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Seed bezoars in the rectum have been considered an uncommon cause of fecal impaction in adults. Although there have been several reports on sunflower seed bezoars, seed bezoars from the fruit of the prickly pear cactus and watermelon have received little notice. This study was designed to determine the frequency of fecal impaction by seed bezoars in the rectum and their clinical characteristics in adults. A retrospective review of the medical records of patients hospitalized with the diagnosis of fecal impaction during a ten-year period. During the study period (January 1996 to December 2005), 55 patients were hospitalized at the Western Galilee Hospital, in northern Israel, with the diagnosis of fecal impaction. Phytobezoars were found in 30 patients (55 percent). The seed bezoars were composed of prickly pear seeds in 12 patients, watermelon seeds in 10 patients, sunflower seeds in 4 patients, popcorn kernels in 1 patient, and pomegranate seeds in 1 patient. The Jew:Arab ratio for seed bezoars was 7:23. Seventy-three patients had seedless fecal masses with a Jew:Arab ratio of 58:15. All 30 patients with bezoar underwent digital disimpaction under general anesthesia. Only 21 of 73 patients with seedless fecal masses were treated under general anesthesia. Seed bezoars found in the rectum were the most common cause of fecal impaction requiring hospitalization, probably to the result of the eating habits in the Middle East. The consumption of seeds with shell fragments or fruits containing many seeds (such as the prickly pear) should be accompanied by the awareness that large quantities may cause fecal impaction. [ABSTRACT FROM AUTHOR]

Background: Acute urinary retention is a common emergency in adult patients, foremost in older men. In childhood urinary retention is a rare entity with only sparse literature on the etiology., Objective: To assess the etiology and treatment of acute urinary retention in the pediatric population and assess age and sex distribution., Study Design: A retrospective analysis of all patients admitted to our emergency department with acute urinary retention between 2005 and 2019 was performed. Exclusion criteria were newborns (because of physiologic postnatal oliguria) and postoperative urinary retention during the same hospital stay., Results: 113 children with acute urinary retention (ICD: R33) meeting the above criteria were identified. 16 Patients were excluded because of incomplete medical charts. 97 children were included into the study (age 0.5-18.3 years, mean age 5.3 years). 89 patients had one episode, 8 patients two episodes. A peak around the third year of age was observed. Sex ratio showed a 2:1 male to female distribution. Most common etiology was balanoposthitis (15.5%) and acute constipation/fecal impaction (15.5%). Traumatic urinary retention was found in 11.4% of the cases. Urinary tract infection were found 7.2%. No underlying reason could be found in 12.4% (idiopathic urinary retention). Other causes included febrile non-urinary infection (8.2%), subvesical obstruction (4.1%), vulvovaginitis (3.1%) and urethritis (2.1%). In 50% of the cases of urinary retention under 1 year of age (2 out of 4) an underlying tumor (rhabdomyosarcoma, sacral teratoma) was identified., Discussion: Age and sex distribution were similar to previously published series; however, this study shows a marked difference concerning the etiology: e. g. we identified a significantly higher proportion of functional disorders as a reason for acute urinary retention in childhood. It is hypothesized that this is partly because previously published studies originate from areas (USA, Israel, Iran) with different socio-demographic and cultural background., Conclusion: AUR in children is a rare condition with very heterogeneous causes. Although the majority of cases exhibit mild underlying conditions, serious reasons, such as malignant diseases especially in the first year of life, must be excluded. AUR relief without catheterization is a child-friendly approach in cases of mild inflammatory or functional disorders and can help to minimize traumatization., Competing Interests: Conflicts of interest The authors have no conflict of interest to disclose., (Copyright © 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)