A Mislocated Intrauterine Device Migrating to the Urinary Bladder: An Uncommon Complication Leading to Stone Formation

Intrauterine devices are a popular form of reversible contraception among women. Its administration can lead to some uncommon but serious complications such as perforation leading to its migration into adjacent organs. Like any foreign body, the presence of an IUD in the bladder can result in stone formation due to its lithogenic potential. We report a case of an IUD migrating from its normal position in the uterine cavity into the urinary bladder causing chronic low urinary tract symptoms in a 43-year-old female patient. The device was securely removed without complications using grasping forceps under cystoscopy, and no parietal defect was detected. A mislocated IUD is a rare complication that should be considered in female patients presenting with chronic urinary symptoms.

Arcanobacterium pyogenes and encrusted pyelitis

Aim: Trueperella pyogenes is known to affect cattle, but was never isolated as a cause of human urinary tract infections. Clinical case: A 69-year-old male presented for recurring low urinary tract symptoms after a 20-day ciprofloxacin regimen for prostatitis. He previously underwent open right nephrolithotomy and left ureterovesical junction reimplantation for an iatrogenic distal ureteral stricture. Computed tomography showed spontaneous cortical calcifications; renoscopy was performed and deep cultures from the pelvis were taken; culture on chocolate agar revealed T. pyogenes. Intravenous teicoplanin for 3 weeks resulted in resolution of low urinary tract symptoms with regression of bladder and ureteral thickening. Conclusion: T. pyogenes can cause encrusted pyelitis in humans especially evoked in a context of persisting or recurring urinary tract infections.

Tadalafil Treatment Improves Inflammation, Cognitive Function, And Mismatch Negativity Of Patients With Low Urinary Tract Symptoms And Erectile Dysfunction

Patients with Benign prostatic hyperplasia, low urinary tract symptoms, and erectile dysfunction (BPH/LUTS-ED) present chronic inflammation. We studied in patients with BPH/LUTS-ED the effect of tadalafil treatment (5 mg/day) on changes in peripheral inflammation, cognitive function, and the auditory evoked potential, “mismatch negativity” (MMN). Nine patients with BPH/LUTS-ED and 12 controls performed psychometric tests, MMN. IL-6, IL-17, IL-18, cGMP and CD4+CD28− autoreactive T-cells were measured in blood. Patients with BPH/LUTS-ED performed psychometric tests, MMN, and blood extraction at baseline and after tadalafil treatment. Patients with BPH/LUTS-ED showed increased CD4+CD28− autoreactive T-cells (p < 0.05), and higher levels of pro-inflammatory interleukins IL-6 (p < 0.001), IL-17 and IL-18 (p < 0.05), compared to controls. Patients got lower scores than controls in psychometric tests assessing mental processing speed and attention (p < 0.05), and showed lower amplitude (p < 0.01) and area (p < 0.05) of MMN wave than controls. Inflammatory, psychometric and electrophysiological parameters were normalized after tadalafil treatment. In conclusion, there is a pro-inflammatory environment in blood in patients with BPH/LUTS-ED which would induce cognitive impairment and alter MMN. Phosphodiesterase-5 inhibition with tadalafil exerts anti-inflammatory effects and ameliorates cognitive function and MMN parameters. Tadalafil could be a promising candidate for chronic treatment in other inflammatory pathologies associated with mild cognitive impairment.

Hubungan antara intravesical prostatic protrution, International prostatic symptom score, dan uroflowmetry pada kasus benign prostatic hyperplasia di RSUP Prof. Dr. R. D. Kandou Manado

Benign prostatic hyperplasia (BPH) is a prostatic gland enlargement due to hyperplasia of its glandular tissue and stroma which can cause low urinary tract symptoms (LUTS). This prostatic gland enlargement could be evaluated by using intravesical prostatic protrution (IPP) with transabdominal ultrasound. This study was aimed to analyze the relationship among IPP, LUTS (evaluated by using International prostate symptom score/IPSS), and uroflowmetry in BPH patients at Prof. Dr. R. D. Kandou Hospital Manado. This was an observational analytical correlation study with a cross sectional design. Subjects were BPH patients at Prof. Dr. R. D. Kandou Hospital from August 2016 to December 2016. IPP with transabdominal ultrasound, IPSS, and uroflowmetry were evaluated in all subjects. Data were anlayzed by using Spearman correlation test. The results showed that there were no significant relationships between IPP and uroflowmetry (r = -0.243; P = 0.165); IPP and IPSS (r = 0.173; P = 0.246); and uroflowmetry and IPSS (r = 0.091; P = 0.360). Conclusion: There were no significant relationships among IPP with transabdominal ultrasound, IPSS. and uroflowmetry.Keywords: IPP, LUTS, uroflowmetryAbstrak: Benign prostatic hyperplasia (BPH) adalah pembesaran kelenjar prostat yang disebabkan oleh hiperplasia jaringan kelenjar dan komponen stroma yang dapat menyebabkan low urinary tract symptoms (LUTS). Pembesaran kelenjar prostat dapat dievaluasi dengan intravesical prostatic protrution (IPP) menggunakan transabdominal ultrasonografi. Penelitian ini bertujuan untuk menganalisis hubungan antara IPP, LUTS (yang dinilai dengan International prostate symptom score; IPSS) dan uroflowmetry pada pasien BPH di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah korelasi analitik observasional dengan studi potong lintang. Subyek penelitian ialah pasien BPH di RSUP Prof. Dr. R. D. Kandou Manado sejak bulan Agustus 2016 hingga Desember 2016. Pada semua subyek penelitian dilakukan evaluasi IPP menggunakan transabdominal ultrasonografi, IPSS, dan uroflowmetry. Data dianalisis dengan uji korelasi Spearman. Hasil analisis hubungan antara IPP dan uroflowmetry menunjukkan tidak terdapat hubungan bermakna antara keduanya (r = -0,243; P = 0,165). Hasil analisis hubungan antara IPP dan IPSS menunjukkan tidak terdapat hubungan bermakna antara keduanya (r = 0,173; P = 0,246). Hasil analisis terhadap hubungan antara uroflowmetry dan IPSS menunjukkan tidak terdapat hubungan bermakna antara keduanya (r = 0,091; P = 0,360). Simpulan: Tidak terdapat hubungan bermakna antara hasil evaluasi IPP secara transabdominal ultrasonografi, IPSS, dan uroflowmetry.Kata kunci: IPP, LUTS, uroflowmetry