A rare case of a testicular lesion related to hand, foot, and mouth disease.

Introduction: Hand, foot, and mouth disease generally occurs in children. In rare cases, hand, foot, and mouth disease affects the testicles. Case presentation: A 29-year-old man presented to our emergency department with testicular pain for several days after the onset of hand, foot, and mouth disease. Ultrasonography revealed hypoechoic mass-like areas in the right testis. A mild inflammatory response was noted, tumor markers and urinary data were normal, and tests for infection were all negative. Antibiotics were initiated and ultrasonography was performed in every subsequent examination. Testicular pain disappeared 6 months later. Conclusion: We encountered a rare case of a testicular lesion related to hand, foot, and mouth disease that was successfully treated. The careful selection of treatment for testicular pain and scrotal enlargement in young adult males, such as surgery and symptomatic treatment, based on their medical history and laboratory findings, is important.

[Cholesterol granuloma of the kidney: a case report].

A 58-year-old woman was referred to our outpatient clinic for further examination of a mass detected in the right kidney on follow-up ultrasonography performed for active surveillance of right ovarian cancer. Ultrasonography and computed tomography showed a cyst (diameter, 30 mm) with an irregular wall in the middle of the right kidney. Right nephrectomy was performed since malignancy was suspected. Histological findings of the mass indicated cholesterol granuloma. Although cholesterol granulomas in the middle ear have been frequently reported, those in other organs have been reported in few studies. In this patient, the cholesterol granuloma could be barely distinguished from the cancer by using imaging techniques.

[Clinical evaluation of transurethral enucleation with bipolar (TUEB)].

OBJECTIVE: Transurethral enucleation with bipolar (TUEB) is an established procedure for treating patients with benign prostatic hyperplasia (BPH). In this study, the usefulness of TUEB was evaluated by comparing the preoperative and postoperative results. MATERIALS AND METHODS: A total of 45 patients with symptomatic BPH underwent TUEB at our hospital between February 2008 and August 2009. All the patients were assessed using the International prostate symptom score (IPSS), quality of life (QOL) index, overactive bladder symptom score (OABSS), maximum urinary flow rate (Qmax), post void urine residue (PVR), serum prostate specific antigen (PSA) measurement, and estimated prostate weight. Total operative time, enucleation time, enucleated tissue weight, changes in levels of hemoglobin, hematocrit and serum sodium, duration of urethral catheterization, and complications were also investigated. IPSS, QOL index, Qmax, and PVR were reassessed 1, 3, 6 and 12 months after surgery. PSA reduction rate was also assessed 3 months after surgery. RESULTS: The average age was 71.6 years (60-84 years), estimated prostate weight 53.2 g (11.8-105.6 g), total operative time 125.5 minutes (76-212 min.), enucleation time 96.1 min (56-169 min), enucleated tissue weight 32.3 g (6-82 g), and duration of urethral catheterization 2.5 days (2-7 days). Blood transfusion was not required and hyponatremia was not observed in any patients. IPSS, QOL index, OABSS, PVR, and Qmax were significantly improved 1 month after surgery. As complications, re-catheterisation was reported in 2 patients (4.4%), bladder tanponade in 1 (2.2%), and urinary incontinence requiring at least 1 pad 6 months after surgery in 1 (5.9%). Postoperative PSA declined by 89.8% 3 months after surgery. CONCLUSIONS: TUEB was a safe and effective treatment procedure for patients with BPH.

[Symptoms of prostate cancer that required treatment in the terminal stage for two years].

We conducted a study of the symptoms of prostate cancer that required medical treatment in terminal patients intermittently hospitalized over a period of two years. We examined the medical records of 54 out of 55 patients who died of prostate cancer between January 2000 and December 2008. The period from the initial visit to death was between 6 and 179 months (median : 48 months). The frequency of hospitalization per patient within two years before death was between 0 and 12 times (median : 3 times). The leading causes of hospitalization (a total of 191 times) were pain (44 times), a poor physical condition (30 times), hematuria (23 times), cancer treatment (22 times), anemia (18 times), and urinary retention (12 times). Thirty-two cases required the use of opioids (0.5 to 25 months before death, median : 5 months), 25 cases required blood transfusion (0.5 to 24, median : 5 months), 17 cases required long-term catheterization (0.5 to 16, median : 4 months), 10 cases required external beam radiation (2 to 25, median : 15 months), 6 cases required percutaneous nephrostomy (0.5 to 7, median : 2 months), three cases required transurethral resection of the prostate (3 to 23, median : 23 months), and two cases required fracture fixation (5 to 6 months before death). Since urologists are in charge of patients from their initial visit to the terminal stage, they are required not only to immediately address, or prevent if possible, these symptoms appearing in the terminal stage, but also to help enhance the quality of life of patients by providing palliative care based on expert knowledge.