenças Uterinas/cirurgiaRESUMO
Between 4 and 15 ng/ml serum prostate-specific antigen (PSA) has a low specificity for prostate cancer (PCa). One accepted method to enhance this specificity is transrectal ultrasonography (TRUS)-measured PSA-density (PSA-D). We compared this method with a new alternative, transition zone PSA (PSA-TZ). We measured total and transition zone prostatic volumes by TRUS and calculated PSA-D and PSA-TZ in 59 patients with suspicion of PCa and PSA between 4 and 15 ng/ml. All patients then had sextant biopsies of the prostate, 30 were positive for PCa and 29 showed benign tissue. With a cut-off value of 0.35, PSA-TZ had a positive predicted value of 77% for PCa, whereas PSA-D, with a cut-off value of 0.12, had a positive predicted value of 55%. Our data suggest PSA-TZ to be more reliable for avoiding unnecessary biopsies in patients with PCa suspicion and serum PSA below 15 ng/ml. PSA-TZ, calculated by TRUS, enhances the specificity of PSA for needle biopsy diagnosis of PCa.
