Bruce Turner

Bacteremia and bacterium after transrectal prostatic biopsy

To determine the efficacy of parenteral gentamicin versus povidone-iodine enema (P.I.E.) in preventing infectious complications, a randomized study was undertaken in 40 patients undergoing transrectal needle prostatic biopsy. In 69 per cent of patients not receiving P.I.E. bacteremia developed, and 32 per cent acquired bacteriuria; whereas only 19 per cent of patients given P.I.E. alone or in combination with gentamicin because bacteremic, and 9.5 per cent had postbiopsy bacteriuria. Thus, P.I.E. provided a safe and effective means for preventing most bacteremia and bacteriuria associated with transrectal biopsy of the prostate.

Anaerobic Infection as a Consequence of Transrectal Prostatic Biopsy

Reports on large series of prostatic needle biopsies have revealed many and varied complications but none has described anaerobic bacteremia as a complication. Herein are reported 2 such cases, with a discussion of the etiology various altered host factors and therapeutic modalities important to anaerobic infections. The consideration of anaerobic infection in the febrile patient after transrectal prostatic biopsy is emphasized.

Bone marrow acid phosphatase: another look.

Recent reports have indicated that bone marrow acid phosphatase is the most sensitive test in detecting bony metastases. The experience reported herein suggests that falsely positive results may be common, especially in patients with primary hematologic disorders. A plea is made that caution be given to the interpretation of this test so that some patients will not be denied appropriate therapy and the role of bone marrow acid phosphatase can be better defined by long-term followup in such patients.

Surgical approach to intracardiac renal cell carcinoma.

Abstract Renal cell carcinoma frequently extends into the vena cava, and the tumor thrombus occasionally continues into the right atrium. Patients often have symptoms of right-sided congestive heart failure of recent onset and signs of inferior vena cava obstruction. Previous reports have documented the value of very aggressive operative management in these situations; the present patient and the literature surveyed support this therapeutic approach.

Venous thromboembolism (VTE) prophylaxis and urological pelvic cancer surgery: a UK national audit.

To evaluate the use of post‐discharge venous thromboembolism (VTE) prophylaxis in UK pelvic cancer centres consistent with national guidelines.

Cryptococcal Septicemia Associated with Urologic Instrumentation in a Renal Allograft Recipient

A case is presented of a renal allograft recipient with 2 episodes of cryptococcal septicemia temporally related to genitourinary manipulation, which preceded the usual signs of meningeal or cutaneous infection. A review of the literature suggests that cryptococcal disease may, occasionally, manifest itself initially in the genitourinary tract. Therefore, we suggest that cryptococcal infection be suspected in the compromised host who has symptoms of cystitis or bladder outlet obstruction during a short period.

Pharmacological treatment of patients with advanced prostate cancer.

Prostate cancer is linked to the male sex hormone testosterone. In advanced disease, blocking the production of testosterone using androgen deprivation therapy causes regression of prostate cancer and minimises or prevents symptoms associated with the disease. Luteinising hormone-releasing hormone agonists are commonly used in the management of prostate cancer, however less is known about the role of the newer gonadotrophin-releasing hormone (GnRH) antagonists. This article focuses on the differences between the two treatments and provides nurses with the knowledge to explain the use of GnRH antagonists to patients and administer this therapy effectively.

Concurrent Renal Tuberculosis and Contralateral Transitional Cell Carcinoma of The Renal Pelvis: A Case Report

We report a case of 2 concurrent serious renal problems in opposite kidneys. The patient presented with gross hematuria, which resulted in a diagnosis of transitional cell carcinoma of the renal pelvis and tuberculosis of the contralateral kidney. Intraoperative nephroscopy allowed for appropriate diagnosis and surgical therapy.

Splenic cysts in the differential diagnosis of suprarenal masses.

Splenic cysts are uncommon and their preoperative diagnosis is suspected rarely from the clinical presentation. The urologist should be aware that on an excretory urogram these cysts appear as suprarenal masses, suggesting adrenal enlargement. Two recent cases are presented, with a discussion of their classification, incidence, diagnostic evaluation and therapy.