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Case presentation. Academic day 13/02/2014 MUBARAK ALKABEER HOSPITAL. Case #1. A 55 years old Kuwaiti lady Admitted through urology OPD C/O frequency. Next?. Present hx. Started 6 months back Severe dysuria, frequency and hematuria. Passed small fragment with the urine 4 months back.

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Case presentation

Case presentation

Academic day 13/02/2014

MUBARAK ALKABEER HOSPITAL


Case 1
Case #1

  • A 55 years old Kuwaiti lady

  • Admitted through urology OPD

  • C/O frequency.

  • Next?


Present hx
Present hx

  • Started 6 months back

  • Severe dysuria, frequency and hematuria.

  • Passed small fragment with the urine 4 months back.

  • Not associated with loin pain, fever or nausea

  • Not known as a stone former

  • Next?


Medical history
Medical history

  • PMH : Nill

  • PSH : tension-free vaginal tape one year ago by gynecologist. Was complaining from stress incontinence.

  • Not on any medication.

  • 3 daughters all by normal vaginal delivery.

  • Next?


Examination
Examination

Afebrile

Vitally stable

Unremarkable examination

Next?


Labs

  • Urine R/M :

    RBC 100-150 /mm3

    WBC >200 /mm3

    PH 6-5

  • Urine C/S

  • CBC & RFT :

    All within the normal range

    Next?






Diagnosis
Diagnosis wall of UB.

  • Intravesical mesh erosion related to the use of the TVT sling with stone formation.


Case 2
Case #2 wall of UB.

  • A 76 years old gentleman

  • Complaining of severe dysuria and frequency.

  • Next?




Examination1
Examination wall of UB.

  • T 39.2

  • BP 150/85

  • HR 91

  • Abdomen was soft, not tender.

  • DRE :

    • moderate enlarged prostate, tender.

    • No nodules.

    • Next?


Labs wall of UB.

  • CBC :

    WBC 13.6

    Hb 134

  • RFT :

    Within normal range

  • Urine R/M (dipstick)

    ++WBC, +RBC

    Next?



U/S Pelvis wall of UB.

  • 70 cc prostate

  • Pre void 260 ml

  • Post void 60

  • Next?


  • 2 wall of UB. nd day morning in the hospital the patient was shivering

  • temperature was 39C

  • Pulse 120

  • BP 120/70

  • Perfalgan 1 gm IV was given.

  • Next day morning his temperature was 38.4

  • Next?





  • TRUS without biopsy wall of UB.

  • Prostate volume is 98 cc

  • Multiple hypo-echoic areas of different sizes involving peripheral and central zones. Suggested of collection.

  • Aspiration done around 35 ml

  • Sample sent for culture





  • 2 night.nd drainage done

  • 25 cc aspirated

  • Continued on meronem

  • Was doing well, no fever for 3 days

  • Went home on Septrin


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