IntroductionPostoperative blood loss after prostate surgery is thought to be associated with an increase in urinary fibrinolytic activity. Tranexamic acid (TXA) is both a potent inhibitor of plasminogen and urokinase activators and a low molecular weight substance that is excreted unchanged in the urinary tract and can be administered both orally and intravenously. We investigated the effect of TXA on the amount of blood loss during transurethral resection of the prostate (TURP).Materials and methodsForty patients with registry numbers ending in even numbers were allocated to the treatment group; those ending in odd numbers were used as controls and received no treatment. The treatment group received 10 mg/kg TXA by intravenous infusion during the first half hour of the operation, while the control group of patients received no medication. Serum hemoglobin was measured before and after surgery. The volume and hemoglobin concentration of the irrigation fluid, resected prostate weight, and duration of resection were recorded.ResultsThe mean loss of hemoglobin per gram of resected prostate tissue was 1.25 g in the TXA group and 2.84 g in the control group. Total hemoglobin loss in the irrigating fluid and hemoglobin loss per 1 gram of prostate tissue was lower in the group of patients given TXA than in the control group (p = 0.018 and p <0.001).ConclusionReduced bleeding during TURP as a result of TXA treatment may lead to better surgical conditions and, as a consequence, shorter operative times and lower irrigating fluid volumes.

Several yet simple factors appear to be effective in postoperative urine leakage from the access sites after percutaneous stone surgery. Precautions may also be simple if these factors are considered preoperatively.

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A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete labial fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.

Objective: We evaluated the clinical presentation, diagnosis and management of patients presenting with emphysematous pyelonephritis (EP). Patients and Methods: The clinical data of 24 EP patients diagnosed between 2000 and 2009 were retrospectively reviewed. The management strategies were discussed according to the severity of condition at presentation. Results: The mean age of the patients was 61.8 years. Diabetes mellitus was detected in 21 (87.5%) of them. Escherichia coli was the predominant pathogen. There were 6 patients (25%) who recovered with antibiotic treatment only (mild). Percutaneous drainage in addition to antimicrobial chemotherapy was necessary in 13 cases (54%) (moderate). The remaining 5 patients (21%) were treated by nephrectomy (severe). Conclusions: EP is a serious infection that can display a fatal progression despite ablative treatment but there are also some cases with mild or moderate severity that can be successfully treated without nephrectomy.