An unusual case of a prenatally detected large mullerian duct remnant.

Mullerian duct remnants presenting in childhood are often diagnosed incidentally and when symptomatic, typically present with recurrent infection and/or voiding disturbances. We present a rare unusual case of a male neonate who presented with a prenatally detected large pelvic cyst that turned out to be a giant prostatic utriculus.

Review of antibiotic prophylaxis recommendations for office-based urologic procedures.

Prophylactic antibiotic recommendations for urologic procedures are not well established. Any assessment of the need for antibiotics entails thorough cost-benefit analysis. The subject of this article is an evaluation of the role of antimicrobial prophylaxis for outpatient office-based diagnostic procedures, including diagnostic flexible cystoscopy, transrectal ultrasound biopsy, and urodynamics. Relevant studies were identified using MEDLINE database searches and review of selected bibliographies. Studies of infections after transrectal ultrasound and biopsy suggest that periprocedure antibiotics are indicated, but that the exact course and timing have not been defined. Most evidence suggests that outpatient cystoscopy is associated with minimal infectious risk and that the routine administration of oral antibiotics is not indicated. Support in the literature for the use of prophylactic antibiotics at the time of urodynamic evaluation is equivocal. The current prophylactic regimens at the University of Michigan are presented as recommendations, but optimization of antimicrobial prophylaxis will require multicenter studies with large numbers of patients.

The cystometrogram at 70 years.

PURPOSE: The origin and the development of the cystometrogram are described. MATERIALS AND METHODS: We reviewed and analyzed the published literature on cystometrography. RESULTS: The cystometrogram originated in the latter half of the nineteenth century, an age of intense clinimetric investigation. Early investigators studied fundamental aspects of bladder function with meticulous techniques using relatively crude equipment. The first clinical cystometer was designed by Dalton K. Rose in 1927. He was followed by Nesbit, McLellan, Muschat and Munro, who brought the cystometrogram to its current key role in modern urology. CONCLUSIONS: Numerous investigators have advanced the knowledge of bladder function using the cystometrogram, a key urological tool.

Frederick C. McLellan and clinical cystometrics.

Precise analysis of lower urinary tract function was an unfulfilled dream only a century ago. By the late 19th century, water manometers and plethysmographs were utilized to measure bladder pressures. In the early 1900s, Rose developed a cystometer that was later improved by Munro. In 1938 Frederick C. McLellan, active in clinical research under Reed Nesbit at the University of Michigan, was the first to apply the earlier principles and cystometric tools to a large group of patients and created the first modern paradigm of bladder dysfunction. McLellan's work brought clinical relevance to the cystometer and thus precision to the analysis of lower urinary tract function.