Adenonocarcinoma of the urinary bladder mimicking simple ureterocele: a case report.

We report a case of adenocarcinoma of the urinary bladder, mimicking simple ureterocele in a 55-year-old man, presenting irritative bladder symptoms. The literature review highlights the rarity of such tumor. Intravenous urography showed a dilated terminal portion of the left ureter resembling a cobra-head appearance. Cystoscopy revealed suspicious hyperemic lesion on the mucosa of the dilated terminal portion of the left ureter. Transurethral biopsy of the lesion was performed and pathological examination revealed a muscle-invasive adenocarcinoma. There were no metastatic lesions on computed tomography. The patient underwent radical cystectomy and urinary diversion.

Effectiveness of ciprofloxacin prophylaxis in preventing bacteriuria caused by urodynamic study: a blind, randomized study of 192 patients.

OBJECTIVES: To determine the efficacy of prophylactic ciprofloxacin in preventing urinary tract infections caused by urodynamic study (UDS). METHODS: A total of 210 patients presenting for UDS during a 16-month period were offered enrollment in the study. A clean-catch midstream urine sample was taken 24 hours before and 48 to 72 hours after the procedure and after microscopic examination and culture were done. All patients underwent a standard UDS. The 192 patients who had sterile urine before intervention were included in the study. Randomly, 98 of the 192 patients were orally given 500 mg of ciprofloxacin 1 hour before the urodynamic intervention and 94 were not given anything. The patients who were found to have significant bacteriuria after UDS were followed up and treated properly. RESULTS: Eighteen patients (8.6%) who had significant bacteriuria in the urine culture before UDS were excluded from the study. The rate of significant bacteriuria in the urine culture after UDS was 7.3% overall, 1% in the prophylaxis group, and 14% in the controls, a significant difference (P = 0.002). The most common uropathogen was Escherichia coli (57%). Three independent risk factors were identified: not giving antibiotic prophylaxis before UDS; antibiotic use in the preceding month; and the presence of pyuria before UDS. CONCLUSIONS: Urinary tract infections after UDS decreased from 14% to 1% with a single dose of ciprofloxacin 500 mg orally before UDS. We recommend antibiotic prophylaxis for patients undergoing a UDS.