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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A five year retrospective review of 15 cases of spermatic cord torsion in male patients 18-years or older was performed. Eighty percent of patients were correctly diagnosed at time of initial presentation while 20% of patients were misdiagnosed as epididymitis. Fifty three percent of cases has history of similar previous attacks. The average delay prior to presentation was 7 hours. Absence of fever was the rule occurring in all patients. Leucocytosis and significant pyuria were commonly encountered occurring in 33% and 27% of patients respectively. Our orchidectomy rate was 20%. Our data suggest that while, in adult patients presenting with scrotal pain, the absence of pyuria make the diagnosis of epididymitis unlikely as a cause of the condition, the presence of significant pyuria even if associated with leucocytosis does not exclude spermatic cord torsion and further studies with Doppler examination and Radionuclide Scans are necessary to establish the diagnosis.
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PMID:Spermatic cord torsion in adults. 781 70

The current trend in South African health services is toward primary care. Pulmonary tuberculosis is well understood by the majority of primary care doctors and nurses, whereas genito-urinary tuberculosis may not be as easy to diagnose and treat. We reviewed our experience with this condition in 52 patients, who represented 0.74% of urology admissions between 1986 and 1991. There was a 3:2 male/female ratio, the age range was 7-76 years (mean 43 years), and the disease was more common among blacks and coloureds than among whites. Multiple sites of involvement were fairly common. Seventy-five per cent of patients had renal involvement and 17% epididymal involvement. The commonest presenting complaints were urinary frequency and haematuria, although flank and scortal pain were also reported by a number of patients. Physical examination seldom helped to suggest the diagnosis. On microscopic examination and culture of the urine, sterile pyuria was present in only 50% of our patients and 29% had positive cultures for a 'normal' coliform organism. Fifty patients underwent excretory urography and the findings were very varied. Patients were treated primarily with antituberculosis drugs, but 58% also required some form of surgery; nephrectomy was the commonest operation. Ureteral strictures developed in over 50% of cases with renal involvement. We conclude that the diagnosis of genito-urinary tuberculosis is not simple, and that treatment must include regular follow-up at a specialist institution.
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PMID:Genito-urinary tuberculosis--experience with 52 urology inpatients. 811 17

Common causes of acute scrotal pain include testicular torsion, epididymo-orchitis and trauma. Epididymitis in adult men is typically associated with a history of urinary tract infection or prostatitis. Testicular torsion typically presents in young adults with a sudden onset of severe scrotal pain and, frequently, a history of recurrent episodes that have spontaneously resolved. With scrotal trauma, ultrasound may demonstrate testicular fracture, hematoceles and areas of hemorrhage or testicular infarction. Since both epididymitis and testicular torsion present with scrotal pain and swelling, and may be accompanied by fever and pyuria, Doppler ultrasound or radionuclide imaging may be necessary to make the diagnosis. In acute testicular torsion, color Doppler ultrasound shows absent flow to the epididymis and testis, while nuclear imaging shows central photon-deficient areas in the ischemic hemiscrotum. In epididymo-orchitis, color Doppler ultrasound shows increased flow to the epididymis and testis, while nuclear imaging shows increased perfusion of the affected testis and hemiscrotum.
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PMID:Diagnostic imaging of patients with acute scrotal pain. 862 98

The authors report a series of 30 horseshoe kidneys observed over a 20-year period. This series consisted of 20 men (66.6%) and 10 women (33.4%) with a mean age of 35 years (20-65 years). The clinical features were dominated by abdominolumbar pain (22 cases), haematuria (12 cases) and pyuria (2 cases). Horseshoe kidney was associated with renal stones (20 cases), ureteropelvic junction syndrome (8 cases), upper urinary tract tumour (1 case). Treatment was surgical depending on the aetiology. The objective of this study was to analyse the epidemiological and diagnostic features of this disease, as well as the therapeutic features specific to each uropathy associated with horseshoe kidney.
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PMID:[Pathological horseshoe kidney. 30 case reports]. 982 98

Genitourinary tuberculosis, once the most prevailed disease, has become very rare. Urinary frequency, pain on urination and aseptic pyuria are the key symptoms of urinary tuberculosis. At least three consecutive urine cultures for Mycobacterium tuberculosis are necessary. Renal calcification in KUB film, distortion, obliteration and destruction of single or more calices in excretory urography may lead to proper diagnosis. Induration and swelling of the globus minor of epididymis adhering to the skin or with cutaneous fistula are suggestive of genital tuberculosis. It is of extreme importance to suspect the tuberculosis in such patients especially when the symptoms are not relieved by antibiotic treatment. Current short-term chemotherapy using pyrazinamide, isonizid and rifampicin with a help of surgery is successful in most of the patients with genitourinary tuberculosis.
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PMID:[Genitourinary tuberculosis]. 988 26

A forty-four-years old man with a left solitary kidney presented a stab wound in the left lumbar region. Upon admission, the patient was hemodynamically stable, the abdominal ultrasonography showed a small perirenal hematoma and the intravenous pyelography was normal. Two days later, he had no hematuria and was discharged from the hospital, with a computed tomography scan control two weeks later. Unfortunately, seven days later, the patient was admitted to emergency for left lumbar pain, a 40 degrees C fever and pyuria. The creatinine level was 72 ng/mL, and the computed tomography scan showed a large urohematoma. The patient was operated and required partial upper polar nephrectomy for distorted upper pole with infected hematoma. A large hematoma was removed and a nephrostomy tube was introduced. The renal function returned to normal six days postoperatively and the nephrostomy tube was removed after nephrostogram at 12 days. Concerning this uncommon case, we emphasize the advantage of the computed tomography scan and the necessity of emergency management in a patient with solitary traumatic kidney.
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PMID:[Stab wound to the left solitary kidney: report of a case]. 1099 41

Clinical experiences of endotoxin removal using polymyxin B immobilized fiber column (PMX) in three septic shock patients are reported. The patients were referred to our hospital with complaints of high fever and severe pain during urination. Physical examination and laboratory data revealed severe hypotension, tachycardia, and pyuria. Diagnoses of septic shock due to urosepsis were made. After antibiotic therapy and anti-shock therapy, direct hemoperfusion using polymyxin B immobilized fiber column (PMX) was carried out. Thereafter, cardiovascular instabilities were improved without increasing the supply of catecholamines. PMX therapy for systemic inflammatory response due to infection was effective in treatment of cardiovascular instabilities.
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PMID:[Clinical experiences of endotoxin removal columns in septic shock due to urosepsis: report of three cases]. 1119 5

We report an 8-year-old boy with acute focal bacterial nephritis (AFBN). At the age of 3 months, he had a history of urinary tract infection and vesicoureteral reflux. He was admitted to our hospital because of high fever and costovertebral angle pain. Although acute pyelonephritis was suspected, neither pyuria nor cultures of blood and urine were positive. An initial ultrasonogram (US) of his kidneys was normal except for bilateral hydronephrosis. Two days later, however, a computed tomography (CT) revealed a poorly enhanced mass in the upper pole of the right kidney. Similar findings were also observed by US. Under the diagnosis of AFBN, he received antibiotics for 3 weeks. Voiding cystourethrogram showed both-sided vesicoureteral reflux and he underwent an operation. At present the mass of the kidney still remains, albeit its size tends to decrease. We suggest that an early examination of US or enhanced CT is necessary in cases with fever of unknown origin, considering the possibility of AFBN even if neither pyuria nor cultures of urine are positive.
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PMID:[A pediatric case of acute focal bacterial nephritis; comparison with the reports in Japanese child cases]. 1176 82

We report a case of acute spongiositis with diabetes mellitus. A 63-year-old man with a 7-year history of diabetes mellitus was admitted to our hospital complaining of perineal pain and pyrexia. Physical examinations revealed induration and tenderness of the corpus spongiosum, but no signs of rubor or erosion. A laboratory investigation showed leukocytosis (12,000/microliter), an elevated level of C-reactive protein (3.38 mg/dl) and hyperglycemia (532 mg/dl). Pyuria and bacteriuria were absent. Magnetic resonance imaging (MRI) yielded abscess-like lesion of the corpus spongiosum. Culture of the aspirated specimen demonstrated B-hemolytic streptococci. Treatment with antibiotics and insulin resolved leukocytosis and tenderness of corpus spongiosum. He left the hospital on the 23rd day after admission and no evidence of recurrence of the spongiositis was found for 1 year after discharge.
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PMID:[A case of acute spongiositis with diabetes mellitus]. 1222 83

A 76-year-old man complained of difficulty in urination and miction pain with abacterial pyuria after radiation therapy for prostate cancer. Transurethral resection of the prostate was performed and histopathologically widespread necrosis was observed in the prostate. Thereafter retention of urine and fever occurred and computed tomography scan revealed an abscess of the penile corpus. The abscess was drained, but the fever continued. He developed an abacterial lung abscess and abacterial necrotic ulcerating lesions on his back, his left leg and his lower abdomen. Macroscopic findings demonstrated typical features of pyoderma gangrenosum. Steroid treatment was initiated and the response to steroid therapy was dramatic. Finally urinary diversion using an ileal conduit was performed. We found few cases of pyoderma gangrenosum involving lesions other than those of the skin in the literature. This is the first report of pyoderma gangrenosum involving the prostate gland after radiation therapy for prostate cancer.
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PMID:[A case of pyoderma gangrenosum involving the prostate gland after radiation therapy for prostate cancer]. 1240 85


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