The role of the IPSS (International Prostate Symptoms Score) in predicting acute retention of urine in patients undergoing major joint arthroplasty.

BACKGROUND: Acute urinary retention following major joint arthroplasty is common. It does necessitate instrumentation, puts patients at risk of complications, and causes discomfort and embarrassment. The aim of the study was to find a test to help the surgeon to predict the possibility of acute retention of urine. METHODS: Male patients admitted for elective major joint arthroplasty filled in an IPSS (International Prostate Symptoms Score) during the pre-operative visit. They were observed post-operatively to document if they passed urine spontaneously or went into acute retention. RESULTS: There was a strong correlation between the IPSS and the likelihood of developing acute retention. Patients with moderate to high IPSS had a 55% to 100% chance of developing acute retention of urine, respectively. CONCLUSION: The IPSS proved to be a simple and reliable test to help the surgeon in predicting the possibility of developing acute retention. It might be a good addition to the pre-admission clinic investigations in patients undergoing major surgery. It could consolidate the decision to pre-emptive catheterisation in patients at risk.

Infrared spectrometric analysis of endemic bladder stones in Niger.

The composition of 42 bladder stones from young children in Niger has been determined by infrared spectrometry. Nucleus and subsequent layers were analyzed separately. The major constituents of the stones were ammonium acid urate (AAU) and calcium oxalate monohydrate (COM). The nucleus consisted of nearly pure AAU in 17 stones (40%) and it was found to be the major constituent of the nucleus in 8 other stones (19%). Furthermore, it was present as a minor constituent of the center in another 9 stones (21%). In only 3 calculi (7%) the nucleus consisted of pure COM. This study suggests that (a) AAU is the initiating material for nucleation in this stone type in Niger, and (b) the incidence of endemic bladder stone disease is higher in Africa than previously reported.

The association of bronchiolitis obliterans organizing pneumonia, systemic lupus erythematosus, and Hunner's cystitis.

An 83-year-old woman with histologically confirmed Hunner's cystitis presented with persistent fever, progressive dyspnea, and pulmonary patchy infiltrates. A transbronchial biopsy specimen revealed bronchiolitis obliterans organizing pneumonia. She progressively had development of renal insufficiency, due to systemic lupus erythematosus, proved by renal biopsy specimen. She recovered under corticosteroid treatment, but irreversible renal failure made long-term hemodialysis necessary.

The use of prostaglandins for diagnosis and treatment of erectile impotence.

The authors present their experience in using PGE-1 for the assessment of 77 impotent patients. This drug can be safely used as a screening test for vasculogenic impotence but is also useful in more invasive diagnostic tests. PGE-1 is probably the only natural product that can be used commonly for the treatment of erectile impotence, because it is a safe and effective drug.

Reproducibility of transrectal ultrasound of prostatic disease.

One hundred patients with suspicion of prostatic disease were examined by transrectal ultrasound. Two urologists with experience in this technique performed the examination separately for each patient. In the present study the differential diagnosis between normal prostate, benign hypertrophy and prostate cancer was almost perfectly reproducible. However, prostatitis was a difficult diagnosis by transrectal ultrasound. Prostatic cysts and stones were readily recognised. Although not perfectly reproducible, the transverse dimensions of the prostatic adenomas were reasonably comparable. Measurement of the longitudinal diameter of prostatic adenomas was difficult and poorly reproducible in our hands.

Endoscopic resection as treatment of enuresis with posterior urethral valves.

25 boys with both nocturnal enuresis and diurnal urgency, underwent a transurethral resection of a posterior urethral valve. Seventeen patients were cured, two improved partially, two did not respond and four were lost to follow-up. The authors recommend a routine voiding cysto-urethrogram in the work-up of enuretic boys, especially when nocturnal enuresis goes with diurnal urgency.

[Echographic anatomy of the male urethra]. / Anatomie échographique de l'urèthre masculin.

Sonographic urethrography is used as a new tool in understanding urethral pathology. Although a prospective study is necessary to demonstrate it, this examination seems to be complementary to retrograde Urethrography.

Peroperative ultrasonography in the diagnosis of splenic vein thrombosis.

A case of recurrent bleeding from gastric varices due to isolated splenic vein thrombosis is reported. There was no evidence of pancreatic, retroperitoneal or infectious disease. The final diagnosis was made by intraoperative ultrasonography during an emergency laparotomy for massive bleeding from a ruptured gastric vein. Splenectomy is the treatment of choice in this case. The patient was cured after splenectomy.

[Clinical experience with the ND-YAG laser in intravesical and intra-urethral pathology]. / Expérience clinique avec ND-YAG laser en pathologies intravésicales et intra-urétrales.

The authors report their early experience with ND-YAG laser in 55 patients treated for superficial bladder or urethral tumors and for urethral stenosis. The advantage of the technique (local anesthesia, shorter hospitalization) and the disadvantages (cost, duration, unsatisfactory results in urethral stenoses) are discussed.