Diagnostic potential of virtual pneumoendoscopy of the urinary tract

Acute diarrhea and metabolic acidosis caused by tuberculous vesico-rectal fistula

Acquired vesico-rectal fistula is an uncommon complication of pelvic malignant tumors, surgical injury, inflammatory disorders such as tuberculosis infection, radiotherapy and less commonly diverticulum of the urinary tract. The fistula is often identified by urinary tract abnormalities such as dysuria, recurrent urinary tract infection, pneumaturia, and fecaluria. Here, we report an unusual case of a patient with a vesico-rectal fistula of tuberculous origin, presenting with severe acute diarrhea, metabolic acidosis, hyperchloremia and hypokalemia while with only mild urinary tract symptoms. The patient was cured by tuberculostatic therapy.

ASSESSMENT OF VOIDING FUNCTION BY ENDOSCOPIC IMAGING — A PRELIMINARY REPORT

We report a novel method of reconstructing the 3D structure of the prostatic urethra and measuring its elasticity using endoscopic video images, and discuss their relation to clinical relevancy. Information regarding pixel color and brightness in the endoscopic video image is converted to relative distance between the object and the light source. An opened, 3D image of the prostatic urethra is obtained from a video image captured by the endoscope as it is slowly pulled through the urethra. The elasticity of the urethra is determined by recording a video image of the endoscope fixed in the prostatic urethra, with and without irrigation under water pressure of approximately 80 cm H 2 O . Angulation of the prostatic urethra is estimated by the number of intersections between the outline of protruded prostate and the midline of the urethra in patients with severe voiding dysfunction scheduled for transurethral resection of prostate, and in those scheduled for transurethral resection of bladder tumor without apparent discomfort during urination. The number of intersections showed a relationship with voiding symptoms. In conclusion, reconstruction of the 3D structure of the prostatic urethra from endoscopic video images is a feasible method that shows promise for estimating the mechanism of voiding dysfunction.