A 71-year-old patient had recurrent urinary tract infections for 7 years after sigmoid colectomy via a Hartmann procedure. Extensive radiological and endoscopic tests were inconclusive as to the cause of bacteriuria. Chronic back pain led to performance of a radionuclide bone scan with the incidental demonstration of a vesicoenteric fistula, confirmed at exploration. Appendectomy with resection of the involved bladder resulted in cessation of bacteriuria.

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BACKGROUND. There are minimal data on the influence of urinary symptoms and participation in prostate cancer screening in African American men. METHODS. This correlational study examined the influence of urinary symptoms on 1) participation in a free prostate cancer screening program and 2) abnormal screening results. The 1,402 African American men in the South Carolina Prostate Cancer Project (SCPCP), mean age of 50 years, completed a survey that included self-reported urinary symptoms, participated in a prostate cancer educational program, and received a free prostate cancer screening consisting of a digital rectal examination (DRE) and prostate-specific antigen (PSA) from their personal physician. RESULTS. One in 5 men reported the presence of urinary symptoms. Over 60% of the 1,402 men participated in the free CaP screening. Among the 852 men who participated in the free prostate cancer screening, 73 (8.6%) had abnormal screening results as classified by abnormal DRE and/or PSA >4.0 ng/ml. Urinary symptoms were significant predictors, both of participation in screening (OR = 1.30, CI = 1.00, 1.70) and of obtaining an abnormal screening result (OR = 1.78, CI = 1.17, 2.72). CONCLUSIONS. Prostate cancer health education needs to include the fact that prostate cancer, in its early stages, has no urinary symptoms.