Department of Urology PGY2 Resident Levels of Care Residents at This Level Should Be Proficient in the Tasks & Activities Commensurate with the PGY-1 Level
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Melanoma of Urinary Bladder Presented As Acute Urine Retention. Nirmal Lamichhane1, Hari P Dhakal2 1Department of Surgical Oncology and 2Pathology, B
dd] fl] /on Sof fnf G;/ O] / c f : =s k L t k f = n L a B L . P A . T K I O P S IR O Nepalese Journal of Cancer (NJC) Volume 1 Issue 1 Page 67 - 70 A 2049BS/1992AD H BPKMCH LA BPKMCH,NEPAL R M CE EMORIAL CAN Case report Melanoma of Urinary Bladder presented as acute urine retention. Nirmal Lamichhane1, Hari P Dhakal2 1Department of Surgical Oncology and 2Pathology, B. P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal. ABSTRACT This report is of a 50-year-old man with a rare urinary bladder melanoma. He presented with hematuria followed by bladder outlet obstruction at the time of presentation. Ultrasonogram of the pelvis revealed a mass in the bladder outlet, suggestive of enlarged prostate. Suprapubic cystostomy was then performed. Subsequent transvesical exploration revealed a dark coloured mass at the outlet of bladder, which on histopathology confirmed to be melanoma. After ruling out other possible primary sites, he underwent radical cysto-urethrectomy with urinary diversion. Disease was confirmed with immunohistochemistry. Patient died after 3 months with bilateral lung metastasis. Keywords: Melanoma, Urinary bladder, Cystectomy, Prognosis. INTRODUCTION but was not successful. Sonography was performed Malignant melanoma of urinary bladder is a very rare which showed enlarged prostate and distended bladder. entity and scantly reported in medical literature. Wheelock Suprapubic cystostomy was performed that comforted was the first to report a primary melanoma of the urinary the patient. bladder in 1942, and Su et al. reported the next case in 1962.1, 2 Approximately 50 patients with this tumour On asking, he had voiding type lower urinary tract have been reported in the literature shown by Medline symptoms for 2 and half months, but had no haematuria search. -
Suprapubic Puncture in the Treatment of Neurogenic Bladder
SUPRAPUBIC PUNCTURE IN THE TREATMENT OF NEUROGENIC BLADDER CHARLES C. HIGGINS, M.D. W. JAMES GARDNER, M.D. WM. A. NOSIK, M.D. The treatment of "cord bladder", a disturbance of bladder function from disease or trauma of the spinal cord, can be a difficult problem. Until the recent publications of Munro, there was little physiological basis for whatever treatment was instituted. With the advent of tidal drainage and recognition of the various types or stages of a given cord bladder, more satisfactory results have been obtained. In his excellent work on the cystometry of the bladder Munro1,2 classifies "cord bladders" into four groups: 1. Atonic — characterized by retention and extreme distention from lack of detrusor tone, lack of any activity of the external urethral sphincter, and complete lack of emptying contractions. 2. Autonomous — the detrusor and internal sphincter musculature show signs of reciprocal action of varying degree. There is an increase in detrusor muscle tone, and an inability to store an appreciable amount of urine without leakage. The condition of this bladder represents the end result in destructive lesions of the sacral segments or cauda equina. 3. Hypertonic — an expression of an uncontrolled spinal segmental reflex, characterized by a markedly increased detrusor muscle tone, almost constantly present emptying contractions, low residual urine, and impairment of control of the external sphincter. 4. Normal cord bladders — in transecting lesions above the sacral segments, consisting of two types which differ largely only in their cystometric findings: (a) Uninhibited cord bladder — an apparently normal bladder which empties itself quite regularly. The detrusor tone is still somewhat increased, emptying contractions are rhythmical, the residual is low, and the capacity is rather low. -
Suprapubic Cystostomy: Urinary Tract Infection and Other Short Term Complications A.T
Suprapubic Cystostomy: Urinary Tract Infection and other short term Complications A.T. Hasan,Q. Fasihuddin,M.A. Sheikh ( Department of Urological Surgery and Transplantation, Jinnah Postgraduate Medical Center, Karachi. ) Abstract Aims: To evaluate the frequency of urinary tract infection in patients with suprapubic cystostomy and other complications of the procedure within 30 days of placement. Methods: Patients characteristics, indication and types of cystostomy and short term (within 30 days); complications were analyzed in 91 patients. Urine analysis and culture was done in all patients to exclude those with urinary tract infection. After 15 and 30 days of the procedure, urine analysis and culture was repeated to evaluate the frequency of urinary tract infection. The prevalence of symptomatic bacteriuria with its organisms was assessed. Antibiotics were given to the postoperative and symptomatic patients and the relationship of antibiotics on the prevention of urinary tract infection was determined. Results: Of the 91 cases 88 were males and 3 females. The mean age was 40.52 ± 18.95 with a range of 15 to 82 years.Obstructive uropathy of lower urinary tract.was present in 81% cases and 17(18.6%) had history of trauma to urethra. All these cases had per-urethral bleeding on examination while x-ray urethrogram showed grade H or grade III injury of urethra. Eighty two of the procedures were performed per-cutaneously and 7 were converted to open cystostomies due to failure of per-cutaneous approach. Nine patients had exploratory laparotomy. Duration of catheterization was the leading risk factor for urinary tract infection found in 24.1% at 15 days and 97.8% at 30 days. -
Preoperative Skin Antisepsis with Chlorhexidine Gluconate Versus Povidone-Iodine: a Prospective Analysis of 6959 Consecutive Spinal Surgery Patients
CLINICAL ARTICLE J Neurosurg Spine 28:209–214, 2018 Preoperative skin antisepsis with chlorhexidine gluconate versus povidone-iodine: a prospective analysis of 6959 consecutive spinal surgery patients George M. Ghobrial, MD, Michael Y. Wang, MD, Barth A. Green, MD, Howard B. Levene, MD, PhD, Glen Manzano, MD, Steven Vanni, DO, DC, Robert M. Starke, MD, MSc, George Jimsheleishvili, MD, Kenneth M. Crandall, MD, Marina Dididze, MD, PhD, and Allan D. Levi, MD, PhD Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida OBJECTIVE The aim of this study was to determine the efficacy of 2 common preoperative surgical skin antiseptic agents, ChloraPrep and Betadine, in the reduction of postoperative surgical site infection (SSI) in spinal surgery proce- dures. METHODS Two preoperative surgical skin antiseptic agents—ChloraPrep (2% chlorhexidine gluconate and 70% iso- propyl alcohol) and Betadine (7.5% povidone-iodine solution)—were prospectively compared across 2 consecutive time periods for all consecutive adult neurosurgical spine patients. The primary end point was the incidence of SSI. RESULTS A total of 6959 consecutive spinal surgery patients were identified from July 1, 2011, through August 31, 2015, with 4495 (64.6%) and 2464 (35.4%) patients treated at facilities 1 and 2, respectively. Sixty-nine (0.992%) SSIs were observed. There was no significant difference in the incidence of infection between patients prepared with Beta- dine (33 [1.036%] of 3185) and those prepared with ChloraPrep (36 [0.954%] of 3774; p = 0.728). Neither was there a significant difference in the incidence of infection in the patients treated at facility 1 (52 [1.157%] of 4495) versus facility 2 (17 [0.690%] of 2464; p = 0.06). -
Incision & Drainage Informed Consent
Jeri Shuster, M.D., P.A. and Women’s Center, Inc. JERI SHUSTER, M.D., PA & WOMEN’SJeri Shuster, CENTER, INC M.D.,. P.A. Jeri Shuster, M.D., Fellowand of the Women’s American CollegeCenter, Obstetricians Inc. and Gynecologists Kathryn Cervi, C.R.N.P., Women’s Health Care Nurse Practitioner Jeri Shuster, M.D., Fellow of the American College Obstetricians and Gynecologists INFORMED CONSENT: Kathryn INCISION Cervi, C.R.N.P., AND Women’s DRAINAGE Health (I Care & D) Nurse Practitioner I hereby request and authorize Dr. to Jeri Shuster perform upon me the procedure: incision and drainage of _________________________________________________________________________ _____________________________________________________________________________________________ This procedure involves making an incision, either with a scalpel or with an electrical device, in order to enable fluid to drain from an area of the body. The procedure is intended to drain a cyst(s), abscess(es), or infected tissue. Risks include: bleeding, infection, burn injury, pain, scarring, failure to diagnose or cure the underlying condition, persistence or recurrence of the condition. To reduce risk of infection, after the procedure keep area as clean and dry as possible. Wash three times each day with lukewarm water and mild soap. Dry by gently dabbing with a soft wel to or carefully use a blow dryer on the cool setting. Follow each wash/dry with antibacterial ointment (such as Neosporin or Bacitracin). If genital incision and drainage ou is performed, y may also place antibiotic ointment onto cotton balls (not cosmetic puffs) to cover the wounds during urination or bowel movements. Benefits may include achieving a diagnosis (by distinguishing between a cyst and an abscss) and alleviating symptoms such as pain. -
Long-Term Indwelling Double-J Stent and Multiple Encrusted Stones in the Ureter and Bladder: a Case Report on Holmium Laser Treatment
Pediatr Urol Case Rep 2018; 5(6):161-164 DOI: 10.14534/j-pucr.2018645052 PEDIATRIC UROLOGY CASE REPORTS ISSN 2148-2969 http://www.pediatricurologycasereports.com Long-term indwelling double-J stent and multiple encrusted stones in the ureter and bladder: A case report on Holmium laser treatment Mehmet Hanifi Okur, Selcuk Otcu Department of Pediatric Surgery, Dicle University, School of Medicine, Diyarbakir, Turkey ABSTRACT Double-J (D-J) stents are widely used in a variety of urological interventions. Forgotten D-J stents may lead to complications, such as migration, fragmentation and encrustation. We report the case of a forgotten stent, concomitant with ureteral and bladder stones. The forgotten D-J stent was placed four years prior to our intervention, during treatment for multiple right renal stones. Holmium laser lithotripsy was used to disrupt encrustations on a ureteral orifice and the ureteral stent. The percutaneous suprapubic cystostomy was removed without breaking the stent. The patient was discharged without further complications. Key Words: Double-J (D-J) stents; forgotten stent; encrustation; stone; Holmium laser lithotripsy. Copyright © 2018 pediatricurologycasereports.com Corresponding Author: Dr. Mehmet Hanifi Okur. endourological and open surgical methods Department of Pediatric Surgery, Dicle University, have been reported for the management of School of Medicine, Diyarbakir, Turkey. forgotten D-J stents, there is no standardized E mail: [email protected] ORCID ID: https://orcid.org/0000-0002-6720-1515 approach for their removal in adults and Received 2018-10-09, Accepted 2018-10-21 children [4]. Publication Date 2018-11-01 We report on a case of a forgotten D-J ureteral stent that had been placed during a Introduction percutaneous nephrolithotomy, four years Although Double-J (D-J) stents are widely prior to our intervention. -
An Unusual Consequence of Urinary Catheter Neglect: a Giant Bladder Stone
Int J Case Rep Images 2014;5(6):427–430. Agarwal et al. 427 www.ijcasereportsandimages.com CASE REPORT OPEN ACCESS An unusual consequence of urinary catheter neglect: A giant bladder stone Archana Agarwal, Justin Gould ABSTRACT How to cite this article Introduction: Indwelling urinary catheters cause Agarwal A, Gould J. An unusual consequence of a variety of complications including infections, urinary catheter neglect: A giant bladder stone. Int J pain and bleeding. Sometimes, the catheter Case Rep Images 2014;5(6):427–430. becomes encrusted and blocked. Case Report: A 66-year-old male was presented with increasing suprapubic pain for about two months because doi:10.5348/ijcri-201481-CR-10392 of a poorly draining Foley catheter. Two years earlier, the patient had undergone a transurethral resection of the prostate (TURP) gland. He was given a Foley catheter and asked to follow-up in a week. He did not follow-up or change the catheter INTRODUCTION for two years. The catheter could not be removed. A computed tomography scan of the abdomen Indwelling urinary catheters cause a variety of showed a large encrustation of 5.0x5.2x5.5 cm complications including infections, pain and bleeding [1]. surrounding the Foley. The patient underwent Sometimes, the catheter becomes encrusted and blocked open suprapubic cystostomy with intact retrieval [1]. We present a case of a giant bladder stone formation of stone along with the catheter. Conclusion: in a patient who did not change the catheter for more Indwelling Foley catheters frequently become than two years. encrusted and may become difficulty to remove. -
Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-In-Ano, and Rectovaginal Fistula Jon D
PRACTICE GUIDELINES Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula Jon D. Vogel, M.D. • Eric K. Johnson, M.D. • Arden M. Morris, M.D. • Ian M. Paquette, M.D. Theodore J. Saclarides, M.D. • Daniel L. Feingold, M.D. • Scott R. Steele, M.D. Prepared on behalf of The Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons he American Society of Colon and Rectal Sur- and submucosal locations.7–11 Anorectal abscess occurs geons is dedicated to ensuring high-quality pa- more often in males than females, and may occur at any Ttient care by advancing the science, prevention, age, with peak incidence among 20 to 40 year olds.4,8–12 and management of disorders and diseases of the co- In general, the abscess is treated with prompt incision lon, rectum, and anus. The Clinical Practice Guide- and drainage.4,6,10,13 lines Committee is charged with leading international Fistula-in-ano is a tract that connects the perine- efforts in defining quality care for conditions related al skin to the anal canal. In patients with an anorec- to the colon, rectum, and anus by developing clinical tal abscess, 30% to 70% present with a concomitant practice guidelines based on the best available evidence. fistula-in-ano, and, in those who do not, one-third will These guidelines are inclusive, not prescriptive, and are be diagnosed with a fistula in the months to years after intended for the use of all practitioners, health care abscess drainage.2,5,8–10,13–16 Although a perianal abscess workers, and patients who desire information about the is defined by the anatomic space in which it forms, a management of the conditions addressed by the topics fistula-in-ano is classified in terms of its relationship to covered in these guidelines. -
Original Article Efficacy of Radical Incision and Drainage for Perianal Abscesses and Related Serum Activin a Levels
Int J Clin Exp Med 2020;13(7):5100-5107 www.ijcem.com /ISSN:1940-5901/IJCEM0111399 Original Article Efficacy of radical incision and drainage for perianal abscesses and related serum activin A levels Hengqing Gao1, Runping Liu1, Zhengchun Yang3, Xiaoqiang Wang1, Wei Wang1, Furao Gong1, Jing Hu2 Departments of 1Anorectal, 2Science and Education, Zigong Hospital of Traditional Chinese Medicine, Zigong, Sichuan Province, China; 3Sichuan Administration of Traditional Chinese Medicine, Chengdu, Sichuan Province, China Received March 25, 2020; Accepted April 24, 2020; Epub July 15, 2020; Published July 30, 2020 Abstract: Objective: To explore the efficacy of radical incision and drainage for patients with perianal abscess and its effect on serum activin A (ACTA) levels. Methods: A total of 128 patients with perianal abscesses were randomly divided into group A (radical incision and drainage, n = 64) and group B (simple incision and drainage, n = 64). Results: Visual analogue scale (VAS) score, gas, postoperative persistent infection and wound healing time in group A were significantly lower than those in group B (all P<0.001). Compared with group B, group A had significantly higher effective treatment rates, but lower serum ACTA levels 3 days after operation and lower recurrence rate of perianal abscess and anal fistula (P<0.001). Conclusion: The application of radical incision and drainage in patients with perianal abscesses can effectively reduce postoperative pain, and also has the advantages of faster postopera- tive recovery, lower incidence of adverse events and reduced inflammatory response. Radical incision and drainage and serum ACTA levels 3 days after operation are key factors for the recurrence of perianal abscess and anal fistula in patients with perianal abscesses. -
General Catalogue GENERAL CATALOGUE
Coloplast develops products and services that make life easier for people with very personal and private medical conditions. Working closely with the people who use our products, we create solutions that are sensitive to their special needs. We call this intimate healthcare. Our business includes ostomy care, urology and continence care, wound and skin care. & Gynaecology Urology We operate globally and employ more than 10 000 employees. General Catalogue GENERAL CATALOGUE Urology & Gynaecology The Coloplast logo and Porgès logo are registered trademarks of Coloplast A/S. © [2016- 05.] All rights reserved. Coloplast A/S, 3050 Humlebaek, Denmark. 2016 - 000NGLOBALCATEN01 INTRODUCTION Introduction With a world class innovative spirit and the ultimate objective of always being able to make your life easier, Coloplast presents its latest dedicated Urology Care catalogue including all of our disposables and implants for urology and gynaecology. For over 120 years, we have supported the medical progress through the development of the latest techniques and devices in co-operation with our leading surgeon partners. Our know-how and high quality industrial processes permit us to offer you medical materials of the very highest standards with worldwide recognition and expertise. Within this catalogue you will find all of the latest products you will need for your daily operating practice: • Endourology : A wide range of disposable products for stone management like Dormia stone extractors, Ureteral stents, Access sheath (Retrace) and guidewires. We have extended our line with a new innovative digital solution to remove ureteral stents in one step: ISIRIS α . The product is a combination between a single use flexible cystoscope with an integrated grasper and a reusable portable device • Female Pelvic Health: slings (Altis, Aris), and lightweight meshes (Restorelle), to treat stress urinary incontinence and pelvic organ prolapses. -
Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017
Supplementary Online Content Berríos-Torres SI, Umscheid CA, Bratzler DW, et al; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. Published online May 3, 2017. doi:10.1001/jamasurg.2017.0904 eAppendix 1. Centers for Disease Control and Prevention, Guideline for the Prevention of Surgical Site Infection 2017 –Background, Methods and Evidence Summaries eAppendix 2. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017: Supplemental Tables This supplementary material has been provided by the authors to give readers additional information about their work. © 2017 American Medical Association. All rights reserved. 1 Downloaded From: https://jamanetwork.com/ on 09/30/2021 eAppendix 1. Centers for Disease Control and Prevention, Guideline for the Prevention of Surgical Site Infection 2017: Background, Methods and Evidence Summaries TABLE OF CONTENTS 1. BACKGROUND ........................................................................................................................................................................................................................................................... 4 1.1. Prosthetic Joint Arthroplasty ................................................................................................................................................................................................................................ -
Details of the Procedure
Information about your procedure from The British Association of Urological Surgeons (BAUS) This leaflet contains evidence-based information about your proposed surgical procedure. We have consulted specialist surgeons during its preparation, so that it represents best practice in UK urology. You should use it in addition to any advice already given to you. To view the online version of this leaflet, type the text below into your web browser: http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Abscess or haematoma.pdf Key Points • Abscesses, fluid collections and haematomas (collections of blood) may form after any type of surgery • They can cause pain and local swelling and, if infected, a high temperature • We may be able to drain an abscess or collection by draining it with a needle, or putting in a small drain under local anaesthetic and X- ray control, but this is not always effective • You will need surgical drainage of the collection if needle drainage fails, and we aim to do this as soon as possible, usually under a general anaesthetic • After the first drainage procedure, an abscess or collection can form again, requiring further drainage What does this procedure involve? Incision and drainage of an abscess, haematoma (blood clot) or fluid collection which has formed after surgery or as the result of a disease process. What are the alternatives? • Observation – waiting for the collection to drain spontaneously without any surgical intervention • Aspiration (puncture) with a needle – usually performed under X- ray or ultrasound control Published: May 2020 Leaflet No: 20/071 Page: 1 Due for review: May 2023 © British Association of Urological Surgeons (BAUS) Limited • Puncture and insertion of a drainage tube – usually performed under X-ray or ultrasound control • Prolonged antibiotic treatment What happens on the day of the procedure? Your urologist (or a member of their team) will briefly review your history and medications, and will discuss the surgery again with you to confirm your consent.