Rare case of bladder chondroma causing lower urinary tract symptoms.

An extraosseous or soft tissue chondroma is a rare, benign cartilaginous tumour characterised by the formation of mature hyaline cartilage. The majority of osseous chondromas are located within the medullary cavity of long bones. Soft tissue chondromas are extremely rare with only five cases affecting the bladder being reported in the literature. Soft tissue chondroma of the bladder is a rare cause of lower urinary tract symptoms and abdominopelvic pain. All reported cases of soft tissue chondromas of the bladder have occurred in women in their fifth to seventh decades of life. We describe the case of a 65-year-old woman diagnosed with a soft tissue chondroma of her bladder while being investigated for lower urinary tract symptoms.

Filiarial chyluria with nephrotic-range proteinuria and associated hypoalbuminaemia and hypogammaglobulinaemia secondary to bilateral lymphorenal fistulae.

A 55-year-old man of Indian descent, presented to the emergency department with a 2-year history of passing 'milky' white urine, associated with dysuria, urinary retention, bilateral flank pain and 15 kg weight loss. He had migrated to Australia from India at the age of 16, with no overseas travel since, and denied having any fevers, rigours or chills. He was found to have chyluria and nephrotic-range proteinuria with marked hypoalbuminaemia and hypogammaglobulinaemia. Due to his ethnic origin and by diagnostic exclusion, a presumptive diagnosis of filariasis was made. With bilateral lymphorenal disconnection, as definitive management, the patient's chyluria and proteinuria resolved with restoration of normal plasma protein and immunoglobulin levels.

Renal colic: a prospective evaluation of non-enhanced spiral CT versus intravenous pyelography.

The aim of this study was to compare non-enhanced spiral CT (NECT) and intravenous pyelography (IVP) in patients with suspected acute renal colic. Two-hundred patients presenting to the Emergency Department with suspected acute renal colic were randomized into groups undergoing NECT or IVP. The main outcome measures were diagnostic utility, incidence of alternative diagnoses, requirement for further imaging, length of hospital stay, urological intervention rates, radiation dosage and costs. Non-enhanced spiral CT was better than IVP in making a definitive diagnosis of ureteric calculus or of recent calculus passage (65/102 or 66% vs 42/98 or 41%; P = 0.003). Calculi were missed in two patients in the IVP group. Two patients in each group had alternative diagnoses by initial imaging. There was no difference in the length of hospital stay or intervention rate. More plain X-rays during admission and more IVPs during follow up were performed in the NECT group. Effective radiation dosages were 2.97 mSv (IVP) and up to 5 mSv (NECT). Non-enhanced spiral CT provided greater diagnostic utility in this randomized comparison but no difference in measured outcomes. The incidence of alternative diagnoses was low, probably due to patient selection. Financial costs for each modality are comparable in a public tertiary hospital. Radiation dosages are higher for NECT and, for this reason, it might be appropriate to consider limiting NECT use to patients who have do not have classical symptoms of renal colic, to older patients and those with a contraindication to the administration of intravenous contrast media.