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Neurilemomas are neoplasms that originate from Schwann cells of the central and peripheral nervous systems. Thirteen case reports or neurilemomas involving the kidney have been described in the English literature. We report the fifth case of a neurilemoma within the renal sinus and review the previous cases of renal neurilemoma. This neoplasm is usually found incidentally. Presenting signs are...
We report a case of symptomatic perineal herniation of a massive posterior bladder diverticulum following abdominoperineal resection in a 75-year-old man with Crohn's disease and renal failure. Presentation, evaluation, and management issues are discussed.
Objectives. Incontinence after radical retropubic prostatectomy remains a common problem. This study determines the efficacy of a tubularized bladder neck reconstruction for improving the time to continence and also the total rate of continence following radical retropubic prostatectomy.Methods. Tubularized bladder neck reconstruction was performed in 29 patients by creating a trapezoidal-shaped...
Objectives. The aim of this study was to investigate whether a significant difference consists between patients with and without prostate carcinoma (CaP) regarding the ratio of prostate-specific antigen (PSA) in complex with major proteinase inhibitors to noncomplexed (free) PSA (FPSA).Methods. We analyzed the sera of 29 patients with untreated CaP, 34 patients with benign prostatic hyperplasia (BPH),...
Objectives. To determine the incidence of urologic trauma during surgical correction of anorectal malformations (ARM).Methods. The records of 228 children with ARM were retrospectively reviewed.Results. Operative trauma to the genitourinary tract was seen in 12 patients, all male. Of 133 patients with a high ARM, 92 underwent an abdominoperineal pull-through and 41 underwent a posterior sagittal...
Objectives. Confidence has increased in the use of an orthotopic reservoir to the urethra after a cystoprostatectomy for bladder cancer; however, many surgeons would welcome a method to simplify the operative procedure. The availability of absorbable staples on a GIA stapler allows study of the incorporation of stapling procedures into formation of a reservoir. Because of the success of hand-sewn...
Objectives. The aim of the present study was to investigate how transurethral resection of the prostate (TURP) affected the serum levels of prostate-specific antigen (PSA) and to establish reference ranges of PSA in patients who have undergone TURP.Methods. PSA was determined preoperatively and 3 months postoperatively in 190 patients who underwent TURP because of benign prostatic hyperplasia (BPH)...
Objectives. To determine the relationship between the symptom of intermittency, objective evidence of intermittency on uroflow traces, benign prostatic enlargement, and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS).Methods. The prevalence of the symptom of intermittency was determined from a symptom questionnaire in 165 men presenting with LUTS. Objective evidence...
Objectives. We have used the technique of ileocecocystoplasty with a cutaneous continent catheterizable limb to incorporate native bladder into the urinary reservoir to treat patients with functional and anatomic bladder disorders. This review was performed to evaluate the outcome of the first 8 patients who underwent this procedure.Methods. A retrospective analysis was performed by chart review...
Urethral prolapse is rarely diagnosed. We describe the clinical findings in an 86-year-old woman. The treatment chosen was the excision of the urethral prolapse over an indwelling Foley catheter and suturing the mucosa edges to the vaginal skin. Etiology, differential diagnosis, and treatment modalities will be discussed.
Inadvertent rectal injury during radical perineal prostatectomy may sometimes lead to the development of a rectocutaneous fistula. This has traditionally been managed with diverting colostomy until closure of the fistula is assured. We report 3 cases of rectocutaneous fistula following radical perineal prostatectomy, which were managed in a more conservative fashion. This included appropriate wound...
Objectives. Assessment of deoxyribonucleic acid (DNA) ploidy status of a tumor as a means for predicting pathologic stages in prostate cancer.Methods. DNA ploidy of each focus of a cancer in 70 radical prostatectomy specimens was determined by nuclear image analysis. DNA ploidy was compared with the pathologic features of tumors.Results. One hundred three individual cancers in 70 patients were...
A case of a traumatic pyeloduodenal fistula secondary to a gunshot wound is reported. After initial conservative management failed, the fistula tract was surgically excised without removal of the involved kidney. Previous treatments of pyeloduodenal fistulas secondary to gunshot wounds have involved nephrectomy. We present the first case of a pyeloduodenal fistula secondary to gunshot wound managed...
We report the first 3 cases of femoral nerve neuropathy after a psoas hitch vesicopexy, a technique commonly used with ureteroneocystostomy. The condition in 2 patients resolved with conservative therapy, and the third patient required reoperation with removal of an offending suture. All 3 patients recovered completely with no residual neurologic deficit. Urologists who use the psoas hitch must...
Objectives. Laparoscopic examination of the contralateral inguinal ring has recently been advocated to exclude contralateral hernia in young children. We report a modification using nondisposable cystoscopic equipment, which is quick and reliable.Methods. Either an 8 or 10 F soft straight catheter or a cystoscope sheath is passed through the open hernia sac. Air is insufflated into the abdomen...
Objectives. The objective of this study was to evaluate efficacy, safety, and dose-response profiles of four dosing schemes of flutamide over 24 weeks.Methods. Patients were randomized to receive one of the following five treatment regimens for a period of 24 weeks: placebo capsule, flutamide capsules 125 mg twice daily, 250 mg once daily, 250 mg twice daily, and 250 mg three times daily. Patients...
Objectives. To determine the intraprostatic pathologic changes following accurately measured doses of transurethral microwave thermal energy in patients with benign prostatic hyperplasia.Methods. Eight patients scheduled for prostate surgery were treated for approximately 1 hour without anesthesia using a newly designed microwave treatment catheter that allows a close impedance match to prostate...
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