Hinyokika kiyo. Acta urologica Japonica
-
In this study, we retrospectively reviewed the experiences at our single institute in the treatment of malignant extrinsic ureteral obstruction (MUO) using ureteral stents to investigate the clinical outcomes and the predictive factors of stent failure. In 52 ureters of 38 patients who had radiologically significant hydronephrosis due to MUO, internal ureteral stents (The BARD(R) INLAY(TM) ureteral stent set) were inserted. The median follow-up interval after the initial stent insertion was 124.5 days (4-1,120). ⋯ The median interval from the first stent insertion to stent failure was 88 days (1-468). A Cox regression multivariate analysis showed that the significant predictors of stent failure were bladder invasion. Based on the possibility of stent failure, the adaptation of the internal ureteral stent placement should be considered especially in a patient with MUO combined with bladder invasion.
-
Review Case Reports
[Two Cases of Urinary Retention with Prostatic Abscess Drained by Transurethral Resection].
A 58-year-old male with alcoholic liver cirrhosis and a 58-year-old male with diabetes mellitus presented with high fever and urinary retention. Prostatic abscess was diagnosed by a computed tomography scan, which showed fluid collection in the prostate in both patients. ⋯ They underwent prostatic abscess drainage by transurethral resection (TUR). Urinary retention was released, and the recurrence of prostatic abscess has not been observed after TUR.
-
Review Case Reports
[A case of chronic expanding hematoma with xanthogranuloma in retroperitoneal space].
Chronic expanding hematoma (CEH), which is defined as persistent hematoma manifesting as enlarging space-occupying mass, rarely occurs in the retroperitoneal space. Here, we report a case of retroperitoneal CEH with xanthogranulama. A 72-year-old man with a history of genuine polycythemia was admitted for idiopathic renal subcapsular hematoma 3 years ago. ⋯ Microscopic findings showed that the hematoma capsule consisted of collagenous tissue with chronic inflammatory infiltrate and foreign-body granuloma with foam cells and giant cells. The final diagnosis was CEH with xanthogranuloma. Our case suggests that early resection for retroperitoneal CEH may be desirable to avoid severe adhesion and invasion around the capsule.
-
We examined the efficacy of recombinant thrombomodulin (rTM) for treatment of patients with disseminated intravascular coagulation (DIC) caused by urinary tract infections. Thirteen DIC patients treated with rTM (rTM group) and 11 not receiving rTM (non-rTM group) were enrolled in this study. Blood data including coagulation markers collected before and after the treatment,a hospitalized term,and period of antibiotic treatment were compared. ⋯ The period of antibiotic usage was significantly shorter in the rTM group,whereas the hospitalized term showed no significant difference between the groups. Definite adverse effects were not present in the rTM group. In conclusion,administration of rTM may have a beneficial effect in patients with DIC induced by urinary tract infections,compared with conventional treatment.
-
We assessed the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection (SSI) in patients undergoing total cystectomy with urinary diversion using the intestine. We reviewed the clinical charts of 43 consecutive patients who underwent total cystectomy with urinary diversion using the intestine from February 2006 to March 2011 at Nishi-Kobe Medical Center. All patients received intravenous prophylactic antibiotics before and throughout surgery as well as for three days after surgery. ⋯ SSI occurred in 7 (31.8%) patients in the mattress group, but did not affect any patient in the SBD group. We compared risk factors for SSI between the groups, and found that the method of skin closure was significant risk factor for SSI (P = 0.005). We concluded that interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous suction drain is effective for prevention of SSI in total cystectomy with urinary diversion using the intestine.