Usama Khater

Urethral prolapse after durasphere injection

Urethral prolapse is an uncommon condition among adult patients. We report a case of adult female patient with urethral prolapse after Durasphere injection. The patient was successfully treated with excision of the prolapsed urethra and Durasphere mass, and fibrin glue injection to support the remaining part of urethra.

Urinary retention caused by adenocarcinoma arising in recurrent urethral diverticulum

We present a case of adenocarcinoma arising in a urethral diverticulum. A 71-year-old woman presented with urinary retention and a mass in the anterior vaginal wall. A biopsy was performed and revealed adenocarcinoma. Anterior pelvic exenteration with continent urinary diversion was performed followed by adjuvant radiation therapy as the tumor was large and poorly differentiated. She developed stomal stenosis and underwent stomal revision. The patient has done well since, with no evidence of recurrence at 1-year follow-up at the time of this report.

MP80-02 INCREASED URINARY CALCIUM EXCRETION IS MORE COMMON IN YOUNGER STONE FORMERS.

INTRODUCTION AND OBJECTIVES: Ureteral colic due to an obstructing stone is a common presentation to the emergency department. We sought to evaluate how often serum and urine studies were unremarkable in patienst with this presentation. METHODS: Two hundred thirty-two consecutive patients evaluated in an urban tertiary care emergency department and who were diagnosed with an obstructing ureteral stone on computerized tomography (CT) were evaluated. Inclusion criteria were as follows: ureteral stone diagnosed on CT, urine dipstick and serum WBC checked. Studies were considered “normal” if urine dipstick showed 0 RBC, 0 WBC, and was nitrite negative AND if serum WBC was < 12.0. RESULTS: Mean patient age was 46.9 years (SD 15.4), gender prevalence was 35.8% female:64.2% male, mean axial stone diameter was 4.0 mm (SD 2.0), and mean serum WBC was 10.1 (SD 3.7). Stone position was proximal ureter e 24.6%, distal ureter e 27.1%, and ureterovesical junction e 48.3%. Completely normal urine dipstick and serum WBC was seen in 47 patients (20.2%), whereas 185 patients (79.7%) demonstrated at least a single abnormality of urine dipstick or WBC. On mulvariate logistic regression, neither age, gender, stone location, or stone size were significant predictors of the presence or absence of laboratory abnormalities. CONCLUSIONS: Up to 20% of patients presenting with ureteral colic and ureteral stones will not demonstrate abnormalities of urine dipstick or serum WBC. These data may be helpful in selecting which patients may benefit from additional imaging or workup in cases when the diagnosis is not obvious.