RECURRENT UROSEPSIS DUE TO NEPHROCOLIC FISTULA IN AN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE Nephrocolic fistula is an abnormal communication between the kidney and the colon, a rare clinical phenomenon with potentially serious complications. We present a case of a 37-year-old female with autosomal dominant polycystic kidney disease who complained of left lumbar pain, fever and urinary frequency. She had multiple similar presentations for years, refractorily treated for recurrent urinary tract infections. Contrast-enhanced computed tomography abdomen demonstrated bilateral staghorn calculi and perinephric abscesses connected to the descending colon. She eventually required surgical intervention after the failure of medical therapy. Our case highlights the diagnosis and management of nephrocolic fistula.

Patients with Benign Prostatic Hyperplasia (BPH) commonly presents with lower urinary tract symptoms (LUTS), which can be of obstructive symptoms such as hesitancy, incomplete voiding, post void dribbling or of irritative symptoms such as urgency, frequency and nocturia. Various recent studies indicate that nocturia is a very important and bothersome lower urinary tract symptom especially among patients with Benign Prostatic Hyperplasia (BPH). The aim of the study was to determine the frequency of common urinary symptoms among patients with BPH in HUSM as well as to evaluate the extent of bothersomeness of each and every symptom to these patients. This study too was aimed at evaluating the success of TURP in resolving pre operative LUTS. This was a questionnaire-based survey using a validated ICSBPH model whereby patients with BPH were selected and quizzed personally by an investigator. A subset of patients who had undergone TURP was further questioned regarding their satisfaction with the procedure. When nocturia is defined as waking up at night once or more to pass urine, the prevalence of nocturia was about 90%, but only 1 in 6 patients considered this is a very serious symptom. Even if the definition was changed to waking up twice or more, the prevalence is still quite high at over 80%. Urgency was noted in half of the patients, but only a quarter of them consider it a serious problem. 1 in 5 patients experienced significant leak and almost all consider it serious. About one third of the studied population had to be catheterized due to urinary obstruction and interestingly only about half of them considered it as a very serious event. Overall, a great majority of these patients considered suffering from these urinary symptoms for the rest of their life as very devastating. This study concludes that although the prevalence of nocturia was high among BPH patients, but it was not considered serious by majority of them. In fact, LUTS in our BPH patients did not differ much from BPH patients elsewhere. On the whole, TURP resolved most of the LUTS effectively.
symptoms <1> ; Prostatic Hypertrophy, Benign ; Nycturia ; Benign ; Urinary Tract