Hinyokika kiyo. Acta urologica Japonica
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A 74-year-old male was referred to our hospital due to microhematuria that was pointed out at his health check-up. Cystoscopy showed many papillary bladder tumors under 5 mm in size. Intravenous pyelography also showed deformity of the right kidney and shadow defects in the left renal pelvis. ⋯ First, he received right radical nephrectomy, and secondly left nephroureterectomy and cystectomy. Our case should be called triple cancer because bladder cancer was thought to be daughter tumor of renal pelvic tumor. This is, to our knowledge, the 11th case report that occurred in the urinary tact, and the first case that needed total resection of urinary tract.
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A 86-year-old woman presented with asymptomatic gross hematuria,and visited our hospital, and a vesicorectal fistula was suspected from a computed tomographic (CT) scan. She had a lower abdominal mass and urinary retention on arrival. ⋯ The gross hematuria was improved and the intramural gas disappeared on a CT scan after urinary drainage and antibiotic therapy. Although emphysematous cystitis is almost always cured with conservative therapy, an accurate diagonosis and prompt treatment are required because rarely emphysematous cystitis can result in rupture of the urinary bladder and lead to septic shock.
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Review Case Reports
[A case of bladder tumor producing granulocyte colony-stimulating factor].
A 75-year-old male was admitted with high grade fever, general fatigue, and appetite loss. The laboratory examinations revealed leukocytosis of 31,700/mm3 (neutrophils: 88%) in the peripheral blood. Cystoscopy demonstrated multiple bladder tumor. ⋯ Total cystectomy and bilateral cutaneous ureterostomy were performed. He died of cancer 3.5 months after admission. This is the 48th case in Japanese literature.
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Review Case Reports
[Complete avulsion of ureter caused by abdominal blunt injury: a case report].
A 21-year-old woman who had been injured in a traffic accident appeared with abdominal pain and macroscopic hematuria. Computed tomography (CT) performed 6 hours after the injury showed extravasation of contrast medium in the right retroperitoneal space. ⋯ We observed a completely separated right ureter at the ureteropelvic junction, and performed an end to end anastomosis. The patient was discharged three weeks after surgery, and has not had any problems for three years.
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Review
[Two cases of ammonium acid urate urinary stones related to anorexia nervosa and laxative abuse].
We report two cases of urolithiasis related to anorexia nervosa and laxative abuse. Case 1: A 21-year-old woman was referred to our hospital because of left flank pain. A left ureteral stone, 10 x 6 mm in size, was successfully fragmented by extracorporeal shock-wave lithotripsy (ESWL), but she experienced repetitive formation of bilateral urinary stones and double J stent encrustation which required 13 sessions of ESWL, one session of transurethral ureterolithotripsy and one session of cystolithotripsy over a period of 5 years. ⋯ She was later diagnosed with anorexia nervosa and it turned out that she had suffered from an eating disorder and laxative abuse (bisacodyl, 200 mg/day) since the age of 15 years. Both patients had marked decrease in urine volume, hyponatremia and hypokalemia. Anorexia nervosa and laxative abuse should be suspected whenever a woman has an ammonium acid urate stone in sterile urine because the treatment of these disorders is crucial to the prevention of repetitive formation of urinary stones.