Massive Gross Hematuria in a Sickle Cell Trait Patient with Renal Papillary Necrosis

Herard, A; Colin, J; Youinou, Y.; Drancourt, E; Brandt, Bernard

doi:10.1159/000019703

Cited by 20 publications

(12 citation statements)

References 3 publications

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“…The mortality rate of prostatic abscesses has been estimated to range between 3 and 30%. This may be due to the non-specific symptoms of prostatic abscesses [13,14], hence the necessity of early diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17][18] Nevertheless, there is still a debate between transrectal and perineal aspiration of prostatic abscesses. The transrectal aspiration procedure, as reported in many references, is easy and fast because it is similar to the well-known technique of transrectal prostate biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…The colored guidelines on the reference frame (upper left) were used to identify the best plane (lower right) for correct needle positioning and drainage of collection. Current reports indicate that CT and MRI hold no advantage over the more cost-effective 2D TRUS [1,2,[6][7][8]13,14] unless the abscess has penetrated the confines of the prostate gland or there are further abscess foci suspected. In these cases, we found that TRSS may overcome the 2D TRUS limitations.…”

Section: Discussionmentioning

confidence: 99%

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Transrectal Sectional Sonography (TRSS) in the Diagnosis and Treatment of Prostatic Abscesses

Elwagdy¹,

A-Khalek²,

El-Kheshen³

et al. 2012

UIJ

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KEYWORDS: Transrectal sectional sonography, prostatic abscess, diagnosis and treatment CORRESPONDENCE: Salah Elwagdy, Azhar University, Cairo, Egypt (salah_elwagdy@yahoo.com).CITATION: UroToday Int J. 2012 Apr;5(2):art 01. http://dx. Aim:The aim of this study was to assess the effectiveness of transrectal sectional sonography (TRSS) in the diagnosis and treatment of prostatic abscess. Materials and Methods:Eighteen patients with prostatic abscess were the material of the present study. The criteria of abscess collection within the prostate gland and the periprostatic tissues were confirmed by TRSS, which guided the aspiration in all patients.Results: Diagnosis and transperineal needle aspiration of prostatic abscesses were successful in all cases. After the second puncture procedure, recurrence was noted in 2 (11.1%) out of 18 patients, who were further subjected to transurethral unroofing under TRSS vision. The amount of pus drained ranged between 3.6 to 29.3 mL (mean 15.1 mL), compatible with the estimated volume by virtual organ computer-aided analysis (VOCAL) 3D measurements.The organism most frequently involved is escherichia coli. All patients received intravenous antibiotics (third generation cephalosporin) after the midstream urine analysis and further proper antibiotics, according to the aspirated pus culture and sensitivity. Conclusions:Transrectal sectional sonography could be a more reliable method in the diagnosis of prostatic abscesses. It can provide precise needle guides into the best drainage location of the abscess cavity and justify transurethral unroofing if persistent recurrence is there.UroToday International Journal ® UI J

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transrectal Sectional Sonography (TRSS) in the Diagnosis and Treatment of Prostatic Abscesses

Elwagdy¹,

A-Khalek²,

El-Kheshen³

et al. 2012

UIJ

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“…Bed rest Increased fluid intake Urine alkalinization (hypotonic saline) Oxygen inhalation [3,16,17] Blood transfusion (washed and irradiated red blood cells) [3,16,17] Use of epsilon aminocaproic acid [3,18,19] Noninvasive procedures: desmopressin infusion [20] oral urea administration [17] (BUN level of 150-200 mg/dl) Invasive procedures: arteriography with focal embolism and local infusion of epinephrine [11] endourologic ureteral balloon [21] irrigation of the pelvi-calyceal system with silver nitrate [3] nephrectomy (partial or total) [3] A form of incomplete distal acidosis has been reported in most patients with SCA, and type IV renal tubular acidosis has been reported in some patients. [4] Urinary acidification was found to be borderline or normal in patients with SCT.…”

Section: Tubular Acidificationmentioning

confidence: 99%

“…Management of hematuria: proposed sequence of procedures if bleeding persists [3,[16][17][18][19][20][21]. BUN = blood urea nitrogen.…”

mentioning

confidence: 99%

Renal Complications of Sickle Cell Disease

2002

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A broad spectrum of renal changes is observed in patients with sickle cell anemia, and ideal therapeutic measures for the management of these alterations are still being studied. Affected patients have deficient urinary concentration and potassium excretion. Perhaps owing to a compensatory mechanism, the proximal tubules are in a condition of "hyperfunction", with increased sodium and phosphorus reabsorption and greater creatinine and uric acid secretion. Mild tubular acidosis may be present. No treatment has been reported for these tubular changes, except for care in the maintenance of hydration. The use of anti-inflammatory drugs is being studied in order to inhibit the prostaglandins involved in the process. Increased renal blood flow, glomerular filtration rate, and filtration fraction are frequent findings. Hematuria commonly occurs as a consequence of red blood cell sickling in the renal medulla, papillary necrosis, or even renal medullary carcinoma. Measures such as increased fluid ingestion, urine alkalinization and, if necessary, administration of epsilon-aminocaproic acid and certain invasive procedures have been proposed to treat hematuria. Nephropathy in patients with sickle cell anemia can be manifested by proteinuria and, more rarely, nephrotic syndrome. Drugs such as prednisone and cyclophosphamide are ineffective for the treatment of patients with nephrotic syndrome. Angiotensin converting enzyme inhibitors decrease proteinuria, but their long-term effect in preventing the progression of glomerular disease has not been established. Chronic renal failure, although infrequent, may be one of the manifestations of this disease. Hemodialysis and transplantation are satisfactory therapeutic options for patients with end-stage renal disease.

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Epidemiology, Genetics and Pathophysiology of Sickle Cell Disease

Okpala¹

2004

Practical Management of Haemoglobinopathies

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Massive Gross Hematuria in a Sickle Cell Trait Patient with Renal Papillary Necrosis

Cited by 20 publications

References 3 publications

Transrectal Sectional Sonography (TRSS) in the Diagnosis and Treatment of Prostatic Abscesses

Transrectal Sectional Sonography (TRSS) in the Diagnosis and Treatment of Prostatic Abscesses

Renal Complications of Sickle Cell Disease

Epidemiology, Genetics and Pathophysiology of Sickle Cell Disease

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