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CAPTOPRIL TEST
(6.25 mmol/d) in women. (See also Section I: majora contain the terminal portion of the round CALCIFICATIONS, BLADDER
“Urolithiasis, Adult, General”; Section I: “Urolithiasis, ligaments of the uterus and an obliterated remnant of DESCRIPTION Bladder calcifications on CT or
Calcium Oxylate/Phosphate”; Section II: peritoneum similar to the tunica vaginalis, which may “Hypercalcuria [Absorptive, Renal and Resorptive].”) persist as the canal of Nuck. A hydrocele (fluid collection) may rarely form in the canal of Nuck.
Intraluminal: Bladder calculi, 7% of bladder REFERENCE
urothelial carcinomas may be calcified and appear Rivers K, et al. When and how to evaluate a patient REFERENCE
as small stones, encrusted cystitis, foreign body, with nephrolithiasis. Urol Clin North Am 2000; Dietrich CS, et al. Surgical exposure and anatomy of iatrogenic (post op sutures, retained prostate chips, the female pelvis. Surg Clin N Am 2008;88(2).
catheter fragments, hair (due to chronicself-catheterization), following intravesical BCG or CALCIUM SUPPLEMENTATION
CANDIDIASIS—CUTANEOUS,
AND UROLITHIASIS
EXTERNAL GENITALIA
Bladder wall: Infections (tuberculosis,schistosomiasis), squamous cell carcinoma, DESCRIPTION Oral calcium supplementation may
DESCRIPTION Candida albicans, the most
cyclophosphamide-induced cystitis, prior radiation be used for a variety of conditions, including common Candida fungus; rarely colonizes normal skin.
osteoporosis. Because calcium carbonate and calcium Risk factors include the elderly, damaged skin, phosphate are widely used but poorly absorbed from diabetes, broad-spectrum antibiotic use, steroids, REFERENCE
the intestinal tract, these can increase urinary calcium pregnancy and immunosuppression. Can involve O’Connor OJ. Imaging of hematuria: Radiol Clin N Am excretion and promote calcium oxalate/phosphate warm, moist areas such as distal urethra, scrotum, stone disease. Calcium citrate (Citracal) has 950 mg of inguinal region, glans penis of uncircumcised male calcium citrate and 200 mg of elemental calcium in and cause itching, burning, discharge, dryness, and each tablet and increases urinary calcium excretion.
dysuria in females (vulvovaginitis). Vesicopustules that CALCIFICATIONS, RENAL
However, this formulation also increases urinary citrate enlarge and rupture and progresses to maceration and excretion, which potentially offsets the lithogenic erythema. There are distinct red borders, often with DESCRIPTION They may represent calcified renal
potential of the calcium supplement–induced satellite lesions with vaginal discharge being white calculi or calcified cystic or solid renal neoplasms.
hypercalciuria. If calcium supplementation is to be and thick. Microscopic examination of scrapings or Renal cell carcinoma is detectable on plain considered to prevent osteoporosis, calcium citrate discharge with potassium hydroxide or Gram stain radiography and calcified ∼8–18% of the time. Other preparations should be used. In women with a history reveals hyphae/ pseudohyphae. (For Systemic candida, possible etiologies for renal calcifications include of stone disease, consider a 24-urine collection to see Section I: “Fungal Infections, Genitourinary.”) papillary tip calcifications, calcified renal pelvis transitional cell carcinoma, nephrocalcinosis, calcified hypercalciuric while on calcium supplementation. In TREATMENT
patients who are normocalciuric while receiving Keep affected areas dry and exposed to air.
r Men: Topical Nystatin 100,000 U/d, miconazole REFERENCES
calcium citrate, no further intervention is necessary. In O’Connor OJ. Imaging of hematuria. Radiol Clin North those patients found to be hypercalciuric, treatment with thiazide diuretics or slow-release potassium Women vulvovaginitis: Oral fluconazole (single 150-mg dose) or topicals such as Nystatin CALCINOSIS, IDIOPATHIC
REFERENCE
Clotrimazole troches or cream 100 mg/d for 3–7 Curhan GC, et al. Comparison of dietary calcium with supplemental calcium and other nutrients as factors DESCRIPTION Occurs in preexisting epidermal
More severe infections may require long-term affecting the risk for kidney stones in women. Ann cysts or in the dermis without cysts. Usually affects young men. Multiple cysts (>50) are not uncommon.
REFERENCES
Calcifications range in size from a few millimeters to CAMEY I AND II ORTHOTOPIC
Margesson LJ. Vulvar disease pearls. Dematol clin. 3 cm. They may represent epidermal cysts that have, over time, lost their normal wall and calcified. Surgical URINARY DIVERSION
excision is curative if symptomatic.
DESCRIPTION In the Camey I surgery, a 40-cm
CAPTOPRIL TEST
REFERENCE
segment of the midportion of the ileum is chosen for Ro JY, et al. Penis and scrotum. In: Bostwick D, ed.
an orthotopic urinary diversion that can reach the DESCRIPTION As a functional test for
Urologic Surgical Pathology, 1st ed. St. Louis: urethra. A LeDuc antireflux ureteral ileal anastomosis renovascular hypertension, PRA (plasma renin activity) is carried out on each end of the ileal segment. In the is measured before and 1 hr after the administration Camey II version, the initial Camey I diversion is of 25 mg of captopril. The test is considered positive if CALCIUM LOAD AND FAST
modified by using 65 cm of ileum, which is all of the following occur: Post-captopril PRA >12 detubularized along its antimesenteric border. It is ng/mL/hr, an absolute increase in PRA >10 ng/mL/hr, folded into a U-shape configuration, the adjoining and a 400% increase in baseline PRA (150% increase DESCRIPTION
sides of the U are sutured, and the resulting bowel is if the baseline PRA was more than 3 ng/mL/hr). A then folded again to create a pouch anastomosed to hypercalciuria in stone-formers. One method is to positive captopril test points to renovascular the urethra with a LeDuc ureteral anastomosis.
place patients on a low-calcium, low-sodium diet for hypertension. The test has a sensitivity of ∼74% and 1 wk. A fast is performed from 9 PM–9 AM. At 7 AM, a specificity of 89%. All diuretics and ACE inhibitors REFERENCE
the patient empties his bladder. This urine is discarded.
must be discontinued 1 wk prior to the test, and a Lilien OM, Camey M. 25-year experience with 600 mL of distilled water is then consumed. Urine is normal or light-sodium diet is necessary.
collected from 7 AM–9 AM. At 9 AM, 1 g of calcium is procedure). J Urol 2002;167(2 Pt 2):1161.
REFERENCE
consumed, and urine is collected from that point until1 Pickering TG, et al. Renovascular hypertension and PM. Urine samples are analyzed for calcium, CANAL OF NUCK HYDROCELE
creatinine, and cAMP. Results can then differentiate ischemic nephropathy. In: Brenner BM, ed. The AND CYST (FEMALE
Kidney, 5th ed. Philadelphia: Saunders; 1996: hypercalciuria, and hyperparathyroidism. On a normal HYDROCELE)
diet, 24-hr urinary calcium levels are considered DESCRIPTION In the female, the labia majora are
300 mg/d (7.5 mmol/d) in men and <250 mg/d homologous to the scrotum in the male. The labia

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