Irrigation dysfunction

A 45-year-old man with mediastinitis and renal and hepatic dysfunction was treated with mediastinal irrigation with povidone iodine (70). He developed toxic plasma iodine concentrations and clinical deterioration hemodialysis and hemofiltration were effective in reducing plasma iodine concentrations. 

A 68-year-old man was treated for a subcutaneous infection of the thigh by subcutaneous irrigation with povidone iodine (71). Toxic plasma and urinary iodine concentrations were associated with abnormalities of cardiac conduction, lactic acidosis, acute renal insufficiency, hypocalcemia, and thyroid dysfunction. 

Itai-itai disease was identified in residents of the Jinzu River Basin in Japan in the mid-1940s. A lead and zinc mine polluted the river with high levels of Cd. The river water was used in the irrigation of rice fields and for drinking water. People affected by the disease suffered severe kidney dysfunction and painful skeletal symptoms. In the worst cases, bones would break from slight pressure, even from simply coughing. It is important to note that the worst cases were presented in... 

A 26-year-old man who had taken risperidone 3 mg/ day and sodium valproate 1500 mg/day for 1 year developed a persistent erection, dysuria, and urinary incontinence, which did not respond to irrigation of the corpora cavernosa on two occasions and required surgical treatment (196). Prolonged priapism also resulted in penile fibrosis, associated with a high risk of permanent erectile dysfunction. 

Cai,S, Yue L, JinT, Nordberg G. Renal dysfunction from cadmium contamination of irrigation water dose-response analysis in a Chinese population. Bull WHO 1998 76 153-159. 

Iodine is readily absorbed from mucosal surfaces. Peritoneal lavage with PVP-I was reported to frequently induce transient thyroid dysfunction in patients from Germany where dietary iodine ingestion is relatively low (Gortz et ai, 1984). In Japan (an iodine-sufficient region), however, intraoperative bowel irrigation with PVP-I does not cause thyroid dysfunction (Tsunoda et ai, 2000). 

Treatment includes antibiotics, bilateral corporot-omy, debridement and placement of intracorporeal irrigation and suction drains. Acute purulent cavernositis often fails to respond to conservative therapy and requires penile amputation. In case of recovery, severe fibrotic cavernosal changes usually develop producing irreversible erectile dysfunction. 

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