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Urogenital Schistosomiasis: A Diagnosis to Consider in Patients with Hematuria in Europe

ABSTRACT

Introduction: Over 100 million people worldwide are affected by urogenital schistosomiasis, a disease caused by Schistosoma haematobium. Here, we report our experience with urogenital schistosomiasis.

Materials and Methods: We retrospectively evaluated patients with urogenital schistosomiasis between 2004 and 2012. Clinical and demographic variables were analyzed.

Results: All cases (5) occurred in male patients with a median age of 33.8 years (range: 14-47). All patients resided in or had visited endemic areas. The average time from the onset of symptoms to diagnosis was 19.5 weeks (1-52). Hematuria was the most common initial clinical sign in 3 cases (60%), 2 of which arose in a monosymptomatic form. One case presented with sepsis and acute renal failure (ARF), and another case presented atypically and was diagnosed in an organ donor candidate. Four cases exhibited consistent bladder calcifications that were found through radiographic imaging at the time of diagnosis. The parasite was identified in urine in 1 case (20%), and cystoscopy results were suspicious for 2 of them (40%). The chosen standard treatment was pharmacological (Praziquantel) after anatomopathological confirmation.

Conclusions: Given the high prevalence of schistosomiasis in sub-Saharan countries, the emergence of macro- or microscopic hematuria in immigrants or travelers requires comprehensive study and the consideration of schistosomiasis as a probable cause. Accurate diagnosis and early treatment can prevent complications from tissue inflammation caused by the parasite.

Lucas Regis,1 Fernando Lozano,1 Miguel A. Lopez-Pacios,1 Juan Morote,1,2

1Department of Urology, Vall d´Hebron Hospital, Universitat Autónoma de Barcelona, 2Vall d´Hebron Research Institute, Universitat Autónoma de Barcelona

Submitted August 5, 2013 - Accepted for Publication September 20, 2013

KEYWORDS: Hematuria, schistosomiasis, Schistosoma haematobium, urine cytology

CORRESPONDENCE: Lucas Regis, Vall d´Hebron Hospital, Department of Urology, Pg Vall d´Hebron 119-129, Barcelona 08035, Spain (This email address is being protected from spambots. You need JavaScript enabled to view it.)

CITATION: UroToday Int J. 2013 December;6(6):art 78. http://dx.doi.org/10.3834/uij.1944-5784.2013.12.13

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Letter from the Editor - December 2013

Dear Colleagues,

With the last issue of UroToday International Journal for 2013, we want to wish all our readers and reviewers a happy holiday and a prosperous New Year 2014! We have received a large number of interesting articles and case reports throughout the year and we want to thank all of the authors for their contributions to another successful year for the UIJ.

An article by Kosilov et al. presents a study looking at the performance management of the long-term results of treatment of overactive bladder (OAB) in elderly men. They found that an additional cycle of treatment with a combination of high-dosed trospium and solifenacin, conducted 2 months after the primary treatment, significantly decreased the probability of recurring OAB in elderly men during 1 year, with low-level side effects.

Logan et al. evaluated whether omission of a pelvic lymphadenectomy (PLND) in patients with D’Amico low-risk prostate cancer was associated with increased rates of 5-year biochemical recurrence (BCR). With a 43-month median follow-up, D’Amico low-risk prostate cancers are no more likely to develop BCR when limited PLND is omitted than those who undergo limited PLND.

An evaluation of the performance of C11-Acetate positron emission tomography/computed tomography (PET/CT) in recurrent prostate cancer patients with early and late imaging was performed byAlmeida et al.  They found that early imaging appears optimal in the evaluation of recurrent prostate adenocarcinoma. In a larger application (300 patients) of early imaging in this patient population, C11-Acetate PET/CT demonstrates a consistently high detection rate.

An article by Cornfield describes in detail the 4-year effort of the Knock Foundation and its volunteers in bringing modern urologic procedures, specifically cystoscopy, transurethral resection/vaporization of the prostate, and visual internal urethrotomy, to previously underserved areas of Kenya and Ethiopia, teaching techniques to local physicians and building sustainable, if nascent, programs in urology at distinct institutions.

Finally, Shchukin et al. investigated the sources of bleeding from the lumen of the inferior vena cava during removal of the tumor thrombus and they concluded that the variant lumbar veins rarely are the main source of bleeding during thrombectomy.

We also present a series of case studies that include various topics, including Isolated Primary Megalourethra, Management of Intravesical Magnetic Beads, Neobladder Vaginal Fistulae, Metanephreic Adenoma of the Kidney, Second Allografted Kidney, Page Kidney Phenomenon, and Fracture of the Penis.

I personally want to thank the authors and reviewers for their valuable contributions to this issue.

Warm Regards, 

Karl-Erik Andersson

Replacement of Both Tunica and Urethra by Inner Prepucial Flap in a Neglected, Old Case of Fracture of the Penis

ABSTRACT

The present case is a rare complication of fractured penis involving the tunica leading to a large fibrous plaque and stricture urethra because of involvement of corpus spongiosum in the plaque. The fibrous plaque in the tunica was excised and distal urethra involved in plaque was resected. An inner preputial flap was divided into 2 and used successfully to cover the resultant tunica defect and for urethral replacement with good results.

Amilal Bhat,1 Mahakshit Bhat,2 Karamveer Sabharwal,3 Manish Singla,3 Vinay Kumar,3 Ravi Upadhayay3

1Senior Professor and Head, Department of Urology, 2Senior Demonstrator, Department of Preventive and Social Medicine, 3Senior Resident, Department of Urology, S. P. Medical College, Bikaner, India 334003

Submitted October 20, 2013 - Accepted for Publication December 13, 2013

KEYWORDS: Penile fracture, Peyronie's, urethral stricture

CORRESPONDENCE: Dr. Amilal Bhat, C-15 Sadul Ganj, Bikaner (Rajasthan), India 334003 (This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it.)

CITATION: UroToday Int J. 2013 December;6(6):art 77. http://dx.doi.org/10.3834/uij.1944-5784.2013.12.12

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