Tuberculosis is one of the most important infectious diseases, particularly in developing countries. Involvement of the prostate gland is very rare. We present a 70-year-old man who presented with low back pain and pr...Tuberculosis is one of the most important infectious diseases, particularly in developing countries. Involvement of the prostate gland is very rare. We present a 70-year-old man who presented with low back pain and progressive weakness of the lower limbs associated with irritative lower urinary tract symptoms. Prostate gland was enlarged, hard and nodular. Prostate specific antigen was 6 ng/ml, Erythrocytes sedimentation rate was 130 mm/hr and Monteux was positive. Prostate biopsy revealed features of tuberculosis and lumbosacral radiograph revealed features of Pott’s disease. Diagnosis of disseminated tuberculosis with prostate involvement was made and patient was placed on anti-tuberculosis drugs with good response.展开更多
Background: Fournier's gangrene is a rapidly spreading necrotizing gangrene affecting the perineum, Perianal and genital regions but remarkably sparing the testicles, bladder and rectum due to their separate blood...Background: Fournier's gangrene is a rapidly spreading necrotizing gangrene affecting the perineum, Perianal and genital regions but remarkably sparing the testicles, bladder and rectum due to their separate blood supply which is directly from the aorta. The aim of this study is to share our experience with the management of 46 cases. Patients and method: We retrospectively analysed the medical records of 46 patients admitted with Fournier's gangrene between April 2005 and December 2011 in the urology unit of Aminu Kano Teaching Hospital. Data extracted from these include age, sex, hospital stay, premorbid diseases, mobility, mortality, laboratory investigations and treatments carried out. Results: Fourty six patients were admitted and managed for Fournier's gangrene during the study period. All the patients were male and mean age was 50 years (range 20 - 80 years). Five patients died (10.90%) mortality, 41 (89.10%) patients survived. The shortest hospital stay was 13 days and longest was 120 days. 45.7% of the patients had urethral stricture with watering can perineum as predisposing factor, 16 (34.80%) had diabetes mellitus, 7 (15.2%) had perineal injuries as the predisposing factors while 5 (10.90%) patients had uraemia and one patient (2.20%) each had bladder tumour and scrotal abscess as their predisposing factors, in 3 patients (6.50%) it was idiopathic. Only 34 (73.90%) patients had wound swab microscopy culture and sensitivity on admission. The culture grew Klebsiella spp. in 9 (26.50%), Staph aureus and E. coli in 5 (10.90%) of cases each, while Gram positive rod and Gram negative Cocci with 4 (11.80%) and 6 (17.60%) respectively. Conclusion: Fournier's gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals, is now changing pattern. Extensive surgical debridement and broad spectrum intravenous antibiotics remain the mainstay of treatment.展开更多
Background: Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. Aims and Objectives: This study was undertaken to identify the causes...Background: Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. Aims and Objectives: This study was undertaken to identify the causes and complications associated with urinary retention in adult male patients at AKTH, Kano. Patients and Methods: It was a prospective hospital-based study of 110 consecutive adult male patients who presented to Aminu Kano Teaching Hospital, Kano with urinary retention over 12 months. On presentation, a brief history was taken and rapid physical examination done;the urinary retention was relieved by urethral catheterization or suprapubic cystostomy. A detailed history and thorough physical examination findings were later obtained. Results: One hundred and ten patients were seen during the study period. There ages ranged from 17 to100 years with a mean of 56 ± 19.3 SD years. Patients within the age range 55 - 74 years accounted for the largest group, (25.5% + 23.6% = 49.1%). The most common cause of urinary retention in this study was benign prostatic hyperplasia (51.8% of the patients). This was followed by urethral stricture (20%), cancer of the prostate (7.3%), urethral injury (7.3%) and bladder tumour (6.4%). More than half of the patients (53.4%) presented with acute urinary retention, 30.5% presented with chronic urinary retention, and 16.1% were diagnosed to have acute-on-chronic urinary retention. The complications of urinary retention found were: urinary tract infection (in 24.5% of patients), renal impairment (14.5%), and anaemia (11.8%). Conclusion: Urinary retention is commoner among the middle aged and the elderly. Benign prostatic hyperplasia remains the leading cause of urinary retention. Acute urinary retention was the commonest type of urinary retention;however, complications due to the retention were associated with chronic and acute-on-chronic urinary retention.展开更多
文摘Tuberculosis is one of the most important infectious diseases, particularly in developing countries. Involvement of the prostate gland is very rare. We present a 70-year-old man who presented with low back pain and progressive weakness of the lower limbs associated with irritative lower urinary tract symptoms. Prostate gland was enlarged, hard and nodular. Prostate specific antigen was 6 ng/ml, Erythrocytes sedimentation rate was 130 mm/hr and Monteux was positive. Prostate biopsy revealed features of tuberculosis and lumbosacral radiograph revealed features of Pott’s disease. Diagnosis of disseminated tuberculosis with prostate involvement was made and patient was placed on anti-tuberculosis drugs with good response.
文摘Background: Fournier's gangrene is a rapidly spreading necrotizing gangrene affecting the perineum, Perianal and genital regions but remarkably sparing the testicles, bladder and rectum due to their separate blood supply which is directly from the aorta. The aim of this study is to share our experience with the management of 46 cases. Patients and method: We retrospectively analysed the medical records of 46 patients admitted with Fournier's gangrene between April 2005 and December 2011 in the urology unit of Aminu Kano Teaching Hospital. Data extracted from these include age, sex, hospital stay, premorbid diseases, mobility, mortality, laboratory investigations and treatments carried out. Results: Fourty six patients were admitted and managed for Fournier's gangrene during the study period. All the patients were male and mean age was 50 years (range 20 - 80 years). Five patients died (10.90%) mortality, 41 (89.10%) patients survived. The shortest hospital stay was 13 days and longest was 120 days. 45.7% of the patients had urethral stricture with watering can perineum as predisposing factor, 16 (34.80%) had diabetes mellitus, 7 (15.2%) had perineal injuries as the predisposing factors while 5 (10.90%) patients had uraemia and one patient (2.20%) each had bladder tumour and scrotal abscess as their predisposing factors, in 3 patients (6.50%) it was idiopathic. Only 34 (73.90%) patients had wound swab microscopy culture and sensitivity on admission. The culture grew Klebsiella spp. in 9 (26.50%), Staph aureus and E. coli in 5 (10.90%) of cases each, while Gram positive rod and Gram negative Cocci with 4 (11.80%) and 6 (17.60%) respectively. Conclusion: Fournier's gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals, is now changing pattern. Extensive surgical debridement and broad spectrum intravenous antibiotics remain the mainstay of treatment.
文摘Background: Urinary retention is one of the common urologic emergencies constituting a significant workload of urologists and non-urologists alike. Aims and Objectives: This study was undertaken to identify the causes and complications associated with urinary retention in adult male patients at AKTH, Kano. Patients and Methods: It was a prospective hospital-based study of 110 consecutive adult male patients who presented to Aminu Kano Teaching Hospital, Kano with urinary retention over 12 months. On presentation, a brief history was taken and rapid physical examination done;the urinary retention was relieved by urethral catheterization or suprapubic cystostomy. A detailed history and thorough physical examination findings were later obtained. Results: One hundred and ten patients were seen during the study period. There ages ranged from 17 to100 years with a mean of 56 ± 19.3 SD years. Patients within the age range 55 - 74 years accounted for the largest group, (25.5% + 23.6% = 49.1%). The most common cause of urinary retention in this study was benign prostatic hyperplasia (51.8% of the patients). This was followed by urethral stricture (20%), cancer of the prostate (7.3%), urethral injury (7.3%) and bladder tumour (6.4%). More than half of the patients (53.4%) presented with acute urinary retention, 30.5% presented with chronic urinary retention, and 16.1% were diagnosed to have acute-on-chronic urinary retention. The complications of urinary retention found were: urinary tract infection (in 24.5% of patients), renal impairment (14.5%), and anaemia (11.8%). Conclusion: Urinary retention is commoner among the middle aged and the elderly. Benign prostatic hyperplasia remains the leading cause of urinary retention. Acute urinary retention was the commonest type of urinary retention;however, complications due to the retention were associated with chronic and acute-on-chronic urinary retention.